Hypertensive disorders of pregnancy (HDPs), encompassing conditions such as gestational hypertension, preeclampsia, and eclampsia, are a leading cause of maternal and neonatal morbidity and mortality in the United States. Affecting approximately 16% of pregnancies nationwide, these disorders pose complex challenges not only during gestation but also in the postpartum period, influencing maternal health and infant care practices, including breastfeeding.
Breastfeeding is widely recognized for its significant health benefits, both for infants and mothers. For newborns, breast milk provides essential nutrients and immunological protection, while for mothers, breastfeeding can aid in recovery, promote weight loss, and reduce the risk of certain chronic diseases. Despite an 83% breastfeeding initiation rate at delivery among U.S. women, only 25% continue exclusive breastfeeding through the recommended six months, according to CDC data.
Scientific and Clinical Evidence: What the Data Tell Us
Recent research published in JAMA Network Open has shed light on the relationship between HDPs and breastfeeding outcomes. A cross-sectional study analyzed data from the CDC Pregnancy Risk Assessment Monitoring System, focusing on deliveries between 2016 and 2021. The study aimed to determine how HDPs influence rates of breastfeeding initiation and duration.
The findings revealed that women diagnosed with HDPs were 11% more likely to never initiate breastfeeding compared to their counterparts without HDPs. Furthermore, breastfeeding cessation rates were higher among this group, with a median duration of 17 weeks compared to 34 weeks in the non-HDP population. These disparities underscore the need for targeted interventions to support breastfeeding among mothers with HDPs.
Misconceptions and Harmful Behaviors
Several factors contribute to the lower breastfeeding rates among women with HDPs. These include physical challenges such as delayed lactogenesis due to medication or complications from cesarean deliveries, as well as psychological barriers like increased stress and anxiety. Misconceptions about breastfeeding safety in the context of hypertensive medications further complicate the issue.
Additionally, socioeconomic factors play a significant role. Women with HDPs often belong to demographic groups already at higher risk for breastfeeding challenges, including those with lower income levels, limited access to healthcare resources, and higher prevalence of comorbidities such as obesity and gestational diabetes.
Correct Health Practices and Practical Recommendations
To mitigate these challenges, healthcare professionals and support systems must provide tailored interventions. Recommendations include:
– **Enhanced Breastfeeding Support:** Initiatives such as lactation counseling and access to breastfeeding-friendly hospital policies can address physical and emotional barriers.
– **Education on Medication Safety:** Dispelling myths about hypertensive medications and their compatibility with breastfeeding is crucial.
– **Addressing Socioeconomic Barriers:** Expanding access to programs like Women, Infants, and Children (WIC) can provide resources and support to economically disadvantaged mothers.
– **Monitoring Postpartum Health:** Close follow-up care to manage HDPs and their complications can improve overall maternal health and breastfeeding outcomes.
Expert Insights and Commentary
Dr. Sarah Johnson, a maternal-fetal medicine specialist, emphasizes the importance of a multidisciplinary approach: “Breastfeeding support for mothers with HDPs requires coordination between obstetricians, lactation consultants, and pediatricians. We must understand the unique challenges these mothers face and adapt our strategies accordingly.”
Dr. Johnson also notes the potential impact of systemic changes, such as implementing standardized protocols for breastfeeding support in hospitals that manage high-risk pregnancies.
Conclusion
The relationship between hypertensive disorders of pregnancy and breastfeeding outcomes highlights an urgent need for targeted support and interventions. By addressing physical, psychological, and socioeconomic barriers, healthcare systems can help improve breastfeeding rates and maternal-infant health outcomes. Further research into tailored approaches for mothers with HDPs will be pivotal in promoting health equity and ensuring optimal care for this vulnerable population.
References
1. Nardella D, Canavan ME, Taylor SN, Sharifi M. Hypertensive disorders of pregnancy and breastfeeding among US women. JAMA Netw Open. 2025;8(7):e2521902. doi:10.1001/jamanetworkopen.2025.21902 2. Ford ND, Cox S, Ko JY, et al. Hypertensive disorders in pregnancy and mortality at delivery hospitalization – United States, 2017-2019. MMWR Morb Mortal Wkly Rep. 2022;71(17):585-591. doi:10.15585/mmwr.mm7117a1 IF: 17.3 Q1
