The article Does breastfeeding protect against substantiated child
abuse and neglect? A 15-year cohort study, discusses a study conducted in
Brisbane, Australia that attempts to discover if breastfeeding reduces or
prevents maternal child maltreatment. The researchers of this study
hypothesized, “. . . that the absence of breastfeeding during the infant’s
first 6 months of life would independently predict maternally perpetrated
child maltreatment” (Strathearn, Mamun, Najman & O’Callaghan, 2009,
p.484). This study was longitudinal, beginning with the initial derivation
of the birth cohort in 1981 through 1984, and then the children and
mothers were monitored for the next fifteen to twenty years and in
September 2000 government reports of child maltreatment were obtained and
reviewed.
Going back to the hypothesis, the researchers of this study reported
from previous studies that, “Breastfeeding may enhance maternal
responsiveness by stimulating oxytocin release, which is associated with
reduced anxiety and elevated mood, a blunted physiological stress
response, and more-attuned patterns of maternal behavior. . .”
(Strathearn, Mamun, Najman & O’Callaghan, 2009, p. 484). This
association between the effects of oxytocin and maternal mood are believed
to reduce and possibly prevent child maltreatment. If a mother decides
not to breastfeed they will not receive the mood effectors of oxytocin and
are therefore more likely to experience stress, frustration, and anxiety
which can all be taken out on their infant or young child.
The results of this study show a strong correlation between the
amount of time spent breastfeeding and the presence or absence of maternal
perpetrated child maltreatment. Mothers who breastfed for more than four
months were the least likely to neglect, emotionally abuse or physically
abuse their children; while mothers who did not breastfeed at all were 6.3
times more likely to neglect their child, 4.3 times more likely to use
emotional abuse, and 2.6 times more likely to physically abuse their child
(Strathearn, Mamun, Najman & O’ Callaghan, 2009). It is made very
clear that breastfeeding is not the only cause of child maltreatment,
there are other confounding factors that can attribute to child abuse and
neglect; the point of this study was to shed light on the idea that
breastfeeding can strengthen the bond between the mother and infant which
can potentially reduce the risk of maternal perpetrated child
maltreatment.
I was interested in this article topic because as an aspiring
Occupational Therapy student I am extremely interested in the field of
home based early intervention age zero to five years old, and this article
fell within the perfect age group because I am especially interested in
working with infants. This article addressed the important matter of the
mother and infant bond that takes place during breast feeding and how this
bond may shape their relationship for years to come. While working in a
home based setting it is essential that the parent(s) care about and are
involved in the infants’ development, because without the parents’
involvement and support the infant will not grow and develop as they
normally would. I was also interested in this article topic because I
personally feel breastfeeding is an extremely beneficial experience for
both the mother and the infant; the eye contact and the close intimate
distance between the two are all contributing factors in the eternal bond
that a mother and infant share.
This article relates to current healthcare through its use of
evidence based practice; there were no treatments used in this study,
instead this study was designed to attempt to find a method to reduce
child maltreatment through infant breastfeeding. Evidence based practice
involves three main components; client preference and collaboration,
clinical expertise, and empirical research which is either qualitative or
quantitative. From this article, an example of client preference and
collaboration is how the participants, in this case the parents, were
invited to participate in the study; they had the choice to take part and
if they chose to do so, they had to fill out self-administered
questionnaires at three different times throughout the study. Through this
process the parents were collaborating with the researchers in completing
this study but the parents always had the option to take part in the study
or not. An example of clinical expertise is how the researchers in this
study were extremely proficient in gathering participants, information,
and keeping the confidentiality of the participants of up most importance.
They obtained participants through basic invitations at prenatal clinical
visits, the information was gathered through questionnaires and
longitudinal observation and the researchers assigned identification
numbers to link their database to the database of a government child
protection agency in order to protect the participants’ confidentiality.
This study was a longitudinal quantitative study; for example the study
was conducted over a fifteen to twenty year period and the researchers
used a multinomial regression analysis to, “. . . compare associations
between breastfeeding duration, confounding variables, and the different
maltreatment categories” (Strathearn, Mamun, Najman & O’Callaghan,
2009).
An additional article to support the importance of breastfeeding is
the, Effects of demographic and household variables on infant and child
under-five mortality: an application of logistic model. This article
continued to stress the importance of breastfeeding but not to highlight
the bond between mother and infant; instead this study stressed the
importance of breastfeeding for the infants’ overall health. This article
supports the first article in the fact that there are many other
confounding factors that will affect an infants’ health; such as the
mothers’ marital age, household conditions, birth order, birth interval
and breastfeeding (Hossain & Islam, 2009). I feel there is a
connection between the environment in which a family lives in and the
treatment between family members; if a home environment is full of stress,
chaos, and unhappiness these feelings can be projected onto an infant in
the form of neglect, instead of projecting the nurturing act that is
associated with breastfeeding.
There is also the factor of the mothers’ age, if a woman has a child
at a young age for example sixteen years old, the chances of her being
fully prepared to take care of an infant may be significantly lower than
that of a woman who has a child at twenty-five years old. Preparedness can
impact how well a mother takes care of her infant, if she is relatively
young there is the possibility she is not fully educated in raising a
child or in the benefits of breastfeeding. The second article supports
that not only can breastfeeding be associated with maternal perpetrated
maltreatment but it also shares a negative correlation with infant
mortality. According to Hossain and Islam, “. . . infant mortality for the
respondents whose breastfeeding is 12-24 and 25+ months there are 0.275
and 0.001 times less risk than that of respondents whose breastfeeding is
less than 12 months” (2009). Both articles support breastfeeding for
different reasons and both articles have strong support as to why
breastfeeding is beneficial for infants and their well being.
This article implies breastfeeding as being a component in the
absence or presence of maternal perpetrated child maltreatment; the
significance this article has on the implications for the future in the
healthcare practice is that there are a variety of possibilities as to why
a mother may neglect or abuse their child and this article implies that as
healthcare professionals it is vital to look at all possible causes even
in the earliest stages of infant development. In the future of healthcare
practice, this article can be applied to educate parents on the
significance breastfeeding has on the mother-infant relationship. Through
this application there may be a decrease in the number of cases of
maternal perpetrated child maltreatment.
References
Hossain, M.M., Islam, M.R. (2009). Effects of demographic and household
variables on infant and child under-five mortality: an application of
logistic model. Internet Journal of Health, 8(2). Retrieved March 15,
2009 from the CINAHL Databse.
Strathearn, L., Mamun, A.A., Najman, J.M., O’Callaghan, M.J. (2009).
Does breastfeeding protect against substantiated child abuse and neglect?
A 15-year cohort study. Pediatrics, 123, 483-493.
Conflict of Interest:
None declared
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