Breastfeeding Difficulties Predict Mothers’ Bonding with Their Infants from Birth to Age Six Months

Marissa C. Roth, Kathryn L. Humphreys, Lucy S. King, Ian H. Gotlib, Thalia K. Robakis

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objectives: We examined the association between breastfeeding difficulties and trajectories of bonding in the first 6 months postpartum. Methods: Each month for the first 6 months following birth, 121 mothers of newborn infants (age = 23–45 years, M = 32.31 ± 4.79, 57% White, 23% Asian, 11% Hispanic, 9% Multiracial, 1% Black/African American) were invited to complete self-assessments of bonding. At the first postpartum assessment, mothers who intended to breastfeed also reported whether breastfeeding was more difficult than they had anticipated. We conducted linear mixed modelling to test whether early breastfeeding difficulty was associated with bonding trajectories and examined whether effects remained when accounting for postnatal depression symptoms. Results: We found main effects of breastfeeding difficulty (β = − .20, 95% CI [− .34, − .06]) and postpartum month (β =.13, 95% CI [.07,.20]) on bonding. On average, women who reported breastfeeding difficulty reported lower bonding than women who did not (Cohen’s d = − 0.44, 95% CI [− 0.81, − 0.06]). Additional analyses indicated that, independent of breastfeeding difficulties, women who reported higher postnatal depressive symptoms across the first 6 months postpartum reported lower levels of bonding, on average. Further, within-individual decreases in postnatal depressive symptoms across the first six months were associated with relative improvements in bonding across this period. Conclusions for Practice: Our findings suggest that mothers who experience breastfeeding difficulties are at risk for reduced bonding with their infants in the first 6 months after birth. Moreover, while postnatal depressive symptoms are also associated with reduced bonding, the effect of breastfeeding difficulties on bonding persists over and above the effect of postnatal depressive symptoms.

Original languageEnglish
Pages (from-to)777-785
Number of pages9
JournalMaternal and Child Health Journal
Issue number5
StatePublished - May 2021
Externally publishedYes


  • Breastfeeding
  • Mother–infant bonding
  • Nursing
  • Postpartum


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