Effects of massage intervention on discharged premature infants’ weight,parental stress,and parent–child attachment: A randomized controlled trial

Infant massage enhances the growth and development of premature infants and promotes parent–child bonding. However, its effects on parental stress and parent–child attachment in premature infants, as well as gender differences thereof, remain unclear. In this randomized controlled trial, we used a repeated-measures design and included 61 premature infants (mean gestational age: 35.1 ± 1.5 weeks). Weight, parental stress, and parent–child attachment were measured at multiple time points: before massage and 1, 4, 8, and 12 weeks after commencing infant massage. The results revealed that the massage group infants had significantly higher weight gain than the control (no massage) group infants at all four time points. Moreover, parents in the massage group reported notably lower levels of stress than those in the control group, particularly in the parental distress and difficult children subscales. No significant between-group differences were observed in parent–child attachment. Furthermore, no significant differences were observed between fathers and mothers in parental stress and parent–child attachment. However, fathers reported higher levels of distress than mothers at 4 and 12 weeks. In conclusion, infant massage led to increased infant weight and reduced parental stress over time, and differences between fathers and mothers were not significant, except fathers exhibiting higher levels of distress than mothers over time. Healthcare professionals should educate and support parents on infant massage before discharge of premature infants.     

Birth characteristics and developmental outcomes of infants of Mexican-origin adolescent mothers: Risk and promotive factors

Infants of adolescent mothers are at increased risk for negative developmental outcomes. Given the high rate of pregnancy among Mexican-origin adolescent females in the US, the present study examined health characteristics at birth and developmental functioning at 10 months of age in a sample of 205 infants of Mexican-origin adolescent mothers. Infants were relatively healthy at birth and had near average developmental functioning at 10 months. The educational attainment of adolescents and their mothers, and infants' temperamental regulation, promoted positive developmental functioning, while the combination of low adolescent parental self-efficacy and high infant temperamental negativity was associated with greater developmental delay. Findings are discussed with respect to implications for prevention with this at-risk population of mothers and infants.     

Early language outcomes in Argentinean toddlers: Associations with home literacy,screen exposure and joint media engagement

This study aimed to analyse the contribution of mothers' home literacy beliefs and practices and the quantity and quality of screen media exposure on Argentinean toddler's language. In addition, we considered parent–child joint engagement, as well as adult scaffolding behaviours during the use of electronic devices. A total of 465 mothers of 18–36 months old children completed an online survey including: the MacArthur Bates CDI, home literacy, screen exposure, joint engagement and scaffolding questionnaires. We observed positive effects of literacy beliefs, PC times and verbal scaffolding on language outcomes. TV exposure contributed negatively to vocabulary and, along with educational content, to sentence use. Shared reading and screen media experiences can be an opportunity for language stimulation, provided there is dialogue and joint engagement. Passive screen exposure and inadequate content may be detrimental for toddlers' language outcomes, probably by displacement of socially significant interactions.     

Infant emotion regulation: Relations to bedtime emotional availability,attachment security,and temperament

The present study examines the influences of mothers’ emotional availability toward their infants during bedtime, infant attachment security, and interactions between bedtime parenting and attachment with infant temperamental negative affectivity, on infants’ emotion regulation strategy use at 12 and 18 months. Infants’ emotion regulation strategies were assessed during a frustration task that required infants to regulate their emotions in the absence of parental support. Whereas emotional availability was not directly related to infants’ emotion regulation strategies, infant attachment security had direct relations with infants’ orienting toward the environment and tension reduction behaviors. Both maternal emotional availability and security of the mother–infant attachment relationship interacted with infant temperamental negative affectivity to predict two strategies that were less adaptive in regulating frustration.     

Precursors of social emotional functioning among full-term and preterm infants at 12 months: Early infant withdrawal behavior and symptoms of maternal depression

This study forms part of a longitudinal investigation of early infant social withdrawal, maternal symptoms of depression and later child social emotional functioning. The sample consisted of a group of full-term infants (N = 238) and their mothers, and a group of moderately premature infants (N = 64) and their mothers. At 3 months, the infants were observed with the Alarm Distress Baby Scale (ADBB) and the mothers completed the Edinburgh Postnatal Depression Scale (EPDS). At 12 months, the mothers filled out questionnaires about the infants’ social emotional functioning (Infant Toddler Social Emotional Assessment and the Ages and Stages Questionnaire-Social Emotional). At 3 months, as we have previously shown, the premature infants had exhibited more withdrawal behavior and their mothers reported elevated maternal depressive symptoms as compared with the full-born group. At 12 months the mothers of the premature infants reported more child internalizing behavior. These data suggest that infant withdrawal behavior as well as maternal depressive mood may serve as sensitive indices of early risk status. Further, the results suggest that early maternal depressive symptoms are a salient predictor of later child social emotional functioning. However, neither early infant withdrawal behavior, nor gestational age, did significantly predict social emotional outcome at 12 months. It should be noted that the differences in strength of the relations between ADBB and EPDS, respectively, to the outcome at 12 months was modest. An implication of the study is that clinicians should be aware of the complex interplay between early infant withdrawal and signs of maternal postpartum depression in planning ports of entry for early intervention.     

The association between observed non-verbal maternal responses at 12 months and later infant development at 18 months and IQ at 4 years: a longitudinal study

Background

An infant's early environment has an important influence on their development. For example, the sensitivity and warmth of a mother's responses towards her infant is associated with the infant's later socio-emotional development. However, it is less clear whether maternal responses are associated with the infant's later cognitive development.

Method

We used data from a large UK cohort study to investigate the association between non-verbal maternal responses and later infant development and IQ. Maternal responses were rated at 12 months during an observed mother–infant interaction. Infant development was assessed using the Griffiths scales at 18 months and IQ at 4 years was assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Data on the infant's developmental level at 6 months (prior to the maternal response ratings) was also available. The complete case sample comprised 732 mother–infant pairs.

Results

There was evidence for an association between positive maternal responses and infant development at 18 months. After adjusting for infant developmental level at 6 months and other confounders, we found a difference of 0.25 standard deviations (coef 2.0, 95% CI (0.8–3.2), p = 0.002) on the Griffiths scales between infant's whose mothers showed positive compared to neutral non-verbal responses at 12 months. However, an association between positive maternal responses and IQ at 4 years diminished following adjustment for maternal educational attainment.

Conclusion

The results provide evidence that positive maternal responses are associated with improved development in infants at 18 months. However, the association between maternal response and IQ at 4 years may be explained by higher educational attainment in mothers who show positive responses. Future studies are needed to explore the influence of maternal responses on different aspects of infant development as well as the role of maternal factors such as education.     

Maternal perception of infant intentionality at 4 and 8 months

This study examines the degree to which mothers perceive infants as intentional and the relations among perception of intentionality, background variables, maternal emotional adjustment, and maternal interactive style. Forty mother-infant dyads were assessed when the infants were 4 months old, and 34 were retested at 8 months. Parent perception of infant intentionality (PPII) was measured via a rating of videotaped segments of infant behavior and an interview. Intentionality scores showed acceptable internal consistency and were positively intercorrelated at each age and across age. The two measures were aggregated to form an index of PPII at each age. Higher educational attainment was associated with lower PPII scores, experience with infants was associated with higher PPII scores, and academic knowledge about child development was not related to PPII. Mothers with more symptoms of anxiety had lower PPII scores, but high maternal separation anxiety was associated with higher PPII scores. Maternal symptoms of depression had a complex relation to PPII scores. Mothers rated as sensitive in mother-infant interactions had higher PPII scores. These variables accounted for 34% of the variance in PPII at 4 months and 49% at 8 months. There were also group differences: Mothers of 8-month-olds had higher PPII scores than mothers of 4-month-olds, mothers of girls had higher PPII scores than mothers of boys, and mothers attributed more intentionality in episodes with girls than in episodes with boys. The results are discussed in relation to mechanisms whereby PPII interacts with aspects of the parent and infant.     

Sleep arrangements and maternal adaptation in infancy

Among the many decisions that parents make regarding child‐rearing practices, an important one involves sleep arrangements. Little is known about the relationship between chosen sleep arrangements, parents' adaptation to these choices, parental sleep quality, spousal support, and parental distress. Forty‐five mothers and fathers with infants 1 to 24 months old completed measures of parental attitudes and practices regarding sleep arrangements. Shared sleep with one's infant was associated with poorer parental adaptation to infant sleep disruption, and this was true even when parents endorsed the practice of sharing sleep with their infants. Among mothers, shared sleep and poorer adaptation to infant sleep were significantly associated with elevated depressive symptoms, poorer sleep quality, and spousal criticism directed to mothers about where the infant slept during the night. For mothers, criticism from their spouses about where the baby slept, mothers' sleep quality, and depressive symptoms mediated the link between sleep arrangements and maternal adaptation. Results emphasize the importance of taking into account individual differences in the quality of parents' adaptation to infant sleep behavior, a construct largely ignored in the child sleep literature to date, in understanding linkages between infant sleep quality and infant–parent outcomes.     

Infant temperament and maternal sensitivity behavior in the first year of life

Maternal sensitivity behavior (MSB) and infant temperament were investigated among 56 Finnish low-risk mothers and their full-term and healthy infants. The mothers were from families with good economic status, the infant's parents lived together, and the mothers were well educated. Mothers and infants were video-recorded in free-play situations at home, and evaluated using the Parent-Child Early Relational Assessment Scale (PCERA). The infants were also assessed using the Revised Infant Temperament Questionnaire (R-ITQ) and the Toddler Temperament Questionnaire (TTQ). Most of the temperament characteristics showed moderate stability during the first year. MSB was related to infant temperament characteristics at 3, 6 and 12 months of age. Gender differences in temperament were evident already at 6 and 12 months of age. Few prior studies have reported gender differences in infancy.     

A longitudinal examination of daily amounts of screen time and technoference in infants aged 2–11 months and associations with maternal sociodemographic factors

This study aimed to examine longitudinal developmental patterns in the daily amounts of screen time and technoference in infants aged 2, 4, 7, and 11 months and to examine associations with maternal sociodemographic factors across all age groups.The results showed that the amount of screen time varied between 6 and 17 min a day, while interruptions in mother-infant interactions due to maternal use of digital technology occurred between 5 and 6 times a day. There was a significant increase in infant screen time from 2 to 4 months, from 4–7 months, and from 7–11 months, and in technoference from 2 to 4 months and from 4–7 months. Maternal age and household income were not associated with infant screen time, but maternal educational level was negatively associated with infant screen time throughout the first year. No associations were found between technoference and maternal age, maternal educational level, or household income.Future research focusing on infant screen time and technoference should aim at including samples that reflect the general population, include measures of screen time and technoference that do not rely on parental report, and include measures of the effects of early infant screen time and technoference on later development.     

Substance use and mothers’ neural responses to infant cues

Substance use may influence mothers’ responsiveness to their infants and negatively impact the parent–infant relationship. Maternal substance use may co-opt neural circuitry involved in caregiving, thus reducing the salience of infant cues and diminishing the sense of reward experienced by caring for infants. Gaps in understanding exist with regard to the mechanisms by which substance use operates to influence mothers’ processing of infant cues and how this translates to caregiving. Therefore, we examined how substance use might relate to maternal neural responses to infant cues using event-related potentials (ERPs). Substance-using (n = 29) and nonsubstance-using (n = 29) mothers viewed photographs of infant faces and heard recordings of infant vocalizations while electroencephalography was recorded simultaneously. Three specific ERP components were used to examine initial processing of infant faces (N170) and cries (N100), and attentional allocation to infant faces and cries (P300). Substance-using mothers did not discriminate facial affect at early encoding stages (N170), were generally slower to orient to infant cries (N100), showed heightened responses to neutral faces (P300), and failed to adaptively differentiate between high-distress versus low-distress cries (P300). These differences may be important to caregiving behaviors associated with the formation of mother–child attachment. Implications are discussed, as are limitations and future directions.     

Cardiac physiological regulation across early infancy: The roles of infant surgency and parental involvement with mothers and fathers

High baseline respiratory sinus arrhythmia (RSA) and infant temperament are associated with a child’s ability to self-regulate, but moderators of this association have not been thoroughly examined in the literature. Parents who are more involved might have more opportunities to interact with and soothe their children. The current study examined whether parental involvement moderated the association between infant temperament and baseline RSA with mothers and fathers across early infancy. Participants included families (n = 91) assessed at 4 and 8 months of age. Infant temperamental surgency and parental involvement were measured via parent-report when infants were 4 months old, and infant baseline RSA was measured at 4 and 8 months of age. Results revealed differences in mother versus father predictors of infant baseline RSA. A significant Infant Surgency X Maternal Play interaction was revealed; infants of mothers who were low involvement increased in their baseline RSA as their surgency increased. A significant main effect of father care was found; infants with highly involved fathers had higher baseline RSA. In conclusion, mothers and fathers may differentially influence their infant’s cardiac physiological regulation based on their specific type of involvement.     

Maternal posttraumatic stress symptoms and infant emotional reactivity and emotion regulation

The current study examined associations between maternal posttraumatic stress disorder (PTSD) symptoms and infant emotional reactivity and emotion regulation during the first year of life in a primarily low-income, urban, ethnic/racial minority sample of 52 mother–infant dyads. Mothers completed questionnaires assessing their own trauma exposure history and current PTSD and depressive symptoms and their infants’ temperament when the infants were 6 months old. Dyads participated in the repeated Still-Face Paradigm (SFP-R) when the infants were 6 months old, and infant affective states were coded for each SFP-R episode. Mothers completed questionnaires assessing infant trauma exposure history and infant current emotional and behavioral symptoms when the infants were 13 months old. Maternal PTSD symptoms predicted infants’ emotion regulation at 6 months as assessed by (a) infant ability to recover from distress during the SFP-R and (b) maternal report of infant rate of recovery from distress/arousal in daily life. Maternal PTSD symptoms also predicted maternal report of infant externalizing, internalizing, and dysregulation symptoms at 13 months. Maternal PTSD was not associated with measures of infant emotional reactivity. Neither maternal depressive symptoms nor infant direct exposure to trauma accounted for the associations between maternal PTSD symptoms and infant outcomes. These findings suggest that maternal PTSD is associated with offspring emotion regulation difficulties as early as infancy. Such difficulties may contribute to increased risk of mental health problems among children of mothers with PTSD.     

Maternal Depression and Family Media Use: A Questionnaire and Diary Analysis

We describe the association between postpartum depression and the quantity and content of infant media use. Households with depressed mothers viewed twice as much television as households with non-depressed mothers did, and depressed mothers appeared to derive comparatively greater pleasure from television viewing. Maternal depression was associated with an increased exposure to child-directed content by 6–9-month-old infants, although it was not associated with an increased exposure to adult-directed programming. Depressed mothers also reported being less likely to sit and talk with their children during television use or to consult outside sources of information about media. This increase in television exposure without corresponding parental involvement could negatively affect developmental outcomes.     

War trauma and infant motor,cognitive, and socioemotional development: Maternal mental health and dyadic interaction as explanatory processes

BackgroundTaking care of infants in conditions of war is highly demanding and a few studies reveal the negative impact of war trauma on maternal and infant well-being. Yet, little is known regarding the influence of trauma on infant development and the potential explanatory mechanisms. First, the present study examines how mothers’ prenatal exposure to traumatic war events is associated with infant cognitive, motor, and socioemotional development. Second, it analyses the mediating roles of maternal postpartum mental health problems, quality of dyadic mother-infant interaction, and earlier infant development (at six months) in the association between prenatal traumatic war events and infants’ developmental skills at 18 months.MethodThis prospective three-wave study involved 502 Palestinian pregnant females in their first trimester during the 2014 Gaza War and participated at delivery (T1) and when the child was six (T2;N = 392) and eighteen (T3; N = 386) months of age. Mothers reported their exposure to traumatic war events (human and material losses, horrors, and threat to life) at T1 and T2, and researchers photo-documented the extent of destruction at T1. Mothers reported infants’ language, fine- and gross-motor, and socioemotional skills at T2 and researchers tested infants’ motor, cognitive-language and socioemotional skills using the Bayley Scales of Infant development (BSID-II) at T3. Mothers reported their mental health problems (symptoms of post-traumatic stress disorder [PTSD], depression and somatization) at T2 and T3 as well as dyadic interaction quality (the emotional availability self-report, [EA-SR] brief) at T2.ResultsFirst, the structural equation model (SEM) on direct effects indicated, in contrast to our hypotheses, that maternal prenatal exposure to traumatic war events did not associate with infants’ developmental skills at T2 and predicted higher level of developmental skills at T3. Second, as hypothesized, we found two negative underlying mechanisms (paths) between high exposure and low levels of motor, cognitive-language, and socioemotional skills at T3: (1) through increased maternal mental health problems at T2, which then were associated with problems at T3, and (2) through increased maternal mental health problems at T2, which then were associated with a low quality of mother-infant-interaction and low level of infant developmental skills at T2.ConclusionImproving maternal mental health and encouraging close and positive dyadic interaction can be critical for infant sensorimotor, cognitive, and socioemotional development in war conditions.     

How are social-emotional and behavioral competences and problems at age 1 year associated with infant motor development? A general population study

Based on limitations in previous research evidence, we concluded that more research is needed for deeper understanding of how social-emotional and behavioral (SEB) outcomes among infant-toddler-aged children in the general population are associated with early motor development. In this study, we investigated associations between early competencies and problems, as measured by the Brief Infant-Toddler Social and Emotional Assessment (BITSEA), and the timing of achievement of the main gross and fine motor milestones usually attained during the first year of life in a general population context. The study sample consisted of 515 infants (mean age 12.9 [SD 0.9] months) and their parents (514 mothers, 434 fathers), who were recruited in child health centers in Northern Finland. The infants were divided into two groups, based on their BITSEA screen status, and motor milestone achievement ages were compared across BITSEA screen status No Concern and Of-Concern infants. An Of-Concern screen status on the maternal and paternal Competence scale and Autism spectrum disorder (ASD) item cluster was associated with later infant achievement ages for gross motor milestones. By contrast, infants who were screened to be in the Of-Concern range on the maternal Problem scale achieved gross motor milestones earlier than infants with the corresponding No Concern screen status. No significant associations were found between the paternal Problem scale screen status and infant motor development. In further analyses, the strongest associations were found between an Of-Concern screen status on the paternal Competence scale and ASD item cluster and infant motor development. The findings indicate that the inclusion of infant motor developmental information may assist early identification and the clinical interpretation of parental reports of early SEB problems. Clinical implications of the current findings are discussed in the paper.     

Exposure to electronic media between 6 and 24 months of age: An exploratory study

This study explores the associations between electronic media exposure, age, and socioeconomic status (SES) in a longitudinal sample of 24 infants from English-speaking families. Leveraging Language ENvironment Analysis (LENA) technology, the study seeks to characterize the relation between electronic media exposure and parental and child vocal activity. We analyzed ecologically valid, daylong audio recordings collected in infants’ homes when they were 6, 10, 14, 18, and 24 months old. SES was measured with the Hollingshead Index, and exposure to electronic media and adult and infant vocal activity were measured automatically with LENA. On average, the children in the sample were exposed to 58 min of electronic media daily. We found that electronic media exposure was negatively associated with SES and decreased with child age, but only amongst high-SES families. We also found that electronic media exposure negatively impacted concurrent adult and child vocal activity, irrespective of SES and infant age. The present findings are an important step forward in examining the role of demographic factors in exposure to electronic media and enhance our understanding of the mechanisms through which exposure to electronic media may impact linguistic development in infancy and beyond.     

Development of self‐produced locomotion in the first year: changes in parent perceptions and infant behaviour

Self‐produced locomotion is regarded as a setting event for other developmental transitions in infancy with important implications for socioemotional development and parent–child interaction. Using an age‐held‐constant design, this study examined changes in reported infant behaviour and maternal proactive/reactive control and compared them with direct observations of infant and maternal behaviour associated with the development of self‐produced locomotion. Maternal reports were obtained prior to the locomotor transition and, for half the sample, after infants had transitioned to effective mobility. Observations of all infants were conducted shortly after the second interview. Prelocomotor and transitioning infants showed none of the expected behavioural differences (e.g. emotionality and compliance) associated with the locomotor transition. There was modest confirmation of expected differences in maternal behaviour, particularly in the use of reactive control techniques, and mothers of transitioning infants showed higher proactive controls before their infants began to crawl. These findings suggest that the changes in parent–child interaction associated with the locomotor transition may have as much to do with parental expectations than with changes in infant socioemotional behaviour. Copyright © 2010 John Wiley & Sons, Ltd.     

Developmental stimulation in child care centers contributes to young infants’ cognitive development

This study examined whether the quality of caregiver behavior in child care centers contributes to infant cognitive development at 9 months of age. Sixty-four infants (34 boys) were observed with their primary caregivers in child care centers at 3, 6, and 9 months of age. Caregiver behavior was rated for sensitivity and for stimulation of infant development during one-to-one caregiving interactions. Infant cognitive development was assessed using the Bayley Scales of Infant Development-II (Mental Development Index). Higher levels of developmental stimulation in the centers predicted higher levels of infant cognitive development at 9 months, beyond infant cognitive development at 3 months (just before entering child care), parental education, and maternal sensitivity. The results suggest that even small increases in developmental stimulation provided in child care centers in the first year of life may foster infants’ cognitive development.     

Synchrony,complexity and directiveness in mothers’ interactions with infants pre- and post-cochlear implantation

This study investigated effects of profound hearing loss on mother–infant interactions before and after cochlear implantation with a focus on maternal synchrony, complexity, and directiveness. Participants included two groups of mother–infant dyads: 9 dyads of mothers and infants with normal hearing; and 9 dyads of hearing mothers and infants with profound hearing loss. Dyads were observed at two time points: Time 1, scheduled to occur before cochlear implantation for infants with profound hearing loss (mean age = 13.6 months); and Time 2 (mean age = 23.3 months), scheduled to occur approximately six months after cochlear implantation. Hearing infants were age-matched to infants with hearing loss at both time points. Dependent variables included the proportion of maternal utterances that overlapped infant vocalizations, maternal mean length of utterance, infant word use, and combined maternal directives and prohibitions. Results showed mothers’ utterances overlapped the vocalizations of infants with hearing loss more often before cochlear implantation than after, mothers used less complex utterances with infants with cochlear implants compared to hearing peers (Time 2), and mothers of infants with profound hearing loss used frequent directives and prohibitions both before and after cochlear implantation. Together, mothers and infants adapted relatively quickly to infants’ access to cochlear implants, showing improved interactional synchrony, increased infant word use, and levels of maternal language complexity compatible with infants’ word use, all within seven months of cochlear implant activation.