The differential role of practical and emotional support in infant feeding experience in the UK

Abstract

Social support is a known determinant of breastfeeding behaviour and is generally considered beneficial. However, social support encompasses a myriad of different supportive acts, providing scope for diverse infant feeding outcomes. Given the vulnerability of postpartum mental health, this paper aims to explore both how support prolongs breastfeeding and which forms of support promote the positive experience of all infant feeding. Using survey data collected online from 515 UK mothers with infants aged 0–108 weeks, Cox regression models assessed the relationship between receiving different types of support, support need and breastfeeding duration. Quasi-binomial logistic regression models assessed the relationship between receiving support, infant feeding mode and maternal experience of infant feeding. Rates of negative infant feeding experience indicate the widespread need for support: e.g. 38% of currently, 47% of no longer and 31% of never breastfeeding women found infant feeding stressful. Overall, practical support via infant feeding broadly predicted shorter breastfeeding durations and poorer feeding experience; results in relation to other forms of support were more complex. Our findings indicate different forms of support have different associations with infant feeding experience. They also highlight the wide range of individuals beyond the nuclear family on which postpartum mothers in the UK rely. This article is part of the theme issue ‘Multidisciplinary perspectives on social support and maternal–child health’.

Testing the buffering hypothesis: breastfeeding problems, cessation and social support in the UK

“…This indicates that multidimensional social support is an important feature of the postnatal period in the UK, even though women, especially those who are more highly educated, frequently live further from family and friends (Chan & Ermisch, 2015). As we have argued previously (Emmott et al, 2020a(Emmott et al, , 2021Emmott & Mace, 2015;Myers et al, 2021), the benefit of an evolutionary anthropological approach is the exploration of investment transfers to mothers from a wide range of supporters due to the emphasis on cooperative childrearing (Emmott & Page, 2019). An evolutionary framework highlights that there are many mechanisms by which support can work, and support which can facilitate breastfeeding need not be limited to health care professionals.…”

“…In our sample of 565 relatively affluent and well-educated women from the UK, we find that almost everyone reported problems breastfeeding, underlining that breastfeeding problems are the norm rather than the exception. Such problems potentially explain why, as reported elsewhere, 71% of respondents who stopped breastfeeding prior to 8 weeks found infant feeding stressful and 60% emotionally draining (Myers et al, 2021). As women often report feeling unprepared, abnormal and isolated when they encounter common issues (Brown, 2016;Wall, 2001), every attempt should be made to inform women antenatally that breastfeeding is a learnt behavior (Varki et al, 2008) and how best to prepare for, and overcome, future challenges (Brown, 2016;Emmott et al, 2020b).…”

“…Increased access to breastfeeding knowledge as well as emotional and practical support may help mothers overcome the often unexpected challenges of breastfeeding (Hough et al, 2018), increasing women's ability to cope and deal with breastfeeding problems. Here, support is operationalized as a "resource transfer" from an individual supporter to the mother (Emmott et al, 2021;Myers et al, 2021). Such transfers or investments span informational, emotional, and practical domains, each predicted to buffer the mother in different ways from the potential negative influence of stressful events, such as breastfeeding problems (Cohen & Wills, 1985).…”

Who cares for women with children? Crossing the bridge between disciplines

“…While we recognize that macro-and community-level factors are also key determinants of maternal and child health, this focus stems from how we define support: from an evolutionary anthropological perspective, we conceptualize support as investments directly or indirectly transferred to a person, which 'cost' the actor some form of time, energy or resource [19]. As outlined by McLeish & Redshaw [31] and Myers et al [13] in this issue, such support is diverse, spanning practical, informational, emotional and affirmative support.…”

“…Further, support can take different forms, including emotional, affirmational, practical and informational support [13,31]. The impact of support on mothers and children may depend on who provides the support, what support is provided, and the context in which the supportive acts take place [7,13,19,[32][33][34], meaning understanding the pathways between support and maternal-child health is likely to be complex. However, despite theoretical acknowledgement of these complexities [7,33], research into support for mothers and children has rarely approached the topic in this holistic manner.…”