Link Between Hypertensive Disorders in Pregnancy and Breastfeeding Rates

Hypertensive disorders in pregnancy (HDP), including chronic and gestational hypertension, preeclampsia, and eclampsia, are significant contributors to maternal and infant mortality in the United States. According to a study published in JAMA Network Open in July 2025, researchers from Yale University have found a concerning correlation between HDP and reduced breastfeeding rates among affected women. This research highlights the urgent need for targeted interventions to improve breastfeeding outcomes in this vulnerable population.

Between 2017 and 2019, approximately 16% of U.S. pregnancies were complicated by an HDP diagnosis, with notably higher rates among non-Hispanic Black and American Indian/Alaskan Native women, as reported by the Centers for Disease Control and Prevention (CDC) (CDC, 2020). HDPs do not only pose immediate risks during pregnancy but also increase long-term health risks, including heart disease and stroke, according to Deanna Nardella, an instructor of pediatrics and physician-scientist at Yale School of Medicine and the study's lead author.

The study examined data from the CDC’s Pregnancy Risk Assessment Monitoring System (PRAMS), which surveys women approximately four months postpartum. The sample included over 205,000 women who had delivered live infants between January 2016 and November 2021. The findings revealed that women diagnosed with HDP had an 11% higher likelihood of never breastfeeding and a 17% higher chance of ceasing breastfeeding earlier than their counterparts without HDP. The median duration of breastfeeding was found to be 17 weeks shorter among women with HDP (Nardella et al., 2025).

Cultural and systemic barriers contribute to the difficulties faced by women with HDP in initiating and sustaining breastfeeding. "Many families encounter challenges such as pain, latch difficulties, and insufficient support, resulting in early cessation of breastfeeding," Nardella explained. Despite 83% of U.S. women initiating breastfeeding, only 25% continue exclusively for the recommended six months (CDC, 2021).

Sarah Taylor, a professor of pediatrics at Yale, emphasized the importance of understanding these barriers to improve health equity. "The communities most affected by HDP, particularly Black and Native women, also have the lowest breastfeeding rates. Addressing these disparities could lead to better long-term health outcomes for mothers and infants" (Taylor, 2025).

Furthermore, the study suggests the need for dedicated prenatal lactation consultations for women with risk factors for breastfeeding challenges, such as HDP. The findings underscore the critical role of the prenatal period in providing lactation education and support.

In conclusion, the association between hypertensive disorders in pregnancy and lower breastfeeding rates necessitates immediate attention from healthcare providers and policymakers. Developing targeted strategies to support breastfeeding among women with HDP could potentially improve health outcomes for both mothers and their infants, particularly in communities at higher risk for cardimetabolic diseases. Future studies are essential to unravel the mechanisms behind this relationship and to create effective interventions (Nardella et al., 2025).

The study received funding from the Yale Pediatric Scholars Program and the Clinical and Translational Science Awards from the National Center for Advancing Translational Science, part of the National Institutes of Health (NIH).

References: 1. Nardella, D., et al. (2025). Hypertensive Disorders of Pregnancy and Breastfeeding Among US Women. JAMA Network Open. doi:10.1001/jamanetworkopen.2025.21902. 2. Centers for Disease Control and Prevention (CDC). (2020). Pregnancy Complications: Hypertensive Disorders. 3. Centers for Disease Control and Prevention (CDC). (2021). Breastfeeding Report Card.