Subjective Environmental Experiences and Women’s Breastfeeding Journeys: A Survival Analysis Using an Online Survey of UK Mothers

Laura J. Brown, Sarah Myers, Abigail E. Page and Emily H. Emmott
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Laura J. Brown: Department of International Development, London School of Economics & Political Science, London WC2A 2AE, UK
Sarah Myers: UCL Anthropology, University College London, London WC1H 0BW, UK
Abigail E. Page: Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Emily H. Emmott: UCL Anthropology, University College London, London WC1H 0BW, UK

IJERPH, 2020, vol. 17, issue 21, 1-27

Abstract: Local physical and social environmental factors are important drivers of human health and behaviour. Environmental perception has been linked with both reproduction and parenting, but links between subjective environmental experiences and breastfeeding remain unclear. Using retrospective data from an online survey of UK mothers of children aged 0–24 months, Cox-Aalen survival models test whether negative subjective environmental experiences negatively correlated with any and exclusive breastfeeding (max n = 473). Matching predictions, hazards of stopping any breastfeeding were increased, albeit non-significantly, across the five environmental measures (HR: 1.05–1.26) Hazards for stopping exclusive breastfeeding were however (non-significantly) reduced (HR: 0.65–0.87). Score processes found no significant time-varying effects. However, estimated cumulative coefficient graphs showed that the first few weeks postpartum were most susceptible to environmental influences and that contrary to our predictions, mothers with worse subjective environmental experiences were less likely to stop breastfeeding at this time. In addition, the hazard of stopping exclusive breastfeeding declined over time for mothers who thought that littering was a problem. The predicted increased hazards of stopping breastfeeding were only evident in the later stages of any breastfeeding and only for mothers who reported littering as a problem or that people tended not to know each other. Perceived harsher physical and social environmental conditions are assumed to deter women from breastfeeding, but this may not always be the case. Women’s hazards of stopping breastfeeding change over time and there may be particular timepoints in their breastfeeding journeys where subjective environmental experiences play a role.

Keywords: UK; breastfeeding; subjective environmental experiences; physical environment; social environment; social support; crime; littering (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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