Keren Epstein-Gilboa PhD, MEd, BScN, RN, FACCE, LCCE. IBCLC, RLC

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Interaction and Relationships in Breastfeeding Families: Implications for Practice by Keren Epstein-Gilboa provides insight into the lifestyle, themes and patterns in families that engage in physiological breastfeeding. The content is based on the author’s research and an analysis of child, parent and family development using established psychological models.

Physiologically based breastfeeding patterns correspond with the recommendations set by the World Health Organization (WHO, 1981, 2017). Physiological breastfeeding is more than a mere means of feeding. Rather, it is an encompassing relationship with implications for infant, child, parental and family development. This style of breastfeeding is facilitated by and influences specific behaviors and themes that ripple through the family system. Most notable are the proximity and child focused behaviors. Themes of respect for natural processes and reverence for children’s unique rhythms remain salient features of parenting and family interaction long after weaning from the last breastfeeding relationship.

Mother and baby attachment

Readers will gain insight into interactions associated with physiological breastfeeding, associated proximity and parenting behaviors, and the physiological nursing on the family system. Discussions connecting breastfeeding related interactions to models of child and parental development will help readers understand the far reaching implications of this physiologically based behavior. One of the psychological models explained in this book is attachment theory. Mary Ainsworth and John Bowlby are two founding theorists of this paradigm. In this model healthy child development is advanced when parents develop the ability to understand, interpret and respond to child cues. This type of parenting is called sensitive or attuned and contributes to the establishment of secure attachment for children. Factors associated with the physiology of lactation and breastfeeding contribute to multiple opportunities for parents to develop sensitive parenting styles associated with healthy attachment systems.

Far reaching implications

Mothers develop sensitive mothering styles by answering frequent cues for initiation of nursing, intricate exchanges during breastfeeding and cues for termination of each session. Sensitive interaction is facilitated by proximity behaviors and is carried on between nursing sessions. The congruence between maternal emotional agendas and mothering through breastfeeding seems to reinforce attuned interaction. In addition, mothers’ narratives indicate that the breastfeeding experience seems to boost sensitivity by providing them with a means of repairing perceived damaged physiology or to compensate for lost fertility in cases of some adoptive mothers.

Nurslings experience ongoing sensitive responses to their cues, a factor contributing to the development of inner feelings of security. Family members observe and replicate components of sensitive interaction with the youngest nursing child. Older siblings’ displays of sensitive interaction with youngest family members, their peers and eventually the next generation point to the strong impact of experiencing and observing sensitive parenting through breastfeeding.  

The discussion about fathers in this book extends beyond traditional notions of support. Fathers internalize sensitive fathering through observation, protection  and by mirroring interactional components associated with breastfeeding. The role of fathering in a breastfeeding family fulfills fathers’ emotional needs,  and contributes to the development of unique paternal styles as well as the common and healthy occurrence of paternal envy.  

The discussion of the parental couple relationship suggests that parents develop couple activities to suit a context of ongoing parent child interaction.  The book suggests that relational difficulties between mothers and fathers likely stem from issues unrelated to breastfeeding and might interfere with parental sensitivity. Yet, the author suggests further that the intense breastfeeding relationship may be scapegoated in cases of couple distention.  

The book provides an insider’s view of a physiological behavior with implications for long-term social and emotional development of children, parents and families. The book’s unique psychological focus provides insights about an area of study that has been disregarded in most current discussions about breastfeeding. Readers may use the information as a means of understanding their own breastfeeding relationships or to help others with this task.  

Dr. Keren Epstein-Gilboa is a Registered nurse who practices psychotherapy. Her graduate degrees and training are in counseling, individual and family psychotherapy and a PhD  in developmental psychology. She has been a lactation consultant (IBCLC) and Lamaze certified childbirth educator for nearly three decades.

Hear Keren on Voice America.

Photo with title Belle Verdiglione.

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