Local environmental quality positively predicts breastfeeding in the UK’s Millennium Cohort Study

Abstract

Using breastfeeding initiation and duration and local-level indicators of environmental quality, we test the life history theory prediction that parental investment will be lower in harsh environments. We find that local environmental quality (as rated by an independent assessor) positively predicts breastfeeding over and above the influences of individual SES and the wider environment. Higher SES also appears to buffer against the negative effects of lower local environmental quality.

Are mothers less likely to breastfeed in harsh environments? Physical environmental quality and breastfeeding in the Born in Bradford study

“…Taken together, these mediation results suggest that mothers with low birthweight and shorter gestation lengths have reduced breastfeeding chances, a finding corroborated by our previous analyses of the Millennium Cohort Study (Brown & Sear, ) that showed that lower birthweight infants had lower initiation rates and average breastfeeding durations (e.g., 67% and 2.07 months vs. 69% and 2.69 months for normal weight and 74% and 3.11 months for heavy weight). Low birthweight and preterm birth (i.e., when gestational lengths are shorter than 37 weeks) may negatively impact breastfeeding in several ways.…”

“…This could be because duration was measured on a smaller, less representative sample, with less power to detect effects. However, we also found stronger initiation than duration results in our previous study (Brown & Sear, ), suggesting that initiation may be genuinely more strongly influenced by environmental quality than duration. It is likely that breastfeeding duration is more influenced by other factors such as women needing to return to work (Andrew & Harvey, ; Heck, Braveman, Cubbin, Chávez, & Kiely, ; Huang & Yang, ; Kimbro, ; Rippeyoung & Noonan, ).…”

“…The detrimental influence of UK societal norms on immigrant breastfeeding chances have been reported quantitatively for immigrants generally (Hawkins, Lamb, Cole, & Law, ) and qualitatively for those immigrating from South Asian countries specifically (Choudhry & Wallace, ). For example, previous analyses using the Millennium Cohort Study have shown that although babies of South Asian descent had similar odds of being breastfed to White babies, immigrant mothers were less likely to initiate breastfeeding the longer they lived in the UK (Brown & Sear, [Supplementary material: Table 3]; Hawkins et al, ).…”

“…We have previously shown a positive association between environmental quality and breastfeeding in the United Kingdom, both when environmental quality was measured using aggregated data at Primary Care Trust level (Brown, ) and with individual data at the home, street, and neighbourhood level (Brown & Sear, ). We looked at environmental effects on breastfeeding initiation and duration of any breastfeeding in the Millennium Cohort Study (Brown & Sear, ), using a broad definition of environmental quality encompassing both sociocultural and physical aspects, such as how supportive and friendly people were, whether there were signs of crime and antisocial behaviour, the built environment, perceptions of cleanliness and general environmental pollution. We found that for every one‐unit increase in objectively assessed local environmental quality, mothers were 54% more likely to initiate breastfeeding (CI [1.23, 1.92]) and 14% less likely to stop breastfeeding (CI [0.77, 0.97]), even after controlling for socio‐economic position.…”

“…We have previously shown a positive association between environmental quality and breastfeeding in the United Kingdom, both when environmental quality was measured using aggregated data at Primary Care Trust level (Brown, 2014) and with individual data at the home, street, and neighbourhood level (Brown & Sear, 2017).…”