title: Breastfeeding in Women Having Experienced Childhood Sexual Abuse.
abstract: BACKGROUND
  Childhood sexual abuse (CSA) can have a serious effect on general and obstetric health. Breastfeeding includes several triggers for memories of abuse experiences, which will likely influence decisions about breastfeeding and its implementation in daily life. This is important since breastfeeding improves maternal well-being and bonding with the child. Research aim: As breastfeeding strongly influences the long-term health of children, we investigated experiences with breastfeeding in women with a history of CSA.
  
  
  METHODS
  Data on breastfeeding were collected within a research project designed to compare labor and delivery experiences in women with a history of CSA to women without such antecedents. Data from 85 women having experienced CSA and 170 controls pair-matched for maternal age, children's age, and nationality were evaluated. The clinical record of pregnancy and a self-administered questionnaire were used to collect data.
  
  
  RESULTS
  Although the prevalence of breastfeeding was similar in women with and without CSA experiences (96.5% vs. 90.6%), women exposed to CSA more often described complications associated with breastfeeding (77.7% vs. 67.1%, p = .08). Mastitis (49.4% vs. 27.6%, p < .01) and pain (29.4% vs. 18.8%, p = .15) were reported significantly more often by women after CSA. For 20% of women after CSA, breastfeeding was a trigger for memories of CSA. Furthermore, 58% of women with CSA reported dissociation when breastfeeding.
  
  
  CONCLUSIONS
  In addition to the growing list of potential health consequences of CSA experience, this experience seems to be associated with an increased number of problems when breastfeeding. However, most women with a history of CSA intend to breastfeed despite particular challenges related to CSA. A support protocol tailored to the specific needs of these women during pregnancy and the lactation period may help to improve breastfeeding and the early mother-child relationship.
authors.affiliation: 1 Breast Centre, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Constanze
authors.initials: C
authors.lastname: Elfgen
authors.affiliation: 2 Department of Biostatistics, University of Zürich, Zürich, Switzerland.
authors.forename: Niels
authors.initials: N
authors.lastname: Hagenbuch
authors.affiliation: 3 Frauennotruf, Aachen, Germany.
authors.forename: Gisela
authors.initials: G
authors.lastname: Görres
authors.affiliation: 4 Private dental office, Aachen, Germany.
authors.forename: Emina
authors.initials: E
authors.lastname: Block
authors.affiliation: 5 Clinic for Reproductive Endocrinology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Leeners
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000523:psychology / Q000706:statistics & numerical data*; D002648:Child; D002650:Child Abuse, Sexual / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany; D006801:Humans; D008413:Mastitis / Q000209:etiology; D008875:Middle Aged; D009034:Mother-Child Relations / Q000523:psychology; D011247:Pregnancy; D015995:Prevalence; D057566:Self Report; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: adult females; breastfeeding; childhood sexual abuse; dissociation; mastitis