Associations between Mothers’ Adverse Childhood Experiences, Material Hardship, and Breastfeeding Challenges in the United States
BY Rebecca J. McCloskey
Most people have heard the phrase, “breast is best,” and are aware of at least some of the superior health benefits that breastfeeding provides. While most mothers attempt and intend to breastfeed, it is often just not that easy. An additional problem is that many mothers then experience shame and personal or societal blame for not breastfeeding according to recommendations.
It is important to emphasize that breastfeeding challenges do not represent a personal failing but a larger social problem that can be prevented and addressed. Thus, this research aimed to better understand some environmental and experiential factors that may influence breastfeeding challenges. These factors are far reaching and offer opportunities for improving environmental, cultural, and intuitional circumstances and systems to better support mothers in achieving their breastfeeding goals.
Over the last several decades, research has established that childhood experiences of abuse, neglect, and various chronic household and community stressors—together known as adverse childhood experiences (ACEs)—can lead to disease and poor well-being in adulthood. For example, we know that people who had four or more ACEs are more likely to experience depression, substance abuse, and poorer physical health (heart disease, diabetes, cancer, etc.). As an extension of this work, the current study was created to further explore how ACEs may influence various aspects of motherhood, and in this case, breastfeeding.
Study results made it clear that breastfeeding poses an overall challenge for the majority of women, whether they had ACEs or not. In this study of 306 mothers in the United States who gave birth in the previous year, over 70% said they had one or more breastfeeding challenges such as pain, under or oversupply of milk, trouble getting the baby to latch to the breast, and complications related to breastfeeding while also having to maintain employment.
Additionally, we found that about 45% of mothers in our study experienced material hardship—at least one instance of not being able to meet one’s basic needs—in the previous year, and 34% reported experiencing some discrimination based on any aspect of their identity at least few times a year or as much as every day. More than two-thirds of the mothers in the study had at least one ACE, and 30% had four or more ACEs. Furthermore, the more ACEs a mother had, the greater number of breastfeeding difficulties she also experienced.
These experiences of material hardship, discrimination, and ACEs may represent significant physical and emotional trauma and stressors on mothers. More research is needed with larger numbers of women in the United States to better under the scope of the problem and how these experiences may affect one another and different health outcomes and behaviors, like breastfeeding.
However, it is vitally important that we further examine and work to prevent ACEs and other injustices like material hardship and discrimination, to help eliminate any potential barriers to successful breastfeeding as doing so has significant health implications for children, mothers, and our communities. Additionally, should mothers have had any of these negative experiences, they should receive culturally appropriate support and intervention to try and prevent and/or resolve any breastfeeding challenges.
Motherhood and breastfeeding can be challenging enough on its own, even in the best of circumstances. As a society, we have a responsibility to conduct research and use its findings to foster positive outcomes for mothers and their families.
Article details
Associations Between Mothers’ Adverse Childhood Experiences, Material Hardship, and Breastfeeding Challenges in the United States
Rebecca J. McCloskey, PhD, MSW, LISW-S & Fei Pei, PhD, MSW
First Published: September 5, 2022
DOI: 10.1177/08903344221120596
Journal of Human Lactation
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