Infant Caregiving as a Resilience Factor for Postpartum Substance Misuse: A Scoping Review

Area of Science:

• Reproductive Health
• Maternal Health
• Addiction Medicine

Background:

• The postpartum period presents significant vulnerability to substance misuse relapse for individuals with a history of substance use disorder.
• Existing research primarily focuses on the negative impacts of postpartum substance use on infant outcomes (risk framework).
• Limited attention has been given to caregiving behaviors as protective factors against postpartum substance use (resilience framework).

Purpose of the Study:

• To synthesize empirical studies on caregiving behaviors as predictors of postpartum substance use outcomes.
• To explore the inverse association where caregiving may protect against substance misuse, contrasting with the more studied risk framework.

Main Methods:

• A systematic scoping review of studies published between 2000 and 2024.
• Searches were conducted across major databases: PubMed, Embase, PsycINFO, and Scopus.
• Inclusion criteria were applied to 42 selected studies examining caregiving behaviors and postpartum substance use.

Main Results:

• Breastfeeding demonstrated consistent protective associations against postpartum substance use, especially nicotine use (28/30 studies).
• Limited evidence suggested breastfeeding also protected against alcohol, cannabis, and opioid use.
• Preliminary findings indicated potential reductions in substance use urges and smoking with skin-to-skin care and babywearing.

Conclusions:

• Caregiving behaviors, particularly those involving physical touch, may mitigate postpartum substance misuse risk via neuroendocrine, psychological, and social pathways.
• Findings support a resilience framework emphasizing the protective role of caregiving.
• Further research is needed to broaden the scope of caregiving practices and populations studied to inform strengths-based interventions.