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Poster #132 - Breastfeeding and room-sharing practices: Mother’s attachment style as a predictor

Thu, March 21, 12:30 to 1:45pm, Baltimore Convention Center, Floor: Level 1, Exhibit Hall B

Integrative Statement

Background: The American Academy of Pediatrics and the World Health Organization have issued recommendations about infant feeding practices and sleeping arrangements, because of their significant implications for infants’ health, safety, and development. These recommendations call for exclusive breastfeeding, as well as parent-infant room-sharing, for the first six months. However, a striking number of parents do not follow these recommended practices. This lack of adherence to pediatric guidelines demands exploration of factors that might predict (a) whether or not parents decide to engage in these behaviors and (b) how these behaviors change over the first months of parenthood.

Objective: To prospectively investigate mothers’ own adult attachment style as predictor of the initiation and course of breastfeeding and room-sharing practices during the infant’s first 6 months.

Study Design: This study included 193 mother–infant dyads living in the Netherlands. During the final weeks of pregnancy, mothers completed a questionnaire measure of attachment style. For the first six months of the infant’s life, mothers used the diaries to provide data on feeding practices (weekly diary) and sleeping arrangements (daily diary). Latent growth curve modeling was used to examine trajectories of breastfeeding and room-sharing and to test whether mothers’ own adult attachment style predicted the initiation and course of these behaviors, adjusting for covariates (selected a priori: maternal age, maternal educational level, infant sex, infant birth weight, number of siblings, and infant age entering non-parental care).

Results: Mothers with higher attachment avoidance showed faster decreases in breastfeeding than less avoidant mothers (b = -1.39, SE = .52, p < .01). Mothers with greater attachment anxiety were less likely to initiate room-sharing after childbirth compared to less anxious mothers (b = -7.45, SE = 3.76, p < .05), though this effect was reduced to a trend after covariates were introduced into the model.

Conclusions: The present results identify mothers’ adult attachment style as a predictor of breastfeeding and room-sharing initiation and course. As such, these findings have important implications for pediatric settings. Understanding key predictors of maternal breastfeeding and room-sharing can improve infant health and safety worldwide. Maternal attachment style may be a relevant psychosocial contributor to these protective behaviors, and could be incorporated into interventions aimed at promoting these behaviors. The use of prospective diary methods also represents a significant methodological advance over prior work that relied on retrospective reports.

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