Despite widespread suboptimal breastfeeding practices and maternal experiences of intimate partner violence (IPV), the association of IPV and breastfeeding practices remains unclear. This study investigated the associations between maternal experience of physical, sexual, emotional violence, and controlling behaviors with suboptimal breastfeeding practices in Malawi, Tanzania, and Zambia. Data included mother-infant dyads from the most recent Demographic and Health Surveys for Malawi (n = 1878), Tanzania (n = 3184), and Zambia (n = 3879). Intimate partner violence (physical, sexual, and emotional) was measured using the Revised Conflict Tactics Scale. Breastfeeding practices were early initiation of breastfeeding (within 1 h of birth), exclusive breastfeeding (in previous 24 h), and continued breastfeeding. Associations between experience of physical, sexual, or emotional violence or controlling behaviors and breastfeeding practices, as well as associations between the frequency of IPV and breastfeeding practices were assessed. Many Malawian (77.6%) and Zambian (67.7%) and just over half (53.6%) of Tanzanian mothers, initiated breastfeeding within 1 h of birth. Exclusive breastfeeding was 70.6% in Zambia and 60.1% in Malawi, while 55.0% of Tanzanian mothers breastfed exclusively. Continued breastfeeding to at least 1 year was high in Malawi 92.2%, Tanzania 93.4%, and Zambia 95.0%. Most mothers reported experiences of IPV in Tanzania 79.1%, Zambia 78.9%, and Malawi 73.9%. Mothers who experienced sexual IPV were significantly more likely to delay breastfeeding (Malawi [AOR 1.55 (1.14, 2.10)]; Tanzania [AOR 1.30 (1.04, 1.62)]; and Zambia [AOR 1.28 (1.06, 1.54)]). Sexual IPV in Malawi and Zambia was associated with greater odds of not exclusively breastfeeding (Malawi [AOR 1.90 (1.05, 3.45)]; Zambia [AOR 1.75 (1.15, 2.67)]). Tanzanian mothers who experienced IPV often or sometimes were two times more likely not to breastfeed at one-year post-delivery [AOR 2.23 (1.09,4.57)]. In the three countries investigated maternal experience of IPV was associated with suboptimal breastfeeding practices. Policies and programs targeting improved breastfeeding practices should consider screening during antenatal and postnatal care for experience of violence and support initiatives to reduce IPV.

中文翻译：

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在马拉维、坦桑尼亚和赞比亚，母亲的亲密伴侣暴力经历与次优母乳喂养实践有关：来自 DHS 分析的见解

尽管普遍存在次优的母乳喂养做法和亲密伴侣暴力 (IPV) 的孕产妇经历，但 IPV 与母乳喂养做法的关联仍不清楚。本研究调查了马拉维、坦桑尼亚和赞比亚的母亲身体、性、情感暴力经历与控制行为与次优母乳喂养实践之间的关联。数据包括来自马拉维（n = 1878）、坦桑尼亚（n = 3184）和赞比亚（n = 3879）的最新人口和健康调查的母婴二人组。使用修订后的冲突策略量表测量亲密伴侣暴力（身体、性和情感）。母乳喂养的做法是尽早开始母乳喂养（出生后 1 小时内）、纯母乳喂养（前 24 小时内）和继续母乳喂养。评估了身体、性或情感暴力或控制行为与母乳喂养实践之间的关联，以及 IPV 频率与母乳喂养实践之间的关联。许多马拉维 (77.6%) 和赞比亚 (67.7%) 以及超过一半 (53.6%) 的坦桑尼亚母亲在出生后 1 小时内开始母乳喂养。赞比亚的纯母乳喂养率为 70.6%，马拉维为 60.1%，而坦桑尼亚的纯母乳喂养率为 55.0%。持续母乳喂养至至少 1 岁的比例在马拉维 92.2%、坦桑尼亚 93.4% 和赞比亚 95.0%。大多数母亲报告说坦桑尼亚 79.1%、赞比亚 78.9% 和马拉维 73.9% 的 IPV 经历。经历过性 IPV 的母亲更可能推迟母乳喂养（马拉维 [AOR 1.55 (1.14, 2.10)]；坦桑尼亚 [AOR 1.30 (1.04, 1.62)]；和赞比亚 [AOR 1.28 (1.28)] 06, 1.54)])。马拉维和赞比亚的性 IPV 与非纯母乳喂养的可能性更大有关（马拉维 [AOR 1.90 (1.05, 3.45)]；赞比亚 [AOR 1.75 (1.15, 2.67)]）。经常或有时经历 IPV 的坦桑尼亚母亲在分娩后一年不进行母乳喂养的可能性是其两倍 [AOR 2.23 (1.09,4.57)]。在调查的三个国家中，IPV 的孕产妇经历与次优母乳喂养做法有关。针对改善母乳喂养做法的政策和计划应考虑在产前和产后护理期间筛查暴力经历并支持减少 IPV 的举措。经常或有时经历 IPV 的坦桑尼亚母亲在分娩后一年不进行母乳喂养的可能性是其两倍 [AOR 2.23 (1.09,4.57)]。在调查的三个国家中，IPV 的孕产妇经历与次优母乳喂养做法有关。针对改善母乳喂养做法的政策和计划应考虑在产前和产后护理期间筛查暴力经历并支持减少 IPV 的举措。经常或有时经历 IPV 的坦桑尼亚母亲在分娩后一年不进行母乳喂养的可能性是其两倍 [AOR 2.23 (1.09,4.57)]。在调查的三个国家中，IPV 的孕产妇经历与次优的母乳喂养做法有关。针对改善母乳喂养做法的政策和计划应考虑在产前和产后护理期间筛查暴力经历并支持减少 IPV 的举措。