Breastfeeding and maternal attachment: The moderating roles of maternal stress and child behavior

Purpose: This study examined the effect of breastfeeding on maternal attachment, and explored the moderating role of maternal stress and child behavior in this relationship, in a sample of Spanish mothers with children aged between 2 and 7 years.Design and methods: A total of 432 mothers participated in a cross-sectional online survey. A three-way interac-tion model was used to test the moderating role of maternal stress and child behavioral problems in the relation-ship between breastfeeding and maternal attachment.Results: The full model accounted for 19% of the variance of maternal attachment. Breastfeeding was significantly associated with mother-rated attachment, and the moderated moderation analysis confirmed the moderating effects of maternal stress and child behavior on the relationship between breastfeeding and maternal attach-ment.Conclusions: This study adds to the existing literature that supports the contribution that breastfeeding makes in enhancing maternal attachment, and may help to clarify the role of breastfeeding in shaping maternal attach-ment. Our findings suggest that breastfeeding is a factor in enhancing maternal attachment, and also identify maternal stress and child behavior as moderators of this relationship.Practice implications: Understanding the mechanisms by which breastfeeding affects maternal attachment will help generate recommendations to improve breastfeeding and maternal attachment.& COPY; 2022 Elsevier Inc. All rights reserved.