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PubMed2005

Unwilling versus unable: infants' understanding of intentional action.

Infants experienced a female adult handling them toys. Sometimes, however, the transaction failed, either because the adult was in various ways unwilling to give the toy (e.g., she teased the child with it or played with it herself) or else because she was unable to give it (e.g., she accidentally dropped it). Infants at 9, 12, and 18 months of age reacted with more impatience (e.g., reaching, looking away) when the adult was unwilling to give them the toy than when she was simply unable to give it. Six-month-olds, in contrast, showed no evidence of this differentiation. Because infants' behavioral responses were appropriately adapted to different kinds of intentional actions, and because the adult's actions sometimes produced results that did not match her goal (when having accidents or failed attempts), these findings provide especially rich evidence that infants first begin to understand goal-directed action at around 9 months of age.

Aptitude↗
PubMed1983

The behavior of jaundiced infants treated with phototherapy.

This study was performed in order to evaluate possible changes in behavior in jaundiced infants without perinatal complications other than hyperbilirubinemia treated with phototherapy. Thirty jaundiced infants (mean bilirubinemia 13.3 mg/100 ml, range 8.4-17.5) born spontaneously at term and undergoing phototherapy for 6 h or more, and 30 comparison subjects similar for sex, birthweight, gestational age, Apgar score, obstetrical history and father's profession were examined during the 3rd day of life according to Brazelton Neonatal Behavior Assessment Scale (BNBAS). For 6 of 26 items we found higher values for comparison group (Wilcoxon's Test): inanimate visual median (m.) 5 vs. 3 (P less than 0.05); animate visual m. 5 vs. 3.5 (P less than 0.01); visual and auditory 5.5 vs. 4 (P less than 0.005); pull-to-sit m. 6 vs. 5 (P less than 0.01); cuddliness m. 5 vs. 4 (P less than 0.01); alertness m. 5 vs. 4 (P less than 0.005). Visual orientation responses were the most compromised. On the 4th day of life, 14 infants who had terminated phototherapy at least 2 h before (mean 9.9 h) were compared with their matched comparison group subjects and the same significantly poorer performances, mainly in visual orientation, were found. At one month of age, 12 of these infants treated with phototherapy still showed a significantly poorer performance in 2 items of orientation: inanimate visual m. 6 vs. 4.5 (P less than 0.05); visual and auditory m. 6.5 vs. 4 (P less than 0.05). Whether these results depend on the jaundice or on the phototherapy remain to be established.

Behavior↗
PubMed1998

Calibrated-orifice nipples for measurement of infant nutritive sucking.

To measure infant nutritive sucking reproducibly, nipple flow resistance must be controlled. Previous investigators have accomplished this with flow-limiting venturis, which has two limitations: flow resistance is highly dependent on fluid viscosity and older infants often reject the venturi nipple. This report describes the validation of calibrated-orifice nipples for the measurement of infant nutritive sucking. The flow characteristics of two infant formulas and water through these nipples were not different; those through venturi nipples were (analysis of variance; p < 0.0001). Flow characteristics did not differ among calibrated-orifice nipples constructed from three commercial nipple styles, indicating that the calibrated-orifice design is applicable to different types of baby bottle nipples. Among 3-month-old infants using calibrated-orifice nipples, acceptability was high, and sucking accounted for 85% of the variance in fluid intake during a feeding. We conclude that calibrated-orifice nipples are a valid and acceptable tool for the measurement of infant nutritive sucking.

Bottle Feeding↗
PubMed1980

Transcutaneous oxygen tension of newborn infants in different behavioral states.

Transcutaneous oxygen tension (tcPO2) was continuously monitored, and behavioral state was evaluated in a group of 10 normal preterm infants and 10 normal term infants. In the preterm infant group, birth weight was 1505 +/- 154 g, gestational age was 32.3 +/- 2.3 wk, and postnatal age was 8.4 +/- 5.1 days (mean +/- S.D.). In the term infant group, birth weight was 3245 +/- 247 g, gestational age was 39.9 +/- 0.3 wk, and postnatal age was 6.3 +/- 3.4 days (mean +/- S.D.). A mean tcPO2 level for each behavioral state in each infant was calculated, and a paired comparison between all states was made. In the preterm and term infant groups, mean tcPO2 levels were higher in state 1 ("quiet sleep"), state 4 ("active awake state"), and state 5 ("crying") than during state 2 ("active sleep"). The difference (delta tcPO2) was significant (P < 0.05). In the preterm infant group, mean tcPO2 level in state 2 was 62.9 +/- 17.1 mm Hg (mean +/- S.D.). Mean delta tcPO2 in state 1 was +5.4 mm Hg (range, -0.9 to +9.2 mm Hg), mean delta tcPO2 in state 4 was +6.8 mm Hg (range, +0.6 to +20.2 mm Hg), and in state 5 was +9.9 mm Hg (range, +5.1 to +17.5 mm Hg). In the term infant group, mean tcPO2 level in state 2 was 64.5 +/- 9.6 mm Hg (mean +/- S.D.). Mean delta tcPO2 in state 1 was +5.8 mm Hg (range, -1.2 to +11.0 mm Hg), mean delta tcPO2 in state 4 was +8.1 mm Hg (range, +2.2 to +32.3 mm Hg), and mean delta tcPO2 in state 5 was +7.3 mm Hg (range, -1.6 to +26.5 mm Hg). There was insufficient data to evaluate tcPO2 levels during state 3 ("quiet awake state"). In the term infant group, the effect of bottle feeding on tcPO2 was also assessed. Gross alterations in tcPO2 during bottle feeding were not observed, and mean tcPO2 levels during bottle feeding (76.1 +/- 8.5 mm Hg; mean +/- S.D.) were not significantly different from mean tcPO2 levels found during states 1, 4, and 5.

Behavior↗
PubMed2004

Sensitivity to linear-speed-gradient of radial expansion flow in infancy.

A radial expansion flow having a linear-speed-gradient (linear-grad) creates robust perception of a rigid object moving-in-depth [Perception 19 (1990) 21]. It has been reported that sensitivity to a linear-grad of radial expansion emerges at 2 months of age [Infant Behavior and Development 17 (1994) 165]. In the present study, we examined the development of sensitivity to the linear-grad of radial expansion after 2 months of age with three experiments. A total of 197 2- to 5-month-old infants participated. The results showed that sensitivity to the linear-grad improves between 2 and 3 months of age (Experiment 1), and that the infants may discriminate between an expansion having linear-grad and that having zero-grad based on their perception of motion-in-depth (Experiments 2 and 3).

Aging↗
PubMed2006

Instrumental and vocal music effects on EEG and EKG in neonates of depressed and non-depressed mothers.

Neonates (M age=16 days) born to depressed and non-depressed mothers were randomly assigned to hear an audiotaped lullaby of instrumental music with vocals or without vocals. Neonatal EEG and EKG were recorded for 2min (baseline) of silence and for 2min of one or the other music presentation. Neonates of non-depressed mothers showed greater relative right frontal EEG asymmetry to both types of music, suggesting a withdrawal response. Neonates of depressed mothers on the other hand showed greater relative left frontal EEG asymmetry to the instrumental without vocal segment, suggesting an approach response, and greater relative right frontal EEG asymmetry to the instrumental with vocal segment, suggesting a withdrawal response. Heart rate decelerations occurred following the music onset for both groups of infants, however, compared to infants of non-depressed mothers, infants of depressed mothers showed a delayed heart rate deceleration, suggesting slower processing and/or delayed attention. These findings suggest that neonates of depressed and non-depressed mothers show different EKG and EEG responses to instrumental music with versus without vocals.

Adult↗
PubMed2004

[Mother-infant Interactions with Very Low Birth Weight multiple newborns (< 1500 g). A comparison of mother-multiple and mother-single births].

BACKGROUND: Assisted reproductive techniques and fertility enhancing therapies have increased the rate of multiple births and, therefore, the risk of prematurity. Our hypothesis is that mothers of preterm multiples are less able to provide such enhancing interactions than mothers of preterm singletons, resulting in a developmental disadvantage for preterm twins and triplets. PATIENTS AND METHODS: Of 77 very low birth weight preterms (VLBW) who were examined prospectively with their mothers in a longitudinal study, 35 were multiples and 42 were singletons. At a corrected age of three months the quality of the mother-infant interaction with multiples vs. singletons was examined. The Mannheim Rating System, a 40-item standardized observation instrument based on a 10 minute videotaped sequence of interaction, was used. RESULTS: The analyses showed several differences between mother-singleton and mother-multiple interactions. Mothers of multiples were less stimulating and reactive and showed less babytalk. Multiple infants were also less reactive than singletons. In mother-multiple dyads there were less verbal exchanges between mother and child. CONCLUSIONS: There are definite differences in mother-multiple compared to mother-singleton interactions, so that VLBW multiples may be at even greater risk for negative mother-infant interactions than singletons.

Adult↗
PubMed2001

Infant sleep problems and postnatal depression: a community-based study.

OBJECTIVES: To describe infant sleep patterns and investigate relationships between infant sleep problems and maternal well-being in the community setting. DESIGN: Cross-sectional community survey. Setting. Maternal and Child Health Centers in 3 middle-class local government areas in Melbourne, Australia. PARTICIPANTS: Mothers of infants 6 to 12 months of age. MAIN OUTCOME MEASURES: Maternal well-being (Edinburgh Postnatal Depression Scale) and infant sleep problems (standardized maternal questionnaire). RESULTS: The survey was completed by 738 mothers (94% response rate), of whom 46% reported their infant's sleep as a problem. In the univariate analyses, sleep patterns characterizing a sleep problem included the infant sleeping in the parent's bed, being nursed to sleep, taking longer to fall asleep, waking more often and for longer periods overnight, and taking shorter naps. The same sleep patterns were associated with high depression scores and tended to increase as depression scores increased. Because of positive skew, the Edinburgh Postnatal Depression Score was analyzed in 3 categories (<10, 10-12, and >12) using validated cutoff scores from community and clinical studies. Fifteen percent of mothers scored above 12 on the depression scale, indicating probable clinical depression, and 18% scored between 10 and 12, indicating possible clinical depression. After adjusting for potential confounders and factors significant in the univariate analyses, maternal report of an infant sleep problem remained a significant predictor of a depression score >12 (odds ratio: 2.13; 95% confidence interval: 1.27,3.56) and >10 (odds ratio: 2.88; 95% confidence interval: 1.93,4.31). However, mothers reporting good sleep quality, despite an infant sleep problem, were not more likely to suffer depression. CONCLUSIONS: Maternal report of infant sleep problems and depression symptoms are common in middle-class Australian communities. There is a strong association between the 2, even when known depression risk factors are taken into account. Maternal report of good sleep quality attenuates this relationship. Appropriate anticipatory guidance addressing infant sleep could potentially decrease maternal report of depressive symptoms.

Adult↗
PubMed1990

Imaging procedures and developmental outcomes in the neonatal intensive care unit.

Behavioural and environmental modification techniques in the neonatal intensive care unit for oxygen-dependent premature infants with chronic lung disease have been shown to result in a decrease in the number of days of respirator support and number of days of supplemental oxygen therapy. Long-term neurodevelopment outcome was significantly better for infants in the experimental therapy group who received specialized environmental modification to decrease stressful stimuli. We present results of cranial ultrasound and chest radiograph studies in this very high-risk population and suggest that such studies represent additional stressful stimuli that should be scheduled with consideration of an overall behavioral infant care plan.

Bronchopulmonary Dysplasia↗
PubMed1977

The age-dependence of intestinal absorption using d-xylose as an example.

In 40 infants the serum concentrations of D-xylose were measured from capillary blood samples up to 300 min after an oral dosage of 0.5 g of D-xylose per kg body weight. The parameters of the absorption kinetics, which are calculated by a digital computer program, showed an age-dependent behavior. Infants up to the age of 2 months have lower maximal serum concentrations compared to older ones because of a larger volume of distribution. The rate constant of invasion k1, which serves as a measure for the rate of intestinal absorption and the rate constant of elimination k2 were significantly lower in infants up to the age of 2 months compared to older ones. The quotient of k1:k2 was independent of age. The time it took to reach maximal serum concentration was significantly longer in young infants. By adding metoclopramide simultanously to the oral D-xylose doses it could be demonstrated that the slower motility of the gastrointestinal tract in newborns and young infants is not exclusively responsible for the slower rate of absorption of D-xylose. Comparing the absorption rates in 26 infants after different D-xylose dosages a saturation kinetics may be supposed.

Age Factors↗
PubMed2001

Social contingency detection and infant development.

The developmental origins and determinants of social contingency detection are discussed. Based on recent research, the author proposes that the origins of social contingency detection correspond to the early propensity developing in the first 6 months of life to differentiate between what pertains to the self (i.e., one's own body) and what pertains to others. Furthermore, from the second month of life, what infants appear to gain from contingency detection while interacting with others is a sense of shared experience or intersubjectivity. Research suggests that although the development of intersubjectivity is a central feature of infant behavior and development, the meaning of contingency detection, hence the source of intersubjectivity, changes radically between birth and 18 months of age. In general, it is proposed that the origins and determinants of social contingency detection must be construed in relation to (1) the developing sense of self in infancy, (2) the infant's developing sense of reciprocity with others, and (3) the infant's developing sense of participation with others. The author concludes by proposing a relevant map of changing social stances adopted by infants in the course of early development.

Conditioning, Psychological↗
PubMed1998

Bathing premature infants: physiological and behavioral consequences.

BACKGROUND: Routine procedures are a large component of the caretaking day for preterm infants. Such procedures can have profound adverse effects on an infant's condition, to the point of disrupting normal growth and development. Despite this evidence, routine procedures are perpetuated in the neonatal ICU. OBJECTIVE: To determine the physiological and behavioral effects of a supposedly beneficial procedure, a sponge bath, on premature infants. METHODS: The study sample consisted of 14 preterm neonates with no neurological abnormalities at two tertiary neonatal ICUs. The ages of the subjects were 28.1 to 31.8 weeks postconception and 4 to 25 days after birth. The study was a prospective, quasi-experimental, repeated-measures design in which each infant acted as his or her own control. Oxygen delivery, heart rate, oxygen saturation, and behavioral responses were continuously recorded by computer or real-time videotape. Physiological and behavioral parameters were compared across three phases: 10 minutes before a bath (baseline), during a standardized bath, and 10 minutes after the bath. RESULTS: Physiological and behavioral disruptions occurred throughout the bath phase and in many cases beyond that phase. These disruptions included significant increases in heart rate, cardiac oxygen demand, and frequency of behavioral motoric cues. Significant decreases in oxygen saturation also accompanied the bath. Nine infants required increased concentrations of ambient oxygen. A significant association was found between physiological components and the frequency and timing of behavioral motoric cues. CONCLUSIONS: The results provide further evidence that routine care is not innocuous to neonates. Routine sponge bathing is not recommended for care of ill premature infants.

Baths↗
PubMed1989

Specificity of infants' response to mothers' affective behavior.

Mother-infant face-to-face interaction is central to infant socioemotional development. Little has been known about the mechanisms that mediate the mother's influence. Findings are reviewed from a series of laboratory studies that suggest the major functional components of a mother's behavior are its affective quality and its contingent relationship to her baby's behavior. Quality of mother's affective expression accounted for individual differences in the behavior of thirteen 7-month-old infants living in multiproblem families. Infants' response was specific to the type of affective expression mothers displayed. Flat, withdrawn maternal affective expression was associated with infant distress. Intrusive maternal expression was associated with increased gaze aversion. Lack of contingent responsiveness was common to all but four mothers. Findings suggest that withdrawn or intrusive maternal affective expression, together with lack of contingent responsiveness, may in part be responsible for the risk-status of infants in multiproblem families.

Affect↗
PubMed1989

[The Mannheim Rating Scale for the Assessment of Mother-Child Interaction in Infancy].

Within a prospective longitudinal study of the first eight years of life, which aimed determination of pathogenesis of neuropsychiatric disorders a qualitative rating system of mother-infant face-to-face-interaction was evaluated. The rating system consists of 8 scales for mother and 5 scales for infant behavior. The rating intervals had a length of 60 sec, whereas the whole video-taped interaction took 10 minutes. Analysing 48 dyads sufficient coefficients of interraterreliability and validity could be demonstrated for the rating system. It proved to be an appropriate measurement for mother-child interaction in early infancy. Behavior of the mother described by the rating system predicts behavior disturbances of the child better than the total of organic and psychosocial risk factors.

Child↗
PubMedDate not supplied

Postpartum counseling perceptions and practices: what's new?

BACKGROUND: The in-hospital postpartum period is a critical opportunity for health care providers to enhance maternal understanding of newborn care, yet few studies have determined whether health care providers' educational priorities match those of new mothers. OBJECTIVE: To document how well pediatricians' perceptions of educational priorities for counseling about care of the newborn match those of new mothers during the postpartum hospitalization, and to determine whether pediatricians' actual counseling practices reflected maternal priorities. DESIGN: Cross-sectional study of perceived educational needs with direct observation of pediatrician counseling practices. SETTING: A suburban Washington, DC, community hospital. PARTICIPANTS AND INTERVENTION: All pediatricians on staff and a convenience sample of postpartum mothers were asked to rate the importance of newborn counseling issues using lists generated from focus groups and interviews. Pediatricians were observed while counseling mothers, and their postpartum counseling practices were scored using a template derived from the rating procedure. MAIN OUTCOME MEASURES: Comparison of pediatricians' and mothers' perceptions of educational priorities and the description of pediatricians' actual counseling practice. RESULTS: Mothers listed 9 issues as "very important" and expected the pediatrician to address health problems, especially jaundice, feeding, testing, pain medications for circumcision, behavior, and when to call the pediatrician for concerns or to schedule well-child care. Pediatricians and mothers agreed on 6 out of 11 very important issues. Pediatricians were observed to discuss an average of 8 issues per session, especially those they rated as very important, but they frequently failed to mention safety, sleep position, when to call for advice, testing, infant behavior, or circumcision issues. CONCLUSION: Mothers desire to learn a significant amount of information regarding the care of their newborn before hospital discharge. Although pediatricians discussed more issues than in a previously reported study of postpartum counseling, they still fell short of maternal expectations. Pediatricians must ensure that other sources of information, such as nurses, media, and reinforcement at postpartum well-child visits, supplement the information they provide in their in-hospital counseling sessions.

Adult↗