Summary: The emotional and psychological bond formed between a mother and her infant in early months lays the neurological foundation for the child’s long-term cognitive, social, and behavioral development. A clinical phenomenon called mother-to-infant bonding difficulties (MIBD) can disrupt this vital connection. MIBD often shows as sudden emotional indifference, emotional distance, or hidden anger during everyday interactions with the baby. This condition is strongly linked with inappropriate caregiving and later developmental delays. Importantly, a large multi-center analysis of the Japan Environment and Children’s Study (JECS) reveals that nearly half of mothers experiencing severe bonding difficulties show no signs of clinical postpartum depression, meaning many affected families remain undetected by standard mental health screenings.
Using the JECS database, researchers examined the prevalence and risk factors for MIBD in mothers who screened negative for postnatal depression. While overall MIBD prevalence aligns with prior reports, the analysis highlights an “invisible half”: a substantial share of bonding problems occurs in mothers without depression symptoms, leaving them unlikely to be identified through routine obstetric and pediatric depression-focused screenings.
Key Facts
- The Invisible Half: MIBD affects about 11.6% of postpartum mothers overall. Among mothers who screened negative for postnatal depression, the prevalence was 7.7%—yet this non-depressed group still represents roughly half of all MIBD cases in the study sample.
- Two Emotional Dimensions: The study divides MIBD into Lack of Affection (LA) and Anger/Rejection (AR). Among mothers reporting difficulties, 38.2% endorsed items related to LA and 51.8% endorsed AR-related items.
- Early Physical Interaction as a Strong Predictor: The single strongest risk factor was mothers reporting difficulty holding the infant when the baby cried, fussed, or arched its back at one month postpartum. That early struggle increased the likelihood of MIBD at one year by approximately 3.45 times.
- First Reaction to Pregnancy: Mothers who felt anything other than happy when they first learned they were pregnant—such as shock, confusion, fear, or emotional neutrality—were about 2.42 times more likely to develop MIBD later on.
- Protective Role of Social Support: High levels of proactive social support from partners, family, or community during pregnancy reduced the risk of MIBD by about 55%.
- Implications for Screening: Because many mothers with MIBD do not show classic depressive symptoms, researchers recommend revising pediatric and postpartum screening protocols to include direct questions about early caregiving interactions—especially whether a mother has trouble holding or soothing a fussy, back-arching infant at the one-month checkup.
Source: University of Toyama
Overview: A secure emotional bond between mother and infant is essential in early life. Yet some mothers experience detachment, emotional numbness, or anger in interactions with their newborns — a pattern defined as mother-to-infant bonding difficulties (MIBD). MIBD has been associated with suboptimal caregiving and increased risk of developmental problems in children, making early identification and support vital.
“The prevalence of MIBD has been reported at 11%–12%, but there is limited information about how often MIBD occurs in mothers who do not meet criteria for postnatal depression,” explains Hitomi Inano from the Department of Nursing Sciences, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama. She and colleagues note that unrecognized bonding difficulties may contribute to the recent rise in child maltreatment and developmental disorders.
The research team analyzed data from 64,938 mother–child pairs registered in JECS between 2011 and 2014. They used the Mother-to-Infant Bonding Scale—Japanese version (MIBS-J) to identify MIBD and applied rigorous exclusion criteria to remove mothers with sustained postnatal depression. Mothers scoring ≥5 on the MIBS-J were classified as having MIBD, while subscale cut-offs identified Lack of Affection and Anger/Rejection components.
Of the variables examined across child, maternal, lifestyle, psychological, social/economic, and medical dimensions, three factors showed the strongest associations with MIBD among mothers without prior postnatal depression: difficulty holding the baby during crying/back-arching (adjusted odds ratio [AOR] 3.45), negative or non-happy feelings at pregnancy confirmation (AOR 2.42), and low social support, with high support strongly associated with lower risk (AOR 0.45).
Ms. Inano emphasizes clinical implications: “Mothers with bonding difficulties who screen negative for postnatal depression are less likely to be identified by healthcare providers. Clinicians should incorporate direct questions about early feeding and soothing challenges—especially difficulty holding or comforting a cranky, arching infant—into routine one-month visits. Early detection allows timely support to improve maternal well-being and promote healthy child development.”
Funding information
The Japan Environment and Children’s Study is funded by the Japanese Ministry of the Environment. The funder did not participate in study design, data collection, analysis, interpretation, or the preparation of the report.
Key Questions Answered
A: Bonding and clinical depression are distinct processes. A mother can be free of depressive symptoms yet still feel emotional detachment, numbness, or frustration toward her infant. If clinicians focus solely on depressive symptoms, they will miss a large group of mothers who need relationship-focused support.
A: When an infant cries inconsolably and physically arches away from a caregiver, the tactile experience can feel like rejection. Without adequate support, some mothers unconsciously detach to protect themselves, creating an early negative interaction pattern that increases the risk of persistent bonding difficulties.
A: In addition to mood-based screening, pediatric and postpartum visits should include direct questions about caregiving interactions—specifically whether the mother has trouble holding or soothing her baby when the infant is fussy or arches its back. Identifying these practical challenges enables early, targeted interventions even when depression screens are negative.
Editorial Notes:
- This article was edited by a Neuroscience News editor.
- The journal paper was reviewed in full.
- Additional contextual information was provided by the editorial staff.
About this research news
Author: Hitomi Inano
Source: University of Toyama
Contact: Hitomi Inano – University of Toyama
Image: The image is credited to Neuroscience News
Original Research: “Factors associated with mother-to-infant bonding difficulties without prior postnatal depression at 1 and 6 months after childbirth: the Japan Environment and Children’s Study (JECS)” by Hitomi Inano, Kenta Matsumura, Akiko Tsuchida, Hidekuni Inadera, Kanako Shimada, Tomomi Hasegawa & the JECS Group. Archives of Women’s Mental Health. DOI: 10.1007/s00737-026-01726-x. Open access.
Abstract
Title: Factors associated with mother-to-infant bonding difficulties without prior postnatal depression at 1 and 6 months after childbirth: the Japan Environment and Children’s Study (JECS)
Purpose
To identify factors linked to mother-to-infant bonding difficulties (MIBD) in mothers who did not have prior postnatal depression and to clarify the condition’s prevalence.
Methods
Researchers analyzed 64,938 mother–child pairs from JECS. MIBD was measured with the MIBS-J. Mothers with Edinburgh Postnatal Depression Scale scores ≥9 at both 1 and 6 months postpartum were excluded. MIBS-J scores ≥5 indicated MIBD; subscale cut-offs identified Lack of Affection (LA) and Anger/Rejection (AR). Thirty potential exposure factors were evaluated using logistic regression.
Results
Among mothers without prior postpartum depression, prevalence rates were 7.7% for MIBD, 3.9% for LA, and 11.7% for AR. The strongest associations were difficulty holding a cranky or back-arching baby (AOR 3.45) and negative feelings toward the pregnancy (AOR 2.42). High social support was strongly associated with lower odds of MIBD (AOR 0.45).
Conclusions
MIBD occurs in a substantial minority of mothers who show no evidence of prior postnatal depression. Key associated factors include difficulty holding the infant when the baby is fussy or arches its back, low social support, and negative feelings about the pregnancy. These findings support revising screening practices to identify and support at-risk mothers even when depression screens are negative.