ABSTRACT
We examined whether severe maternal morbidity (SMM) at delivery was associated with the initiation and duration of breastfeeding among nulliparous individuals in the United States in a secondary analysis from the prospective nuMoM2b-HHS (Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be Heart Health Study). Among 6,762 nulliparous individuals, the frequency of any breastfeeding by duration was as follows: 759 (11.2%) breastfed for less than 6 weeks; 1,847 (27.3%) breastfed for 6 weeks to 6 months; and 3,359 (49.7%) breastfed for more than 6 months, and the frequency of exclusive breastfeeding among those with any breastfeeding was 4,653 (85.4%). The frequency of any SMM was 160 (2.4%) and nontransfusion SMM was 124 (1.8%). Breastfeeding initiation did not vary by SMM status. Among those who breastfed, SMM was associated with a lower likelihood of breastfeeding for more than 6 months (adjusted odds ratio [aOR] 0.50; 95% CI, 0.36–0.68) and a lower likelihood of exclusive breastfeeding (aOR 0.60; 95% CI, 0.37–0.98). In a prospective cohort of nulliparous pregnant individuals from across the United States, SMM at delivery was not associated with breastfeeding initiation, but was associated with a significantly lower likelihood of breastfeeding duration and exclusive breastfeeding.