Prenatal anxiety, breastfeeding and child growth and puberty: linking evolutionary models with human cohort studies

Sinead English, India Wright, Verity Ashburn, Gemma Ford, Doretta Caramaschi

Research output: Contribution to journalArticle (Academic Journal)peer-review

13 Citations (Scopus)
79 Downloads (Pure)


Background: Stress experienced by mothers during pregnancy can have both immediate and long-term effects on child development, potentially mediated by breastfeeding.

Aim: Using a UK birth cohort study, we asked how maternal stress relates to breastfeeding and consequences for growth and puberty onset.

Subjects and methods: We analysed data from the Avon Longitudinal Study of Parents and Children, collected via questionnaires and clinic visits (N: 698–8,506). We used reports of prenatal anxiety, breastfeeding, early growth and age at menarche or first voice change. Confounding by maternal age, parity, smoking, education and body mass index (BMI) was considered.

Results: Mothers with higher levels of reported anxiety were less likely to breastfeed (Odds ratio (OR): 0.83, 95% confidence interval (CI): 0.71, 0.97). Breastfed infants had slower growth before weaning, although growth differences were unclear thereafter. Being breastfed for more than six months was associated with later puberty onset in females (2.76 months later than non-breastfed; CI: 0.9, 4.63), although the association was attenuated by confounders and BMI (1.51 months, CI: -0.38, 3.40). No association between breastfeeding and puberty onset in males was found.

Conclusion: Our studies fit results shown previously, and we consider these in light of evolutionary life history theory while discussing key challenges in such an approach.
Original languageEnglish
Pages (from-to)106-115
Number of pages10
JournalAnnals of Human Biology
Issue number2
Early online date20 May 2020
Publication statusE-pub ahead of print - 20 May 2020

Structured keywords



  • stress
  • lactation
  • breastfeeding
  • cohort study


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