Maternal Milk Provision in the Neonatal Intensive Care Unit and Mother-Infant Emotional Connection for Preterm Infants.

Clare Viglione,Wendy Timpson,Cindy H Liu,Sara Cherkerzian,Mandy B Belfort,Lianne J Woodward

doi:10.3390/children9020296

Abstract

Maternal milk (MM) intake during neonatal intensive care unit (NICU) hospitalization is associated with improved neurodevelopment in preterm infants. Underlying mechanisms may include stronger mother–infant emotional connection. This paper examines associations between MM provision in the NICU with maternal connection to her infant using three factors validated in our sample: maternal sensitivity, emotional concern, and positive interaction/engagement. We studied 70 mothers of infants born <1500 g and/or <32 weeks’ gestation. Associations between MM provision and mother–infant connection were modeled using median regression adjusted for clustering. Mothers who provided exclusive MM (i.e., 100% MM, no other milk) reported higher levels of maternal sensitivity by a median score of 2 units (β = 2.00, 95% CI: 0.76, 3.24, p = 0.002) than the mixed group (i.e., MM < 100% days, other milk ≥1 days), as well as greater emotional concern (β = 3.00, 95% CI: −0.002, 6.00, p = 0.05). Among mothers of very preterm infants, greater milk provision was associated with greater maternal sensitivity, but also with greater emotional concern about meeting the infant’s needs. These findings highlight the importance of supporting MM provision and early infant care as an integrated part of lactation support. The findings may also provide insight into links between MM provision in the NICU and infant neurodevelopment.

Highlights

There is clear evidence to support the importance of maternal breastfeeding for child cognitive and socioemotional development, but the specific mechanisms underlying this association are less well understood [1]
Nutritional and non-nutrient bioactive components of maternal milk (MM) likely play an important role in improving brain development for the preterm-born infant, an alternative or complementary explanation is that provision of maternal milk may offer increased opportunities for mother– infant connection and attachment, which in turn contribute to positive neurodevelopment, especially socioemotional development [7]
We aimed to (1) examine the underlying factor structure of a series of scales designed to assess the quality of early mother–infant relations in the neonatal intensive care unit (NICU), and (2) assess associations between maternal milk provision during neonatal hospitalization and maternal reports of the quality of their connection with their newborn infant, taking into consideration clustering among study sites as well as potential confounding by gestational age and maternal education

Summary

Introduction

There is clear evidence to support the importance of maternal breastfeeding for child cognitive and socioemotional development, but the specific mechanisms underlying this association are less well understood [1]. Breastfeeding mothers of term infants spend more time with their offspring outside of the feeding episode compared with bottle feeding mothers and are more likely to engage in mutual touch [11] Maternal behaviors such as tactile stimulation, mother’s gaze, and mutual touch are significantly more frequent during a session of breastfeeding than a session of bottle feeding [12]. Breastfeeding has been linked to a heightened response to infant cues in maternal brain regions implicated in bonding and empathy [13]. This response may be mediated by the release of oxytocin during breastfeeding, as oxytocin-induced neural activations facilitate greater maternal sensitivity [14]

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