Possible contribution of better maternal psychological well-being to the acquisition of sleeping through the night in infants during the early postpartum period

The objective of this study was to elucidate whether better maternal psychological well-being contributes to the acquisition of “sleeping through the night” (STN) in infants during the early postpartum period. Fifty-two primiparous mothers completed the General Health Questionnaire-28 (GHQ-28) in the third trimester (prenatal) and when the conceptional ages of their babies reached 8–9 weeks (hereafter, 2 months), 12–13 weeks (3 months), and 16–17 weeks (4 months). They also recorded babies’ nocturnal sleep patterns in a timetable for 5 consecutive days each month postpartum. “Regular STN” was defined when the mean of longest nocturnal sleep duration for 5 consecutive days was > 8 h or between 6 and 8 h with < 1.0 nocturnal awakenings. According to these criteria, a total of 14 infants (27 %) acquired regular STN at 4 months (referred to as “STN infants”), with STN infants showing a marked increase in longest nocturnal sleep duration and a decrease in nocturnal awakenings from 2 to 3 months of age. The mothers of STN infants demonstrated steady reductions in postnatal GHQ-28 scores and had significantly lower prenatal GHQ-28 scores compared with the mothers of non-STN infants (3.7 ± 3.0 vs. 6.4 ± 4.1, p = 0.027). In random forest models for binomial classification, both prenatal and postnatal (at 4 months) GHQ-28 scores were identified as significant covariates for distinguishing STN infants, and other important covariates, including weeks of delivery, stepfamily, birth weight of the infant, and maternal co-sleeping at bedtime, were selected. Among these covariates, maternal co-sleeping at bedtime had relatively stronger correlations with both STN infants (r = − 0.440) and prenatal maternal GHQ-28 scores (r = 0.377). In conclusion, because prenatal maternal psychological well-being was thought to predict the acquisition of STN in infants, infants born from mothers with better psychological well-being appear to have some advantages in acquiring STN. These cross-lagged correlations suggest that the pathway from mothers to infants may be mediated by certain parenting behaviors, such as maternal co-sleeping at bedtime.     

Neuroimaging the sleeping brain: Insight on memory functioning in infants and toddlers

Episodic memory, or the ability to remember past events with specific detail, is central to the human experience and is related to learning and adaptive functioning in a variety of domains. In typically developing children, episodic memory emerges during infancy and improves during early childhood and beyond. Developmental processes within the hippocampus are hypothesized to be primarily responsible for both the early emergence and persistence of episodic memory in late infancy and early childhood. However, these hypotheses are based on non-human models. In-vivo investigations in early human development of hippocampal processes have been significantly limited by methodological challenges in acquiring neuroimaging data, particularly task-related functional neuroimaging data, from infants and toddlers. Recent studies in adults have shown neural activity in the brain regions supporting episodic memory during slow-wave sleep using functional magnetic resonance imaging (fMRI), and fMRI has been increasingly utilized in infancy and early childhood to address other research questions. We review initial evidence and present preliminary data showing the promise of this approach for examining hippocampal contribution to how infants and toddlers remember individual events, and their association with information about the context in which the event occurred. Overall, our review, integrated with the presentation of some preliminary data provides insight on leveraging sleep to gain new perspectives on early memory functioning.     

Cherish the good times: Relational savoring in parents of infants and toddlers

Savoring, or prolonging emotions associated with positive events, improves emotion and life satisfaction; little work, however, focuses on the savoring of interpersonal experiences, termed relational savoring. In a sample of 435 parents, the authors evaluated the impact of relational savoring on emotion and parent–child relationship satisfaction compared to a personal savoring and neutral control condition. Two years later, the authors reassessed parents' feelings of closeness with their children in a subsample of the original participants (n = 64). Both savoring conditions resulted in higher positive emotion for all parents, whereas the effects on negative emotion, relationship satisfaction, and closeness were only present for those higher in attachment avoidance. This study opens new avenues of investigation in both relational savoring and parent–child relationships.     

Interaction behavior of infants and their dual-career parents

The behaviors of dual-career parents were compared in face-to-face interactions with their 8-month-old infants who attended on all-day infant nursery. Mothers, as compared to fathers, exhibited more frequent smiling, vocalizing, and touching with their infants. In turn, the infants spent a greater proportion of the interaction time smiling and being motorically active when they were interacting with their mothers versus their fathers.     

A clinical interview for parents of high-risk infants: Concept and applications

The birth and hospitalization of a preterm infant are stressful and emotionally demanding experiences for parents. The Clinical Interview for Parents of High-Risk Infants (CLIP) is a semistruc tured clinical interview that may be used as a one-time assessment or as a cornerstone for ongoing psychosocial work with parents. The interview assesses early parental adaptation and alerts the clinician to areas of concern as identified by the parents. The interview enables parents to consolidate emotionally their experiences relative to the infant's high-risk status. The CLIP has utility both for planning psychosocial care in the intensive care nursery, and for discharge preparation. The rationale underlying the design of the CLIP is presented, the interview is described, and clinical applications are discussed.     

A follow-up study of infants who wake at night

A retrospective follow-up study of 68 adolescents treated for night waking when infants or toddlers showed that 82% of them were described by their parents as currently sleeping "well," and only two continued to experience a night-waking difficulty.     

Eighteen-month-old infants show false belief understanding in an active helping paradigm

Recently, several studies have claimed that soon after their first birthday infants understand others’ false beliefs. However, some have questioned these findings based on criticisms of the looking-time paradigms used. Here we report a new paradigm to test false belief understanding in infants using a more active behavioral response: helping. Specifically, the task was for infants to help an adult achieve his goal - but to determine that goal infants had to take into account what the adult believed (i.e., whether or not he falsely believed there was a toy inside a box). Results showed that by 18 months of age infants successfully took into account the adult’s belief in the process of attempting to determine his goal. Results for 16-month-olds were in the same direction but less clear. These results represent by far the youngest age of false belief understanding in a task with an active behavioral measure.     

Self-blame among parents of infants with perinatal complications: the role of self-protective motives

According to the literature on defensive attribution, behavioral self-blame can bolster a sense of personal efficacy and is more likely to occur when victims perceive their misfortune as severe. In this study, mothers of infants with severe perinatal complications rated the severity of their child's condition, were asked about its causes, and completed a measure of emotional adaptation. As predicted according to the defensive attribution hypothesis, behavioral self-blame was associated with greater perceived severity and preventability of recurrence. The pattern of correlations suggests that greater perceived severity may produce greater self-blame, which in turn may play an indirect role in adaptation through its association with the belief that a recurrence could be prevented. Results of a post hoc path analysis were consistent with this hypothesis. These findings are discussed in terms of the adaptive features of behavioral self-blame, its relation to perceived control, methodological issues in the study of coping with victimization, and implications for helping professionals.     

An outreach approach to high risk parents and their infants

This paper describes a special project designed to evaluate services to high risk parents and their infants. Twenty-three families were served by intensive outreach and home-based model of intervention. Sixty-one percent of these parents had significant mental health problems prior to referral. The paper describes the sample, outlines the approach to therapy and gives a specific case example. The data post-treatment is summarized and results detailed.     

Intrinsic and extrinsic factors associated with night waking in 9-month-old infants

This study examined relations between infant night waking and both daytime behaviors reflective of poor behavioral and emotional regulation (intrinsic factors) and parent behaviors that may contribute to infant night waking (extrinsic factors) in 41 infants. Mothers completed questionnaires and an infant sleep and crying diary. More time awake at night was related to separation distress, frequent daytime crying, dysregulation, co-sleeping with parents, breast feeding, and being put to bed asleep. More frequent waking was related to separation distress, frequent daytime crying, co-sleeping, and breast feeding. The combination of intrinsic and extrinsic factors predicted night waking better than behaviors from one category alone. Implications for parenting are discussed.     

Maternal and paternal infant representations: A comparison between parents of term and preterm infants

Objective

Research on parental attachment representations after preterm birth is limited and inconclusive. The present study is the first in which maternal and paternal attachment representations after term, moderately and very preterm birth are compared. In addition, special attention was directed toward disrupted attachment representations.

Method

Mothers and fathers of term infants (≥37 weeks of gestational age, n = 71), moderately preterm infants (≥32–37 weeks of gestational age, n = 62) and very preterm infants (<32 weeks of gestational age, n = 56) participated in the present study. Attachment representations (balanced, disengaged, distorted) about their infants were evaluated with the Working Model of the Child Interview (WMCI). To asses disrupted representations the coding of the WMCI was extended with the disrupted scale (WMCI-D).

Results

The three main classifications of attachment representations were not affected by preterm birth. In addition, there were no gender differences in the rate of balanced representations. In case of non-balanced representations however, maternal representations were more often distorted, whereas fathers showed more often disengaged representations. Results further revealed that maternal disrupted attachment representations were marked by role/boundary confusion or disorientation, whereas paternal disrupted attachment representations were characterized by withdrawal.

Conclusion

Given the gender differences it is essential to tailor interventions according to the attachment representations of the parent, in order to be able to alter their non-balanced and/or disrupted attachment representations.     

Mindful Parenting: a group approach to enhancing reflective capacity in parents and infants

In this paper, the process of ending therapy is likened to the ordinary developmental task of ‘letting go’ that parents have to undertake, to help their child to grow up. ‘Letting go’ is contrasted with the process of ‘holding’ the child in mind that is so central to the therapeutic and parental task Following thoughts about some of the external issues that play a part in the decision to end a child's treatment, this developmental perspective of psychoanalytic psychotherapy is discussed through a clinical illustration of the ending of a 5-year-old boy's treatment. Different strands of the therapeutic relationship as highlighted during the ending phase of therapy are distinguished and attention is drawn to the role of the ‘new relationship’ between therapist and child and how this differs from the transference relationship. Countertransference issues in their broadest form are also considered.     

Read your baby: A follow-up intervention program for parents with NICU infants

An intervention model designed to provide education and support to parents of sick or preterm infants throughout their first year of life is described. The intervention focused on helping parents communicate more skillfully with their infant and encouraging parents to maximize their infant's participation in the family system. Seventeen medium-risk infants received intervention; another seventeen served as controls. Independent evaluations of all families at 12 months adjusted age revealed that intervention babies were significantly advanced on Bayley Scales of Infant Development and Mastery Motivation tasks and that their mothers viewed them as easier to care for and less irritable.