Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1997 October; 90(10): 551–559.
PMCID: PMC1296597

Extreme attitudes to body shape, social and psychological factors and a reluctance to breast feed. ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood.


Despite widespread advocacy of breast feeding, many babies are breast fed only briefly, if at all. Mothers' decisions on how to feed are often made before the birth; so we have sought demographic, social and psychological factors that might be amenable to intervention during pregnancy. In the Avon Longitudinal Study of Pregnancy and Childhood about 12,000 women completed questionnaires in pregnancy. Univariate analyses were carried out to establish which factors were related to breast feeding intentions. All significant factors in univariate analyses were entered into logistic regression analyses. Demographic characteristics independently related to intentions to breast feed included older maternal age, more maternal education, primiparity and not smoking; in previous work all these had been associated with actual feeding behaviour. Social relationship variables had a small influence. Of the psychological variables, a notable finding was that women who were preoccupied with their body shape and those who expressed controlling, less child-centred, responses to managing an infant in the postnatal months were less likely to express intentions to breast feed. Depression did not predict breast feeding intentions once the other factors had been taken into account. Health care professionals may be able to intervene to increase breast feeding by making routine enquiries during antenatal care and targeting appropriate subgroups.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.2M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Howie PW, Forsyth JS, Ogston SA, Clark A, Florey CD. Protective effect of breast feeding against infection. BMJ. 1990 Jan 6;300(6716):11–16. [PMC free article] [PubMed]
  • Wright AL, Holberg CJ, Martinez FD, Morgan WJ, Taussig LM. Breast feeding and lower respiratory tract illness in the first year of life. Group Health Medical Associates. BMJ. 1989 Oct 14;299(6705):946–949. [PMC free article] [PubMed]
  • Pollock JI. Long-term associations with infant feeding in a clinically advantaged population of babies. Dev Med Child Neurol. 1994 May;36(5):429–440. [PubMed]
  • Lucas A, Morley R, Cole TJ, Gore SM, Lucas PJ, Crowle P, Pearse R, Boon AJ, Powell R. Early diet in preterm babies and developmental status at 18 months. Lancet. 1990 Jun 23;335(8704):1477–1481. [PubMed]
  • Lucas A, Morley R, Cole TJ, Lister G, Leeson-Payne C. Breast milk and subsequent intelligence quotient in children born preterm. Lancet. 1992 Feb 1;339(8788):261–264. [PubMed]
  • Lanting CI, Fidler V, Huisman M, Touwen BC, Boersma ER. Neurological differences between 9-year-old children fed breast-milk or formula-milk as babies. Lancet. 1994 Nov 12;344(8933):1319–1322. [PubMed]
  • van Wezel-Meijler G, Wit JM. The offspring of mothers with anorexia nervosa: a high-risk group for undernutrition and stunting? Eur J Pediatr. 1989 Nov;149(2):130–135. [PubMed]
  • Stein A, Woolley H, Cooper SD, Fairburn CG. An observational study of mothers with eating disorders and their infants. J Child Psychol Psychiatry. 1994 May;35(4):733–748. [PubMed]
  • Cooper PJ, Murray L, Stein A. Psychosocial factors associated with the early termination of breast-feeding. J Psychosom Res. 1993;37(2):171–176. [PubMed]
  • Alder EM, Cox JL. Breast feeding and post-natal depression. J Psychosom Res. 1983;27(2):139–144. [PubMed]
  • Easterbrooks MA, Goldberg WA. Toddler development in the family: impact of father involvement and parenting characteristics. Child Dev. 1984 Jun;55(3):740–752. [PubMed]
  • Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987 Jun;150:782–786. [PubMed]
  • Fairburn CG, Beglin SJ. Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord. 1994 Dec;16(4):363–370. [PubMed]
  • Stein A, Stein J, Walters EA, Fairburn CG. Eating habits and attitudes among mothers of children with feeding disorders. BMJ. 1995 Jan 28;310(6974):228–228. [PMC free article] [PubMed]
  • Graham H. Women's smoking: government targets and social trends. Health Visit. 1993 Mar;66(3):80–82. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press