Date of Award

January 2012

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Rafael Perez-Escamilla


Objective: To assess associations of experiences of intimate partner violence (IPV) and breastfeeding behaviors among a large, population-based sample of Zambian women using the 2007 Zambian Demographic and Health Survey (2007 ZDHS).

Methods: All women with a last-born infant aged under 2 years in Zambia who participated in the 2007 ZDHS Domestic Violence Module were included in the analysis. Logistic regression analyses were conducted to assess the associations of experiences of lifetime IPV, type of IPV, current IPV, and IPV during any pregnancy to the following breastfeeding outcomes: early breastfeeding initiation, use of prelacteal feeds, any breastfeeding (N=1892), and exclusive breastfeeding (EBF) (N=469). Multivariate logistic regression models were adjusted for all significant socio-demographic, breastfeeding, and IPV variables from bivariate analyses and then backward-step elimination was used to find the best reduced model.

Results: Almost half of the women in our sample experienced some form of intimate partner violence in their lifetime (49.2%). Lifetime experience of maternal IPV did not predict any breastfeeding outcomes, but experience of only sexual violence was associated with late breastfeeding initiation (ORadj: 0.53, 95% CI: 0.30-0.94). Recent IPV was associated with the use of prelacteal feeding (1.81, 95% CI: 1.02-3.21) and IPV exposure during a pregnancy was inversely associated with EBF (ORadj: 0.16, 95% CI: 0.04-0.55). For both prelacteal feed use and EBF, employment was found to predict higher adverse outcomes. No association was found between any maternal IPV exposure and any breastfeeding.

Conclusions: While lifetime IPV exposure does not seem to affect overall breastfeeding rates in Zambia, women who experience IPV in some form may have poorer breastfeeding outcomes. Interventions and care should be focused on employed women as they may have higher IPV risk and poor breastfeeding outcomes. While further research is warranted, IPV appears to be another risk factor to poor child health outcomes in the context of breastfeeding.


This is an Open Access Thesis.

Open Access

This Article is Open Access