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Patterns of Breastfeeding Among Individuals with Opioid Use Disorder and Integration of Lactation Support into Perinatal Recovery Programs Across the United States

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 (Unpublished)

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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.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Narbey, Laurenltn9@pitt.eduLTN90000-0003-0437-3173
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairDemirci, JillJVR5@pitt.eduJVR50000-0002-4802-7849
Committee MemberKrans, Elizabethkransee@upmc.edu0000-0001-8190-6039
Committee MemberNiemczyk, NancyNAN37@pitt.eduNAN370000-0003-1094-1210
Committee MemberSereika, SusanSSEREIKA@pitt.edu0000-0002-7840-1352
Committee MemberStandish, Katherinekatherine.standish@bmc.org0000-0002-1110-277X
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

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