{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:18:35Z","timestamp":1790615915789,"version":"4.1.0"},"reference-count":40,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Breastfeeding rates in the United Kingdom are low, and cumulative stressful life events (SLEs) experienced over time influence health behaviors including breastfeeding. Yet extant breastfeeding studies have neither considered cumulative SLEs, time-to-breastfeeding events, nor social support and pregnancy intention as moderators. We address these limitations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We analyzed a cross-section of 14,953 new mothers from the UK Millennium Cohort\u2019s first wave (10,001 initiated breastfeeding). We fit logistic and Cox proportional hazards regression models to assess associations between cumulative SLEs and breastfeeding initiation, and between cumulative SLEs and time to any\/exclusive breastfeeding (EBF) cessation. We also assessed pregnancy intention, emotional and financial support as moderators of the main association(s).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Cumulative SLEs were not significantly associated with breastfeeding initiation but directly associated with any\/exclusive breastfeeding cessation. Effects of \u22655 SLEs on EBF cessation were higher (HR\n                      <jats:sub>a<\/jats:sub>\n                      = 1.37; 95% confidence interval = 1.07\u20131.75) among mothers with unintended pregnancies versus planned pregnancies (HR\n                      <jats:sub>a<\/jats:sub>\n                      = 1.24; 0.98\u20131.58). Mothers with 3\u20134 SLEs faced a 64% risk of stopping EBF (HR\n                      <jats:sub>a<\/jats:sub>\n                      = 1.64; 0.99\u20132.87) among those without emotional support compared to a 10% risk among those with emotional support (HR\n                      <jats:sub>a<\/jats:sub>\n                      = 1.10; 1.00\u20131.21). SLEs affected initiation and any breastfeeding equally, regardless of pregnancy intention, emotional and financial support.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SLEs are detrimental to breastfeeding. Planned pregnancies and emotional support buffer adverse SLE effects on EBF but not initiation and any breastfeeding. To identify highly stressed mothers with low support who would benefit from EBF support, cumulative SLEs and pregnancy intention screenings should be integrated into routine prenatal\/obstetric care from 1 week postpartum.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253261490304","type":"journal-article","created":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:08:27Z","timestamp":1790402907000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association Between Cumulative Stressful Life Events and Breastfeeding Outcomes in the United Kingdom: The Modifying Roles of Pregnancy Intention and Social Support"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-6372","authenticated-orcid":false,"given":"Chinedu U.","family":"Obioha","sequence":"first","affiliation":[{"name":"Maternal and Child Health, Department of Family Science, University of Maryland, College Park, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2009.11.021"},{"key":"e_1_3_4_3_1","unstructured":"2.Global Breastfeeding Collective United Nations Children\u2019s Fund (UNICEF) World Health Organization (WHO). Global breastfeeding scorecard 2024: Meeting the global target for breastfeeding requires bold commitments and accelerated action by governments and donors. 2025. Available from: https:\/\/knowledge.unicef.org\/child-nutrition-and-development\/resource\/global-breastfeeding-scorecard-2024 [Last accessed: April18 2025]."},{"key":"e_1_3_4_4_1","unstructured":"3.Gov.UK. Research and analysis. Breastfeeding at 6 to 8 weeks: A comparison of methods. Office of Health Improvement and Disparities. 2023. Available from: https:\/\/www.gov.uk\/government\/publications\/breastfeeding-at-6-to-8-weeks-comparison-of-nhs-england-and-ohid-data\/breastfeeding-at-6-to-8-weeks-a-comparison-of-methods#:\u223c:text=In%202020%20to%202021%20the no%20breastfeeding%20(table%201) [Last accessed: May7 2025]."},{"key":"e_1_3_4_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.12626"},{"key":"e_1_3_4_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10903-014-0049-0"},{"key":"e_1_3_4_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13006-021-00380-6"},{"key":"e_1_3_4_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/902487"},{"key":"e_1_3_4_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2022.105604"},{"key":"e_1_3_4_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2019.0058"},{"key":"e_1_3_4_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2017.0200"},{"key":"e_1_3_4_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2017.1421929"},{"key":"e_1_3_4_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2007.00602.x"},{"key":"e_1_3_4_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2012.0010"},{"key":"e_1_3_4_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2018.11.012"},{"key":"e_1_3_4_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2022.0329"},{"key":"e_1_3_4_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/00221465211055993"},{"key":"e_1_3_4_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/Archinte.1993.00410180039004"},{"key":"e_1_3_4_19_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2276"},{"key":"e_1_3_4_20_1","unstructured":"19.Mann S. 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Relationship between unintended pregnancy and antenatal care use during pregnancy in Hadiya Zone, Southern Ethiopia. J Reprod Infertil 2019;20(1):42\u201351.","journal-title":"J Reprod Infertil"},{"key":"e_1_3_4_35_1","unstructured":"34.Samele CL-MH Zamperoni V Goldie I et al. Stress: Are we coping? 2018. Available from: https:\/\/www.mentalhealth.org.uk\/explore-mental-health\/publications\/stress-are-we-coping-report [Last accessed: July28 2025]."},{"key":"e_1_3_4_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0006-3223(03)00465-7"},{"key":"e_1_3_4_37_1","first-page":"1","volume-title":"Encyclopedia on Early Childhood Development","author":"Melhuish E","year":"2024","unstructured":"36.Melhuish E, , Belsky J, , Barnes J. Sure start and its evaluation in England. In: Tremblay RE, , Barr RG, , Peters RD, , Boivin M., eds. Encyclopedia on Early Childhood Development. 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