Mother-infant signalling during lactation following late preterm and early term delivery: An investigation of infant feeding from physiological, psychological, anthropological and microbiological perspectives

Abstract

Breastfeeding is a dynamic process involving signalling between mother and offspring through biological (breast milk) and non-biological (behavioural) pathways. Maternal stress is one modifiable variable that could influence signalling and negatively affect breastfeeding and infant growth. Understanding this dynamic process may facilitate targeted interventions that promote breastfeeding and improve infant and maternal outcomes. My research investigated mother-infant signalling following late preterm (LP) and early term (ET) delivery – a situation associated with higher maternal stress and greater breastfeeding difficulty than full-term delivery - with interpretation from physiological, psychological, and anthropological perspectives. The acute effects of five relaxation techniques on physical and perceived relaxation among 20 Chinese primiparous breastfeeding mothers were compared in a pilot study. A relaxation meditation recording was the most effective intervention, and was subsequently tested (versus no intervention) in a randomised controlled trial in 96 healthy primiparous mother-infant pairs following LP or ET delivery. Relaxation therapy significantly reduced maternal stress and increased infant weight gain from 1-8 weeks. There was a significant interaction with greater intervention effects on weight gain in girls. Mothers of girls used the intervention more frequently with a trend for higher milk fat and energy at 8-weeks. Infant length gain and milk energy and fat at 8-weeks were also non-significantly higher in the intervention group. Additionally, my research innovatively explored the role of the microbiome in mother-infant signalling. The relaxation intervention led to reduced maternal gut and breast milk microbiome diversity whilst increasing infant gut microbiome diversity; it also influenced the change in microbiome from 1-8 weeks. The study findings have practical implications for supporting breastfeeding mothers following LP and ET delivery. The relaxation meditation tape is a simple, practical tool that could easily be used in clinical settings. The research findings also contribute to understanding the mechanisms of mother-infant signalling during early lif