Postpartum maternal mood,feeding practices,and infant temperament in Barbados

Maternal mood, infant feeding practices, and infant temperament, using the Carey-R scales, were assessed in 226 healthy, well-nourished Barbadian mothers and their infants during the first 6 months of life. Maternal moods were assessed by self-report using the Zung depression and anxiety scales and a morale scale. Even after correcting for background variables, maternal depression and anxiety ratings and reports of despair at 6 months postpartum were significantly associated with infant temperament ratings at 6 months, using the original Carey-R scales, with factors derived from principal components analysis of the Carey items, and with summary difficulty scores. Maternal depressive symptoms were associated with decreased infant adaptability, reduced approach, negative mood and an increased sensory threshold. Infants of depressed and anxious mothers were more resistant to change and preferred constancy. These significant relationships were linear across the range of maternal mood scores and were not limited to diagnosed cases of depression or anxiety. In contrast, feeding practices were not significantly correlated with infant temperament, although infant difficulty on the temperament scales was associated with an increase in difficult feeding behaviors and with fathers’ involvement in the feeding of their infants. We conclude that interventions focused on improving maternal mood in the postpartum period are likely to impact positively upon maternal perceptions of their infants, with implications for improving child behavioral development and health in this underserved population.     

Bed-sharing, breastfeeding and maternal moods in Barbados

Bed-sharing among Barbadian mothers and infants was studied in relationship to maternal and infant characteristics. This prospective study followed 226 healthy, well-nourished mother–infant dyads at birth, 7 weeks, 3 months, and 6 months postpartum. At each age, approximately half of the infants shared the same beds as their mothers. Bed-sharing was associated with demographic characteristics, especially fewer home conveniences, and also maternal characteristics, including less information seeking by the mother and younger maternal age at first pregnancy. Bed-sharing was also associated with lower infant birth weights. Maternal moods were significantly correlated with bed-sharing, such that mothers who reported having more despair and anxiety were also more likely to sleep with their infants. Bed-sharing was also significantly associated with increased breastfeeding at all infant ages, but this relationship was no longer significant once the effects of maternal moods were controlled. This study emphasizes the importance of assessing maternal moods in studies evaluating the risk and benefits of bed-sharing.     

Infant feeding and maternal attitudes among mothers of low-income

Demographic variables, maternal attitudes, knowledge, practices, and support systems were examined in a sample of 50 women attending a public health clinic for well baby visits. Black women were nonsystematically selected an approached as they were waiting for their babies. Because the number of white women attending the clinic was small, an effort was made to include all of them. Data were obtained through individual interviews conducted by a trained interviewer. A questionnaire was constructed to obtain demographic information, information regarding prenatal awareness, delivery, mother infant interaction in the hospital, nutrition and infant care during the 1st year of life, and attitudes. 68% of the women were black and 32% were married. Most unmarried mothers lived with parents (50%), other relatives (26.5%), or ex husbands/boyfriends (5.9%). The mean educational level of 11.8 years was higher than anticipated for studies of public health department clinic populations. Teenagers made up 38% of the sample. 74% of the women reported family incomes below $8000. 64% had more than 1 child. Only 2 mothers in the sample had attended childbirth classes. 2/3 of the mothers recalled receiving no prior information about labor and delivery procedures and medications. Practices during the 1st few days after delivery indicate that only 20% of the mothers held their babires in the 1st hour after delivery and none of the mothers had the baby rooming in with them. 54% of the babies spent some time in the high risk nursery. This limited the mothers' opportunities to interact with and feed them. Only 3 of the mothers breastfed their babies for any length of time. 2 of them decided to breastfed because that was the best nutrition for the baby, and 1 did so because her mother had breastfed. The most common reasons given for bottlefeeding were not wanting to nurse (43.5%) and inconvenience (26.1%). Only 13% mentioned the necessity of back to school/work as a reason for not breastfeeding. No differences were observed between teenage mothers and older mothers in regard to the reasons for not breastfeeding. Since the number of breastfeeding mothers in this study was too small to permit statistical analysis, only scores for bottlefeeding mothers were compared. Bottlefeeding mothers of the low income group had statistically significant higher mean scores on 3 attitudinal scales: seclusion of the mother, acceleration of development, and mother's covert attitudes toward breastfeeding. Lower scores alone or with their spouses suggest that, when the childrearing responsibility was shared with extended family, mothers tended to be stricter with their children and minimized physical and emotional dependence of the children on them. Mothers who lived with spouses or alone tended to be more nurturing and less strict with their children.     

Postpartum depression and infant-mother attachment security at one year: The impact of co-morbid maternal personality disorders

Previous studies on effects of postpartum depression (PPD) on infant-mother attachment have been divergent. This may be due to not taking into account the effects of stable difficulties not specific for depression, such as maternal personality disorder (PD).Mothers (N = 80) were recruited for a longitudinal study either during pregnancy (comparison group) or eight weeks postpartum (clinical group). Infants of mothers with depressive symptoms only or in combination with a PD diagnosis were compared with infants of mothers with no psychopathology. Depression and PD were assessed using self-report and clinical interviews. Infant-mother attachment was assessed when infants were 13 months using Strange Situation Procedure (SSP). Attachment (in)security was calculated as a continuous score based on the four interactive behavioral scales of the SSP, and the conventional scale for attachment disorganization was used.PPD was associated with attachment insecurity only if the mother also had a PD diagnosis. Infants of PPD mothers without co-morbid PD did not differ from infants of mothers with no psychopathology. These results suggest that co-existing PD may be crucial in understanding how PPD impacts on parenting and infant social-emotional development. Stable underlying factors may magnify or buffer effects of PPD on parenting and child outcomes.     

Infant colic and maternal depression

The combined impact of infant colic and maternal depression on infant, parent, and family difficulties was examined. The sample included 93 consecutive patients seen at an outpatient Colic Clinic. Most mothers had private insurance and completed high school. Infants were approximately 2 months of age. Questionnaires completed by the mother prior to treatment onset were used to measure depressive symptoms in the mothers, infant cry, sleep and temperament, characteristics, parenting stress, maternal self‐esteem, social support, and family function. Moderate to severe depressive symptoms were reported by 45.2% of the mothers. More severe depressive symptoms in the mothers were related to fussy/difficult infant temperament, more parenting stress, lower parental self‐esteem, and more family‐functioning problems. Pediatric health care providers need to be aware that the combined effects of colic and maternal depression can be problematic for the family. ©2005 Michigan Association for Infant Mental Health.     

Correlation between maternal and infant cortisol varies by breastfeeding status

ObjectiveThe objective of this study was to examine associations of mother and infant salivary cortisol, measured three times over the course of a day, and assess whether these varied by breastfeeding status.MethodsWe conducted a cross-sectional study of 54 mothers and their infants aged 4–11 months. Mothers collected their own saliva and that of their infants upon awakening, 30 min after waking and at bedtime. Breastfeeding status was reported by mothers and cortisol level was measured in saliva in μg/dl using standard techniques. We used generalized linear models to evaluate relationships between maternal and infant cortisol levels, and assessed whether the relationship differed by breastfeeding status: formula only compared to partial and full breastfeeding, adjusting for infant sex, race, age, maternal education, and family income.ResultsThirty-four infants received formula only and 20 were either partially or fully breastfed. Breastfeeding was associated with higher household income, higher maternal education, and white race. Cortisol levels were higher among breastfed infants at all three time points. After adjustment, maternal cortisol levels were related with infant cortisol at bedtime only (regression estimate 0.06; 95% CI: 0.10, 1.1; p = 0.02). The adjusted association between bedtime maternal and infant cortisol was stronger among breastfeeding dyads than among formula-feeding dyads (regression estimate 1.0; 95% CI: 0.1, 2.0; p = 0.04 vs. 0.6; CI: −0.1, 1.3; p = 0.10). In addition, we assessed the influence of maternal education and household income in our adjusted model; income strengthened the observed association, whereas maternal education did not change the estimate.ConclusionsBreastfeeding mothers and infants had significant correlations for cortisol at bedtime, while formula-feeding dyads did not. These data suggest that several factors may contribute to cortisol synchrony observed in mother/infant dyads, including the transfer of cortisol in human milk, physical interaction such as skin-to-skin contact, and shared environment. In addition, our findings support household income as a possible contributor.     

Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

Infant massage improves attitudes toward childbearing,maternal satisfaction and pleasure in parenting

The first year of motherhood is a period of growth and adaptation in women's lives with several challenges such as identifying the baby’s needs and giving appropriate answers, so that mother and baby get to know each other and form a strong bond. Infant massage is one of the approaches that make an important contribution to the psychological and physiological wellbeing of both baby and mother, helping to form a harmonious relationship. This longitudinal study assessed the benefits of infant massage in the relationship between mother and baby, from birth to 12 months old. Comprising 194 dyads of mothers and their babies the subjects were divided into two groups of 97 dyads each. The Experimental group (EG) comprised mothers who undertook infant massage in a postnatal program with a physical therapist once a week. The Control group (CG) comprised mothers who did not attend any postnatal program and did not perform infant massage. Self-reported measures of attitudes concerning motherhood (CAQ-P), experience associated to motherhood (WBPB), parental satisfaction (PSS) and maternal separation anxiety (MSAS) were evaluated. Results showed that mothers in the experimental group were better adapted to motherhood, had greater confidence in their abilities and received more support from their mothers and husbands than mothers in the control group and were therefore more confident in their abilities. The EG group experienced a stronger relationship with their babies and described it as more positive than mothers in the control group. This longitudinal study suggests that mothers who learned how to perform infant massage had more positive attitudes towards the experience of motherhood in helping to increase the level of knowledge, regulation and proximity in the dyad. These findings can in turn help mothers to develop strategies that enable them to better cope with motherhood.     

Examining maternal age,breastfeeding self-efficacy and health locus of control in psychological wellbeing of mothers

We investigated the direct and interaction influence of maternal age, breastfeeding self-efficacy (BSE), health locus of control (HLOC) on six dimensions of psychological wellbeing of breastfeeding mothers in Lagos, Nigeria. Data were collected from a convenience sample of 291 mothers attending health facilities in two suburb local government areas. The survey included socio-demographics (maternal age, marital status, ethnicity, education level and position of the baby currently breastfeeding), breastfeeding self-efficacy, health locus of control and psychological wellbeing scales. Independent variables were tested against sense of autonomy, positive relations with others, purpose in life, self-acceptance, environmental mastery and personal growth using factorial Multivariate Analysis of Variance. Results showed direct influence of BSE, HLOC and maternal age on various dimensions of psychological wellbeing. Interaction influences indicate BSE and HLOC on environmental mastery; BSE and maternal age on self-acceptance and HLOC and maternal age on sense of autonomy, positive relationship with others and self-acceptance respectively. In conclusion, maternal age, breastfeeding self-efficacy and health locus of control are vital for mothers to enjoy plenty dimensions of psychological wellbeing. Breastfeeding mothers need to be confident in their abilities to breastfeed and have control over their health-related behaviour in order to enjoy sufficient dimensions of psychological wellbeing.     

Perceived stress,life events,dysfunctional attitudes,and depression in adolescent psychiatric inpatients

Hewitt, Flett, and Mosher (1992) examined the factor structure of the Perceived Stress Scale (PSS) and its relation to depression in adult psychiatric patients. This study sought to replicate and extend their findings, using a sample of 203 adolescent psychiatric inpatients. All patients admitted to the adolescent unit in a psychiatric hospital over a 3-year period were administered the PSS, as well as measures of depression, life events, dysfunctional attitudes, and intellectual abilities. Consistent with Hewittet al., two factors were found in the PSS, reflecting perceived distress and perceived coping ability. Regression analyses indicated that, for males, both factors account for independent variance in depression, whereas for females, only the distress factor is related to depression. In addition, for both male and female, dysfunctional attitudes account for significant variance in depression in addition to PSS, but negative life events do not. None of the variables were related to intellectual abilities. Implications for clinical assessment and intervention are discussed.     

Perinatal loss and maternal attitudes toward the subsequent child

Twenty-five mothers who had experienced a previous perinatal loss and a comparison group of 30 nonloss mothers completed the Maternal Attitude Questionnaire (MAQ) and the Maternal Separation Anxiety Scale (MSAS) when their children were 16 months old. The purposes of the study were to describe and evaluate the development of a new measure (the MAQ) and to examine the hypothesis that mothers who experienced a perinatal loss would express (a) more concern about the subsequent child's health, (b) more investment in the child, and (c) heightened concern about maternal-child differentiation/separation in comparison to nonloss mothers. The results showed that the MAQ had good internal consistency. None of the three factors of the MSAS differentiated between the two groups of mothers while two subscales of the MAQ did: (1) Maternal Concern with Child's Health and (2) Maternal Concern with Differentiation. Mothers who had experienced a perinatal loss thus expressed more concerns about their children's physical well-being and more concerns about differentiating from their child than mothers who had not had a perinatal loss.     

Infant sensitivity to negative maternal emotional shifts: Effects of infant sex,maternal postnatal depression,and interactive style

This study examined the effects of infant sex, maternal postnatal depression, and maternal interactive style on infant sensitivity to maternal negative emotional shifts. Face‐to‐face interactions of 68 mother–infant dyads were analyzed at 8 and 18 weeks. Twenty‐five (28%) mothers had postnatal depression. Interactions were analyzed in terms of overall maternal interactive style: “sensitive,” “anxious,” “intrusive,” and “sad.” Episodes of negative shifts in maternal emotional expression were recorded, along with expressions of infant sensitivity to these changes. Daughters of depressed mothers showed higher rates of sensitivity to maternal negative emotion whereas their sons showed lower rates, in comparison to both girl and boy infants of well mothers. While maternal interactive style had no effect on 8‐week infant sensitivity to maternal negative emotional shifts, high rates of 18‐week infant sensitivity were predicted by both an 8‐week and a concurrent, “sad” maternal interactive style. The findings are discussed in relation to theories of emotional and interpersonal development.     

Putting the pieces together: Maternal depression,maternal behavior,and toddler helplessness

This study assessed relations between maternal depression, maternal behavior, and helplessness in toddlers. Helplessness was assessed behaviorally in 25‐ and 32‐month‐old toddlers while the toddlers were engaged with an impossible task. Maternal behavior (warmth, negativity, control, intrusiveness) was assessed during a mother–child teaching task when toddlers were 18 and 25 months of age. Mothers who reported more depressive symptoms on the BDI had 32‐month‐old toddlers who displayed more affect‐related helplessness. No direct relations were found between maternal diagnosis of depression and helplessness in toddlers. Few differences emerged in the behavior of depressed and nondepressed mothers while interacting with their toddlers, and few relations were found between maternal behavior alone and toddlers' helplessness. However, results suggest that maternal behavior moderates the relation between maternal depression (diagnosis, recency, and symptoms) and helplessness. ©2003 Michigan Association for Infant Mental Health.