Page, A. E., Emmott, E. H., and Myers, S. (2nd Revisions) Testing the buffering hypothesis: breastfeeding problems, cessation and social support. OSF Pre-print: https://osf.io/byf5g/.
Objectives: Physical breastfeeding problems can lead women to terminate breastfeeding earlier than planned. In high-income countries, breastfeeding problems have been attributed to the cultural and individual “inexperience” of breastfeeding, ultimately leading to lower breastfeeding rates. Yet, cross-cultural evidence suggests breastfeeding problems still occur in contexts where breastfeeding is common, prolonged and seen publicly. This suggests breastfeeding problems are not unusual and do not necessarily lead to breastfeeding cessation. Having evolved a cooperative childrearing system, what matters for breastfeeding continuation may be the availability of social support during the postnatal period. Here, we test the hypothesis that social support buffers mothers from the negative impact breastfeeding problems have on duration. Methods: We run cox models on a sample of 566 UK mothers who completed a retrospective online survey about infant feeding and social support in 2017-2018. Results: Breastfeeding problems were important predictors of cessation; however, the direction of the effect was dependent on the type of problem. These relationships were also moderated by informational, practical and emotional support from a range of supporters. Helpful support for discomfort issues (blocked ducts, too much milk) significantly reduced the hazard of cessation, as predicted. However, helpful support for reported milk insufficiency increased the hazard of cessation. Conclusions: Experiencing breastfeeding problems is the norm, but its impact may be mitigated via social support. Working from an interdisciplinary approach, our results highlight that a wide range of supporters who provide different types of support have potential to influence maternal breastfeeding experience.