Understanding the association of experience of violence on women's breastfeeding decisions in a South African context

Background:

Breastfeeding initiation and exclusivity have been shown to have a myriad of benefits for both mother and infant; however, breastfeeding continuation in South Africa is relatively low. One relatively unstudied contributor to this phenomenon could be the high incidence of violence against women within this context. The objective of this study was to conceptually understand key factors associated with violence and breastfeeding in this context.

Methods:

A review of the individual and combined literatures on violence against women and breastfeeding was conducted to identify potential pathways connecting women’s experiences of violence to their breastfeeding initiation and continuation decisions. Additional information about the social and historical context surrounding the violence and breastfeeding cultures in South Africa was reviewed to identify context-specific contributors to violence and breastfeeding behaviors.

Results:

The literature supports a new conceptual framework in which the primary pathways between experience of violence and breastfeeding decisions in South Africa include mental health consequences of violence, breastfeeding difficulty, and women’s support systems. Additional factors, identified as mediators in this context, included availability and coordination of services, demographic characteristics, and HIV status.

Conclusions:

Our review of the literature highlights the need for further context-specific research on this subject. This conceptual model may be useful for informing further research on the impact of violence on breastfeeding decisions in South Africa. Additionally, it may serve to inform programmatic work, in which research shows that context-specific interventions achieve greater impact than generic interventions.