Maternal Postpartum Behaviors and Mother-infant Relationship During the First Year of Life

Objective: To assess the hypothesis that maternal postpartum behaviors toward the newborn may predict the quality of the maternal-infant relationship during the first year.

Design: Prospective, non-randomized, longitudinal cohort study of 174 maternal-infant dyads.

Methods: A Postpartum Parenting Behavior Scale (PPBS) was formulated to measure clearly defined observed maternal behaviors toward the infant shortly after birth. The quality of the maternal-infant relationship was assessed at 6 months after birth with the Nursing Child Assessment Satellite Training (NCAST) Feeding Scale and at 12 months after birth with the NCAST Teaching Scale and Ainsworth Strange Situation.

Results: The PPBS score correlated significantly with the Feeding Scale score (r =.27, P <.005) and with the Teaching Scale score (r =.23, P <.01). Mothers whose infants were later classified as securely attached in the Ainsworth Strange Situation had higher PPBS scores than mothers of infants classified as insecurely attached (mean +/- SD: 5.18 +/- 1.51 vs 4.63 +/- 1.69, respectively, P <.05). In regression models adjusting for social and demographic factors, the PPBS remained a significant predictor of the Feeding Scale score, the Teaching Scale score, and security of attachment.

Conclusions: Maternal behaviors in the immediate postpartum period may aid in predicting quality of the maternal-infant relationship during the subsequent 12 months, suggesting the potential for early identification of suboptimal parenting.