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Who Supports Breastfeeding Mothers?

An Investigation of Kin Investment in the United States

Abstract

Breastfeeding is one important form of maternal investment that is influenced by support from kin and non-kin. This paper investigates who provides support for breastfeeding mothers and their children, what type of support they provide, and how support impacts breastfeeding duration. The data were derived from a survey of 594 American mothers and were analyzed using quantitative methods, including Cox regression. Analyses indicate that mothers receive significant support, particularly from spouses and maternal grandmothers. More frequent breastfeeding discussions with La Leche League and maternal grandfathers were associated with longer duration, whereas discussions with physicians were associated with shorter breastfeeding duration. Results indicate that consulting others specifically about breastfeeding may influence breastfeeding decisions. The results are consistent with the idea that social support may influence breastfeeding duration and that some types of support are more influential than others. Furthermore, support persons should be educated about breastfeeding to prevent early weaning.

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References

  • Abrahams, S. W., & Labbok, M. H. (2009). Exploring the impact of the baby-friendly hospital initiative on trends in exclusive breastfeeding. International Breastfeeding Journal, 4, 11. doi:10.1186/1746-4358-4-11.

    Article  Google Scholar 

  • Atabay, E., Moreno, G., Nandi, A., Kranz, G., Vincent, I., Assi, T., et al. (2015). Facilitating working mothers’ ability to breastfeed: global trends in guaranteeing breastfeeding breaks at work, 1995-2014. Journal of Human Lactation, 3, 81–88.

    Article  Google Scholar 

  • Aubel, J., Touré, I., & Diagne, M. (2004). Senegalese grandmothers promote improved maternal and child nutrition practices: the guardians of tradition are not averse to change. Social Science and Medicine, 59, 945–959.

    Article  Google Scholar 

  • Avery, A. B., & Magnus, J. H. (2011). Expectant fathers and mothers perceptions of breastfeeding and formula feeding: a focus group study in three US cities. Journal of Human Lactation, 27, 147–154.

    Article  Google Scholar 

  • Bai, D. L., Fong, D. Y. T., & Tarrant, M. (2015). Previous breastfeeding experience and duration of any and exclusive breastfeeding among multiparous mothers. Birth, 42, 70–77.

    Article  Google Scholar 

  • Bentley, M. E., Caulfield, L. E., Gross, S. M., Bronner, Y., Jensen, J., Kessler, L. A., & Paige, D. M. (1999). Sources of influence on intention to breastfeed among African-American women at entry to WIC. Journal of Human Lactation, 15, 27–34.

    Article  Google Scholar 

  • Bernard, H. R. (2011). Research methods in anthropology: Qualitative and quantitative approaches. Lanham, MD: Altamira.

  • Bishop, D., Meyer, B., Schmidt, T., & Gray, B. (2009). Differential investment behavior between grandparents and grandchildren: the role of paternity uncertainty. Evolutionary Psychology, 7, 66–77.

    Article  Google Scholar 

  • Borgerhoff Mulder, M. (2007). Hamilton’s rule and kin competition: the Kipsigis case. Evolution and Human Behavior, 28, 299–262.

    Article  Google Scholar 

  • Cadwell, K. (2002). Reclaiming breastfeeding for the United States. Sudbury: Jones and Bartlett.

    Google Scholar 

  • Centers for Disease Control and Prevention (CDC). (2015). Breastfeeding among U.S. children born 2002–2012, CDC National Immunization Surveys. Retrieved from http://www.cdc.gov/breastfeeding/data/nis_data/index.htm.

  • Chrastil, E. R., Getz, W. M., Euler, H. A., & Starks, P. T. (2006). Paternity uncertainty overrides sex chromosome selection for preferential grandparenting. Evolution and Human Behavior, 27(3), 206–223.

    Article  Google Scholar 

  • Clifford, J., & McIntyre, E. (2008). Who supports breastfeeding? Breastfeeding Review, 16, 9–19.

    Google Scholar 

  • Coall, D. A., & Hertwig, R. (2010). Grandparental investment: past, present, and future. Behavioral and Brain Sciences, 33, 1–59.

    Article  Google Scholar 

  • Danielsbacka, M., Tanskanen, A. O., Jokela, M., & Rotkirch, A. (2011). Grandparental child care in Europe: evidence for preferential investment in more certain kin. Evolutionary Psychology, 9, 3–24.

    Article  Google Scholar 

  • Dermer, A., Eglash, A., Hineman, E., Isley, A., Lyon, C., Meyers, D. .… Wood, J.K. (2008). Family physicians supporting breastfeeding (position paper). American Academy of Family Physicians (AAFP). http://www.aafp.org/about/policies/all/breastfeeding-support.html.

  • Derosas, R. (2002). Fatherless families in nineteenth century Venice. In R. Derosas & M. Oris (Eds.), When dad died: individuals and families coping with distress in past societies (pp. 421–452). Bern: Peter Lang.

    Google Scholar 

  • Dowling, S., & Brown, A. (2013). An exploration of the experiences of mothers who breastfeed long-term: what are the issues and why does it matter? Breastfeeding Medicine, 8, 45–52.

    Article  Google Scholar 

  • Emmott, E. H., & Mace, R. (2015). Practical support from fathers and grandmothers is associated with lower levels of breastfeeding in the UK millennium cohort study. PloS One, 10, e0133547.

    Article  Google Scholar 

  • Euler, H. A., & Michalski, R. L. (2007). Grandparental and extended kin relationships. In C. Salmon & T. K. Shackelford (Eds.), Family relationships: an evolutionary perspective (pp. 185–204). Oxford: Oxford University Press.

    Google Scholar 

  • Fein, S. B., & Roe, B. (1998). The effect of work status on initiation and duration of breast-feeding. American Journal of Public Health, 88, 1042–1046.

    Article  Google Scholar 

  • Forster, D. A., McLachlan, H. L., & Lumley, J. (2006). Factors associated with breastfeeding at six months postpartum in a group of Australian women. International Breastfeeding Journal, 1, 18. doi:10.1186/1746-4358-1-18.

    Article  Google Scholar 

  • Foss, K. A., & Southwell, B. G. (2006). Infant feeding and the media: the relationship between Parents’ Magazine content and breastfeeding, 1972–2000. International Breastfeeding Journal, 1, 10. doi:10.1186/1746-4358-1-10.

    Article  Google Scholar 

  • Fox, M., Sear, R., Beise, J., Ragsdale, G., Voland, E., & Knapp, L. A. (2009). Grandma plays favourites: X-chromosome relatedness and sex-specific childhood. Proceedings of the Royal Society B: Biological Sciences, 277, 567–573.

  • Geary, D. C. (2001). Evolution of paternal investment. In D. M. Buss (Ed.), The handbook of evolutionary psychology (pp. 483–505). Hoboken: John Wiley and Sons.

    Google Scholar 

  • Geraghty, S. R., Riddle, S. W., & Shaikh, U. (2008). The breastfeeding mother and the pediatrician. Journal of Human Lactation, 24(3), 335–339.

    Article  Google Scholar 

  • Guzman, L. (1999). The use of grandparents as child care providers (NSFH working paper, no. 84). Madison: Center for Demography and Ecology, University of Wisconsin-Madison.

  • Hank, K., & Buber, I. (2009). Grandparents caring for their grandchildren: findings from the 2004 survey of health, ageing and retirement in Europe. Journal of Family Issues, 30, 53–73.

    Article  Google Scholar 

  • Hawkes, K., O’Connell, J. F., Blurton Jones, N. G., Alvarez, H., & Charnov, E. L. (2000). The grandmother hypothesis and human evolution. In Human behavior and adaptation: an anthropological perspective (pp. 371–395). Hawthorne: Aldine.

    Google Scholar 

  • Heath, K. M. (2003). The effects of kin propinquity on infant mortality. Social Biology, 50, 270–280.

    Google Scholar 

  • Heinig, M. J., Ishii, K. D., Bañuelos, J. L., Campbell, E., Loughlin, C. O., Elvia, L., et al. (2009). Sources and acceptance of infant-feeding advice among low-income women. Journal of Human Lactation, 25, 163. doi:10.1177/0890334408329438.

    Article  Google Scholar 

  • Henderson, C. E., Haslip, B., Sanders, L. M., & Louden, L. (2009). Grandmother-grandchild relationship quality predicts psychological adjustment among youth from divorced families. Journal of Family Issues, 30, 1245–1264.

    Article  Google Scholar 

  • Hewlett, B. S. (1991). Intimate fathers: the nature and context of aka pygmy paternal infant care. Ann Arbor: University of Michigan Press.

    Book  Google Scholar 

  • Hill, K., & Hurtado, A. M. (1996). Ache life history: the ecology and demography of a foraging people. New York: Aldine de Gruyter.

    Google Scholar 

  • Hrdy, S. B. (1999). Mother nature. New York: Pantheon.

    Google Scholar 

  • Hrdy, S. B. (2004). Comes the child before the man: how cooperative breeding and prolonged postweaning dependence shaped human potential. In B. S. Hewlett & M. E. Lamb (Eds.), Hunter-gatherer childhoods: evolutionary, developmental and cultural perspectives (pp. 65–91). New Brunswick: Aldine/Transaction.

    Google Scholar 

  • Hurtado, A. M., & Hill, K. R. (1992). Paternal effect on offspring survivorship among Ache and Hiwi hunter-gatherers: implications for modeling pair-bond stability. In B. S. Hewlett (Ed.), Father-child relations: cultural and biosocial contexts (pp. 31–55). New York: Aldine de Gruyter.

    Google Scholar 

  • Ingram, J., Johnson, D., & Hamid, N. (2002). South Asian grandmothers influence on breast feeding in Bristol. Midwifery, 19, 318–327.

    Article  Google Scholar 

  • Ivey, P. K. (2000). Cooperative reproduction in Ituri forest hunter-gatherers: who cares for Efe infants? Current Anthropology, 41, 856–866.

    Google Scholar 

  • Kaplan, E. L., & Meier, P. (1958). Nonparametric estimation from incomplete observations. Journal of the American Statistical Association, 53, 457–485.

    Article  Google Scholar 

  • Kaplan, H., Hill, K., Lancaster, J., & Hurtado, A. (2000). A theory of human life history evolution: diet, intelligence, and longevity. Evolutionary Anthropology, 9, 156–185.

    Article  Google Scholar 

  • Kaptijn, R., Thomese, F., van Tilburg, T. G., & Liefbroer, A. C. (2010). How grandparents matter: support for the cooperative breeding hypothesis in a contemporary Dutch population. Human Nature, 21, 393–405.

    Article  Google Scholar 

  • Kendall-Tackett, K. A., & Sugarman, M. (1995). The social consequences of long-term breastfeeding. Journal of Human Lactation, 11, 179–183.

    Article  Google Scholar 

  • Kramer, K. L. (2010). Commentary: intergenerational transfers and the cost of allomothering in traditional societies. Behavioral and Brain Sciences, 33, 30–31.

    Article  Google Scholar 

  • Lavender, T., McFadden, C., & Baker, L. (2006). Breastfeeding and family life. Maternal & Child Nutrition, 2, 145–155.

    Article  Google Scholar 

  • Leonetti, D. L., Nath, D. C., & Hemam, N. S. (2007). In-law conflict. Women’s reproductive lives and the roles of their mothers and husbands among the matrilineal Khasi. Current Anthropology, 48, 861–890.

    Article  Google Scholar 

  • Li, R., Darling, N., Maurice, E., Barker, L., & Laurence, M. (2005). Breastfeeding rates in the United States by characteristics of the child, mother, or family: the 2012 National Immunization Survey. Pediatrics, 115, e31–e37. doi:10.1542/peds.2004-0481.

    Article  Google Scholar 

  • Libbus, M. K., & Bullock, L. F. C. (2002). Breastfeeding and employment: an assessment of employer attitudes. Journal of Human Lactation, 18(3), 247–251.

    Article  Google Scholar 

  • Lussier, G., Deater-Deckard, K., Dunn, J., & Davies, L. (2002). Support across two generations: Children’s closeness to grandparents following parental divorce and remarriage. Journal of Family Psychology, 16(3), 363–376.

    Article  Google Scholar 

  • Mace, R. (2000). Evolutionary ecology of human life history. Animal Behaviour, 59, 1–10.

    Article  Google Scholar 

  • Mace, R. (2013). Cooperation and conflict between women in the family. Evolutionary Anthropology, 22, 251–258.

    Article  Google Scholar 

  • Marlowe, F. W. (1999). Male care and mating effort among Hadza foragers. Behavioral Ecology and Sociobiology, 46(1), 57–64.

    Article  Google Scholar 

  • Marlowe, F. W. (2003). A critical period for provisioning by Hadza men: implications for pair bonding. Evolution and Human Behavior, 24, 217–229.

    Article  Google Scholar 

  • Meehan, C. L., Helfrecht, C., & Quinlan, R. J. (2014). Cooperative breeding and aka children’s nutritional status: is flexibility key? American Journal of Physical Anthropology, 153, 513–525.

    Article  Google Scholar 

  • Michalski, R. L., & Shackelford, T. K. (2005). Grandparental investment as a function of relational uncertainty and emotional closeness with parents. Human Nature, 16, 293–305.

    Article  Google Scholar 

  • Nagy, E., Orvos, H., Pal, A., Kovacs, L., & Loveland, K. (2001). Breastfeeding duration and previous breastfeeding experience. Acta Paediatrica, 7, 51–56.

    Google Scholar 

  • Natland, S. T., Andersen, L. F., Ivar, T., Nilsen, L., Forsmo, S., & Jacobsen, G. W. (2012). Maternal recall of breastfeeding duration twenty years after delivery. BMC Medical Research Methodology, 12, 179. doi:10.1186/1471-2288-12-179.

    Article  Google Scholar 

  • Pashos, A. (2000). Does paternal uncertainty explain grandparental solicitude? A cross-cultural study in Greece and Germany. Evolution and Human Behavior, 21(2), 97–109.

    Article  Google Scholar 

  • Pilkauskas, N. V. (2014). Breastfeeding initiation and duration in coresident grandparent, mother and infant households. Maternal and Child Health Journal, 18, 1955–1963.

    Article  Google Scholar 

  • Pollet, T. V., Nettle, D., & Nelissen, M. (2006). Contact frequencies between grandparents and grandchildren in a modern society: estimates of the impact of paternity uncertainty. Journal of Cultural and Evolutionary Psychology, 4(3–4), 203–213.

    Article  Google Scholar 

  • Pollet, T. V., Nelissen, M., & Nettle, D. (2009). Lineage based differences in grandparental investment: evidence from a large British cohort study. Journal of Biosocial Science, 41, 355–379.

    Article  Google Scholar 

  • Rempel, L. A. (2004). Factors influencing the breastfeeding decisions of long-term breastfeeders. Journal of Human Lactation, 20, 306–318.

    Article  Google Scholar 

  • Robert, E., Coppieters, Y., Swennen, B., & Dramaix, M. (2014). Breastfeeding duration: a survival analysis-data from a regional immunization survey. BioMed Research International. doi:10.1155/2014/529790.

    Google Scholar 

  • Scelza, B. A. (2010). Fathers’ presence speeds the social and reproductive careers of sons. Current Anthropology, 51, 295–303.

    Article  Google Scholar 

  • Scott, J. A., Binns, C. W., Oddy, W. H., & Graham, K. I. (2006). Predictors of breastfeeding duration: evidence from a cohort study. Pediatrics, 117, e646–e655. doi:10.1542/peds.2005-1991.

    Article  Google Scholar 

  • Sear, R., & Coall, D. (2011). How much does family matter? Cooperative breeding and the demographic transition. Population and Development Review, 37, 81–112.

    Article  Google Scholar 

  • Sear, R., & Mace, R. (2008). Who keeps children alive? A review of the effects of kin on child survival. Evolution and Human Behavior, 29, 1–18.

    Article  Google Scholar 

  • Sear, R., Mace, R., & McGregor, I. A. (2000). Maternal grandmothers improve the nutritional status and survival of children in rural Gambia. Proceedings of the Royal Society of London B: Biological Sciences, 267, 461–467.

  • Shenk, M. K., & Scelza, B. A. (2012). Paternal investment and status-related child outcomes: timing of father’s death affects offspring success. Journal of Biosocial Science, 44(05), 549–569.

    Article  Google Scholar 

  • Snopkowski, K., & Sear, R. (2013). Kin influences on fertility in Thailand: effects and mechanisms. Evolution and Human Behavior, 34, 130–138.

    Article  Google Scholar 

  • Snopkowski, K., & Sear, R. (2015). Grandparental help in Indonesia is directed preferentially towards needier descendants: a potential confounder when exploring grandparental influences on child health. Social Science & Medicine, 128, 105–114.

    Article  Google Scholar 

  • Tanskanen, A. O., & Danielsbacka, M. (2012). Beneficial effects of grandparental involvement vary by lineage in the UK. Personality and Individual Differences, 53, 985–988.

    Article  Google Scholar 

  • Thomese, F., & Liefbroer, A. C. (2013). Child care and child births: the role of grandparents in the Netherlands. Journal of Marriage and Family, 75, 403–421.

    Article  Google Scholar 

  • Thulier, D., & Mercer, J. (2009). Variables associated with breastfeeding duration. Journal of Obstetric, Gynecologic, and Neonatal Nursing, 38, 259–268.

    Article  Google Scholar 

  • Vandell, D. L., McCarney, K., Tresch Owen, M., Booth, C., & Clarke-Stewart, A. (2004). Variations in child care by grandparents during the first three years. Journal of Marriage and Family, 65(2), 375–381.

    Article  Google Scholar 

  • Wambach, K., Campbell, S. H., Gill, S. L., Dodgson, J. E., Abiona, T. C., & Heinig, M. J. (2005). Clinical lactation practice: 20 years of evidence. Journal of Human Lactation, 21, 245–258.

    Article  Google Scholar 

  • Wolf, J. H. (2003). Low breastfeeding rates and public health in the United States. American Journal of Public Health, 93, 2000–2010.

    Article  Google Scholar 

  • Yamaguchi, K. (1991). Event history analysis. Newbury Park: Sage.

    Google Scholar 

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Acknowledgments

Thanks to Mary Shenk, Lisa Sattenspiel, Robert Walker, David Nolin, Jonathan Cisco, and the many mothers who completed the survey.

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Correspondence to Jayme Cisco.

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Cisco, J. Who Supports Breastfeeding Mothers? . Hum Nat 28, 231–253 (2017). https://doi.org/10.1007/s12110-017-9286-y

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Keywords

  • Parenting
  • Breastfeeding
  • Maternal investment
  • Kin investment
  • Social support