Noriko Cable, Mel Bartley, Anne McMunn, Yvonne Kelly University College London

1. Noriko Cable, Mel Bartley, Anne McMunn, Yvonne Kelly University College London SLLS 2010, Cambridge

2. Gender differences in the effect of breast feeding on adult psychological well-being Source: WHO www.ucl.ac.uk/icls

3. Background • WHO and UNICEF recommend exclusive breastfeeding for 6months. • Established links between breastfeeding and physical health, extending to adulthood • What about psychological health? • Beyond childhood? www.ucl.ac.uk/icls

4. The theoretical model: Adult psychological ill health Breastfeeding Childhood psychosocial adjustment Adult self-efficacy www.ucl.ac.uk/icls

5. Aims: • To examine the role of breastfeeding on • childhood psychosocial adjustment • adulthood psychological well-being • To compare the results are persistent between two British Birth Cohort Studies born 12 years apart www.ucl.ac.uk/icls

6. Method: • Participants: • NCDS (1958 cohort) • Birth, age 7, age 11, age 33 • Men (N=3,797); Women (N=3,953) • BCS70 (1970 cohort) • Birth, age 5, age10, age30 • Men (N=3,166); Women (N=3,326) www.ucl.ac.uk/icls

7. Methods: • Independent variables: • Breastfeeding • 1 month+(=1), Never/less 1 mo (=0) www.ucl.ac.uk/icls

8. Methods: • Outcome variables: • Childhood psychosocial adjustment (2pt, top three quartiles =1, being adjusted) • NCDS: Teacher assessed BSAG score • BCS70: Teacher assessed Rutter score • Adult psychological well-being • Psychological health • Malaise score 0-6 (=1, healthy), 7+ (=0, ill health) • Self-efficacy • Cut off a total sum (3 items) into a 2pt (0=low, 1= high self-efficacy www.ucl.ac.uk/icls

9. Methods: • Confounders • Socio-demographic adversity index (0, not disadvantaged, 1=disadvantaged) • Cut off at a median of the sum of: • Maternal education • Stayed in min. education=0, No=1 • Mother’s age • Non-teen =0, teenage=1 • Parenthood • two parents=0, lone parent =1) • Being a first born child • no siblings =0, has siblings=1 indicated by parity www.ucl.ac.uk/icls

10. Analysis: • Logistic regression • Childhood psychosocial adjustment • Adult psychological well-being • Compared the results by gender and cohorts www.ucl.ac.uk/icls

11. Findings: • Proportions of breastfeeding 1mo+ decreased • 20% Mothers of BCS70 children breastfed for 1+ months • Most of the participants psychologically well childhood & adulthood • Breastfeeding practice appears to associate with social adversity www.ucl.ac.uk/icls

12. Findings: descriptive by cohort (Men) % www.ucl.ac.uk/icls

13. Findings: descriptive by cohort (Women) % www.ucl.ac.uk/icls

14. Findings: Childhood psychosocial adjustment Note: adjusted for social demographic adversity www.ucl.ac.uk/icls

15. Findings: • Girls appear to benefit from being breastfed more than 1 month. • All effects were adjusted for social adversity www.ucl.ac.uk/icls

16. Findings: Adult psychological health Note: adjusted for social demographic adversity+childhood psychosocial adjustment www.ucl.ac.uk/icls

17. Findings: Adult self-efficacy Note: adjusted for social demographic adversity+childhood psychosocial adjustment www.ucl.ac.uk/icls

18. Findings: • A direct path from breastfeeding to childhood psychosocial adjustment • Supported among girls only • A direct path from breastfeeding to adult psychological well-being (psychological health and self-efficacy) • Supported among women from BCS70 only. • All effects were adjusted for social demographic factors and childhood psychosocial adjustment. • Breastfeeding had no significant effects on men’s outcomes. www.ucl.ac.uk/icls

19. Discussion: • Gender differences in the findings, why girls/women? • As a proxy for a mother-child relationship/attachment? • Why not so important for boys after their infanthood? • Why becomes so important to mid-childhood girls and adult women? • Can compare with the data from the MCS • Cohort effect, why BCS70? • Period changes in the contexts of social demographic factors? • Can compare with the data from the MCS www.ucl.ac.uk/icls

20. Discussion: • Limitations • Breastfeeding measures • Not robust enough to assess dose-response relationships with the outcomes • Maternal education • Not precise • Social context of education • Stayed in minimum age full time education or not www.ucl.ac.uk/icls

21. Summary: • The effect of breastfeeding on psychological health is limited • Not extensive as seen in physical health • Prevalent in women from the late cohort • A path from breastfeeding to adult psychological well-being via child psychosocial adjustment www.ucl.ac.uk/icls

22. Summary • A direct path from breastfeeding to adult psychological well-being for the later cohort • For NCDS women • A direct effect from childhood psychosocial adjustment via breastfeeding • Breastfeeding can be women’s psychological well-being across lifecourse • Policy implications • Encourage expecting mothers to take on and continue breastfeeding up to 6 months as recommended www.ucl.ac.uk/icls

23. Acknowledgement: ESRC, UK data archive and CLS Thank you for listening! Contact: n.cable@ucl.ac.uk www.ucl.ac.uk/icls

24. Descriptive: Men % www.ucl.ac.uk/icls

25. Descriptive: Women % www.ucl.ac.uk/icls