The effect of mother-infant physical contact on breastfeeding responsiveness

Rates of breastfeeding in the US are lower than most countries (Victoria et al., 2016), and mothers who do breastfeed often feed in accordance to publicly recommended guidelines for frequency and duration of nursing sessions. Such restrictions neglect to account for infants’ capacities for communication and self-regulation, leading to mismatched responses to infants’ needs and potentially compromising the milk quality (Woolridge, 1995). Alternatively, responsive feeding – or feeding in response to infants’ cues – facilitates the potential for infants’ early biological capacity for communication and self-regulation (Wright, 1988). Above and beyond the many health benefits of breastmilk, responsive feeding specifically has been linked to decreased risk of malnutrition and obesity (Birch & Fischer, 1998; Black & Aboud, 2011; Bornstein & Tamis-LeMonda, 1989; Engle, Bently, & Pelto, 2000), and increased self-regulation and healthy eating behaviors (Wright, 1981; Wright, Fawcet, & Crow, 1980). Responsive feeding is also associated with decreased crying (Barr & Elias, 1988; Keller & Otto, 2009) secure attachment (Tharner et al., 2012) and improved cognitive outcomes (Fergussen, Beutrais, & Silva, 1982; Menkes, 1977; Rodgers, 1978; Taylor & Wadsworth, 1984). However, we know very little about the cultural, social, and psychological factors that may facilitate breastfeeding responsiveness.

The goal of the current project was to examine how mother-infant physical contact relates to responsiveness to feeding cues in the context of breastfeeding. In Study 1, responsiveness to hunger cues was measured with a feeding log, for which mothers recorded the position of the infant and the reason for feeding at each feeding session over three days.  We tested the hypothesis that mother-infant physical contact preceding a feeding session would be predictive of initiating a feeding because of early hunger cues (e.g., rooting, squirming) rather than late cues (i.e., crying) or adult-determined schedules. Given the profound health implications of breastfeeding – and on-demand breastfeeding specifically – understanding how culturally-mediated mother-infant interaction shapes breastfeeding behavior is a crucial and often overlooked component of public health efforts to increase breastfeeding success.