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Breast-feeding, maternal feeding practices and mealtime negativity at one year.

This paper explores whether breast-feeding, mediated by lower maternal use of controlling strategies, predicts more positive mealtime interactions between mothers and their 1 year old infants. Eighty-seven women completed questionnaires regarding breast-feeding, assessing their control over child feeding and mealtime negativity at 1 year of infant age. Seventy-four of these women were also observed feeding their infants solid food at 1 year. Mediation analyses demonstrated that the experience of breast-feeding, mediated by lower reported maternal control over child feeding, predicted maternal reports of less negative mealtime interactions. The experience of breast-feeding also predicted observations of less conflict at mealtimes, mediated by observations of maternal sensitivity during feeding interactions. The implications of these findings are discussed.

Adult↗

Cocaine and pregnancy: a challenge for health care providers.

There is an alarming increase in the number of individuals using cocaine in this country. As many as 10 percent of all pregnant women have used cocaine one or more times during their pregnancy. The rising number of pregnant cocaine abusers who present themselves for medical services is creating a challenge for health care practitioners. This article addresses the biopsychosocial issues of cocaine abuse during pregnancy, including the medical impact of cocaine abuse on pregnant women and their newborn infants, behavioral manifestations of cocaine abusers that create health care management problems, and social work's contribution to the health care management of these women.

Adolescent↗

Infant age, context, and family system influences on the interactive behavior of mothers of infants with mental delay.

Interactive behavior of 30 mothers of infants with mental delay and 30 comparison mothers and infants was examined in relation to child age (first and second year), context (feeding versus teaching), maternal characteristics (family stress, coping resources), and family social system (maternal education). Groups were compared from two perspectives: with infants matched on mental age (9 and 19 months MA), and on chronological age (8 and 18 months CA). Study mothers scored lower than comparison mothers during teaching but not during feeding in year 1 with both MA and CA match, but only with the CA match in year 2. Study infants scored lower than comparison infants in both contexts in year 1, but not in year 2. Groups did not differ on maternal or family measures. In year 1, group status, coping, and maternal education were predictive of mother interaction. In year 2, only maternal education was predictive. Results confirm the importance of type of match, context, and family system variables in understanding effects of child mental delay on maternal interactive behavior.

Adaptation, Psychological↗

Effects of the pacifier activated lullaby on weight gain of premature infants.

Within the past 5 years there has been an increase of premature infants surviving in the neonatal intensive care unit as well as an increasing cost for each day the infant is kept there. It is important for the premature infant to acquire the feeding skills necessary for weight gain, which lead to discharge from the hospital, and recent advancements have indicated the effectiveness in using contingent music to teach sucking skills to premature infants. The purpose of the first analysis in this study was to determine the effects of Pacifier Activated Lullaby (PAL) trials on weight gain of premature infants. During a 2-year time period, 62 infants from a sample of 188 met criteria for analysis. A one-way analysis of variance showed no significance in daily weight gain for the number of PAL trials completed. The mean weight gains for infants with 1 PAL trial = 13.85 grams, 2 trials = 26.67, 3 trials = 29.64, and 4 or more = 22.89. The Pearson product-moment correlation between the mean percent of music earned via nonnutritive sucking (NNS) and mean weight gain of all trials approached significance (p = .077, r = 0.18). In a second analysis, weight gained prior to use of PAL, during use of PAL, and post use of PAL was analyzed. Results indicated no significant difference between weight gain 1 day prior to use of PAL, the day of PAL trial, and 1 day post use of PAL. Mean weight gain for those infants who participated in 1 PAL trial was 8.49 grams for 1 day prior to use of PAL, 18.73 the day of PAL trial, and 24.81 for 1 day post use of PAL. Mean weight gain for 3 days prior to using the PAL was 10.78, 11.30 on the day of PAL trial, and 24.78 grams for 3 days post PAL use. The analyses show definite trends of greater weight gain with PAL use; however, individual variability within groups was greater than group differences leading to no significance in statistical analysis. In the third analysis the effect of proximity between premature infants' feeding schedule and PAL trial on amount of time the infant received contingent music via NNS was examined; the infants' feeding and sleep schedules were divided into 5 blocks of time. Results indicated no statistical significance among the amount of time premature infants sucked/received music according to their schedule, although there were noticeable differences in the average percent of music reinforcement received according to assigned block. Infants who participated in PAL trials 30 minutes prior to feeding scored the highest average at 77.25 %, followed by 71% for infants who participated in PAL trials during feeding. Other times, primarily after the infants' feeding, resulted in averages of 59% and 54.5%; these infants often fell asleep after their feeding and did not complete the full 15-minute trial. Based on this research and previous research on NNS, it seems beneficial for premature infants to participate in PAL opportunities 30 minutes prior to feeding.

Analysis of Variance↗

Stability and transmission of attachment across three generations.

Stability of adult attachment and transmission of attachment across 3 generations were examined in a longitudinal study of 96 infants, mothers, and maternal grandmothers. The Adult Attachment Interview (AAI) was used to assess attachment in mothers (during pregnancy and when infants were 11 months old) and grandmothers (any time during the study). The Strange Situation (SS) was used to assess attachment in infants at 12 months. Both the 3- and 4-category classification systems of the AAI and SS were used. Mothers' AAI classifications were stable over 12 months in 90% (3-category) and 77% (4-category) of mothers. Mothers' AAI classifications during pregnancy predicted infants' SS classifications in 81% (3-category) and 68% (4-category) of cases, and grandmothers' AAI classifications in 75% (3-category) and 49% (4-category) of cases. Using log-linear analysis, we show that a simple parent-to-child model accounts for transmission of attachment.

Female↗

[Assessment of taste development in 62 newborn infants].

OBJECTIVE: To study the differential facial responses to four basic tastes of the newborns and the gender-related different taste sensitivity. METHODS: Sixty-two newborns (31 females and 31 males) born in the Department of Obstetrics, First Hospital of the Chongqing University of Medical Sciences were tested for responses to four solutions, including 25% sucrose (sweet), 5% sodium chloride (salt), 1.43% citric acid (sour), and 0.025% berberine (bitter) 90 minutes after birth. The inclusion criteria were: (1) medically uncomplicated full-term pregnancy; (2) medically uncomplicated spontaneous vaginal delivery; (3) Apgar score of at least 8 at 1 and 5 min. All the infants were found to be normal and healthy on pediatric examination. The facial responses of the newborns were recorded by video. The facial responses were divided into nine facial action units and expressions from A1 to C3, which are also expressed as the 1 - 9 grades of intensity, crying was included as grade 9 and nausea was defined as grade 10 intensity. The distinctions of the facial responses were analyzed by chi-square test. The distinctions of sex in the facial responses were analyzed by the Wilcoxon test. RESULTS: All the newborns were full term, excluding the medical conditions. The average birth weight of the newborns was 3324.3 g. The data from the study indicated that absence of distinctive mouth action or sucking was the major facial response of the infants to sucrose solution (P < 0.01). There were no special expressions when the newborns were given the salt solution (P > 0.01). The lip pursing with negative brow and middle face actions were major response of the infants to the sour solution (citric acid) (P < 0.01). The expressions in response to the bitter solution of the infants were the mouth gaping with negative brow and middle face actions (P < 0.01). The facial responses to the sweet and bitter solutions in the boys were more sensitive than those in the girls (P < 0.01). There was no sex difference in the intensities of the facial responses to the salt and sour solutions (P > 0.05). CONCLUSIONS: The newborns had distinct responses to the four solutions shortly after birth. The facial expression to sweet and bitter solutions in the boys were more sensitive than in the girls.

Berberine↗

Development in the first years of life.

Any discussion on how we care for infants and toddlers must begin with the interests and needs of the children themselves. Therefore, this issue opens with an overview of the dramatic development that takes place during the first three years of life, which turns the dependent human newborn into a sophisticated three-year-old who walks, talks, solves problems, and manages relationships with adults and other children. This article explains the new understanding of brain development that has captured public attention in recent years, and links it to developments in infant behavior that are equally impressive and influential: the growth of the body (size and coordination), the growth of the mind (language and problem-solving abilities), and the growth of the person (emotional and social mastery). It emphasizes how much early experiences and relationships matter. The article highlights themes that resonate across these aspects of development: A drive to development is inborn, propelling the human infant toward learning and mastery. The opportunities for growth that enrich the early years also bring with them vulnerability to harm. The experiences that greet children in their human and physical surroundings can either enhance or inhibit the unfolding of their inborn potential. People (especially parents and other caregivers) are the essence of the infant's environment, and their protection, nurturing, and stimulation shape early development. The author envisions a society that stands beside the families and caregivers who nurture young children, equipping them with knowledge and resources, and surrounding them with supportive workplaces, welfare policies, and child care systems.

Brain↗

The common marmoset (Callithrix jacchus jacchus) as a model for ethological research.

The uses and advantages of the common marmoset (Callithrix jacchus jacchus) as an animal model for ethological research were examined. It was found that this species had advantages over Old World primates for work on social behavior as a nearer approximation to the group structure occurring in natural conditions could be obtained in the laboratory. The small size of the common marmoset also made it easier to handle and cheaper to maintain. The adult female gave birth at five-month intervals and usually reared twin offspring. This, and the short generation time, made it an ideal model for mother-infant behavioral studies. The common marmoset was also shown to be a useful model for studies of social play, especially for categorizing the changes in playful behavior with age, and the relationship of the patterns seen in play to other behaviors. It was also suggested that it may be an ideal model for experimental studies of play. Other suggested uses included studies of the relationship of food supply and feeding habits to territory size and group structure, and of the advantages to elder offspring of helping to rear younger siblings. As a result of these observations the common marmoset was considered to have great potential as a model for ethological research, both in its natural habitat and in the laboratory.

Aggression↗

Nutritional management of failure to thrive.

Failure to thrive, or failure to grow or gain weight, could have several causes that are reviewed in this article. Infant behaviors are discussed, together with nutritional management, catch-up growth, effects of nutritional rehabilitation on body composition, follow-up, and long-term prognosis.

Child↗

Validation of a new pediatric air-displacement plethysmograph for assessing body composition in infants.

BACKGROUND: The accurate measurement of body composition is useful in assessments of infant growth and nutritional status. OBJECTIVE: This study evaluated the reliability and accuracy of a new air-displacement plethysmography (ADP) system for body-composition assessment in infants. DESIGN: Between- and within-day reliability was assessed by comparing the percentage body fat (%BF) obtained on consecutive days and on the same day, respectively, in 36 full-term infants. Accuracy was assessed by comparing %BF measured with the use of ADP and %BF measured with the use of deuterium (2H2O) dilution in 53 infants. RESULTS: There were no significant differences in %BF between days (-0.50 +/- 1.21%BF) or within days (0.16 +/- 1.44%BF). Mean between- and within-day test-retest SDs of 0.69 and 0.72%BF, respectively, indicated excellent reliability. The %BF measurements obtained by using ADP were not significantly influenced by infant behavioral state. Mean %BF obtained by using ADP (20.32%BF) did not differ significantly from that obtained by using 2H2O dilution (20.39%BF), and the regression line [%BF(2H2O) = 0.851%BF (ADP) + 3.094] gave a high R2 (0.76) and a low SEE (3.26). The 95% limits of agreement between ADP and 2H2O (-6.84%BF, 6.71%BF) were narrower than those reported for other body-composition techniques used in infants. Individual differences between the 2 methods were not a function of body mass or fatness. CONCLUSION: ADP is a reliable and accurate instrument for determining %BF in infants, and it has the potential for use in both research and clinical settings.

Body Composition↗

Serum fluvoxamine levels in breastfed infants.

BACKGROUND: Between 10% and 15% of new mothers will experience an episode of postpartum depression. Although antidepressants are effective agents for the treatment of postpartum depression, minimal data are available to support their safety in infants of breastfeeding mothers. METHOD: In this article, we present 2 cases of nursing mother-infant pairs in which the mother was treated with fluvoxamine and in which infant serum fluvoxamine levels were obtained. Both mothers began the fluvoxamine treatment postpartum, and serum levels were obtained from mothers and infants after a minimum of 7 days on a stable maternal dose. One level was obtained from the infant in case 1, and 2 levels were obtained from the infant in case 2. RESULTS: Each of the infant serum fluvoxamine levels obtained was too low to quantify (at a limit of detection of 2.5 ng/mL). Neither of the infants experienced adverse events related to the mother's treatment with fluvoxamine. Each of the infants is reportedly healthy 2 to 3 years after the exposure. CONCLUSION: While these results are encouraging, they are limited and cannot be generalized to all cases of infants exposed to fluvoxamine. Additional mother-infant serum fluvoxamine levels and infant behavioral observations will facilitate the risk-benefit decision-making process for women who choose to breast-feed while taking fluvoxamine.

Breast Feeding↗

The psychic life of the young infant: review and critique of the psychoanalytic concepts of symbiosis and infantile omnipotence.

The subjective life of the young infant is examined in the light of classical psychoanalytic theory and of recent empirical studies of early infant behavior and development. The concepts of symbiosis and omnipotence are argued to be products of poetic but largely misguided reconstructions from adult experience, providing a questionable developmental foundation for contemporary psychodynamic theories of object relations.

Child Development↗

Clinical approaches to families in early intervention.

Clinical approaches to families with infants in early intervention programs require more sophisticated and individualized plans that have been traditionally available. Clinicians in early intervention programs, including those trained in child-oriented disciplines, will increasingly be expected to develop comprehensive family focused interventions. Empirical findings support the legislative mandate of PL99-457 in requiring that families have an active role in specifying the intervention services they require. In addition, the broader concept of risk that now includes multi-problem families also complicates the job of the early interventionist. As parents must learn to adapt to their infant's unique characteristics, early interventionists must adapt to the unique characteristics of each family with whom they are involved. To aid in this process, we apply the concept of a working alliance to the aspect of the parent-professional relationship that early interventionists must develop and maintain in providing empathic and individualized care to families in early intervention. Sensitivity to the families' unique characteristics, responsitivity to their concerns, positive connotation of parents' and infants' behavior, a nonjudgmental attitude, and a willingness to monitor one's feelings and responses elicited by the family are clinical principles essential for developing and maintaining the working alliance.

Child Guidance Clinics↗

Attachment disorders in infancy and early childhood: a preliminary investigation of diagnostic criteria.

OBJECTIVE: The primary purpose of this study was to compare the reliability of differing sets of criteria for attachment disorders by using a retrospective case review. METHOD: Forty-eight consecutive clinical case summaries from an infant behavior clinic were reviewed by four experienced clinicians. Attachment disorders were coded as present or absent by using competing criteria and were scored by using a continuous scale of relationship functioning. RESULTS: The reliability of alternative criteria was acceptable, but the reliability of DSM-IV criteria in diagnosing attachment disorders was marginal. Preliminary validity for the criteria was demonstrated by the fact that more severe relationship disturbances were seen in infants diagnosed with attachment disorders than in infants diagnosed with other disorders. CONCLUSIONS: Standardized assessments of at-risk populations should be used to replicate these preliminary results; revision of DSM-IV criteria may be necessary to obtain adequate reliability for diagnosing attachment disorders.

Adult↗

The role of talker-specific information in word segmentation by infants.

Infants' representations of the sound patterns of words were explored by examining the effects of talker variability on the recognition of words in fluent speech. Infants were familiarized with isolated words (e.g., cup and dog) from 1 talker and then heard 4 passages produced by another talker, 2 of which included the familiarized words. At 7.5 months of age, infants attended longer to passages with the familiar words for materials produced by 2 female talkers or 2 male talkers but not for materials by a male and a female talker. These findings suggest a strong role for talker-voice similarity in infants' ability to generalize word tokens. By 10.5 months, infants could generalize different instances of the same word across talkers of the opposite sex. One implication of the present results is that infants' initial representations of the sound structure of words not only include phonetic information but also indexical properties relating to the vocal characteristics of particular talkers.

Female↗

Effects of unanticipated cesarean section on mothers, infants, and their interaction in the first month of life.

The impact of an unanticipated primary cesarean section on the mother, on the infant, and on their interaction was studied during the perinatal period and at 1 month following delivery. Thirty-four mother-infant pairs participated in the study. Fourteen subjects delivered by nonelective, nonemergency cesarean section. Twenty mothers, who delivered vaginally, served as the controls. All subjects had attended a series of prepared childbirth classes. Maternal questionnaire and infant observational data were collected on day 2 and on day 30. Mother-infant interactions in teaching and play sessions were assessed on day 30. The cesarean group was found to have a higher number of obstetrical complications, an increased incidence of maternal depression, and a more difficult convalescence. Previous experience with children emerged as an important mediating variable in the analysis of maternal affective status. No infant behavioral differences were detected as a function of mode of delivery. The discussion highlights the interventions that can be utilized to minimize the negative emotional consequences for women who deliver by cesarean section.

Adult↗