ORIGINAL ARTICLE

Breast feeding and resilience against psychosocial stress

S M Montgomery¹, A Ehlin², A Sacker³

¹ Clinical Epidemiology Unit, Karolinska Institutet, Stockholm; Clinical Research Centre, Örebro University Hospital, Örebro, Sweden
² Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden
³ Department of Epidemiology and Public Health, Royal Free and University College Medical School, London, UK

Correspondence to:
Dr S M Montgomery
Enheten för klinisk epidemiologi, Karolinska sjukhuset, M9:01, 171 76 Stockholm, Sweden; scott.montgomery{at}ki.se

Background: Some early life exposures may result in a well controlled stress response, which can reduce stress related anxiety. Breast feeding may be a marker of some relevant exposures.

Aims: To assess whether breast feeding is associated with modification of the relation between parental divorce and anxiety.

Methods: Observational study using longitudinal birth cohort data. Linear regression was used to assess whether breast feeding modifies the association of parental divorce/separation with anxiety using stratification and interaction testing. Data were obtained from the 1970 British Cohort Study, which is following the lives of those born in one week in 1970 and living in Great Britain. This study uses information collected at birth and at ages 5 and 10 years for 8958 subjects. Class teachers answered a question on anxiety among 10 year olds using an analogue scale (range 0–50) that was log transformed to minimise skewness.

Results: Among 5672 non-breast fed subjects, parental divorce/separation was associated with a statistically significantly raised risk of anxiety, with a regression coefficient (95% CI) of 9.4 (6.1 to 12.8). Among the breast fed group this association was much lower: 2.2 (–2.6 to 7.0). Interaction testing confirmed statistically significant effect modification by breast feeding, independent of simultaneous adjustment for multiple potential confounding factors, producing an interaction coefficient of –7.0 (–12.8 to –1.2), indicating a 7% reduction in anxiety after adjustment.

Conclusions: Breast feeding is associated with resilience against the psychosocial stress linked with parental divorce/separation. This could be because breast feeding is a marker of exposures related to maternal characteristics and parent–child interaction.

Keywords: breast feeding; resilience; stress; longitudinal; HPA axis

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