By Massimo Lattanzi¹²³, Tiziana Calzone¹²³
¹Italian Association of Psychology and Criminology (AIPC), Rome, Italy ²Italian Center for Relational
Psychotraumatology (CIPR), Pescara-Rome, Italy ³National Observatory on Family Homicides (ONOF), Rome, Italy
 

Introduction
This article explores the multifaceted implications of infant feeding choices, beginning with a review of the global scientific consensus on their biological and psychological impact. Subsequently, the analysis will focus on using the lens of Relational Psychotraumatology to investigate how early feeding experiences can reverberate through adult relationships and across generations. The central thesis is that the act of nourishing transcends mere subsistence, representing a foundational relational event whose echoes can be traced through epigenetic signatures, cognitive development, adult attachment patterns, and ultimately, in the legacy of trauma transmitted to subsequent generations.

Part I: The Scientific Consensus on Infant Feeding: A Global and Integrated Perspective

This first part establishes the foundational consensus based on evidence from international research, creating the factual basis upon which the specialized theoretical analysis of Part II will be built.

The Biological Matrix: Neuro-Psycho-Physical Correlates of Breastfeeding

This section summarizes data on the direct health outcomes for the child and mother and provides a nuanced examination of research on cognitive development.

Physical Health Outcomes for the Child A detailed review of the protective effects of breastfeeding reveals significant benefits.

·        Reduced Risk of Infections: Breast milk contains immunologically active substances that significantly lower the risk of acute infections. Data indicate a 100% excess risk for otitis media, 178% for gastrointestinal infections, and 257% for hospitalizations due to lower respiratory tract infections in the first year of life for non-breastfed infants.

·        Reduced Risk of Chronic Diseases: Long-term benefits include a reduced incidence of diabetes, celiac disease, and Crohn's disease. Breastfeeding is also associated with a lower risk of childhood leukemia.

·        Reduced Infant Mortality: Breastfeeding is linked to a lower risk of Sudden Infant Death Syndrome (SIDS) and a reduction in overall infant mortality. The World Health Organization (WHO) estimates that optimal breastfeeding could save over 820,000 children's lives each year.

Physical Health Outcomes for the Mother The analysis shows significant and dose-dependent advantages for the mother as well.

·        Reduced Oncological Risk: There is extensive evidence of a protective relationship between breastfeeding and the risk of breast cancer. The risk decreases by about 4% for each year of breastfeeding. This protection extends to ovarian and endometrial cancer.

·        Reduced Risk of Metabolic Diseases: Breastfeeding is associated with a lower risk of type 2 diabetes, osteoporosis, and cardiovascular disease in the mother.

Neuro-Cognitive Development: A Contested but Significant Correlation Multiple meta-analyses report a positive association between breastfeeding and higher scores on intelligence tests, often quantified as an increase of 3-5 IQ points. The benefit appears to be dose-dependent, with longer durations correlating with higher scores. However, the scientific debate acknowledges the role of confounding variables such as maternal intelligence and socioeconomic status. Although some studies show a diminished effect after controlling for these factors, others confirm a significant, albeit smaller, benefit.

The biological plausibility of such benefits is supported by the presence in breast milk of crucial nutrients for brain development, such as long-chain polyunsaturated fatty acids (LCPUFAs) and human milk oligosaccharides (HMOs). The controversy itself shifts the analysis from a purely biological model to a bio-psycho-social one. The confounding factors (e.g., maternal education, supportive environment) are indicators of a specific relational context. Consequently, the cognitive benefits may not derive solely from the milk, but from the entire experience of being breastfed, preparing the ground for the analysis of psychological dimensions.

The Epigenetic Signature: How Early Nutrition Sculpts Long-Term Health

Epigenetics describes changes in gene function that do not alter the DNA sequence. Breastfeeding acts as a primary epigenetic modulator during a critical developmental window. Its components can directly influence mechanisms such as DNA methylation, modulate the expression of pre-existing genetic risks (e.g., obesity) in a dose-dependent manner, and shape the gut microbiota, which in turn produces epigenetically active metabolites. Recent discoveries highlight that breast milk transports microRNAs via exosomes, capable of directly influencing the child's gene expression.

These mechanisms provide a tangible biological pathway through which the mother's environment and state (health, stress levels) are biologically incorporated into the child. The concept of intergenerational trauma finds a physical substrate here. The traumatic experiences of parents can induce epigenetic changes in their offspring. Epigenetics thus becomes the physical mechanism through which the mother's state is translated into the child's biology, creating a powerful convergence between the pathways of biological and psychological transmission.

The Primacy of the Relationship: Attachment and Psychological Well-being

Breastfeeding is a foundational communicative and relational act that shapes the mother-child dyad. It is an intimate and early contact, crucial for bond-building and the development of a secure attachment. Successful breastfeeding can enhance maternal self-esteem, while difficulties are a significant risk factor for anxiety and postpartum depression (PPD).

According to Bowlby's theory, early caregiving experiences shape the "internal working models" that persist throughout life. The mother's own adult attachment style is a significant predictor of breastfeeding duration; specifically, mothers with higher attachment avoidance tend to stop breastfeeding earlier. This suggests that the inability to breastfeed is not the cause of future problems, but a powerful symptom of a pre-existing distress in the mother or the dyad. The primary trauma is not the absence of milk, but the potential absence of a regulated and attuned caregiver.

In summary, the scientific literature documents a wide range of consequences associated with the failure to exclusively breastfeed. For the child, there is high evidence for an increased risk of otitis media, gastrointestinal and respiratory infections, as well as SIDS and infant mortality. In the long term, correlations emerge with an increased incidence of chronic diseases such as diabetes and celiac disease, and even leukemia. The mother's health is also impacted: not breastfeeding is associated with a higher risk of developing breast, ovarian, and endometrial cancer, as well as type 2 diabetes and cardiovascular disease. On the neuro-cognitive level, although the scientific debate is still open, research indicates moderately lower IQ scores in non-breastfed children. Finally, on the dyadic and relational level, difficulties with or the absence of breastfeeding can correlate with an increased risk of postpartum depression and anxiety for the mother and have a potential negative impact on the development of the mother-child bond.

Part II: A Relational Psychotraumatology Analysis of Intergenerational Feeding Trauma

This part applies a targeted theoretical framework, reframing feeding difficulties as a symptom of deep relational dynamics.

Foundations of Relational Psychotraumatology

The approach of the Italian Center for Relational Psychotraumatology (CIPR) considers the impact of trauma on the individual and their relational systems, with a focus on intersubjective aspects. Relational trauma includes "adverse relational experiences" which, if repeated, are profoundly traumatizing. Such experiences are encoded in the body as implicit, non-verbal memory. A central principle is the intergenerational transmission of trauma through attachment dynamics: the caregiver can unconsciously "unload" their own unresolved trauma into the developing brain of the child, making children "unwitting carriers" of parental trauma.

The Echo of Unmet Needs: The "Partner Paradox" and the "Traumatic Bubble" by Lattanzi and Calzone

To explain the perpetuation of these patterns, two key concepts have been developed:

·        The Partner Paradox (Lattanzi): This concept describes the unconscious mechanism whereby individuals with a history of relational trauma are drawn to partners with complementary vulnerabilities. It is a search for a familiar "emotional homeland" that, paradoxically, leads to the co-creation of a relationship that re-enacts the original dysfunction, multiplying the psychopathological risk.

·        The Traumatic Bubble (Lattanzi & Calzone): This is the closed relational system created by the paradox. It has a dual function: protective, offering a sense of being understood by someone who "speaks the same language" of trauma, and pathogenic, acting as an "echo chamber" that amplifies dysfunctional patterns and prevents access to new, healing experiences.

Traumatic Resonance and Intergenerational Transmission

Applying this model, it is hypothesized that two partners who were not breastfed may carry a shared implicit memory of unmet early needs. Drawn to each other by the "Partner Paradox," they might create a "Traumatic Bubble" characterized by a resonance around themes of nourishment, dependency, and intimacy.

When this couple, trapped in the bubble, has a child, the dysregulated relational system is reactivated. The mother's dysregulated state (anxiety, implicit memories) is "unloaded" onto the baby during feeding. The infant, sensitive to this state, may respond with agitation or refusal, triggering a self-fulfilling prophecy: the baby's difficulty confirms the mother's fears ("I am inadequate"), amplifying her anxiety and leading to a negative feedback loop that culminates in the cessation of breastfeeding.

The probability of this happening is not statistically quantifiable, but it is a function of the rigidity of the parents' "Traumatic Bubble." The probability is high if the parents remain unaware of their dynamics; it is significantly mitigated if they undertake therapeutic work to make their implicit patterns explicit and break the cycle. The point of intervention is the parents' relationship with their own past, not the baby's feeding technique.

Conclusion and Clinical Implications

This article has traced a path from the cellular to the relational level, arguing that while the biological benefits of breastfeeding are clear, the psychological context is of paramount importance. The clinical implication is the need for a paradigm shift: perinatal interventions should focus less on the mechanics of breastfeeding and more on supporting the emotional regulation of parents and processing their attachment histories, in order to interrupt the intergenerational echo of the first, unmet, embrace.

Do you know or wish to explore your relational trauma history? Contact CIPR Pescara / Rome.

AIPC/CIPR Email: aipcitalia@gmail.com Reference Website: www.associazioneitalianadipsicologiaecriminologia.it WhatsApp Phone: +39 3924401930

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