934 JOURNAL OF WOMEN’S HEALTH Volume 15, Number 8, 2006 © Mary Ann Liebert, Inc. Intimate Partner Violence around the Time of Pregnancy: Association with Breastfeeding Behavior JAY G. SILVERMAN, Ph.D., 1 MICHELE R. DECKER, M.P.H., 1 ELIZABETH REED, M.P.H., 1 and ANITA RAJ, Ph.D. 2 ABSTRACT Objective: To assess associations of experiences of intimate partner violence (IPV) and breast- feeding behaviors among a large, population-based sample of U.S. women. Methods: Data were collected from women giving birth to live infants in 26 U.S. states and participating in the 2000–2003 Pregnancy Risk Assessment Monitoring System (PRAMS) (n  118,579). Logistic regression analyses were conducted to assess the relations of experiences of IPV in the year prior to and during pregnancy to initiation and early cessation of breast- feeding. Results: Approximately 1 in 17 (5.8%) women delivering liveborn infants reported IPV ei- ther during or in the year prior to pregnancy. In crude logistic regression analyses, women who reported IPV in the year prior to pregnancy but not during pregnancy (OR 1.45, CI 1.26- 1.66), IPV during pregnancy but not in the year prior to pregnancy (OR 1.35, CI 1.11-1.64), and women reporting experiencing IPV across both periods (OR 1.52, CI 1.34-1.72) were signifi- cantly less likely to breastfeed the infants born subsequent to this pregnancy. Similarly, wo- men reporting IPV around the time of pregnancy who initiated breastfeeding were more likely to cease breastfeeding by 4 weeks postpartum (ORs 1.41-1.71). In analyses adjusted for de- mographics and current smoking, however, experiences of IPV did not relate to women’s risk for either outcome. Conclusions: Although other factors beyond experiences of IPV may better predict a wo- man’s decision or ability to breastfeed, abused women are overrepresented among mothers who do not or prematurely cease to breastfeed and should be identified and referred to ap- propriate services. INTRODUCTION B REASTFEEDING IS WIDELY ACCEPTED as critically important to promoting child health and de- velopment 1 ; known benefits of breastfeeding in- clude a lower incidence of infectious and nonin- fectious disease, diarrhea, respiratory infection, and ear infection among infants. 2 Breastfeeding is also found to lead to improved infant cognitive development 3,4 and to facilitate development of parenting skills of new mothers. 5 For these and other reasons, the American Academy of Pedi- 1 Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachu- setts. 2 Department of Social and Behavioral Sciences, Boston University School of Public Health, Boston, Massachusetts. This work was supported through a grant to J.G.S. from the Division of Reproductive Health of the Centers for Disease Control and Prevention (S3062-23-23).