Breastfeeding and antidepressants

Although a large literature supports the benefits of breastfeeding, this review suggests that breastfeeding is less common among postpartum depressed women, even though their infants benefit from the breastfeeding. Depressed mothers, in part, do not breastfeed because of their concern about potentially negative effects of antidepressants on their infants. Although sertraline (Zoloft) and paroxetine (Paxol) concentrations are not detectable in infants’ sera, fluoxetine (Prozac) and citalopram (Celexa) do have detectable levels. Unfortunately these findings are not definitive because they are based on very small sample, uncontrolled studies. As in the literature on prenatal antidepressant effects, the question still remains whether the antidepressants or the untreated depression itself has more negative effects on the infant. It is possible that the positive effects of breastfeeding may outweigh the positive effects of the antidepressants for both the mother and the infant. In addition, some alternative therapies may substitute or attenuate the effects of antidepressants, such as vagal stimulation or massage therapy, both therapies being noted to reduce depression. Further studies of this kind are needed to determine the optimal course of therapy for the benefit of the depressed, breastfeeding mother and the breastfed infant.     

Differential impact of parenting sick infants

Parenting a newborn infant has been identified as a significant stressor, and parenting a sick infant evokes an even greater stress. This study evaluated the differential impact of parenting infants with interrupted infantile apnea vs. extremely low birth weight infants. These infants were compared to normal infants on the Bayley Scales of Infant Assessment and the Parenting Stress Index when the infants were 6 months old. Significant effects on the mental index revealed that the low birthweight infants performed more poorly than did the other groups. A stepwise multiple discriminant analysis on the Parenting Stress Index suggested that child adaptability, maternal restrictions, isolation, and health were significant stressors. Mothers of apneic infants were affected most severely by their child's illness. The lower educational level of these mothers may have influenced these findings.     

MATERNAL SELF‐REPORTED DEPRESSIVE SYMPTOMS AND MATERNAL CORTISOL LEVELS INTERACT TO PREDICT INFANT CORTISOL LEVELS

Three basic findings have emerged from research on maternal depressive symptoms and offspring hypothalamic–pituitary–adrenal functioning: (a) Mothers’ depressive symptoms are positively associated with their offsprings’ cortisol stress response, (b) numerous individual and interpersonal maternal characteristics moderate this association, and (c) maternal and infant cortisol levels are highly correlated. In combination, these findings have suggested that maternal cortisol levels may moderate the relation between maternal depressive symptoms and infant cortisol responsivity; the current study assessed this hypothesis. Participants were 297 mother–infant dyads who were recruited from the community. Maternal depressive symptoms were assessed via self‐report. Dyads participated in two differentially stressful infant challenges when infants were 16 and 17 months old. Mother and infant salivary cortisol was collected before and after challenges. Results indicate that maternal cortisol levels moderated associations between maternal depressive symptoms and infant cortisol levels across both challenges. Infants showed higher cortisol levels if their mothers had both higher depressive symptoms and higher cortisol levels, as compared to infants of mothers with higher depressive symptoms and lower cortisol, and to infants of mothers with lower depressive symptoms and either higher or lower cortisol levels. We discuss findings in relation to environmental and biological factors that may contribute to the intergenerational transmission of depressive symptoms.     

Mothers' interactions with temperamentally frustrated infants

A sample of 162 six‐month‐old infants was selected from a larger sample of 346 infants on the basis of mothers' report of their infants' temperament and a laboratory assessment of temperament. Infants were classified as easily frustrated or less frustrated and observed in several types of interactions with their mothers in the laboratory. Mothers completed several measures that indicated their level of parenting stress, psychological functioning, and marital adjustment. Maternal behavior with infants was coded along the dimensions of sensitivity, intrusiveness, and physical stimulation. Results indicated that maternal intrusiveness was related to infant temperament and that maternal physical stimulation was predicted by an interaction of infant temperament and mothers' perceived parenting stress. Implications of these findings for mother–infant interaction and subsequent child adjustment are discussed. ©2004 Michigan Association for Infant Mental Health.     

Risks and realities: dyadic interaction between 6-month-old infants and their mothers in opioid maintenance treatment

A number of studies point to methadone exposure in utero as a possible risk factor in the developing mother–infant relationship in the first year of life. This study is part of a larger, national follow-up of 38 infants prenatally exposed to methadone or buprenorphine and 36 comparison, low-risk infants. The aim of the present paper is to assess the quality of mother–infant relationship when the infants are 6 months old. Videotaped mother–infant interactions were rated in a global scale (NICHD). Maternal and infant contributions collapsed into the variables “infant style” and “maternal style” showed that the only factor making significant contribution to the outcome measure “dyadic mutuality” was maternal style. The importance of group membership (exposed versus non-exposed), was reduced when controlling for maternal drug use prior to opioid maintenance treatment (OMT), maternal depression and parenting stress as well as infants’ developmental status and sensory-integrative functions. This suggests that prediction of dyadic mutuality should be based on individual characteristics rather than group characteristics. These results support previous research findings that methadone and buprenorphine use per se does not have direct influence on the quality of early mother–infant relationship, but tailored follow-up procedures targeting drug-free pregnancies and parenting support are beneficial for women in OMT and their children.     

Infants’ statistical word segmentation in an artificial language is linked to both parental speech input and reported production abilities

Individual variability in infant's language processing is partly explained by environmental factors, like the quantity of parental speech input, as well as by infant‐specific factors, like speech production. Here, we explore how these factors affect infant word segmentation. We used an artificial language to ensure that only statistical regularities (like transitional probabilities between syllables) could cue word boundaries, and then asked how the quantity of parental speech input and infants’ babbling repertoire predict infants’ abilities to use these statistical cues. We replicated prior reports showing that 8‐month‐old infants use statistical cues to segment words, with a preference for part‐words over words (a novelty effect). Crucially, 8‐month‐olds with larger novelty effects had received more speech input at 4 months and had greater production abilities at 8 months. These findings establish for the first time that the ability to extract statistical information from speech correlates with individual factors in infancy, like early speech experience and language production. Implications of these findings for understanding individual variability in early language acquisition are discussed.     

Maternal Symptoms of Attention-Deficit/Hyperactivity Disorder and Maternal Language: Implications for Infant Language Development

The relationship between maternal ADHD symptoms and maternal language was examined in a community sample of 50 mothers of infants age 3–12 months. It was hypothesized that higher maternal symptoms of ADHD would be related to lower quality of maternal language use. Recordings of mothers’ speech were coded for complexity and elaboration of speech and vocabulary diversity during an interview with an adult and during mother–infant play interactions in the home. Hierarchical regression analysis revealed that maternal ADHD symptoms were significantly related to mothers’ lower mean length of utterances during the interview and during mother–infant play interactions. Maternal ADHD symptoms were not related to maternal vocabulary use in either of these situations. Our findings suggest that mothers with higher ADHD symptoms may display exiguous language behaviors when interacting with their infants and with adults. In addition, findings suggest one reason why current parent-management programs for children with ADHD, which are verbally based and rely heavily on the parent’s communication skills, are relatively ineffective when ADHD may be present in the parent.     

An integrative model of rational imitation in infancy

It has been proposed that infants selectively imitate based on a rational evaluation of an observed action (Gergely, Bekkering, & Király, 2002). This rational-imitation account has been rejected based on findings which suggested that infant imitation depends on: (a) the similarity between the infant's and the model's body posture; and (b) the presence of action effects (Paulus, Hunnius, Vissers, & Bekkering, 2011). Despite this controversy, we show that both accounts have received empirical support from different fields of research. We propose that both accounts operate on different levels, and we present an integrative model, which combines the two seemingly competing accounts. Motor resonance is perceived as a mechanism that enables infants to imitate, and a rational evaluation of the model's action is conceived as a mechanism that guides infants’ imitative behavior.     

Home-based early intervention: Emerging purposes,intervention approaches,and evaluation strategies

Infant and toddler home visiting programs constitute an important subgroup within the rapidly growing field of early intervention. Scores of such programs have been implemented by health, educational, and mental health agencies during the past decade. Recent reviews have reported on home-based early intervention for specific populations, such as biologically impaired infants or infants from economically disadvantaged families. Other reviews have focused on the effects of home-based early intervention in particular outcome domains, such as I.Q., or infant health. In this review the author draws together the information emerging from partial reviews and specific program reports in order to describe the full range of purposes and strategies encompassed by home-based early intervention and to draw inferences about its potential to enhance infant health and development and broader family functioning.     

Using the HOME inventory with infants in Costa Rica

It has been established through several decades of research that children's home environments significantly influence their development. Many researchers have also been interested in expanding research beyond indirect measures of the home environment, such as socioeconomic status, to help understand the nature of specific environmental mechanisms which influence early behavior and cognitive development. The Home Observation for Measurement of the Environment (HOME) Inventory was developed to meet these needs. Specifically, HOME measures the quality of stimulation in a child's early family environment. Almost all studies of the approach's reliability and validity have been conducted with US samples. HOME is, however, being used in other countries. The authors report their findings from a study of whether the psychometric properties of HOME based upon US samples parallel those found in Costa Rica, and whether HOME discriminates between Costa Rican environments with different associations to child health and development. Focus centers upon the infant/toddler version of the HOME Inventory. HOME data for 183 healthy Costa Rican infants were compared to the original HOME standardization sample from Little Rock, Arkansas. The study found the HOME Inventory to be helpful in identifying children at risk for delayed development in this Latin American sample. Lower HOME scores related to a shorter duration of breastfeeding and differentiated children with iron deficiency anemia in infancy, a condition associated with long-lasting developmental disadvantage.     

Infant day care. Maligned or malignant?

Today, the mothers of half the infants in the United States work outside the home. This concerns psychologists and parents because of the possible detrimental effects on these infants of separations from mother and experience in day care. Available data suggest that infants whose mothers work full time are somewhat more likely as one-year-olds to avoid their mothers after a brief separation and later to be less compliant with their mothers and more aggressive with their peers. The argument that these behaviors indicate that infants in day care are at risk for emotional insecurity and social maladjustment is evaluated in light of current research results. It is concluded that other interpretations of the data are more plausible and that further research on the factors moderating and mediating the effects of infant day care is needed.     

Infant state in relation to its environmental context

Two neonatal intensive care units (NICU) were observed every 15 minutes for at least 72 consecutive hours. Although infants on both NICUs were exposed to considerable amounts of stimulation, there were differences between the units for each environmental measure in the amount of stimulation and/or the pattern of circadian periodicity. The two NICUs also differed in the amount of time infants spent in various states and in the pattern of state periodicity. In general, the diurnal rhythms of the infant states were associated with the diurnal rhythms of different environmental events; furthermore, the patterns of association were not the same on the two NICUs. The results point to potential problems in depicting a “typical” NICU. More importantly, they suggest that the environmental of NICUs has a recognizable influence on aspects of their inhabitants' behavior and that the nature of influence is different from NICU to NICU. The effects are potentially significant for physical, social, and cognitive development.     

Effectiveness of therapeutic and behavioral interventions for parents of low‐birth‐weight premature infants: A review

Premature birth has been associated with a number of adverse maternal psychological outcomes that include depression, anxiety, and trauma as well as adverse effects on maternal coping ability and parenting style. Infants and children who were premature are more likely to have poorer cognitive and developmental functioning and, thus, may be harder to parent. In response to these findings, a number of educational and behavioral interventions have been developed that target maternal psychological functioning, parenting, and aspects of the parent–infant relationship. Since the last comprehensive review of this topic in 2002, there have been a significant number of developments in the quality of the studies conducted and the theoretical models that address the experience of parents of premature infants. In the current review, 18 new interventions were identified and grouped into four categories based on treatment length and the target of the intervention. Findings suggest a trend toward early, brief interventions that are theoretically based, specifically target parent trauma, and utilize cognitive behavioral techniques. Although it is difficult to generalize study findings, conclusions from the review suggest that targeted interventions may have positive effects on both maternal and infant outcomes.     

Sex stereotyping of infants: A review of gender labeling studies

Studies that have addressed the question of whether adults and children respond differently to male and female infants because of actual differences in the infants or because of preconceived sex stereotypes are reviewed, and the overall conclusions from these studies are evaluated. Twenty-three studies were identified in which neutrally clothed infant stimuli were labeled male in some conditions and female in other conditions. The strength and consistency of gender labeling effects on perceptions and behaviors in these studies were appraised. The results indicate that knowledge of an infant's gender is not a consistent determinant of adults' reactions, but more strongly influences young children's reactions. The implications of these findings for research on early sex role socialization are considered.     

Maternal and infant touching behaviours during perturbed interactions: Associations with maternal depressive symptomatology and infant crying

Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal and infant touching behaviours among 41 mother-infant dyads, some of whom were deemed at-risk due to maternal depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability; SF) and Separation (maternal physical unavailability; SP) procedures. Infant crying was examined across procedures and investigated as a brief period of perturbation. Results revealed that mothers and infants displayed a positive pattern of tactile synchrony (coordinated, analogous changes in touch) during infant crying episodes. However, dyads in the high depression group displayed significantly less affectionate touch during instances of infant crying. Furthermore, more depressive symptoms were associated with less maternal and infant touch and lower rates of infant crying. This group of dyads may be less expressive via touch, be less affected by disruptions in their interactions, have impaired regulatory abilities, or simply require minimal amounts of touch to mutually regulate following social stressors and during brief perturbation periods. These findings enrich our limited knowledge about the dynamic interplay of maternal and infant touch and inform preventative intervention programs for at-risk groups.     

A Piagetian approach to infant referential behaviors

Near the end of the first year of life, infants begin producing referential behaviors that in adults indicate joint attention, or coordinating shared attention to an object with another person. These behaviors have been interpreted in the social cognitive literature as an indication that infants realize they are sharing attention to an object with another person. In this paper, we address theory and research on infant referential behaviors described as joint attention and offer an alternative explanation for the presence of these behaviors. Using Piaget's constructivist theory, we show how research in this area can be interpreted without assuming that infants have advanced social cognitive abilities. We argue that infants’ referential behaviors are motor signifiers of thought and that infants recognize humans as particularly relevant objects for their goal-directed behaviors. Finally, we describe how the field of infant joint attention research should proceed if a comprehensive understanding of infant cognitive processes is to be desired.     

Infant and maternal behaviors regulate infant reactivity to novelty at 6 months

Three issues were investigated: (a) the regulatory effects of presumed infant and maternal regulation behaviors on infant distress to novelty at 6 months, (b) stability of infant regulatory effects across contexts that vary in maternal involvement, and (c) associations and temporal dynamics between infant and maternal regulation behaviors. Participants were 87 low-risk infants and their mothers, observed at 6 months postpartum during infant exposure to novel toys. Contingencies derived from sequential analyses demonstrate that, by 6 months, some infants reduce their own distress to novelty by looking away from the novel toy or self-soothing, maternal engagement and support have comparable effects, and certain infant and maternal behaviors co-occur. Moreover, infants whose mothers engaged contingently when they looked away from the novel toy expressed less distress than comparable infants whose mothers did not. These findings implicate both infants and mothers in the development of emotion regulation during the infant's first year.     

Motion tracking of parents’ infant‐ versus adult‐directed actions reveals general and action‐specific modulations

Parents tend to modulate their movements when demonstrating actions to their infants. Thus far, these modulations have primarily been quantified by human raters and for entire interactions, thereby possibly overlooking the intricacy of such demonstrations. Using optical motion tracking, the precise modulations of parents’ infant‐directed actions were quantified and compared to adult‐directed actions and between action types. Parents demonstrated four novel objects to their 14‐month‐old infants and adult confederates. Each object required a specific action to produce a unique effect (e.g. rattling). Parents were asked to demonstrate an object at least once before passing it to their demonstration partner, and they were subsequently free to exchange the object as often as desired. Infants’ success at producing the objects’ action‐effects was coded during the demonstration session and their memory of the action‐effects was tested after a several‐minute delay. Indicating general modulations across actions, parents repeated demonstrations more often, performed the actions in closer proximity and demonstrated action‐effects for longer when interacting with their infant compared to the adults. Meanwhile, modulations of movement size and velocity were specific to certain action‐effect pairs. Furthermore, a ‘just right’ modulation of proximity was detected, since infants’ learning, memory, and parents’ prior evaluations of their infants’ motor abilities, were related to demonstrations that were performed neither too far from nor too close to the infants. Together, these findings indicate that infant‐directed action modulations are not solely overall exaggerations but are dependent upon the characteristics of the to‐be learned actions, their effects, and the infant learners.     

Infant positioning: A brief review

The American Academy of Pediatrics (2016a) has made several recommendations regarding the safe positioning of infants by caregivers, including placing infants in a supine position for sleep and in prone for supervised periods of tummy time. However, caregivers may have difficulty adhering with these recommendations. A small, but growing, number of behavior analytic studies have examined these infant safety recommendations and strategies for increasing adherence. This review describes behavior analytic research on infant positioning and provides suggestions for future research.     

Effects of Early Parenting Interventions on Parents and Infants: A Meta-Analytic Review

This systematic review evaluates the efficacy of parenting interventions on parent, infant and parent-infant relationship outcome measures for parents of infants under 12 months old. Parent outcomes examined included competence, and confidence; baby outcomes included infant behaviours of crying, settling, and sleeping problems and parent-infant relationship outcomes included parental responsiveness. Systematic searches of five databases were carried out. In total, 36 randomised controlled trials over the past 35 years were included in the meta-analyses, with a total of 4880 participants. Interventions were carried out either during pregnancy or within the first 12 months after birth and involved teaching specific strategies and provision of information on infant development and behaviour. Mean effect sizes were obtained using a structural equation modelling (SEM) approach to meta-analysis. Heterogeneity was found on parent responsiveness and infant sleep. Potential moderator variables were assessed for these two outcomes using the SEM approach. Results showed that early parenting interventions are effective in improving parental responsiveness (d?=?0.77), and improving or preventing infant sleep problems (d?=?0.24), but not crying problems (d?=?0.27) possibly due to low power. No conclusions could be drawn in regards to parental competence or confidence. Moderator analysis showed that for interventions aimed at improving responsiveness, briefer interventions were more effective than longer ones; and studies published more recently reported smaller effects than older studies. No other moderators influenced the assessed intervention outcomes. The findings of this study provide further evidence for the positive effects of early parenting interventions for infants under 12 months of age, however future research is needed to assess intervention effects on parental competence and confidence.