The Relationship between Life Stress and Breastfeeding Outcomes among Low-Income Mothers
Table 4
Stress logistic regression for breastfeeding duration and exclusivity outcomes modeling for breastfeeding cessation.
Cessation of any BF by 4 Weeks
Cessation of any BF by 13 Weeks
Cessation of Exclusiveg BF by 4 Weeks
Cessation of Exclusiveg BF by 13 Weeks
OR (95% CI)
-valuea
OR (95% CI)
-valuea
OR (95% CI)
-valuea
OR (95% CI)
-valuea
Financial Stressb [Reference]
Financial Stress [No]
0.02
0.29
0.18
0.80
Yes
2.76 (1.25, 6.06)
0.70 (0.36, 1.35)
1.51 (0.82, 2.78)
1.11 (0.51, 2.42)
Race/Ethnicity [White]
NS
NS
NS
0.02
Black
—
—
—
0.21 (0.08, 0.57)
Hispanic
—
—
—
0.41 (0.12, 1.41)
Mixed/Other
—
—
—
0.33 (0.08, 1.39)
Education [<High School]
0.04
NS
NS
NS
Unknown
4.21 (0.85, 20.83)
—
—
—
≥High School
2.54 (1.14, 5.64)
—
—
—
Breastfeeding Plan [None/Unknown/Up to 3 months]
<0.01
<0.01
<0.01
<0.01
4+ Months
2.89 (1.52, 5.50)
6.80 (3.71, 12.46)
4.94 (2.65, 9.24)
10.91 (3.54, 33.66)
Depressionc [No]
NS
<0.01
NS
NS
Yes
—
0.38 (0.19, 0.75)
—
—
BMI [<25.0]
NS
NS
0.01
NS
25.0–29.0
—
—
1.13 (0.58, 2.18)
—
>30.0
—
—
0.36 (0.17, 0.77)
—
Emotional Stressd Reference
Emotional Stress [No]
0.11
0.91
0.53
0.79
Yes
0.56 (0.27, 1.14)
1.04 (0.54, 1.99)
1.23 (0.65, 2.33)
0.89 (0.38, 2.09)
Race/Ethnicity [White]
NS
NS
NS
0.22
Black
—
—
—
0.23 (0.09, 0.61)
Hispanic
—
—
—
0.41 (0.12, 1.45)
Mixed/Other
—
—
—
0.26 (0.06, 1.22)
Breastfeeding Plan [None/Unknown/Up to 3 months]
<0.01
<0.01
<0.01
<0.01
4+ Months
2.82 (1.48, 5.39)
6.65 (3.60, 12.29)
4.56 (2.44, 8.52)
10.60 (3.45, 32.63)
Depressionc [No]
NS
0.02
NS
NS
Yes
—
0.45 (0.23–0.88)
—
BMI [<25.0]
NS
NS
0.02
NS
25.0–29.0
—
—
1.03 (0.52, 2.01)
—
>30.0
—
—
0.37 (0.17, 0.77)
—
Alcohol Use [Never/Not Now]
NS
0.03
NS
NS
Current Use
—
0.66 (0.46, 0.95)
—
—
Smoking [Never/Not Now]
NS
<0.01
NS
NS
Current Use
—
0.37 (0.17, 0.76)
—
—
Traumatic Stresse Reference
Traumatic Stress [No]
0.71
0.61
0.17
0.04
Yes
1.14 (0.57, 2.27)
0.84 (0.43, 1.64)
1.59 (0.82, 3.12)
2.95 (1.04, 8.38)
Mom Age
NS
0.04
NS
NS
Continuous
—
1.07 (1.00, 1.13)
—
Breastfeeding Plan [None/Unknown/Up to 3 months]
<0.01
<0.01
<0.01
<0.01
4+ Months
2.66 (1.41, 5.01)
7.24 (3.92, 13.39)
5.24 (2.78, 9.85)
12.50 (4.03, 38.77)
Depressionc [No]
NS
<0.01
NS
NS
Yes
—
0.38 (0.19, 0.76)
—
—
BMI [<25.0]
NS
NS
0.02
NS
25.0–29.0
—
—
1.11 (0.57, 2.17)
—
>30.0
—
—
0.40 (0.19, 0.83)
—
Smoking [Never/Not Now]
NS
<0.01
NS
NS
Current Use
—
0.37 (0.18, 0.77)
—
—
Partner-Associated Stressf Reference
Partner-Associated Stress [No]
0.11
0.30
0.79
0.11
Yes
1.71 (0.88, 3.30)
1.37 (0.76, 2.48)
1.08 (0.61, 1.93)
1.92 (0.86, 4.31)
Education [<High School]
<0.05
NS
NS
NS
Unknown
3.89 (0.77, 19.63)
—
—
—
≥High School
2.53 (1.14, 5.60)
—
—
—
Breastfeeding Plan [None/Unknown/Up to 3 months]
<0.01
<0.01
<0.01
<0.01
4+ Months
2.84 (1.51, 5.37)
7.39 (4.01, 13.63)
4.84 (2.61, 9.00)
11.46 (3.72, 35.36)
Depressionc [No]
NS
0.03
<0.05
NS
Yes
—
0.46 (0.24, 0.92)
0.50 (0.25, 0.99)
—
BMI [<25.0]
NS
NS
0.02
NS
25.0–29.0
—
—
1.09 (0.57, 2.11)
—
>30.0
—
—
0.38 (0.18, 0.80)
—
Smoking [Never/Not Now]
NS
<0.01
NS
NS
Current Use
—
0.37 (0.18, 0.77)
—
—
Note: Reference is “no” for all 4 types of stress. Modeling for breastfeeding cessation. OR score 1< indicates more likely to breastfeed; OR score 1> indicates less likely to breastfeed. Variables Included in Model: age (continuous), race, language, education, inner-city residence, breastfeeding plan, parity and breastfeeding, depression, BMI, alcohol use, smoking. Abbreviations: BF: Breastfeeding; NS: not significant.
aGlobal -value.
bFinancial stress defined as answering yes to one of the following occurring during or in the month after pregnancy: big problems with money, moved to a new address.
cSelf-reported depression during or right after pregnancy.
dEmotional stress defined as answering yes to one of the following occurring during or in the month after pregnancy: family member had serious accident/illness, husband/partner had serious accident/illness, husband/partner died, friend/relative died.
eTraumatic stress defined as answering yes to one of the following occurring during or in the month after pregnancy: stayed in a shelter or needed emergency shelter, physical fights with partner/husband or someone else, husband/partner had legal trouble and/or went to jail, mother had legal trouble and/or went to jail, someone very close had a problem with drinking or drugs.
fPartner-Associated stress defined as answering yes to one of the following occurring during or in the month after pregnancy: separated from husband/partner, argued with husband/partner more often, husband/partner said he did not want pregnancy.
gBreastfeeding exclusivity was defined as the infant receiving only breast milk and no other liquid or solid food. This calculated outcome was based on mothers self-report of length of breastfeeding (infant age when last received breastmilk) and age when the infant first received formula, other liquids cereal, or solid foods.
