Maternal Time Use and Nurturing: Analysis of the Association between Breastfeeding Practice and Time Spent Interacting with Baby

Background: Breastfeeding supports child development through complex mechanisms that are not well understood. Numerous studies have compared how well breastfeeding and nonbreastfeeding mothers interact with their child, but few examine how much interaction occurs. Subjects and Methods: Our study of weekly time use among 156 mothers of infants aged 3-9 months investigated whether lactating mothers spend more time providing emotional support or cognitive stimulation of their infants than nonbreastfeeding mothers, and whether the amount of such interactive time is associated with breastfeeding intensity. Mothers were recruited via mother's and baby groups, infant health clinics, and childcare services, and used an electronic device to record their 24-hour time use for 7 days. Sociodemographic and feeding status data were collected by questionnaire. Statistical analysis using linear mixed modeling and residual maximum likelihood analysis compared maternal time use for those giving "some breastfeeding" and those "not breastfeeding." Analysis was also conducted for more detailed feeding subgroups. Results: Breastfeeding and nonbreastfeeding mothers had broadly similar socioeconomic and demographic characteristics. Breastfeeding was found to be associated with more mother-child interaction time, a difference only partially explained by weekly maternal employment hours or other interactive care activities such as play or reading. Conclusion: This study presents data suggesting that lactating mothers spent significantly more hours weekly on milk feeding and on carrying, holding, or soothing their infant than nonlactating mothers; and on providing childcare. Understanding the mechanisms by which child mental health and development benefits from breastfeeding may have important implications for policies and intervention strategies, and could be usefully informed by suitably designed time use studies.