{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:06:16Z","timestamp":1787162776442,"version":"build-2736575974"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T00:00:00Z","timestamp":1617321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP19K08040"],"award-info":[{"award-number":["JP19K08040"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>It is important to clarify how the breastfeeding method affects women\u2019s mental health, and how women\u2019s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants\u2019 breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal\u2013infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.<\/jats:p>","DOI":"10.3390\/nu13041184","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T10:34:09Z","timestamp":1617359649000},"page":"1184","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Exclusive Breastfeeding Is Not Associated with Maternal\u2013Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity"],"prefix":"10.3390","volume":"13","author":[{"given":"Naoki","family":"Fukui","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaharu","family":"Motegi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koyo","family":"Hashijiri","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryusuke","family":"Tsuboya","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuro","family":"Sugai","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Egawa","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Enomoto","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Someya","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/S0273-2297(84)80008-8","article-title":"Mother-infant bonding: Weighing the evidence","volume":"4","author":"Kennell","year":"1984","journal-title":"Dev. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1046\/j.1365-3016.1999.00167.x","article-title":"Breast feeding and later psychosocial adjustment","volume":"13","author":"Fergusson","year":"1999","journal-title":"Paediatr. Perinat. Epidemiol."},{"key":"ref_3","unstructured":"World Health Organization (2015, August 30). Counselling for Maternal and Newborn Health Care: A handbook for Building Skills: World Health Organization. Available online: http:\/\/bit.ly\/2rd1wkS."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1177\/0890334403253292","article-title":"Maternal and perinatal factors influencing the duration of exclusive breastfeeding during the first 6 months of life","volume":"19","author":"Cernadas","year":"2003","journal-title":"J. Hum. Lact."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1353\/mpq.2003.0020","article-title":"Breastfeeding, bonding, and the motherinfant relationship","volume":"49","author":"Hyde","year":"2003","journal-title":"Merrill Palmer. Q."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jad.2011.04.027","article-title":"A prospective study of the relationship between breastfeeding and postpartum depressive symptoms appearing at 1-5 months after delivery","volume":"133","author":"Nishioka","year":"2011","journal-title":"J. Affect. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3117","DOI":"10.2147\/NDT.S287036","article-title":"Depression, anxiety and primiparity are negatively associated with mother\u2013infant bonding in Japanese mothers","volume":"16","author":"Motegi","year":"2020","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"927","DOI":"10.1017\/S0033291713001530","article-title":"Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression","volume":"44","author":"Figueiredo","year":"2014","journal-title":"Psychol. Med."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ystrom, E. (2012). Breastfeeding cessation and symptoms of anxiety and depression: A longitudinal cohort study. BMC Pregnancy Childbirth, 12.","DOI":"10.1186\/1471-2393-12-36"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1177\/0890334416662241","article-title":"Postpartum anxiety and infant-feeding outcomes","volume":"32","author":"Fallon","year":"2016","journal-title":"J. Hum. Lact."},{"key":"ref_11","first-page":"e3035","article-title":"Breastfeeding self-efficacy and postpartum depression: A cohort study","volume":"6","author":"Vieira","year":"2018","journal-title":"Rev. Lat. Am. Enfermagem."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1111\/pcn.12920","article-title":"Identifying the factor structure of the Mother-to-Infant Bonding Scale for post-partum women and examining its consistency during pregnancy","volume":"73","author":"Motegi","year":"2019","journal-title":"Psychiatry Clin. Neurosci."},{"key":"ref_13","first-page":"221","article-title":"Factor Structure and Measurement Invariance of the Hospital Anxiety and Depression Scale Across the Peripartum Period Among Pregnant Japanese Women","volume":"26","author":"Ogawa","year":"2020","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_15","first-page":"371","article-title":"Hospital anxiety and depression scale","volume":"4","author":"Kitamura","year":"1993","journal-title":"Arch. Psychiatr. Diagn. Clin. Eval."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1192\/bjp.171.2.175","article-title":"\u201cAnybody\u2019s child\u201d: Severe disorders of mother-to-infant bonding","volume":"171","author":"Kumar","year":"1997","journal-title":"Br. J. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/s00737-005-0074-z","article-title":"A new Mother-to-Infant Bonding Scale: Links with early maternal mood","volume":"8","author":"Taylor","year":"2005","journal-title":"Arch. Womens Ment. Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1007\/s00737-012-0291-1","article-title":"A Japanese version of Mother-to-Infant Bonding Scale: Factor structure, longitudinal changes and links with maternal mood during the early postnatal period in Japanese mothers","volume":"15","author":"Yoshida","year":"2012","journal-title":"Arch. Womens Ment. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives","volume":"6","author":"Hu","year":"1999","journal-title":"Struct. Equ. Mode."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association, DSM-5 Task Force (2013). Diagnostic and Statistical Manual of Mental Disorders: DSM-5TH, American Psychiatric Publishing, Inc. [5th ed.].","DOI":"10.1176\/appi.books.9780890425596"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1089\/jwh.2010.2355","article-title":"Changes in depressive symptoms over 0-9 months postpartum","volume":"20","author":"Gjerdingen","year":"2011","journal-title":"J. Womens Health Larchmt."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Hairston, I.S., Handelzalts, J.E., Lehman-Inbar, T., and Kovo, M. (2019). Mother-infant bonding is not associated with feeding type: A community study sample. BMC Pregnancy Childbirth, 19.","DOI":"10.1186\/s12884-019-2264-0"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/imhj.21866","article-title":"Do postpartum anxiety and breastfeeding self-efficacy and bonding at early postpartum predict postpartum depression and the breastfeeding method?","volume":"41","author":"Minamida","year":"2020","journal-title":"Infant. Ment. Health J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.psyneuen.2015.02.009","article-title":"Oxytocin and HPA stress axis reactivity in postpartum women","volume":"55","author":"Cox","year":"2015","journal-title":"Psychoneuroendocrinology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1089\/jwh.2012.3768","article-title":"Association between maternal mood and oxytocin response to breastfeeding","volume":"22","author":"Stuebe","year":"2013","journal-title":"J. Womens Health Larchmt."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1521\/pdps.2017.45.4.475","article-title":"Attachment figure\u2019s regulation of infant brain and behavior","volume":"45","author":"Sullivan","year":"2017","journal-title":"Psychodyn. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"105242","DOI":"10.1016\/j.earlhumdev.2020.105242","article-title":"A breastfeeding support program changed breastfeeding patterns but did not affect the mothers\u2019 self-efficacy in breastfeeding at two months","volume":"151","author":"Ljungberg","year":"2020","journal-title":"Early. Hum. Dev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/jmwh.12101","article-title":"Beyond labor: The role of natural and synthetic oxytocin in the transition to motherhood","volume":"59","author":"Bell","year":"2014","journal-title":"J. Midwifery Womens Health"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/4\/1184\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:33:40Z","timestamp":1760362420000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/13\/4\/1184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,2]]},"references-count":28,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["nu13041184"],"URL":"https:\/\/doi.org\/10.3390\/nu13041184","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,2]]}}}