Poster #92 - Breastfeeding Difficulties Predict Change in Mother–Infant Bonding from Birth to Age 6 Months

• In Event: 2-110 - Poster Session 07
  In Poster Session: PS 07 Section - Family Context & Processes

Integrative Statement

Introduction
Despite evidence that the intention to breastfeed is as predictive of infant health outcomes as successful breastfeeding (Raissian & Su, 2018), many mothers who intend to breastfeed but subsequently face difficulties struggle with their maternal identity and report feeling disconnected from their infant (Williamson et al., 2012). While difficulties in breastfeeding are most commonly reported immediately in the first month following birth (Scott et al., 2006), it is unclear whether potential difficulties in reported levels of bonding and connectedness with one’s infant persist after these early challenges. We followed 121 women from pregnancy until their infant reached age 6 months, conducting monthly assessments to examine mother–infant bonding across early life. We investigated whether difficulties in breastfeeding in mothers who intended to breastfeed would be associated with both initial levels of bonding and trajectories of bonding levels across the first six months of life.
Materials & Methods
Each month for the first six months following birth, 121 mothers of newborn infants (age=23-45 years, M=32.3±4.8; 56.6% White/Caucasian, 23.0% Asian, 10.7% Hispanic, 9.0% Multiracial, 0.8% African American) completed the Mother-to-Infant Bonding Scale (MIBS) and reported whether breastfeeding was more difficult than they had anticipated (1=yes, 0=no). Mothers who attempted to breastfeed (107) reported on breastfeeding difficulty at the initial post-birth assessment, and all participants completed the MIBS at least once. MIBS scores greater than 3 standard deviations from the mean were winsorized to the next closest value. We conducted linear mixed modeling to utilize the nested data structure (repeated observations within individuals), and examined both intercept (initial levels) and slope (change in bonding) as a function of breastfeeding difficulty.
Results
Setting aside breastfeeding difficulty, we found a small effect of age on bonding levels, such that bonding increased with infant age (β=.12). We then split the sample into two groups based on initial breastfeeding difficulty (i.e., difficulty breastfeeding [n=44] and no difficulty breastfeeding [n=63]). For illustrative purposes the first and last month of assessment are shown in Figure 1. At month 1, there was a main effect of breastfeeding difficulty (p<.001): mothers with difficulties breastfeeding reported significantly lower levels of bonding with their infant than did mothers who reported no difficulties. While mean levels of bonding increased over time more for mothers with initial breastfeeding difficulty, at month 6 a significant group difference remained (p=.043): mothers who reported initial breastfeeding difficulties reported significantly lower levels of bonding with their infant at month 6 than did mothers who reported no difficulties breastfeeding.
Conclusion
Mothers who reported difficulty breastfeeding in the first month also reported lower levels of initial bonding with their infants than did mothers who do not report difficulty breastfeeding. Importantly, however, bonding increased across the first 6 months of life, and differences between mother with and without initial difficulties breastfeeding decreased over time. These results suggest that the initial effects of breastfeeding challenges lead to reduced bonding with one’s infant, but that this decrease in bonding may be attenuated over time.

Authors

• Marissa Roth, Vanderbilt University
  Presenting Author

• Kathryn Humphreys, Vanderbilt University
  Non-Presenting Author

• Lucy S. King, Stanford University, Department of Psychology
  Non-Presenting Author

• Ian H. Gotlib, Stanford University, Department of Psychology
  Non-Presenting Author

• Thalia Robakis, Stanford University School of Medicine
  Non-Presenting Author