bridging social and biological sciences noriko cable, mel bartley, anne mcmunn, yvonne kelly...
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Bridging social and biological scienceswww.ucl.ac.uk/icls
Noriko Cable, Mel Bartley, Anne McMunn, Yvonne Kelly
University College London
SLLS 2010, Cambridge
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Gender differences in the effect of breast feeding on adult psychological well-being
Source: WHO
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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?
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
The theoretical model:
Breastfeeding Childhood psychosocial adjustment
Adult psychological ill health
Adult self-efficacy
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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)
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Methods:
• Independent variables:– Breastfeeding
• 1 month+(=1), Never/less 1 mo (=0)
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Analysis:
• Logistic regression – Childhood psychosocial adjustment– Adult psychological well-being
• Compared the results by gender and cohorts
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Findings: descriptive by cohort (Men)
0
10
20
30
40
50
60
disadvantaged+ maladjusted+ psychologically ill health+ low self-efficacy
NCDS: Never/less
NCDS: 1mo+
BCS70:Never/less
BCS70:1mo+
%
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Findings: descriptive by cohort (Women)
0
10
20
30
40
50
60
disadvantaged+ maladjusted+ psychologically ill health+ low self-efficacy
NCDS: Never/less
NCDS: 1mo+
BCS70:Never/less
BCS70:1mo+
%
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Findings: Childhood psychosocial adjustment
Unadjusted Adjusted*
Boys NCDS 1.17(1.01-1.36) 1.11(0.96-1.29)
BCS70 1.18(0.96-1.45) 1.14(0.93-1.41)
Girls NCDS 1.30(1.10-1.55) 1.25(1.05-1.48)
BCS70 1.55(1.23-1.94) 1.44(1.15-1.81)
Note: adjusted for social demographic adversity
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Findings:
• Girls appear to benefit from being breastfed more than 1 month.
• All effects were adjusted for social adversity
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Findings: Adult psychological health
Unadjusted Adjusted*
Men NCDS 1.03(0.78-1.37) 0.97(0.73-1.29)
BCS70 1.12(0.87-1.44) 1.04(0.80-1.35)
Women NCDS 1.26(1.03-1.54) 1.17(0.95-1.44)
BCS70 1.41(1.13-1.76) 1.31(1.04-1.64)
Note: adjusted for social demographic adversity+childhood psychosocial adjustment
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Findings: Adult self-efficacy
Unadjusted Adjusted*
Men NCDS 1.15(0.99-1.33) 1.09(0.94-1.25)
BCS70 1.15(0.94-1.40) 1.06(0.97-1.30)
Women NCDS 1.16(1.01-1.34) 1.09(0.94-1.26)
BCS70 1.44(1.17-1.78) 1.31(1.06-1.61)
Note: adjusted for social demographic adversity+childhood psychosocial adjustment
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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.
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
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
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Acknowledgement: ESRC, UK data archive and CLS
Thank you for listening!
Contact: [email protected]
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Descriptive: Men
0
50
100
NCDS BF <1mo BCS70 BF <1mo
mother teen
non teen
mother left f/teducationmother stayed
lone mother
two parenthouseholdSibling+
Sibling -
%
SLLS 2010 www.ucl.ac.uk/icls
An ESRC Research Centre
Descriptive: Women
0
50
100
NCDS BF <1mo BCS70 BF <1mo
mother teen
non teen
mother left f/teducationmother stayed
lone mother
two parenthouseholdSibling+
Sibling -
%