Background It is a priority for public health professionals to improve global breastfeeding rates, which have remained low in Western countries for more than a decade. Few researchers have addressed how maternal perceptions of birth experiences affect infant feeding methods. Furthermore, mixed results have been shown in research regarding breastfeeding and mother-child bonding, and many studies are limited by small sample sizes, representing a need for further investigation. Purpose We aimed to examine the relationship between subjective birth experiences and breastfeeding outcomes, and explored whether breastfeeding affected mother-infant bonding. Methods 3,080 mothers up to three years postpartum completed a cross – sectional survey. Results Mothers who had more positive birth experiences were more likely to report breastfeeding their babies. Moreover, mothers who perceived their birth as more positive were more likely to breastfeed their child for a longer period (over 9 months) than those who had more negative experiences. In line with recent research, breastfeeding behaviours were not associated with reported mother-infant bonding. Conclusions Mothers who reported better birth experiences were most likely to breastfeed, and breastfeed for longer. We find no evidence to suggest that feeding methods are associated with bonding outcomes.

In their recent paper published in JCPP, Bilgin and Wolke (2020a) argue that leaving an infant to ‘cry it out’, rather than responding to the child’s cries, had no adverse effects on mother–infant attachment at 18 months. This finding opposes evidence across a wide range of scientific fields. Here, we outline several concerns with the article and argue against some of the authors’ strong claims, which have already gained media attention, including a report on the NHS website. We suggest that the authors’ conclusions should be considered one piece of a larger scientific whole, where ‘cry it out’ seems, overall, to be of detriment to both attachment and development. Crucially, we are concerned that this study has issues regarding power and other analytical decisions. More generally, we fear that the authors have overstated their findings and we hope that members of the public do not alter their parenting behaviours in line with such claims without further research into this controversial topic.

Attachment styles in individuals with autism are not well understood, and research into the topic is limited to date. Authors regularly utilise standardised measures to classify attachment in adulthood, and this is the case for research with neurotypical and autistic populations. Here, we argue that there may be fundamental problems with using such measures, developed for neurotypical populations, in order to quantify attachment in those with autism. Crucially, such tools may be unable to differentiate between autistic behaviours and behaviours associated with insecure attachment styles. Furthermore, many studies which have investigated attachment and autism may lack sufficient statistical power due to the use of time-consuming attachment interviews or student populations which typically do not contain sufficient numbers of adults with autism. We argue that it is essential that measures are developed which accurately distinguish between insecure attachment styles and behaviours associated with autism, with the goal of better understanding attachment in those with autism for both parental and romantic relationships.

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