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PubMedDate not supplied

Mother-infant interaction: achieving synchrony.

BACKGROUND: Interventions that promote positive mother-infant interactions may reduce the risk of poor developmental outcomes for the child. OBJECTIVE: To examine the effect of infant communication education presented prenatally to first-time mothers on the quality of interaction that occurs between the mother-infant dyad in the first 24 hours following birth. METHOD: Twenty-nine first-time mothers were randomly assigned to either an intervention or control group. The intervention group received education on infant behaviors, states, and communication cues. A specific mother-infant interaction was videotaped and scored using the Nursing Child Assessment Teaching Scale (NCATS). The scores between groups were compared to determine the effect of education on the interaction that occurred between the dyads. RESULTS: Significant intervention effect was found in the overall totals (t(27)= 1.69; p = .05) as well as the contingency scores related to sensitivity to cues (t(27)= 1.93; p = .05) and social-emotional growth-fostering behaviors (t(27)= 1.93; p = .05). CONCLUSION: A videotaped educational intervention on infant communication implemented prenatally resulted in significant differences between the intervention and control groups on NCATS scores (totals, sensitivity to cues, and social-emotional growth-fostering behaviors). The use of videotaped educational information facilitates very early mother-infant interaction.

Adolescent↗
PubMed2001

Home and videotape intervention delays early complementary feeding among adolescent mothers.

BACKGROUND: The American Academy of Pediatrics, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the World Health Organization recommend that infants receive only breast milk or formula for the first 4 to 6 months of life, followed by the introduction of complementary foods. Despite these recommendations, many infants, particularly those with adolescent mothers, receive solid foods (often cereal mixed with formula in a bottle) and liquids other than formula or breast milk in the first few weeks of life. Decisions on early feeding are often guided by grandmothers and influenced by beliefs that infants need complementary food to counteract signals of hunger, reduce crying, and sleep through the night. OBJECTIVE: This investigation evaluated the efficacy of an intervention to delay the early introduction of complementary feeding among first-time, black, adolescent mothers living in multigenerational households. The intervention focused on reducing the cultural barriers to the acceptance of the recommendations of the American Academy of Pediatrics, WIC, and World Health Organization on complementary feeding by highlighting 3 topics: 1) recognition of infants' cues; 2) nonfood strategies for managing infant behavior; and 3) mother-grandmother negotiation strategies. The intervention was delivered through a mentorship model in which a videotape made by an advisory group of black adolescent mothers was incorporated into a home-visiting program and evaluated through a randomized, controlled trial. METHODS: One hundred eighty-one first-time, low-income, black mothers <18 years old, living in multigenerational households were recruited from 3 urban hospitals. Infants were born at term, with birth weight appropriate for gestational age and no congenital problems. Shortly after delivery, mothers and grandmothers completed a baseline assessment and mothers were randomized into an intervention or control group. Intervention group mothers received home visitation every other week for 1 year. At 3 months, a subset of 121 adolescent mothers reported on their infant's intake through a food frequency questionnaire. Mothers who fed their infant only breast milk, formula, or water were classified as optimal feeders. Mothers who provided complementary foods other than breast milk, formula, or water were classified as less optimal feeders. RESULTS: Sixty-one percent of the infants received complementary foods before 3 months old. Multivariate hierarchical logistic regression was used to evaluate the determinants of being in the optimal versus less optimal feeders group. After controlling for infant age and family income, mothers of infants in the optimal feeders group were more likely to report accurate messages from WIC regarding the timing of complementary food and nearly 4 times more likely to be in the intervention group. The most common complementary food was cereal mixed with formula in the bottle. CONCLUSIONS: The success of this relatively brief intervention demonstrates the importance of using ecological theory and ethnographic research to design interventions that enable participants to alter their behavior in the face of contradictory cultural norms. The intervention focused on interpreting infants' cues, nonfood methods of managing infant behavior, and mother-grandmother negotiations. It was delivered through methods that were familiar and acceptable to adolescent mothers-a mentorship model incorporating home visits and videotape. The skill-oriented aspects of the intervention delivered in a culturally sensitive context may have enabled the young mothers to follow the guidelines that they received from WIC and from their pediatricians. Strategies, such as those used in this intervention, may be effective in promoting other caregiving recommendations, thereby enabling providers to meet the increasing demands from parents for advice regarding children's early growth and development.

Adolescent↗
PubMed1986

Measuring difficult temperament in infancy.

Thirty-four couples rated their 6-month-old first-born infants' temperaments with Bates' Infant Characteristics Questionnaire (ICQ) and Carey's Infant Temperament Questionnaire (ITQ). Mothers and infants were videotaped in their homes during feedings on two consecutive days to assess mother and infant behavior. Results indicated that parents had moderate agreement about their own infant's temperament on the ICQ. There was little convergence between the ICQ and the ITQ measures of infant difficulty. ICQ parent-rated unpredictable infants were rated by observers as less responsive during the feedings. These results are discussed in the context of the meaning and measurement of infant temperament.

Adult↗
PubMed2003

Impact of postpartum depressive symptoms on mother and her 18-month-old infant.

BACKGROUND: Postpartum depression (PPD) is known to have important negative effects on mother, infant and mother-child relationship. METHODS: We present a case-control study of 35 mothers and their 18-month-old infants. These mothers suffered from postpartum depressive symptoms (PDS) when the infants were three months old, as rated with the Edinburgh Postnatal Depression Scale (EPDS, Cox 1987). A control group of 35 mothers without postpartum depressive symptoms (NPDS) with their 18-month-old infants was also evaluated. The infants were assessed using the Infant Behavior Record of the Bayley Scales of Infant Development, the Strange Situation and an object concept task. RESULTS: 15 months later, the PDS mothers were less affectionate and more anxious than the NPDS mothers. The PDS dyads demonstrated less verbal interaction and less playing interaction. 18-month-old infants of PDS mothers performed less well on object concept tasks, and were more often insecurely attached to their mothers. Only some results were linked to the mothers' depressive state (D-mothers) diagnosed at 18 months (e. g. responsiveness to persons). CONCLUSIONS: The important negative effects observed at 18 months on mother and infant of maternal PDS at 3 months confirm the need for early identification and therapeutic or preventive interventions.

Adult↗
PubMed2006

Studying cross-cultural differences in the development of infant temperament: People's Republic of China, the United States of America, and Spain.

Investigated early development of temperament across three cultures: People's Republic of China (PRC), United States of America (US), and Spain, utilizing a longitudinal design (assessments at 3, 6, and 9 months of age). Selection of these countries presented an opportunity to conduct Eastern-Western/Individualistic-Collectivistic comparisons. The greatest number of significant differences (i.e., involving more temperament dimensions) was anticipated for the US (Western/Individualistic) and PRC (Eastern/Collectivistic) comparisons. The US sample included 66, the PRC group 69, and the Spanish sample, 60 mothers, all of whom completed the Infant Behavior Questionnaire (IBQ) 3 times, when their infants were 3, 6, and 9 months of age. Results related to mean group differences were generally consistent with our hypotheses, demonstrating a greater number of significant differences for US versus PRC, with fewer differences observed for US and Spain. Analyses addressing developmental changes in temperament indicated patterns consistent with a priori expectations and cross-cultural differences.

China↗
PubMed2005

Correlates of early postpartum depressive symptoms.

BACKGROUND: Postpartum depressive symptoms negatively affect the quality of life and daily functioning of mothers and infants. Little research has examined the impact of situational factors such as physical symptom burden and function on early postpartum depressive symptoms. OBJECTIVES: To explore the association between situational factors and early postpartum depressive symptoms. To predict correlates of early postpartum depressive symptoms. METHODS: Cross sectional telephone survey of 720 mothers between 2 and 6 weeks postpartum. Mothers reported on demographic factors, physical and psychological symptoms, daily function, infant behaviors, social support, and skills in managing infant and household. The association between these factors and postpartum depressive symptoms were investigated with bivariate and multivariable analyses. RESULTS: Nearly, 39% of patients screened positive for depressive symptoms. Bivariate analyses showed symptomatic patients were more likely to be nonwhite, have lower incomes, less education, a past history of depression, have higher physical symptom burdens, more physical functional limitations, more infant colic, receive less social support, and have lower-self-efficacy scores as compared with patients without symptoms of depression. In a multivariable model predicting depressive symptoms, nonwhite race (odds ratio (OR) of 1.96, 95% confidence interval (CI) of 1.38, 2.78), more physical symptoms (OR 1.16, 95% CI 1.01, 1.32), infant colic (OR 1.79, 95% CI 1.29, 2.50) lack of social support (OR 0.90, 95% CI 0.86, 0.95), and lower self-efficacy scores (OR 0.90, 95% CI 0.86, 0.94) were associated with depressive symptoms. CONCLUSIONS: Nonwhite race, physical symptom burden, infant colic, lack of social support, and lower self-efficacy scores are associated with early postpartum depressive symptoms. Further research is needed to investigate whether providing social support and teaching skills to enhance self-efficacy will reduce the incidence of early postpartum symptoms of depression.

Adult↗
PubMed1989

Iron deficiency anemia: adverse effects on infant psychomotor development.

In a double-blind, placebo-control prospective cohort study of 196 infants from birth to 15 months of age, assessment was made at 12 months of age of the relationship between iron status and psychomotor development, the effect of a short-term (10-day) trial of oral iron vs placebo, and the effect of long-term (3 months) oral iron therapy. Development was assessed with the mental and psychomotor indices and the infant behavior record of the Bayley Scales of Infant Development in 39 anemic, 30 control, and 127 nonanemic iron-deficient children. Anemic infants had significantly lower Mental and Psychomotor Developmental Index scores than control infants or nonanemic iron-deficient infants (one-way analysis of variance, P less than .0001). Control infants and nonanemic iron-deficient infants performed comparably. No difference was noted between the effect of oral administration of iron or placebo after 10 days or after 3 months of iron therapy. Among anemic infants a hemoglobin concentration less than 10.5 g/dL and duration of anemia of greater than 3 months were correlated with significantly lower motor and mental scores (P less than .05). Anemic infants failed specifically in language capabilities and body balance-coordination skills when compared with controls. These results, in a design in which intervening variables were closely controlled, suggest that when iron deficiency progresses to anemia, but not before, adverse influences in the performance of developmental tests appear and persist for at least 3 months despite correction of anemia with iron therapy. If these impairments prove to be long standing, prevention of iron deficiency anemia in early infancy becomes the only way to avoid them.

Anemia, Hypochromic↗
PubMed2004

Parent-infant synchrony and the social-emotional development of triplets.

To study the social-emotional development of triplets, 23 sets of triplets, 23 sets of twins, and 23 singleton infants (N=138) were followed from birth to 2 years. Maternal depression and social support were assessed in the postpartum period, mother-infant and father-infant interaction and the home environment were observed at 3 months, a separation-reunion episode and a maternal interview were conducted at 12 months, and infant behavior problems were evaluated at 24 months. Lower parent-infant synchrony was observed for triplets. Triplets showed less distress during maternal separation and less approach at reunion. Mothers reported lower adjustment and differentiation among siblings for triplets than for twins. Higher internalizing problems were reported for triplets, and the triplet with intrauterine growth retardation showed the poorest outcomes. Behavior problems were predicted by medical risk, maternal depression, parent-infant synchrony, infant approach, and mother adjustment. Discussion focuses on developmental risk when the exclusivity of the parent-infant relationship is compromised.

Adaptation, Psychological↗
PubMed1999

Serum concentrations of antidepressants and benzodiazepines in nursing infants: A case series.

OBJECTIVE: The relative risk of psychotropic medication use in women with puerperal psychiatric illness who are breastfeeding has yet to be quantified adequately. Although the emotional and medical benefits of breastfeeding and adverse effects of maternal depression on infant development are well described, how these absolute benefits weigh against the potential effects of psychotropic drug use during lactation to ultimately guide clinical decisions is still unclear. The objective of this report was to evaluate the extent that psychotropic medications were present in the serum of infants breastfed by mothers treated with antidepressants and benzodiazepines. DESIGN: Serum samples were obtained from 35 nursing infants whose mothers were treated with psychotropic medications while breastfeeding. When a detectable concentration of medication was reported, information regarding infant behavior was obtained by maternal report. SETTING: The Perinatal and Reproductive Psychiatry Program at Massachusetts General Hospital serves as a regional consultation center for the treatment of psychiatric disorders during pregnancy and the postpartum period. PATIENTS: Subjects were mothers referred to the Perinatal Psychiatry Program for consultation regarding the relative safety of psychotropic medication use while breastfeeding. PRIMARY OUTCOME MEASURES: Presence of detectable levels of medication in infants whose mothers breastfed while taking psychotropic medications during pregnancy and/or during the puerperium and the well-being (based on maternal report) of infants who had detectable serum concentrations of medication. RESULTS: Seventy-four percent (n = 26) of infants had serum medication concentrations below the laboratory limit of detection (assay sensitivity 5-50 ng/mL). In the remaining 26% of the sample (n = 9), serum concentrations of psychotropic medications and/or active metabolites were detected. In each of these cases, infants had been exposed to the medication during pregnancy. Medications were not detected in infant serum when mothers had taken these agents solely during the postpartum period. No readily apparent difficulties with the infants were reported by mothers. CONCLUSIONS: These data support the low incidence of infant toxicity and adverse effects associated with antidepressant and benzodiazepine use during breastfeeding. These data also suggest that infant serum monitoring is helpful in the assessment of medication exposure in children of mothers who breastfeed while using psychotropic medications. Given the limited accumulated data regarding serum concentrations of psychotropic medications in breastfeeding infants, no single agent seems to be safer than another. Therefore, choice of pharmacologic treatment should be guided by the likelihood that it will result in restoration of maternal psychiatric well-being.

Antidepressive Agents↗
PubMed2001

Maternal analgesia during labor disturbs newborn behavior: effects on breastfeeding, temperature, and crying.

BACKGROUND: Newborns not exposed to analgesia, when placed on the mother's chest, exhibit an inborn prefeeding behavior. This study was performed to assess the effects of different types of analgesia during labor on the development of spontaneous breastfeeding movements, crying behavior, and skin temperature during the first hours of life in healthy term newborns. METHODS: Video recordings were made of 28 newborns who had been dried and placed in skin-to-skin contact between their mother's breasts immediately after delivery. The video recordings were analyzed blindly with respect to infant exposure to analgesia. Defined infant behaviors were assessed every 30 seconds. Group 1 mothers (n = 10) had received no analgesia during labor, group 2 mothers (n = 6) had received mepivacaine via pudendal block, and group 3 mothers (n = 12) had received pethidine or bupivacaine or more than one type of analgesia during labor. RESULTS: All infants made finger and hand movements, but the infant's massagelike hand movements were less frequent in infants whose mothers had received labor analgesia. A significantly lower proportion of group 3 infants made hand-to-mouth movements (p < 0.001), and a significantly lower proportion of the infants in groups 2 and 3 touched the nipple with their hands before suckling (p < 0.01), made licking movements (p < 0.01), and sucked the breast (p < 0.01). Nearly one-half of the infants, all in groups 2 or 3, did not breastfeed within the first 2.5 hour of life. The infants whose mothers had received analgesia during labor had higher temperatures (p = 0.03) and they cried more (p = 0.05) than infants whose mothers had not received any analgesia. CONCLUSIONS: The present data indicate that several types of analgesia given to the mother during labor may interfere with the newborn's spontaneous breast-seeking and breastfeeding behaviors and increase the newborn's temperature and crying.

Adult↗
PubMed2002

Pulse rate and behavioral state correlates after auditory, tactile, visual, and vestibular intervention in drug-exposed neonates.

OBJECTIVE: Compare responses of nonexposed and drug-exposed newborns to auditory, tactile, visual, and vestibular (ATVV) intervention. STUDY DESIGN: Prospective design with random assignment of drug-exposed (N=45) and nonexposed (N=72) newborns to control and experimental groups. METHODS: Experimentals received 15 minutes of ATVV twice after birth. Infant behavioral state (IBS) and pulse rate (PR) were measured. RESULTS: The nonexposed and drug-exposed control groups (p=0.021) differed on the distribution of IBS yet no differences were noted between the two experimental groups. Nonexposed and drug-exposed experimentals experienced more alertness and less quiet sleep than controls (p<0.05). PR and IBS were significantly correlated for all but the drug-exposed control group (nonexposed control, r=0.938, p=0.006; nonexposed experimental, r=0.979, p=0.001; drug-exposed experimental, r=0.955, p=0.003). Within the combined (control+experimental) drug-specific groups, only polydrug-exposed infants demonstrated such a correlation (r=0.584, p=0.046). A significant correlation was also identified within the cocaine-exposed group for the experimentals only (r=0.992, p<0.001). CONCLUSION: The ATVV promoted normal physiologic and behavioral function.

Adult↗
PubMed1991

Anxiety in rhesus monkey infants in relation to interactions with their mother and other social companions.

In this study the anxiety-related components of rhesus monkey infant behavior at an early stage of social development were examined. Eight rhesus infants (age 30-40 weeks) belonging to 3 captive groups were administered with an anxiogenic drug (beta-CCE; 0.2 mg/kg) and an anxiolytic drug (midazolam; 0.2 mg/kg). Saline solution was used as placebo. All infants were tested twice with each drug (four times with placebo) and their behavioral interactions with their mother and other social companions were recorded in 1-hr observation sessions. No convulsant or sedative effects of the drugs were observed. beta-CCE was associated with an increase in time spent by the infant with its mother and a concomitant reduction in proximity with other individuals and in social play. Midazolam did not affect the mother-infant interaction but increased the infant's locomotor activity away from the mother and its proximity and social play with juveniles and subadults when compared to peers. These results suggest that, although infant anxiety can be experimentally induced, it is not a major component of the mother-infant relationship. Infant anxiety, however, might affect the formation of other social bonds and play a part in the development of avoidance responses toward other individuals.

Animals↗
PubMed1977

Stranger responses: effects of familiarity, stranger's approach, and sex of infant.

Most investigators examining contextual influences on infant responses to a stranger have limited their study to the initial responses of the infant. Few have considered infant reactions beyond the first minutes of the encounter or the enduring effects of contextual variables once mothers have left. The present study examines the effects of stranger's style of approach, familiarity with the stranger, and infant sex on infant response before and after maternal separation. Familiarity was operationalized in 2 ways: the length of time mothers stayed before leaving infants with the stranger and meeting the stranger a second time. Findings suggest that all these factors influence infant behavior. Ifants looked and smiled at the stranger significantly more when approached slowly. Contrary to expectations, infants (particularly girls) who met the familiar stranger after 1 week protested significantly more when left with her at that time. Trends indicate the length of time mothers stayed was least influential since most infants became extremely distressed once mothers departed.

Child Behavior↗
PubMed1991

Optimization of automated hearing test algorithms: a comparison of data from simulations and young children.

A five-up, five-down automated staircase procedure was used to explore the effects of variable starting and stopping rules as they interact with infant behavior in influencing the accuracy and efficiency of infant auditory threshold testing. Results from 146 infants were compared to results from computer simulations (see accompanying article) in order to evaluate an infant response model used in the simulations. Results indicate that the automated procedure successfully discriminated between infants with normal versus abnormal tympanograms. In addition, the model accurately predicted infant results in terms of the effects of starting and stopping rules. The model was less useful in predicting the relationship between minimum response levels and false positive rates.

Algorithms↗
PubMed2003

Use of the Alberta Infant Motor Scale to characterize the motor development of infants born preterm at eight months corrected age.

The Alberta Infant Motor Scale (AIMS) was used to examine variations in motor development of infants born preterm. Sixty infants attending a Developmental Follow-up Clinic participated. Infants were assessed by physical therapists using the AIMS and independently judged by physicians to be neurodevelopmentally and neurologically "normal," "suspect," or "abnormal." The AIMS clearly differentiated infants in these three categories. Compared to the normative sample, infants judged to be "normal" demonstrated similar motor behaviors, infants judged to be "abnormal" were significantly different across a wide range of items, and infants judged to be "suspect" were significantly different on items requiring antigravity postural control, lower extremity dissociation, and trunk rotation. The AIMS can be used to identify infants developing abnormally, to affirm normalcy in infants developing typically, and to identify motor differences in infants who are neurologically "suspect." In the latter group of infants, the AIMS can be used to provide anticipatory guidance to parents regarding the components of movement they might expect their infants to be developing next.

Developmental Disabilities↗
PubMedDate not supplied

Behavioral characteristics of infants with nonorganic failure to thrive during a play interaction.

PURPOSE: To examine the behavioral responses of infants with nonorganic failure to thrive (NOFTT) during play interactions with their mothers. DESIGN: Comparative descriptive. METHODS: The sample consisted of 31 infants; 17 with nonorganic failure to thrive (NOFTT) and 16 matched healthy controls. The infants were videotaped during a play interaction with their mothers. The behaviors exhibited by the infants were scored with the Parent-Child Early Relational Assessment. The environmental context of the play interaction was also rated for how play was initiated, maternal involvement, and the presence of chaos. RESULTS: Infants with NOFTT exhibited more difficult behaviors during play such as more negative affect, less vocalizing, and more gaze aversion. Mothers of the infants with NOFTT were less likely to remain involved during the play interaction. The environments of the infants with NOFTT were also found to be more chaotic during play. CLINICAL IMPLICATIONS: Assessment of the infant-mother interaction during play may provide insight into the interactions that occur during other caretaking activities. Strategies could be developed to assist the mother with interacting with her difficult infant. Future research could lead to interventions that could help improve the dynamics of the infant-mother interaction in infants with NOFTT.

Child Development↗
PubMed1987

Infants' detection of visual-tactual discrepancies: asymmetries that indicate a directive role of visual information.

Infants' cross-modal functioning was investigated in two studies. In Study 1, 11-month-old infants were confronted with five different visual-tactual discrepancies created with a mirror arrangement. The infants' behavioral reactions to the discrepancies were compared with their behavior on matched control trials with a forced-choice judgement procedure. Infants detected discrepancies in which they saw an egg and felt a cube, saw a fur-covered cube and felt an egg, and saw a cross and felt a fur-covered cube. However, they provided no evidence that they detected discrepancies in which they saw a cube and felt a cross or saw a cube and felt a fur-covered cube. In Study 2, infants were confronted with discrepancies that were the converse of those which seemed to go unnoticed in Study 1: They saw either a cross or a fur-covered cube and felt a plain cube. Both of these new discrepancies were detected according to the forced-choice judgment procedure. The results indicate that texture as well as shape can serve as a basis for cross-modal matching for infants. The asymmetries in cross-modal matching that were observed across Studies 1 and 2 are interpreted as evidence that visual information plays a directive, goal-setting role for infants' manual explorations.

Attention↗