Department of Medicine and Surgery, Public Health, Psychology and Immunology and Medical Microbiology, Odontology and Nursing, Rey Juan Carlos University, Madrid, Spain.
Breastfeed Med. 2019 Nov;14(9):616-629. doi: 10.1089/bfm.2019.0106. Epub 2019 Aug 19.
Breastfeeding has been associated to an improved mother-child bond, although this link is lacking the sufficient empirical support. The aims of this study were to carry out a systematic review as a continuation to the one by Jansen et al., and to clarify the link between breastfeeding and mother-infant relationships. Data sources: A search was conducted using PsycINFO, MEDLINE, and CINAHL (2008-2018), using both free text words and subject headings. Additional hand-searching was performed. Study selection: The Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) framework guided (the reporting of) the study selection and data extraction. Eligible articles were subsequently selected by title, abstract, and full text review. Data extraction: Data regarding study setting, participants, breastfeeding, mother-infant relationships, and outcome measures were extracted in a systematic way. Ultimately, 13 articles were included. Most studies were conducted in Europe (46.15%) and were nonexperimental studies (92.3%). Eight studies were longitudinal, using between two and five assessment time points. The instruments used to assess the bond between mother and child showed great variability. From the studies, 8 (61.5%) employed self-report measures and four assessed maternal perception. Others used open-ended questions regarding the maternal lactation process or about the mother's activity while breastfeeding. Other measures used were maternal perception of her baby and personality variables associated to breastfeeding. Five articles studied the bond using external observations of the interactions between mother-child. The quality of the studies (Medical Education Research Studies Quality Instrument [MERSQI]) was overall fair to good. It is complicated to extract generalizable results because of the conceptual and instrumental variability of the mother-child relationship. This association is complex and the way in which breastfeeding is carried out would appear to be a decisive factor, influenced in turn by additional variables that should also be taken into account. The relationship indicators most frequently associated to breastfeeding are maternal sensitivity and secure attachment.
母乳喂养与母婴关系密切相关，尽管这一联系缺乏足够的实证支持。本研究的目的是对 Jansen 等人的研究进行系统回顾，并阐明母乳喂养与母婴关系之间的联系。
使用 PsycINFO、MEDLINE 和 CINAHL（2008-2018 年）进行了搜索，同时使用自由文本词和主题词。此外还进行了手工检索。
《系统评价和荟萃分析的首选报告项目》（PRISMA）框架指导了研究选择和数据提取的报告。通过标题、摘要和全文审查，有资格的文章随后被选中。
系统地提取了关于研究背景、参与者、母乳喂养、母婴关系和结果测量的相关数据。最终，有 13 篇文章被纳入。大多数研究在欧洲进行（46.15%），且为非实验性研究（92.3%）。8 项研究是纵向的，使用了 2 到 5 个评估时间点。用于评估母婴关系的工具差异很大。在这些研究中，有 8 项（61.5%）采用了自我报告测量方法，4 项评估了母亲的感知。其他研究则使用了关于母亲哺乳过程或母亲哺乳时活动的开放性问题。其他使用的测量方法包括母亲对婴儿的感知和与母乳喂养相关的人格变量。有 5 篇文章通过观察母婴之间的互动来研究这种联系。研究的质量（医学教育研究质量工具[MERSQI]）总体上是良好的。
由于母婴关系的概念和工具变异性，很难提取可推广的结果。这种关联是复杂的，母乳喂养的方式似乎是一个决定性因素，而这反过来又受到其他也应考虑的变量的影响。与母乳喂养最常相关的关系指标是母亲的敏感性和安全依恋。
