Breastfeeding Behaviors and Maternal Interaction Quality in a Low-Income, Ethnic Minority Population

MacKenzie D.M. Whipps, Elizabeth B. Miller, Debra L. Bogen, Alan L. Mendelsohn, Pamela A. Morris, Daniel Shaw, Rachel S. Gross

Research output: Contribution to journalArticlepeer-review


Objective:To examine the associations between breastfeeding intensity and underexplored features of maternal-child interaction quality over and above the influence of breastfeeding initiation.Methods:The current study leveraged an on-going, multisite randomized controlled trial of a tiered parenting program for 462 Medicaid-eligible mothers and their infants in the United States. We examined whether breastfeeding intensity and exclusivity was associated with observed maternal sensitivity, intrusiveness, and detachment, as well as self-reported maternal verbal responsiveness, 6 months infant age. Analyses controlled for breastfeeding initiation, demographics, and early parenting experiences.Results:Higher intensity breastfeeding at 6 months was significantly related to higher maternal sensitivity (ß = 0.12, p = 0.004) and lower maternal intrusiveness (ß =-0.10, p = 0.045). There was no significant association between breastfeeding intensity at 6 months and detachment (ß =-0.02, no significant [ns]) or self-reported verbal responsiveness (ß = 0.11, ns). Results were the same when intensity was measured as a dichotomous indicator for exclusive breastfeeding. Effect sizes were small-to-moderate, ranging from Cohen's d = 0.26 to 0.31. Associations did not vary by site, race/ethnicity, infant difficultness, or household poverty.Conclusion:The finding that breastfeeding intensity was significantly and independently associated with maternal sensitivity and intrusiveness is novel in the literature on low-income families from the United States. These findings have implications for breastfeeding promotion strategies and indicate that future research should explore synergistic or spillover effects of interventions aimed at maternal-child interaction quality into the infant feeding domain, particularly in the primary care setting.

Original languageEnglish (US)
Pages (from-to)180-186
Number of pages7
JournalJournal of Developmental and Behavioral Pediatrics
Issue number3
StatePublished - Apr 1 2020


  • breastfeeding
  • infant feeding
  • low-income families
  • parenting
  • sensitivity
  • Poverty/statistics & numerical data
  • United States
  • Humans
  • Minority Groups/statistics & numerical data
  • Infant
  • Mother-Child Relations
  • Young Adult
  • Breast Feeding/statistics & numerical data
  • Ethnicity
  • Adult
  • Female
  • Maternal Behavior/ethnology
  • Racial Groups
  • Medicaid/statistics & numerical data

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Developmental and Educational Psychology
  • Pediatrics, Perinatology, and Child Health


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