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. 2019 Apr 11;19(1):125.
doi: 10.1186/s12884-019-2264-0.

Mother-infant bonding is not associated with feeding type: a community study sample

Ilana S Hairston  1   2 , Jonathan E Handelzalts  3 , Tamar Lehman-Inbar  3 , Michal Kovo  4   5
Affiliations

Mother-infant bonding is not associated with feeding type: a community study sample

Ilana S Hairston et al. BMC Pregnancy Childbirth. .

Abstract

Background: Bonding refers to emotions and cognitions towards one's infant. Breastfeeding is believed to facilitate bonding, yet only a handful of studies have empirically tested this assertion. This study aimed to confirm whether a positive association between breastfeeding and bonding exists and whether breastfeeding may be protective against the negative consequences of mood and sleep disturbances on bonding.

Method: A cross-sectional survey was administered to a convenience sample of Israeli mothers of infants ages 1-9 months. The main outcome measures were breastfeeding history, bonding (Postpartum Bonding Questionnaire, PBQ), mood (Edinburgh Postnatal Depression Scale, EPDS) and sleep (Pittsburgh Sleep Quality Index, PSQI).

Results: Two hundred seventy-one mothers (21-46 years) completed the survey. 65.7% reported current breastfeeding, 22.1% past breastfeeding, 12.2% never nursed. The PBQ correlated with both the EPDS and PSQI. Breastfeeding was associated with greater daytime fatigue, but not with any other sleep problem, and was not associated with bonding. This negative result was confirmed with Bayesian analysis demonstrating that the probability for the null hypothesis was 4.5 times greater than the hypothesized effect. Further, hierarchical regression revealed a positive relationship between bonding, daytime fatigue and depression symptoms only among women who were currently breastfeeding.

Conclusions: These findings suggest that among healthy mothers, breastfeeding may not be a central factor in mother-infant bonding, nor is it protective against the negative impact of mood symptoms and bonding difficulties. Theoretical and methodological bases of these findings are discussed.

Keywords: Bayesian statistics; Nursing; Postpartum depression; Sleep disturbances.

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Conflict of interest statement

Ethics approval and consent to participate

The protocol and consent form for the study was approved by the Helsinki committee of Edith Wolfson Medical Center and the Institutional Review Board of the Academic College of Tel Aviv – Yaffo. Informed consent was obtained online in the following manner: The opening screen provided respondents with information regarding the aims and risks of the study, inclusion and exclusion criteria, and contact information of the authors. Upon reviewing this information, respondents were required to agree to participate to continue to the full survey. Agreement to participate and exclusionary questions were the only required responses in the survey.

Consent for publication

N/A

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Results of ANOVAs on the subscales of the PBQ (a. General Factor; b. Rejection and Anger; c. Anxiety about care). The ordinate reflects the mean scores on each of the subscales, for each of the three breastfeeding groups (black line, ‘Never breastfed’ | full grey line and circle ‘Past breastfed’ | hashed gray line ‘currently breastfeeding, exclusive or partial’)
Fig. 2
Fig. 2
Scatter plots of the relationship between bonding (ordinate) and PSQI component of ‘daytime dysfunction’ (abscissa of a-c), and bonding with EPDS (abscissa of d-f), each plot representing a different category of breastfeeding (never, past, current). The formulas in each plot are of relationship between the factors
See this image and copyright information in PMC

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