Exploring the Relationship Between Maternal-Infant (Dyadic) Attachment, Postpartum Depression, and Breastfeeding Self-Efficacy: A Scoping Review

This scoping review explores intersecting relationships among the concepts of postpartum depression, maternal-infant (dyadic) attachment (or bonding), and breastfeeding self-efficacy within postpartum populations and how often these concept relationships are examined among predominantly historically marginalized populations (non-White, low-income, low education level).

To address the ongoing public health concern of postpartum depression, we must understand its relationship with dyadic attachment and breastfeeding self-efficacy.

Four studies met inclusion criteria, examining the relationships between the concepts of postpartum depression, dyadic attachment, and breastfeeding self-efficacy. Because these 4 studies had heterogeneous study designs, study measures, and study time points, the exact nature of the relationship between these 3 concepts is difficult to parse. Furthermore, only 1 study evaluated these concepts in historically marginalized populations (low-income). Future research using rigorous study design approaches is warranted.

While studies found a relationship between increased breastfeeding self-efficacy and increased dyadic attachment, mixed results remain regarding the relationships between postpartum depression and dyadic attachment or breastfeeding self-efficacy. Nevertheless, dyad-focused interventions have shown the potential to improve breastfeeding self-efficacy and dyadic attachment while reducing postpartum depression. The scoping review findings suggest that these concepts collectively need more research attention, given their potential effects on improving maternal-child dyadic outcomes.