Measuring Shaken Baby Syndrome awareness: preliminary reliability of a caregiver attitudes and beliefs survey

Recent estimates of Shaken Baby Syndrome awareness suggest that approximately half of all American adults have not heard of the often devastating risks of shaking an infant. Using a sample of 288 undergraduate students, we developed a measure of attitudes around infant care practices. A total of 264 community participants completed a revised survey. Between-group comparisons, exploratory factor analyses, and internal consistency tests were employed to determine the directionality and reliability of any scale structure present in the data. A five factor structure fits the data reliably, and each of these factors seems to represent a unique dimension. Implications for using this measure clinically and preventatively are discussed.     

When soothing succeeds: Simulating a risk for repeated shaking in abusive head trauma in infants

PurposeTo investigate the observation that perpetrators of abusive head trauma engage in repeated shakings because shaking “works” to quiet the infant.MethodsSixty first-time parent couples individually cared for a programmable model infant in two consecutive 7-min trials. After six minutes of consolable followed by inconsolable crying, parents selected one of three soothing techniques. For trial one, parents were randomized to a “Successful” or “Failed” Soothing Condition. Whether the soothing technique was repeated after trial two was determined by the study investigators. Parents rated their frustration after each trial.ResultsAs hypothesized, parents were more likely to repeat a soothing technique that “worked” in trial one. Compared to fathers, mothers reported more frustration when soothing failed.ConclusionsThat caregivers were more likely to repeat a successful soothing technique converges with perpetrator confessions that crying cessation after shaking may be a reason why shaking is used repeatedly in response to crying.     

Microstate analysis in infancy

BackgroundMicrostate analysis is an emerging method for investigating global brain connections using electroencephalography (EEG). Microstates have been colloquially referred to as the “atom of thought,” meaning that from these underlying networks comes coordinated neural processing and cognition. The present study examined microstates at 6-, 8-, and 10-months of age. It was hypothesized that infants would demonstrate distinct microstates comparable to those identified in adults that also parallel resting-state networks using fMRI. An additional exploratory aim was to examine the relationship between microstates and temperament, assessed via parent reports, to further demonstrate microstate analysis as a viable tool for examining the relationship between neural networks, cognitive processes as well as emotional expression embodied in temperament attributes.MethodsThe microstates analysis was performed with infant EEG data when the infant was either 6- (n = 12), 8- (n = 16), or 10-months (n = 6) old. The resting-state task involved watching a 1-minute video segment of Baby Einstein while listening to the accompanying music. Parents completed the IBQ-R to assess infant temperament.ResultsFour microstate topographies were extracted. Microstate 1 had an isolated posterior activation; Microstate 2 had a symmetric occipital to prefrontal orientation; Microstate 3 had a left occipital to right frontal orientation; and Microstate 4 had a right occipital to left frontal orientation. At 10-months old, Microstate 3, thought to reflect auditory/language processing, became activated more often, for longer periods of time, covering significantly more time across the task and was more likely to be transitioned into. This finding is interpreted as consistent with language acquisition and phonological processing that emerges around 10-months. Microstate topographies and parameters were also correlated with differing temperament broadband and narrowband scales on the IBQ-R.ConclusionThree microstates emerged that appear comparable to underlying networks identified in adult and infant microstate literature and fMRI studies. Each of the temperament domains was related to specific microstates and their parameters. These networks also correspond with auditory and visual processing as well as the default mode network found in prior research and can lead to new investigations examining differences across stimulus presentations to further explain how infants begin to recognize, respond to, and engage with the world around them.     

Child care centre adherence to infant physical activity and screen time recommendations in Australia,Canada and the United States: An observational study

ObjectiveThe aim of this study was to compare adherence to physical activity and sedentary behaviour recommendations within the 2011 Institute of Medicine Early Childhood Obesity Prevention Policies as well as screen time recommendations from the 2013 American Academy of Pediatrics for samples of infants in child care centres in Australia, Canada, and the United States (US).MethodsThis cross-sectional study used data from: the Australian 2013 Standing Preschools (N = 9) and the 2014–2017 Early Start Baseline (N = 22) studies; the 2011 Canadian Healthy Living Habits in Pre-School Children study (N = 14); and the American 2008 (N = 31) and 2013–2017 (N = 31) Baby Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) trials. Data were compared on the above infant recommendations. Percentages were used to describe compliance to the recommendations and chi-square tests to determine whether compliance differed by country.ResultsChild care centres were most compliant (74%–95%) with recommendations to: provide daily indoor opportunities for infants to move freely under adult supervision, daily tummy time for infants less than 6 months of age, indoor and outdoor recreation areas that encourage infants to be physically active, and discourage screen time. Centres were least compliant (38%-41%) with adhering to recommendations to: limit the use of equipment that restricts an infant’s movement and provide education about physical activity to families. Compared with Canadian and US centres, Australian centres were less compliant (46%) with the recommendation to engage with infants on the ground each day, to optimize adult-infant interactions and to limit the use of equipment that restricts the infant’s movement. Canadian centres were less compliant (39%) with the recommendation to provide training to staff and education to parents about children’s physical activity. US centres were less compliant (25%–41%) with the recommendations to provide daily opportunities for infants to explore their outdoor environment, limit the use of equipment that restricts the infant’s movement and provide education to families about children’s physical activity.ConclusionsAssisting child care centres on limiting the use of equipment that restricts an infant’s movement, and providing education about children’s physical activity to families may be important targets for future interventions.     

Is sensory processing an issue for infants with colic?

ObjectivesTo determine the association between sensory functioning, sleep, cry/fuss, and feeding behaviors of infants with colic younger than 4 months of age.MethodsDunn’s Infant/Toddler Sensory Profile™ and a modified Barr Baby Day Diary^© were used to assess 44 breastfed infants with colic under four months of age. Colic was defined according to Wessel’s criteria.ResultsThirty-four of the 44 infants with colic (77%) scored as atypical for sensory processing. Of these, 56% scored atypical for sensory processing on quadrant one (Q1) (Low Registration), with 24%, 65%, and 18% scoring as atypical for sensory processing on Q2 (Sensory seeking), Q3 (Sensory sensitivity), and Q4 (Sensation avoiding), respectively. All infants demonstrating sensation avoiding also scored as Low Threshold. A moderate statistically significant correlation was found between sensation seeking and time spent sleeping (r = 0.31; p = 0.04). No other statistically significant associations between infant behaviors and their sensory functioning were demonstrated. Overall, infants demonstrating atypical sensory responses (in any quadrant) slept significantly more than infants demonstrating typical sensory responses (mean difference = −67.8 min/day; 95% CI = −133.6 to −2.1; p = 0.04).ConclusionVery limited associations between infant behaviors and sensory functioning were demonstrated, suggesting that sensory functioning may not be a significant factor in the multifactorial nature of infant colic. Further well-designed studies using validated tools for infants with colic are required to determine whether associations between infant behaviors and sensory functioning exist.     

Antenatal and postnatal depressive symptoms: Association with quality of mother–infant interaction

Antenatal and postnatal depression are independently associated with an increased risk of adverse infant development. A key linking mechanism is the quality of mother–infant interaction.ObjectivesThis study assesses the association between postnatal depressive symptoms (PDS) and their severity, with the quality of mother–infant interaction and compare the quality of mother–infant interaction and severity of the symptoms depending on the presence or absence of antenatal depressive symptoms (ADS).Methodsobservational study in 177 psychosocial risk mother–infant dyads from Chile (infant aged 2–12 months).ResultsMothers with PDS had lower maternal sensitivity and a more intrusive/controlling style than mothers without PDS, although the severity of the symptoms was not associated with lower maternal sensitivity. Maternal sensitivity did not differ in the postnatal depressed mothers depending on the presence of ADS, although the mothers differed in interaction style and the severity of symptoms. Mothers with ADS and PDS presented with a predominant intrusive/controlling interaction style and more severe depressive symptoms, whereas those with only PDS presented with a predominant nonresponsive/passive interaction style and reduced severity of symptoms.ConclusionsThe results corroborate the need to offer treatment and dyadic interventions to antenatal and postnatal depressive mothers and postulate that the presence of antenatal depressive symptoms may influence the subsequent mother–infant interaction style and greater severity of symptoms.     

Prem Baby Triple P a new parenting intervention for parents of infants born very preterm: acceptability and barriers

Over 10% of preterm infants develop major disabilities, 50% develop behavioural problems and 40% need special education ( [Huddy et al., 2001] and [0185] ). Prem Baby Triple P is a new variant of the Positive Parenting Program (Triple P) adapted specifically for parents of very preterm infants. The aim of this study is to assess the acceptability of Prem Baby Triple P to parents of infants born preterm and to test whether parental attributions and parental perception of infant health/developmental status are barriers to intervention acceptability. One hundred and twenty-three parents of preterm infants participated, 83 parents of very preterm infants and 40 parents of preterm infants. In addition, 32 parents of term infants participated as a comparison group. The acceptability of Prem Baby Triple P was moderately high and did not differ significantly across the three groups. Parental attributions were not found to be barriers to intervention acceptability and parental perceptions that their infant is less healthy/developmentally delayed facilitated Prem Baby Triple P acceptance in parents of infants born very preterm. This suggests that the planned Prem Baby Triple P content is acceptable to parents of infants born very preterm and sensitised to medical and developmental issues. These findings, as social validation data, will contribute towards the further development of Prem Baby Triple P and a future randomised controlled trial.     

Early infant temperament shapes the nature of mother-infant bonding in the first postpartum year

ObjectiveThis study examined longitudinal relations between maternal bonding and infant temperament in the first nine months after birth.DesignOur sample consisted of 281 women, enrolled at five maternity hospitals, who completed questionnaires during the first week (T1), at six weeks (T2) and nine months postpartum (T3). Maternal bonding was assessed using the Mother-to-Infant Bonding Scale at T1 and T2 and the Postpartum Bonding Questionnaire at T3. Infant temperament was measured using the Infant Characteristics Questionnaire, completed by the mothers at T2 and T3.ResultsThe results of a path model showed a long-term effect flowing from the child to the mother, with infant temperament at T2 predicting maternal bonding at T3 over and above stability in bonding. At T3, bonding was linked more strongly to child temperament at T2 than to child temperament assessed concurrently at T3. Maternal bonding did predict infant temperament, but this was true only of bonding reported at T1 and infant temperament at T2, that is, not of bonding assessed at T2 and infant temperament at T3.ConclusionOur results indicate that maternal bonding in the first week postpartum may temporarily affect child temperament, but infant’s temperament several weeks after birth – rather than several months postpartum – plays a pervasive role in shaping the long-lasting nature of the mother-child relationship. Our findings thus seem to support the suggestion that the early postpartum weeks represent an important period in the development of maternal bonding.     

Maternal avoidance,anxiety cognitions and interactive behaviour predicts infant development at 12 months in the context of anxiety disorders in the postpartum period

BackgroundFew studies have examined the relation between anxiety disorders in the postpartum period and cognitive as well as language development in infancy.AimsThis longitudinal study investigated whether anxiety disorder in the postpartum period is linked to infant development at twelve months. A closer look was also taken at a possible link between maternal interaction and infant development.Study designSubjects were videotaped during a Face-to-Face-Still-Face interaction with their infant (M = 4.0 months). Specific maternal anxiety symptoms were measured by self-report questionnaires (Anxiety Cognition Questionnaire (ACQ), Body Sensations Questionnaire (BSQ), Mobility Inventory (MI)) to check for a connection with infant development. The Bayley Scales of Infant and Toddler Development-III (Bayley-III) were used to assess infant language and cognitive development at one year of age.Subjectsn = 34 mothers with anxiety disorder (SCID-I; DSM-IV) and n = 47 healthy mothers with their infant.Outcome measuresInfant performance on Bayley-III language and cognitive scales.ResultsInfants of mothers with anxiety disorder yielded significantly lower language scores than infants of controls. No significant group differences were found regarding infant cognitive development. Exploratory analyses revealed the vital role of “maternal avoidance accompanied” in infant language and cognitive development. Maternal neutral engagement, which lacks positive affect and vocalisations, turned out as the strongest negative predictor of cognitive development. Maternal anxiety cognitions and joint activity in mother-infant interaction were the strongest predictors of infant language performance.ConclusionsResults underline the importance to also consider the interaction behaviour of women with anxiety disorders to prevent adverse infant development.     

Young adults’ reactions to infant crying

AimTo determine whether young childless adults show negative emotions and cognitive disturbances when listening to infant crying, compared to other disturbing noises, and whether negative emotions and cognitive disturbances are associated.MethodsWe tested the cognitive performances and emotional reactions of 120 childless participants on a working memory task while being subjected to different disturbing noises including infant crying.ResultsParticipants had the least correct trials on the working memory task, and showed the most negative emotions, when hearing infant crying as compared to the other noises. Participants also showed less positive emotions when hearing infant crying as compared to working in silence. Overall, negative emotions were associated with less correct trials on the working memory task, except in the infant crying condition. Furthermore, cognitive performance and emotional reactions to infant crying were unrelated to personality characteristics.ConclusionNegative emotions and cognitive disturbances may be general adult responses to infant crying that are not limited to parents. These results suggest a broadly present human emotional and cognitive response to infant crying, that may underlie a general predisposition to care for infants in distress.     

The influence of infant irritability on maternal sensitivity in a sample of very premature infants

The relationship between maternal sensitivity and infant irritability was investigated in a short‐term longitudinal study of 29 very preterm infants. Infant irritability was assessed at term with the Brazelton NBAS, the Mother and Baby Scales (MABS) and the Crying Pattern Questionnaire (CPQ). Maternal sensitivity was assessed by nurses' ratings in the neonatal care unit and at three months during mother–infant interaction observation. Cross‐lagged panel analysis indicated that neonatal irritability did not influence sensitivity at 3 months nor did maternal sensitivity in the newborn period lead to reduced irritability at 3 months. Both irritability and maternal sensitivity showed moderate stability over time (r = 0.55 and r = 0.60, respectively). It is concluded that in early infancy maternal sensitivity shows little influence on infant irritability in very preterm infants. Copyright © 2003 John Wiley & Sons, Ltd.     

Infant brain responses to live face-to-face interaction with their mothers: Combining functional near-infrared spectroscopy (fNIRS) with a modified still-face paradigm

BackgroundNon-invasive imaging techniques, such as fNIRS, allow us to shed light on the neural correlates of infant’s social-emotional development within the context of parent-infant interaction. On a behavioral level, numerous studies have investigated parent-infant interaction employing the still-face paradigm and found that the primary caregiver(s), often the mother, is an important coregulator of the infant’s physiological and behavioral stress response. However, limited information is available on how the infant’s brain reacts to the maternal cues during real-life interaction.MethodsTherefore, the main aim of the current study was to design a fNIRS paradigm to study live mother-infant interaction and to explore the neural correlates of infant affect regulation during real-life dyadic interaction. To this end, a modified still-face paradigm was designed, which consists of live face-to-face mother-infant, and stranger-infant, interaction episodes, including stressful, “still-face” and non-stressful, “happy-face” interaction blocks, combined with infant fNIRS imaging.ResultsHemodynamic brain responses were collected in n = 10 (6 females, mean age 230.2 ± 17.5 days), typically developing infants using the Hitachi ETG-4000 continuous-wave system (22 channels spanning the frontal cortex; 10 Hz system sampling frequency). Infants with usable data (n = 7) showed negative activations, indicated by a decrease in oxygenated hemoglobin, over the middle frontal gyrus in response to happy-face (reunion) interaction with their mothers compared to a female stranger; suggesting deactivation of brain regions associated with affect regulation. We also explored correlations between infant brain responses to maternal interaction and infant characteristics (temperament) as well as experiential/environmental factors (mothers’ self-reported depression symptoms).ConclusionsAlthough the current results are very preliminary, they overall suggest that live design in infant populations is doable and offers unique opportunities to study the neural mechanisms underlying early caregiver(s)-child interaction in a more naturalistic context. Restrictions, and implications, of the methodology are critically discussed.     

Seeking sacred pathways: How ritual is being used as a means for spiritual support

ABSTRACT

Baby boomers are confronting new life stages as they navigate the revolution in longevity. Emerging in this journey are new rituals and reinterpretations of old ones that speak to these new life stages. These rituals help provide a grounding and guide to create moments of meaning as we encounter our own aging.     

Infant mental health home visiting in the context of an infant—toddler court team: Changes in parental responsiveness and reflective functioning

This article describes an infant–toddler court team in Michigan, the community-based participatory research approach to the implementation evaluation, and the resulting changes in parenting. Like other court teams, Michigan's Baby Court is led by a science-informed jurist, and all service providers are knowledgeable about the developmental needs of young children and engage in collaborative communication throughout the case. Relationship-based treatment in the form of infant mental health home-visiting was provided to families. Sixteen parents participated in pre- and posttest evaluation visits to assess changes in parents’ reflective functioning and interactions with their child. Findings suggest improvements in parents’ responsiveness, positive affect, and reflective functioning, with moderate effects. Higher risk parents demonstrated significant changes in reflective functioning, as compared to those at lower risk. These findings add to and support the limited literature on the effectiveness of infant–toddler court teams, which include relationship-based and trauma-informed services.     

Post-discharge outcomes for mothers and the mother–infant relationship following admission to a psychiatric Mother–Baby Unit

Mother–Baby Unit research has focussed on maternal psychopathology over the course of an admission. Less is known about the baby's well-being, the shared relationship, or the mother's recovery. In an initial sample of 45 women, we describe discharge and post-discharge outcomes for maternal psychopathology (using maternal report and the Global Assessment of Function, GAF) and the mother–infant relationship (using the Child and Adult Relational Experimental Index, CARE Index). Three months post-discharge, one third of women described themselves as “completely recovered,” one third were experiencing significant deterioration and 17% were readmitted to inpatient care. Poorer GAF scores were associated with a clinical diagnosis of comorbid personality disorder, antenatal presence of the index illness, partner illicit substance use, maternal perception of her bond, infant social withdrawal, and child protection concern. Post-discharge, the mother–infant relationship results were concerning. Only 17% were regarded as adequate. Improvement was observed across this period in 56% but relational deterioration occurred for 35%. Maternal and relational outcomes were weakly correlated at discharge (r² = 0.29, p = 0.07) but this was lost post-discharge (r² = 0.03, p = 0.89). The shared relationship and infant mental health should both be targets for intervention; both during MBU admission, and post-discharge.     

Affective facial expression in sub-clinically depressed and non-depressed mothers during contingent and non-contingent face-to-face interactions with their infants

BackgroundDepression in the postpartum period involves feelings of sadness, anxiety and irritability, and attenuated feelings of pleasure and comfort with the infant. Even mild- to- moderate symptoms of depression seem to have an impact on caregivers affective availability and contingent responsiveness. The aim of the present study was to investigate non-depressed and sub-clinically depressed mothers interest and affective expression during contingent and non-contingent face-to-face interaction with their infant.MethodsThe study utilized a double video (DV) set-up. The mother and the infant were presented with live real-time video sequences, which allowed for mutually responsive interaction between the mother and the infant (Live contingent sequences), or replay sequences where the interaction was set out of phase (Replay non-contingent sequences). The DV set-up consisted of five sequences: Live1-Replay1-Live2-Replay2-Live3. Based on their scores on the Edinburgh Postnatal Depression Scale (EPDS), the mothers were divided into a non-depressed and a sub-clinically depressed group (EPDS score ≥ 6).ResultsA three-way split-plot ANOVA showed that the sub-clinically depressed mothers displayed the same amount of positive and negative facial affect independent of the quality of the interaction with the infants. The non-depressed mothers displayed more positive facial affect during the non-contingent than the contingent interaction sequences, while there was no such effect for negative facial affect.ConclusionsThe results indicate that sub-clinically level depressive symptoms influence the mothers’ affective facial expression during early face-to-face interaction with their infants. One of the clinical implications is to consider even sub-clinical depressive symptoms as a risk factor for mother-infant relationship disturbances.     

Bullinger's Defence of Infant Baptism in Debate with the Anabaptists

Abstract

Bullinger presents his understanding of infant baptism not only in systematic or summary form in the Decades and confessional works but also in dialogue or discussion form in other works. From 1525 what is fundamental in expounding his view and in challenging his opponents’ views is the argument from the covenant, which is one and eternal. In 1525 he begins with this and then examines Anabaptist objections. However in 1531 and 1560 he begins with his opponents’ case, though with different elements in it. The substance of his defence of infant baptism is unchanged between 1525 and 1560, though some new arguments emerge over the years. There is continuity between Zwingli and Bullinger, both in the argument from the covenant and in a range of biblical arguments. However, unlike Zwingli, Bullinger makes no use of election in support of his case and later expounds Acts 19 differently from Zwingli.     

The effect of preterm birth on infant negative affect and maternal postpartum depressive symptoms: A preliminary examination in an underrepresented minority sample

ObjectiveTo examine the effect of preterm birth on maternal postpartum depressive symptoms and infant negative affect in an underrepresented minority sample.MethodParticipants were 102 mothers and their 3- to 10-month-old infants. Mothers completed the Edinburgh Postnatal Depression Scale and the Infant Behavior Questionnaire-Revised.ResultsRelative to normative samples, the current underrepresented minority sample of mostly Hispanics and Blacks displayed high rates of preterm birth (30%) and maternal postpartum depressive symptoms (17%). Preterm birth had a significant direct effect on postpartum depressive symptoms and infant negative affect. Additionally, there was an indirect effect of postpartum depressive symptoms on the relation between preterm birth and infant negative affect. Specifically, lower birth weight and gestational age predicted higher levels of depressive symptoms in the mother, and higher levels of depressive symptoms in the mother, in turn, predicted higher levels of infant negative affect.ConclusionFindings emphasize the importance of screening for postpartum depressive symptoms and infant negative affect among mothers and their preterm infants, especially among families from underrepresented minority backgrounds.     

Babies' logic activity: a differential study

From a neuroconstructivist point of view based on infant cognitive development, the aim of this study is to get to know and compare the logical organization and content of the spontaneous activity of babies with alternative developmental courses (typical babies and Down's Syndrome ones). A fundamental form of logic is observed since the beginning of babies' interaction with their environment. This protologic is constructed through their organised and significative activity with the environment and it results in the elaboration of logico-mathematical and physical knowledge. Using Systematic Observation, we recorded the spontaneous activity of n=20 babies, (n=10 typical babies, n=10 Down Syndrome babies), with a cognitive developmental level of 1; 3 years (15 months). Microgenetical and statistical analyses were applied and the results obtained showed a reduced logical content and organization of the activity of Down's Syndrome babies, which corroborates and amplifies the results of previous research works. These results make evident the need to plan early educational intervention in order to optimize babies' developmental resources.     

Parenting and mother-infant interactions in the context of maternal postpartum obsessive-compulsive disorder: Effects of obsessional symptoms and mood

BackgroundMaternal mental illness is associated with negative effects on the infant and child. Increased attention has been paid to the effects of specific perinatal disorders on parenting and interactions as an important mechanism of influence. OCD can be a debilitating disorder for the sufferer and those around them. Although OCD is a common perinatal illness, no previous studies have characterized parenting and mother infant interactions in detail for mothers with OCD.Methods37 mothers with postpartum OCD and a 6 month old infant were compared with 37 community control dyads on a variety of measures of psychological distress and parenting. Observed mother-infant interactions were assessed independently.ResultsObsessions and compulsions were reported in both groups, although they did not cause interference in the control group. Mothers with OCD were troubled by their symptoms for a mean of 9.6 hours/day. Mothers with OCD were less confident, reported more marital distress and less social support than healthy peers and were less likely to be breastfeeding. Infant temperament ratings did not differ. Mothers with OCD were rated as less sensitive in interactions than the comparison group, partly attributable to levels of concurrent depression.ConclusionsMaternal postpartum OCD is a disorder that can affect experiences of parenting and mother-infant interactions although this may not be driven by OCD symptoms. Longitudinal studies are required to assess the trajectory and impact of maternal difficulties as the infant develops.