The association of breastfeeding initiation with sensitivity, cognitive stimulation, and efficacy among young mothers: A propensity score matching approach

Objective: This study examined the association between breastfeeding initiation and maternal sensitivity, efficacy, and cognitive stimulation among young, low-income, African American mothers. Subjects and Methods: Two hundred twenty-one mothers were interviewed during pregnancy, at birth, and at 4 months postpartum regarding breastfeeding and parenting. Medical records were collected after birth, and mother-infant interactions were videotaped at 4 months. Propensity score matching was used to address selection bias by matching breastfeeding and nonbreastfeeding mothers on characteristics measured prior to breastfeeding. Results: One hundred twenty-four (56%) mothers initiated breastfeeding. After matching, mothers who initiated breastfeeding reported greater parenting efficacy (effect size, d=0.44) and were observed to be more sensitive with their 4-month-old infants (effect size, d=0.42) than nonbreastfeeding mothers. Breastfeeding was marginally associated with less maternal intrusiveness (effect size, d=0.28) but was not related to parenting attitudes or cognitive stimulation. Conclusions: This study presents evidence supporting the claim that breastfeeding may enhance maternal efficacy and sensitivity. Providing breastfeeding support to young mothers may have effects that extend beyond maternal and child health outcomes to parenting and mother-child interactions.