Getting off to the best start: the vital role of mother-infant bonding

Sometimes we forget how vital those first mother-child encounters are for establishing a positive mother-infant bonding relationship. Do we remember to pause and allow time for a mother to appreciate those first images on the ultrasound screen when they see their baby move and hear the doppler heartbeat echoing into the examination room? Do we remark upon that first moment of physical touch as the newborn is lain skin to skin against their mother? Are we really promoting breast feeding that is both mutually satisfying and prolonged? Do we encourage mothers to find companionship and support with their newborn through community groups and activities?

There is clear evidence that successful bonding relationships optimize child development [1]. Repeated positive actions lead to the development of neurological pathways that enhance development, cognition and behavior in children [1]. The consensus from the various developmental attachment theories is that positive maternal-infant bonding relationships enhance neurodevelopmental outcomes and protect against interactional disturbances [2]. Newborns clearly benefit from the optimization of mother-infant bonding.

However, bonding can be beneficial in both directions. There is now emerging evidence that the benefits of bonding are bidirectional and can also help protect mothers from postpartum anxiety and depressive symptoms and parenting distress [3]. In a novel study exploring the relationship between maternal bonding and parenting stress, it was found that elevated levels of maternal bonding partially mitigated subsequent levels of depression and anxiety symptomatology [3]. More importantly, positive maternal-infant bonding totally mitigated the effects of depression and anxiety symptoms upon parenting stress in a sample of 105 postpartum women [3]. This means that successful maternal-infant bonding can be an important bidirectional intervention to both enhance neurodevelopmental outcomes in children and simultaneously reduce parenting stress and adverse psychosocial symptomatology in new mothers. It may be that the bonding relationship is a causal link between women with postnatal depression and the observed poorer neurodevelopmental outcomes in their children.

There are other factors that can help protect new mothers from postnatal depression and anxiety that could also optimize child development. One key protection variable is family support. In a study published in this edition, data from 1654 postpartum women were extracted from the 2016 Korean Study of Women’s Health-related Issues [4]. The authors found that high levels of support were associated with lower levels of postnatal depression compared to women reporting moderate or low levels of support [4]. Whilst most obstetric services formally screen for depressive symptoms both antenatally and postnatally, social histories remain an ad hoc venture. Partners might be recorded, but the quality and quantity of support available to the new mother is often neglected and never formally assessed.

The vital role of providing clinical care that leads to intergenerational improvements in childhood outcomes remains ever important. This means that the education of the next generation of care providers is essential. In this edition we publish a literature review on educational methodology to develop best practices for teaching issues related to psychosomatic obstetrics and gynecology [5]. The paper outlines the importance of identifying common learning objectives at a global level, and how to deliver the curriculum and assess learners’ ability to meet objectives [5]. We hope that those individuals who share a passion to teach the next generation of clinicians and researchers in psychosocial obstetrics and gynecology might join us at the 21st ISPOG conference to be held in April 2025 at Omnibus Park in Seoul, Korea.

The year in review

This year the Journal of Psychosomatic Obstetrics and Gynecology (JPOG) achieved a new milestone. Volume 45 (2023) of JPOG represents the transition year from a four-edition paper-based journal to a single edition on-line journal. This transition has been associated with other changes. As editors in chief, we have observed a rise in the quality of submissions and a fall in the number of out-of-scope submissions. The journal is now registered in all key academic databases. There has also been a change in the country of origin of submissions. In 2020–2021 the top countries of submission were China, Iran, Italy and India. However, in the past 12 months the top countries of submission were China, the Netherlands, the USA, Sweden and Turkey.

JPOG has also faced challenges, along with other global journals. We have had to discuss the role of artificial intelligence, the cost of open access fees for junior researchers, and the difficulty in securing robust peer review in an era when many of us lack time for intellectual academic pursuit. Despite these challenges, JPOG has emerged stronger than ever with an expanding global submission and readership base and continues to publish articles that directly influence patient care and education of the next generation of clinicians. Just as enhanced mother-infant bonding enables the newborn baby to have an optimal start to life, JPOG remains bonded to our base of clinical and scientific researchers and remains well placed to manage the new era of open access on-line activity to educate the future workforce.

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No potential conflict of interest was disclosed by the authors.

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Funding

The author(s) reported there is no funding associated with the work featured in this article.