title: Breastfeeding Duration after Childhood Sexual Abuse: An Australian Cohort Study.
abstract: BACKGROUND
  Childhood sexual abuse (CSA) is prevalent across the world. Childhood sexual abuse is associated with poorer health, but information on its impact on breastfeeding is limited. In this study, the authors investigated the link between CSA and duration of breastfeeding for 6 months or more.
  
  
  OBJECTIVE
  The purpose of this study was to determine the association between CSA and breastfeeding duration for Australian women.
  
  
  METHODS
  Data from 3778 women from the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health were used. A stepped approach was used to assess the association between CSA and breastfeeding the first child for 6 months or more with logistic regression modeling, adjusting for significant sociodemographic characteristics, health behaviors, and adult violence.
  
  
  RESULTS
  The 15.5% of women who had experienced CSA were less educated, younger, and more likely to be smokers and to have experienced adult violence. The CSA group was less likely to breastfeed for 6 months or more (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.65-0.93), even after adjusting for smoking (OR, 0.81; 95% CI, 0.68-0.98) and adult violence (OR, 0.80; 95% CI, 0.67-0.96). There was no longer a significant association once sociodemographic factors were adjusted for, which remained true in the fully adjusted model (OR, 0.90; 95% CI, 0.75-1.09).
  
  
  CONCLUSIONS
  Women who experienced CSA were successfully able to maintain breastfeeding at a level similar to those who had not experienced CSA after controlling for sociodemographic factors. Further testing of whether the effects of CSA are mediated through social variables is warranted to investigate whether addressing social factors in service provision may be key to improving breastfeeding duration.
authors.affiliation: Department of General Practice, Monash University, Faculty of Medicine, Nursing & Health Sciences, Notting Hill, VIC, Australia jan.coles@monash.edu.au.
authors.forename: Jan
authors.initials: J
authors.lastname: Coles
authors.affiliation: The University of Newcastle Australia, Faculty of Health, Priority Research Centre for Gender, Health and Ageing, Callaghan, NSW, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Anderson
authors.affiliation: The University of Newcastle Australia, Faculty of Health, Priority Research Centre for Gender, Health and Ageing, Callaghan, NSW, Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Loxton
mesh_terms: D000293:Adolescent; D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000368:Aged; D001315:Australia; D001942:Breast Feeding / Q000523:psychology* / Q000706:statistics & numerical data*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008875:Middle Aged; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult
keywords: access to care; adult violence; breastfeeding; breastfeeding barriers; breastfeeding duration; childhood sexual abuse