Breastfeeding, sensitivity, and attachment
Breastfeeding, sensitivity, and attachment
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DOI：
10.1542/peds.2005-2916
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发表时间：
2006-11-01
期刊：
影响因子：
8
通讯作者：
Gronwaldt, Virginia
中科院分区：
文献类型：
--
作者：
Britton, John R.;Britton, Helen L.;Gronwaldt, Virginia
目标。我们的目的是验证母乳喂养与增强的母婴依恋及其之前的母亲敏感性相关的假设。在妊娠32周至产后12个月期间，对152名母亲进行了问卷调查，评估了母乳喂养的意图和做法。3月龄时采用《护理儿童评估卫星训练喂养量表》线索敏感性子量表测量母亲早期敏感性，6月龄时采用《护理儿童评估卫星训练喂养量表》测量母婴互动质量。在12个月时采用Ainsworth奇异情境量表评估依恋的安全性。依恋安全和母乳喂养实践之间的直接关系尚未确定。6个月时的母婴互动质量，而不是喂养类型，预测了依恋的安全性。然而，选择母乳喂养的母亲在产后3个月与婴儿的二元互动中表现出比选择奶瓶喂养的母亲更高的敏感性，并且产前母乳喂养的预期持续时间与产后3个月的敏感性相关。虽然通径分析未能证明早期母乳喂养持续时间对敏感性或安全性的贡献，但它确实证实了产前母乳喂养意图与敏感性介导的依恋安全性之间存在显著的路径。此外，多变量分析显示，母乳喂养母亲的早期敏感性是第一年任何母乳喂养和纯母乳喂养持续时间的独立预测因子。虽然婴儿时期二元互动的质量，而不是喂养方式，是依恋安全的预测因素，但选择母乳喂养的母亲在婴儿早期表现出更高的敏感性，这反过来可能会促进安全的依恋。在母乳喂养的母亲中，较高的敏感性与产后第一年母乳喂养时间较长有关。这些发现表明依恋安全感和母乳喂养之间存在联系。
OBJECTIVE. Our goal was to test the hypothesis that breastfeeding is associated with enhanced infant-mother attachment and its antecedent maternal sensitivity.METHODS. Breastfeeding intent and practice were assessed by questionnaires administered to 152 mothers between 32 weeks of gestation and 12 months postpartum. Early maternal sensitivity was measured by the Sensitivity to Cues subscale of the Nursing Child Assessment Satellite Training Feeding Scale at 3 months, and quality of the mother-infant interaction was measured by the Nursing Child Assessment Satellite Training Feeding Scale at 6 months. Security of attachment was evaluated by the Ainsworth Strange Situation at 12 months.RESULTS. A direct relationship between attachment security and breastfeeding practice was not identified. The quality of the mother-infant interaction at 6 months, rather than the type of feeding, predicted security of attachment. However, mothers who chose to breastfeed displayed greater sensitivity in dyadic interactions with their infants 3 months postnatally than those who chose to bottle feed, and intended breastfeeding duration prenatally correlated with sensitivity 3 months postpartum. Although a path analysis failed to demonstrate contributions of early breastfeeding duration to either sensitivity or security, it did substantiate a significant path between prenatal breastfeeding intent and attachment security mediated by sensitivity. In addition, multivariate analyses revealed that early sensitivity among breastfeeding mothers was an independent predictor of the duration of any and exclusive breastfeeding during the first year.CONCLUSIONS. Although the quality of the dyadic interaction in infancy, rather than feeding type, is predictive of attachment security, mothers who choose to breastfeed display enhanced sensitivity during early infancy that, in turn, may foster secure attachment. Among breastfeeding mothers, higher sensitivity is associated with longer duration of breastfeeding during the first postpartum year. These findings suggest a link between attachment security and breastfeeding.