Factors related to a disturbance in the mother-child bond and attachment

J Pediatr Nurs. 2024 May-Jun:76:114-123. doi: 10.1016/j.pedn.2024.02.009. Epub 2024 Feb 20.


Introduction: Establishing an adequate bond and attachment between a mother and child is essential for preventing pathologies and developing this relationship in the future.

Purpose: To identify the factors related to a disturbance of the mother-child bond or attachment.

Methods: A cross-sectional descriptive study was carried out with women with a biological child between 6 weeks and 18 months of age. The Mother-Child Bond-Attachment Questionnaire (VAMF, for its name in Spanish) was administered to measure the bond and postnatal attachment together with a questionnaire containing sociodemographic, psychosocial, and health variables referring to the mother and the newborn.

Results: 1114 women participated. The multivariate analysis showed that skin-to-skin contact (aOR = 0.58; 95% CI: 0.37, 0.90) and breastfeeding (aOR = 0.55; 95% IC: 0.35, 0.86) reduce the probability of presenting a bond disturbance. Anxiety during pregnancy, childbirth, and the puerperium (aOR = 3.95; 95% CI: 2.57, 6.05) and postpartum complications (aOR = 1.60; 95% CI: 1.03, 2.48) increase the chance of having a bond disturbance. Skin-to-skin contact (aOR = 0.61; 95% CI: 0.38, 1.00), breastfeeding (aOR = 0.47; 95% CI: 0.27, 0.80,) and an older age of the infant (months) (aOR = 0.77: 95% CI: 0.72, 0.82) reduces the probability of presenting an attachment disturbance.

Conclusions: Skin-to-skin contact and breastfeeding are associated with a lower probability of impaired bonding and attachment. Anxiety states during pregnancy, childbirth, and the puerperium, and complications after childbirth increase the probability of developing a bond disorder. The older the age of the infant, the lower the frequency of having an impaired attachment.

Implications to practice: Identifying the factors associated with the establishment of the mother-child bond and attachment is essential for the development of prevention strategies and early identification of cases that may present alterations and avoid their consequences on the health of the mother and child.

Keywords: Attachment; Bond; Breastfeeding; Skin-to-skin contact; VAMF questionnaire.

MeSH terms

  • Adult
  • Breast Feeding* / psychology
  • Breast Feeding* / statistics & numerical data
  • Cross-Sectional Studies
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Mother-Child Relations*
  • Mothers / psychology
  • Multivariate Analysis
  • Object Attachment*
  • Pregnancy
  • Spain
  • Surveys and Questionnaires
  • Young Adult