Dear editor 
The intricate relationship between a nursing mother’s health, lifestyle, and environment and the developmental outcomes of her child is a critical area of study that has far-reaching implications. While much attention has been given to the physical benefits of breastfeeding, such as improved immunity and nutrition for infants, the potential for behavioral disorders in children as a consequence of maternal factors during the nursing period remains underexplored. These disorders, ranging from Attention-Deficit/Hyperactivity Disorder (ADHD) to anxiety and conduct issues, may be influenced by a variety of maternal factors, including mental health, substance use, and environmental stressors. Addressing this overlooked issue is essential for promoting holistic child development and supporting maternal well-being (1).
Breastfeeding is often heralded as a cornerstone of early childhood development, providing essential nutrients and fostering emotional bonding. However, the maternal environment during this period can significantly impact the child’s neurological and psychological development. For instance, a mother’s mental health plays a pivotal role. Postpartum depression, which affects approximately 10-15% of new mothers, can alter the quality of mother-infant interactions (2). Depressed mothers may exhibit reduced responsiveness or inconsistent caregiving, which can disrupt the emotional security necessary for healthy brain development. Studies have shown that children of mothers with untreated postpartum depression are at a higher risk of developing behavioral issues, such as hyperactivity or emotional dysregulation, by early childhood. This connection suggests that the psychological state of a nursing mother is not merely a personal concern but a public health issue that can shape the next generation (3).
Another critical factor is the potential transmission of substances through breast milk. Maternal use of alcohol, nicotine, or certain medications during breastfeeding can have subtle but profound effects on a child’s developing brain. For example, exposure to alcohol via breast milk has been linked to impaired cognitive and behavioral outcomes, including increased irritability and difficulty with self-regulation in infants. Without proper medical guidance, these exposures could contribute to behavioral disorders later in life. Yet, this issue is rarely discussed in prenatal or postnatal care, leaving many mothers unaware of the risks (4).
Environmental stressors, such as socioeconomic challenges or domestic violence, further complicate the picture. Nursing mothers facing financial strain or unsafe home environments may experience chronic stress, which can elevate cortisol levels in both the mother and, through breast milk, the infant. Elevated cortisol in early infancy has been associated with heightened stress responses in children, potentially predisposing them to anxiety disorders or aggressive behaviors. Moreover, mothers in such circumstances may struggle to maintain consistent breastfeeding practices, leading to nutritional or emotional deficits that exacerbate developmental risks. These environmental factors highlight the need for systemic support to mitigate stressors that indirectly affect child outcomes (5).
Despite the mounting evidence, behavioral disorders as a consequence of maternal factors during nursing remain under addressed in healthcare systems. Prenatal and postnatal care often focuses on physical health metrics, such as infant weight gain or maternal recovery, while mental health screenings and education about substance transmission are inconsistent. This gap is particularly concerning given the long-term implications of untreated behavioral disorders, which can lead to academic struggles, social difficulties, and increased healthcare costs. Early intervention, such as maternal mental health support or counseling on safe breastfeeding practices, could significantly reduce these risks. For example, integrating routine mental health screenings into postnatal checkups could identify mothers at risk of depression, enabling timely interventions that benefit both mother and child (6).
To address this issue, a multifaceted approach is necessary. Healthcare providers should be trained to educate nursing mothers about the potential impacts of their mental health, substance use, and environmental stressors on their children. Public health campaigns could raise awareness about the importance of maternal well-being during the nursing period, destigmatizing mental health treatment and encouraging help-seeking behaviors. Additionally, policy interventions, such as expanded access to mental health services or social support programs for low-income mothers, could alleviate environmental stressors. Research into the long-term effects of breastfeeding under various maternal conditions is also critical to developing evidence-based guidelines (7).
In conclusion, the link between maternal factors during nursing and behavioral disorders in children is a critical yet overlooked issue. By addressing maternal mental health, substance use, and environmental stressors, healthcare systems can mitigate risks and promote healthier developmental outcomes. Ignoring this connection perpetuates a cycle of untreated disorders that burden individuals and society. A proactive approach, rooted in education, support, and research, is essential to ensure that the benefits of breastfeeding extend beyond physical health to foster emotional and behavioral well-being in children.

Funding
None declared. 

Conflict of Interest
There was no conflict of interest in this manuscript.