Doctoral student's research brings new insight to removing breastfeeding barriers
A new study from The University of Toledo suggests providing more robust support for new mothers who experience stressful life events leading up to the baby's birth, such as a lost job or a critically ill family member, could improve breastfeeding rates.
Slightly more than half of U.S. mothers follow the American Academy of Pediatrics recommendation that their infants receive only breast milk for the first six months of their lives.
Vickie Dugat wanted to better understand what barriers may exist for women—and identify efforts that might remove some.
"There's a lot of data that suggests it's beneficial for both mother and baby to breastfeed for six months," said Dugat, a health education doctoral student in the UToledo College of Health and Human Services. "This is an issue that we need to talk about, and one that needs to be researched more deeply."
There are a variety of reasons why new mothers may either choose not to breastfeed or find themselves unable to do so. A lack of family and social support, embarrassment, personal preference, lactation problems, and work-related issues are commonly cited in studies of American breastfeeding practices.
As Dugat sifted through the existing literature, she noticed that little work had been done examining the association between prenatal stressful life events and exclusive breastfeeding.
With help from Dr. Joseph Dake, professor and chair of the UToledo School of Population Health, Dugat linked up with a pair of Ohio University researchers to dig into the issue.
Using a data set of nearly 44,000 U.S. mothers, researchers compared breastfeeding statistics for an infant's first three months with self-reported incidents of 13 major stressful events in the mother's life during the year prior to birth.
Included in that list were separations or divorce, homelessness, moving to a new address, bills that couldn't be paid, someone close to them suffering with a drug or alcohol problem, lost jobs, and the death or serious illness of someone close to them.
Their findings, published in the journal Breastfeeding Medicine, found a clear connection between higher numbers of stressful life events and lower rates of exclusive breastfeeding for three months.
Of the U.S. mothers included in their data set, 52 percent of those who did not report any major stressful life events in the year prior to giving birth were more likely to breastfeed exclusively for three months. Among women who experienced three or more stressful life events, that dropped to just 32 percent.
While the findings were consistent across most demographic groups, the association between stressful life events and shorter duration of breastfeeding was most pronounced for women younger than age 30.
"The implication is it might be possible to create policies or programs to educate lactation consultants and physicians on which population may need a little bit more assistance when it comes to breastfeeding and handling stressful life events," said Dugat, who was lead author on the study. "We could also potentially improve breastfeeding practices with efforts that minimize exposure to stressful life events."
Originally from Florida, Dugat completed her undergraduate work at the University of Florida and earned a master's in public health from Morehouse School of Medicine in Atlanta.
She chose UToledo for her doctoral work after meeting Dake at a conference and learning the flexibility she'd have in her research here.
"Something that we pride ourselves in is that we do not assign our doctoral students to a particular faculty member when they come in," Dake said. "There are benefits to that, but our program is geared a little more toward allowing them to explore and shift their research interests, as long as it's under the oversight of a faculty member who can be a good mentor to them."
For Dugat, who is passionate about improving the health of mothers and infants, that freedom to pursue her interests was crucial in selecting a doctoral program.
"I absolutely love that. With other Ph.D. programs, sometimes you have to do the research that faculty are already doing," Dugat said. "Having that flexibility and the ability to be creative in my research is what attracted me here."
Thanks to the relationship Dake has built with Ohio University through the Ohio Alliance for Innovation in Population Health, he was able to make a connection for Dugat with researchers who had similar areas of interest.
"We really try to push the idea that if you love what you do, you spend time on it, and you're passionate at what you do, you're going to be a better professional, and you're going to be more successful in it," Dake said.