Narbey, Lauren
(2024)
Patterns of Breastfeeding Among Individuals with Opioid Use Disorder and Integration of Lactation Support into Perinatal Recovery Programs Across the United States.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Background: Prenatal opioid use continues to increase across the United States with a corresponding incidence of neonatal opioid withdrawal syndrome. Breastfeeding remains one of the only evidence-based practices that can decrease the need for medication in the newborn with proven benefits to individuals with opioid use. Despite these benefits, breastfeeding rates remain low. This dissertation study sought to understand patterns of breastfeeding outcomes among individuals with prenatal opioid use as well as breastfeeding support provided by perinatal recovery programs across the United States.
Methods:
To examine patterns of breastfeeding, the 2019-20 PRAMS Core 8 and Opioid Supplement were analyzed using binary logistic regression for complex sample surveys to model the impact of prenatal opioid use, Social Determinants of Health using race as a proxy for racism, years of maternal education for educational attainment, and enrollment in a supplemental nutrition program as a proxy for socio-economic status on the primary outcomes of breastfeeding initiation and continuation.
An online survey querying perinatal recovery program staff and leaders about their programs’ lactation support services and perceived barriers and facilitators to providing lactation support within the program and affiliated healthcare system(s) was distributed to all known programs across the United States between January and April of 2024. Quantitative data were summarized with descriptive statistics and open-ended survey responses were analyzed using content analysis. Qualitative themes were overlaid on quantitative findings to triangulate findings.
Results:
Among the overall sample using PRAMS data, 7.1 % of participants reported prenatal opioid use. Prenatal opioid use, racism, and educational attainment conferred an increased risk for breastfeeding non-initiation and non-continuation when adjusted for all covariates.
Of the 43 perinatal recovery program personnel who complete the survey, 35 unique programs in 16 states were represented. Four themes were identified: breastfeeding support, provider knowledge, limited breastfeeding feasibility and access to breastfeeding support, and updating and implementing evidence-based policies.
Conclusions:
To increase breastfeeding uptake for individuals with prenatal opioid use, the context of their unique social determinants of health must be taken into account and addressed along with increasing breastfeeding knowledge, support, and evidence-based policies within perinatal recovery programs.
Share
| Citation/Export: |
|
| Social Networking: |
|
Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
|
| Date: |
19 December 2024 |
| Date Type: |
Publication |
| Defense Date: |
20 November 2024 |
| Approval Date: |
19 December 2024 |
| Submission Date: |
17 December 2024 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
118 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Nursing > Nursing |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
perinatal, opioid use, breastfeeding |
| Date Deposited: |
19 Dec 2024 20:24 |
| Last Modified: |
19 Dec 2024 20:24 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/47296 |
Metrics
Monthly Views for the past 3 years
Plum Analytics
Actions (login required)
 |
View Item |
![[img]](https://d-scholarship.pitt.edu/style/images/fileicons/application_pdf.png)
![[feed]](/images/feed-icon-32x32.png){kind=icon}