Risk factors and assessment tools for mother-infant bonding: A scoping review to assist future research

Background. Mother-infant bonding refers to the early emotional connectedness between a mother and her infant. As there are clear benefits to strong mother-infant bonding and evidence of negative outcomes following impaired mother-infant bonding, knowledge of any risk or protective factors that affect mother-infant bonding is important. The administration of synthetic oxytocin to induce or augment labour has been shown to affect breastfeeding and maternal mood, however there appears to be no literature investigating the effects of synthetic oxytocin on mother-infant bonding. The aim of this scoping review was to identify factors that are known to influence or disrupt the mother-infant bond, and to examine how the motherinfant bond is assessed, to be able to assist future research investigating the effect of synthetic oxytocin administered during childbirth on mother-infant bonding. Methods. A scoping review of published literature was guided by the framework of Arksey and O'Malley (2005). Eight electronic databases and reference lists were searched. Key words were used to guide the search. Inclusion criteria included any form of literature written in English pertaining to mother-infant bonding in an infant population, and articles where the overall theme related to one of the two research questions. Exclusion criteria included articles published before 2005, animal studies, and articles relating to mother-infant attachment. Information was collated into tables to summarise findings. Results. A total of 2298 articles were identified, 38 of which were included in this review. Twenty-four articles were identified relating to risk factors for disrupted mother-infant bonding. Factors identified were grouped into five categories: mental health, lifestyle influences, thinking and attitudes, obstetric history, and infant factors. Fourteen articles were identified that related to tools to measure mother-infant bonding. Four tools were described, all of which employed self-reporting methods. Conclusion. This review highlights the absence of literature investigating the effect of synthetic oxytocin to induce or augment labour, a common practice in Western countries, on mother-infant bonding. Secondly, all tools that measure mother-infant bonding utilise self-reporting methods, potentially introducing bias. While the literature is lacking in these two areas, there appears to be substantial knowledge on the risk factors that influence disrupted mother-infant bonding, such as postpartum depression and poor maternal social networks. Such factors will be important to consider when conducting future research into the effects of synthetic oxytocin on mother-infant bonding.