Exclusive Breastfeeding Is Not Associated with Maternal–Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity

Abstract

It is important to clarify how the breastfeeding method affects women’s mental health, and how women’s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants’ breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal–infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.

Association of Maternal Mood Symptoms in Pregnancy with Exclusive Breastfeeding at Six Weeks Postpartum: A Cross-Sectional Study

“…A possible explanation for the difference in results could be that they are limited to a point in the perinatal period, regardless of the pregnancy period. In addition, our ndings demonstrating that anxiety disorders during pregnancy are not signi cantly associated with EBF is consistent with those of previous studies [15,23,24]. However, a North Carolina study reported that anxiety symptoms were associated with earlier introduction of formula supplementation and cessation of breastfeeding [25].…”

“…Similarly, our research also indicated that EBF was negatively affected by depression during pregnancy. However, Shari et al [13] and Fukui et al [23] reported that depression was not associated with failure to breastfeed exclusively. A possible explanation for the difference in results could be that they are limited to a point in the perinatal period, regardless of the pregnancy period.…”

Identification of Bonding Difficulties in the Peripartum Period Using the Mother-to-Infant Bonding Scale-Japanese Version and Its Tentative Cutoff Points

“…This study was part of the Perinatal Mental Health Research Project. [14][15][16][17][18] In this study, we conducted a largescale questionnaire survey in cooperation with the Department of Obstetrics and Gynecology, the Niigata University Medical and Dental Hospital, and 33 associated obstetric institutions in Niigata Prefecture, Japan, between March 2017 and March 2021. We recruited pregnant women, as previously described.…”

“…We recruited pregnant women, as previously described. [14][15][16][17][18] In brief, we included pregnant Japanese women aged 18 years or older and excluded those with serious physical complications, serious pregnancy complications, or severe psychiatric disorders (eg, severe schizophrenia or severe depression).…”

“…The MIBS-J is widely used in Japan, 9,[11][12][13][14][15][16][17][18] and the Japanese Society of Psychiatry and Neurology and the Japanese Society of Obstetrics and Gynecology 25 recommend that the MIBS-J is administered to pregnant women during antenatal and postnatal checkups. Matsunaga et al 11 proposed that midwives follow mothers with MIBS-J scores of 4 or more at discharge from a gynecological ward until community health centers provide home visiting services.…”