Maternal attitudes during pregnancy predict mother-infant physical proximity six months after birth

The purpose of this study was to develop an instrument for assessing maternal attitudes. Three photographs representing infants or mother-infant dyads were presented to 26 mothers in the second half of pregnancy and six months after birth. Nine mothers were clinical cases, seventeen mothers were nonpathological controls. Thirty-three semantic categories were used to code the mothers' responses to the pictures. Mothers' responses were coded independently by two researchers. The factor analysis of the codes yielded an ‘attraction to, vs rejection of, children’ factor. Compared with the control group, the mean factor score of the clinical group was significantly lower, i. e. reflected less attraction (p < 0.01). To study the relation between the attraction factor and the physical proximity of mothers and infants, 21 of these mother-infant dyads were videotaped in a semi-structured play interaction six months after birth. Recordings were coded independently by two researchers for various indices of proximity (spatial proximity, kisses, embraces, touches). The factor analysis of the codes yielded a factor contrasting distant vs close and tender interaction. A significant correlation was found between the attraction scores of pregnant women and the proximity scores of mother-infant interaction (r = 0.46; p < 0.05). These results suggest that this instrument is useful in assessing maternal attitudes of psychiatrically disturbed pregnant women and that maternal attitudes of pregnant women are significant predictors of physical proximity in motherinfant interaction at the end of the first semester.     

The impact of optimality on maternal sensitivity in mothers with substance abuse and psychiatric problems and their infants at 3 months

The main aim of this study was to investigate the predictive validity of four different optimality indexes, as well as infant perinatal status, in relation to maternal sensitivity in interaction at 3 months. The four optimality indexes comprised items related to substance abuse, psychiatric condition, relational experience and socioeconomic status (SES). Maternal sensitivity in mother-infant interaction was assessed in two different groups of mothers. One group consisted of mothers with substance abuse and psychiatric problems who underwent treatment during pregnancy. The other group of mothers had neither substance abuse nor psychiatric problems. The expectant mothers were interviewed in the third trimester of pregnancy. Medical records and meconium were obtained from the infants at birth. Three months after birth, maternal sensitivity in mother-infant interaction was assessed. Altogether 79 mother-infant dyads participated in the study. The mothers' optimality associated with relational experiences, as well as the infants' perinatal status were found to predict maternal sensitivity in mother-infant interaction at 3 months. The SES index was also significantly related to maternal sensitivity. The relation between group and maternal sensitivity was mediated by the mothers' optimality associated with relational experiences. This study points to the importance of addressing the mothers' own relational experiences and their current representations of motherhood during treatment, in order to support and enhance maternal sensitivity.     

Individual differences in non-clinical maternal depression impact infant affect and behavior during the still-face paradigm across the first year

Maternal depression can significantly impact mothers’ sensitivity to their infants’ needs as well as infants’ social and emotional development. The still-face paradigm (SFP) is widely used to assess infants’ understanding of the contingency between their own behavior and that of their caregivers, as well as infants’ ability to self-regulate arousal levels during sudden changes in maternal responsiveness. Infants of clinically depressed mothers display blunted levels of negative affect compared to infants of non-depressed mothers during the still-face (SF) phase. However, little is known about whether individual differences in elevated, non-clinical levels of maternal depression similarly affect mother-infant interactions. The current study examines the longitudinal effects of non-clinical maternal depression on infant and maternal behaviors during the SFP. Infants (N = 63) were assessed at 5 and 9 months and maternal depression was assessed at 5 months using the Beck Depression Inventory (BDI). Infants of mothers with elevated levels of depression displayed less negative engagement during the SF phase compared to infants of mothers with lower levels of depression. This effect was present at 5 months, but not at 9 months. Findings demonstrate that non-clinical levels of maternal depressive symptomatology can have a significant impact on infants’ affective regulation during the first half of the first year of life, but this does not necessarily have a long-lasting influence later in infancy. Interventions may want to target mothers with non-clinical depression to promote healthy infant social and emotional development.     

The effect of mother-infant skin-to-skin contact on Ghanaian infants’ response to the Still Face Task: Comparison between Ghanaian and Canadian mother-infant dyads

The effect of mother-infant skin-to-skin contact on Ghanaian infants’ developing social expectations for maternal behavior was investigated. Infants with high and low mother-infant skin-to-skin contact experience in the infants’ first month engaged with their mothers in a Still Face Task at 6 weeks of age. Infants with high skin-to-skin contact experience, but not those with low skin-to-skin contact experience, demonstrated the still face effect with their smiles. Infants with both high and low skin-to-skin contact experience demonstrated the still face effect with their visual attention. The behaviors of the Ghanaian infants and their mothers during the task were compared to archival evidence of Canadian mother-infant dyads’ behaviors in skin-to-skin and control groups who engaged in the Still Face Task at the infant ages of 1 and 2 months. Similarities and differences between the behaviors of the mother-infant dyads in the two cultures were assessed.     

Mother–infant interaction and maternal postnatal psychological distress are associated with negative emotional reactivity among infants and toddlers— A FinnBrain Birth Cohort study

Studies have reported mixed findings regarding the effects of mother-infant interaction and maternal distress on children’s negative emotional reactivity. In the current study (N = 134 and 107), we examined the effects of maternal Emotional Availability (sensitivity, structuring, non-intrusiveness and non-hostility) and maternal psychological distress on negative reactivity among children in the FinnBrain birth cohort study. In addition, the possible moderating effect of mother-infant interaction on the associations between maternal psychological distress and children's negative reactivity was examined. We used questionnaires to asses maternal psychological distress, observations of mother-infant interaction and observations as well maternal reports of child temperament to overcome the key limitations of many studies relying on single-method assessments. Our results showed that higher maternal sensitivity and structuring at 8 months of child’s age were associated with lower mother-reported negative reactivity among children at 24 months. Higher maternal postnatal distress associated with higher parent-reported negative reactivity in children at 12 and 24 months of age when the effects of prenatal distress and the quality of mother-infant interaction were controlled for. Mother-infant interaction and maternal psychological distress did not associate with observations of child negative reactivity. We found no moderation effects of mother-infant interaction regarding the associations between maternal distress and children’s negative emotional reactivity. Our findings reflect the importance of developing interventions to reduce the maternal distress symptoms while enhancing maternal sensitivity and structuring to prevent the possible harmful effects of these on child negative reactivity.     

Chronic stress in the mother-infant dyad: Maternal hair cortisol,infant salivary cortisol and interactional synchrony

Stress physiology is shaped by early experience, with enduring effects on health. The relation of chronic maternal physiological stress, as indexed by hair cortisol, to infants’ stress systems and to mother-infant interaction quality has not been established. We examined maternal hair and salivary cortisol, six-month-old infants’ salivary cortisol, and mother-infant interaction in 121 mother-infant dyads. High maternal hair cortisol was related to higher infant average salivary cortisol concentration. Maternal hair cortisol and bedtime salivary cortisol were both uniquely related to infant bedtime salivary cortisol. Mothers with higher hair cortisol were more intrusive and had lower positive engagement synchrony with their infants. Maternal intrusiveness moderated the association of maternal hair cortisol and infant salivary cortisol, such that maternal hair and infant average salivary cortisol were related only when mothers were more intrusive. Maternal chronic physiological stress may upregulate infants’ developing stress systems, particularly in the context of lower mother-infant interaction quality.     

Mothers speak differently to infants at‐risk for dyslexia

Dyslexia is a neurodevelopmental disorder manifested in deficits in reading and spelling skills that is consistently associated with difficulties in phonological processing. Dyslexia is genetically transmitted, but its manifestation in a particular individual is thought to depend on the interaction of epigenetic and environmental factors. We adopt a novel interactional perspective on early linguistic environment and dyslexia by simultaneously studying two pre‐existing factors, one maternal and one infant, that may contribute to these interactions; and two behaviours, one maternal and one infant, to index the effect of these factors. The maternal factor is whether mothers are themselves dyslexic or not (with/without dyslexia) and the infant factor is whether infants are at‐/not‐at family risk for dyslexia (due to their mother or father being dyslexic). The maternal behaviour is mothers’ infant‐directed speech (IDS), which typically involves vowel hyperarticulation, thought to benefit speech perception and language acquisition. The infant behaviour is auditory perception measured by infant sensitivity to amplitude envelope rise time, which has been found to be reduced in dyslexic children. Here, at‐risk infants showed significantly poorer acoustic sensitivity than not‐at‐risk infants and mothers only hyperarticulated vowels to infants who were not at‐risk for dyslexia. Mothers’ own dyslexia status had no effect on IDS quality. Parental speech input is thus affected by infant risk status, with likely consequences for later linguistic development.     

Cortisol reactivity and negative affect among preterm infants at 12 months during a mother-infant interaction task

The purpose of this study was to investigate correlates of preterm (PT) infant’s cortisol reactivity and the association to infant negative affect, during a mother-infant interaction procedure. Participants included 48 infants born prematurely (gestational age < 37 weeks) and their mothers, assessed when infants were 12 months old corrected for prematurity. The examined variables comprised both neonatal and environmental dimensions including maternal interactive behavior. Infant negative affect and maternal interactive behavior were assessed with a standardized mother-infant interaction task. A baseline infant saliva sample was collected before the interaction began, and a second sample after the interaction episodes ended. Results revealed that decrease of infant’s cortisol concentration was significantly associated with the exposure to more sensitive, and less intrusive maternal behaviors. However, once controlled for neonatal risk, family SES and maternal psychological distress, the associations were rendered non-significant. Although the association between cortisol reactivity and negative affect trended toward significance, maternal intrusiveness was the only significant predictor of observed infant negative affect. Findings suggest the importance of primary relational experiences on PT infants' early regulatory competencies.     

Depression in the early postpartum period and attachment to children—in mothers of NICU infants

Depression in early puerperium was evaluated in terms of maternal attachment in mothers of children admitted to the neonatal intensive care unit (NICU) in comparison to a control group of mothers of full‐term infants. A survey including Zung's self‐rating depression scale (ZSDS), a postpartum maternal attachment scale and items addressing the mother's feelings and peripheral conditions was conducted on mothers of children admitted to the NICU. Among the 153 mothers who gave valid responses, positive ZSDS scores of over 40 were seen in 61.8%. In terms of the children's disorder, strong depressive tendency was noted among mothers of low birth weight infants. Significant correlation was noted between the ZSDS and the ‘core maternal attachment’ (negative correlation) and ‘anxiety regarding children’ (positive correlation) subscales of postpartum maternal attachment. Path analysis revealed the father's positive reaction in learning of the pregnancy resulted in elevation of the ‘core maternal attachment’ score, in contrast to the control group mothers. Copyright © 2003 John Wiley & Sons, Ltd.     

Comparison of Maternal Perceptions of Preterm and Fullterm Infants

We compared maternal attitudes and feelings in two groups of mother–infant dyads: 25 mothers with preterm newborns (M=30.9 weeks of gestational age) and 25 mothers with fullterm newborns (M=39.7 weeks of gestational age). Both groups were matched for infant sex, age (corrected in preterms) and birth order as well as for maternal age and education. Semi-structured interviews were used to collect data on maternal attitudes and feelings about pregnancy and the first contacts with the newborn. Mothers completed rating scales to indicate the specific behavioural problems they perceived in their infants at 6 weeks and 3 months of (corrected) age. Observations of infant responses to visual and/or auditory stimuli were made at 6 weeks and 3 months in a laboratory setting. At 3 months, each infant was administered the Bayley Scale of Mental Development. There were no differences in maternal attitudes and feelings between the two groups of mothers prior to the birth. However, significant differences appeared after birth and indicated increased anxiety in mothers of preterm infants. Significantly more 6-week-old preterm infants were perceived by their mothers as irritable and to cry more than fullterm infants. At the age of 3 months, both groups of infants differed only in terms of irritability. Differences between the two groups of mother–infant dyads, age-related changes in these differences and relationships between maternal evaluations and the laboratory-based assessments are discussed in the context of contrasts in the stability of behavioural regulation in preterm and fullterm infants.     

Music therapy enhances preterm infant’s signs of engagement and sustains maternal singing in the NICU

Hospitalized preterm infants are exposed to stressful stimuli and early parental separation, which can undermine their long-term development and mother-infant bonding. Family-centered music therapy can enable positive mother-infant interactions, mediated by maternal infant-directed singing. This study aimed to investigate the effects of music therapy on preterm infant’s signs of engagement, namely Eye Opening (EO) and Smiling (SM), and maternal vocalizations. Participants were 30 mother-preterm infant dyads in a Brazilian Neonatal Intensive Care Unit (NICU), divided into a Music Therapy Group (MTG) and a Comparison Group (CG). The MTG participated in 6 sessions of the Music Therapy Intervention for the Mother-Preterm Infant Dyad (MUSIP), with the aim of supporting maternal singing with the infant. Prior to discharge, all mothers were filmed during a Non-singing (NS) and Singing (S) interactional condition; in the S condition, mothers were explicitly asked to address their infants by singing. Results of video and audio analysis showed that infants in the MTG displayed greater Eye Opening (EO) frequency compared to CG, but only when they were in an initial awake state at test, suggesting that music therapy can potentialize infants’ alertness, by increasing their disposition and chances of being engaged in the interaction with the mother. Non-religious mothers appeared to sing significantly more in the MTG than in the CG. These preliminary findings indicate that music therapy in the NICU could promote infant’s signs of engagement during interactions and can sustain maternal singing, especially with non-religious mothers in Brazil.     

Synchrony in mother-infant vocal interactions revealed through timed event sequences

This report extends a previous cross-cultural study of synchrony in mother-infant vocal interactions (Bornstein et al., 2015) to immigrant samples. Immigrant dyads from three cultures of origin (Japan, South Korea, South America) living in the same culture of destination (the United States) were compared to nonmigrant dyads in those same cultures of origin and to nonmigrant European American dyads living in the same culture of destination (the United States). This article highlights an underutilized analysis to assess synchrony in mother-infant interaction and extends cross-cultural research on mother-infant vocal interaction. Timing of onsets and offsets of maternal speech to infants and infant nondistress vocalizations were coded separately from 50-min recorded naturalistic observations of mothers and infants. Odds ratios were computed to analyze synchrony in mother-infant vocal interactions. Synchrony was analyzed in three ways -- contingency of timed event sequences, mean differences in contingency by acculturation level and within dyads, and coordination of responsiveness within dyads. Immigrant mothers were contingently responsive to their infants’ vocalizations, but only Korean immigrant infants were contingently responsive to their mothers’ vocalizations. For the Japanese and South American comparisons, immigrant mothers were more contingently responsive than their infants (but not robustly so for South American immigrants). For the Korean comparison, mean differences in contingent responsiveness were found among acculturation groups (culture of origin, immigrant, culture of destination), but not between mothers and infants. Immigrant dyads’ mean levels of responsiveness did not differ. Immigrant mothers’ and infants’ levels of responsiveness were coordinated. Strengths and flexibility of the timed event sequential analytic approach to assessing synchrony in mother-infant interactions are discussed, particularly for culturally diverse samples.     

Clinical,developmental and social aspects of infant crying and colic

Persistent unexplained infant crying in the first few months is a common source of distress for parents and is costly for the health services. The aim was to assess the merits of developmental and social conceptualizations of this phenomenon, compared to the clinical approach as represented by the concept of colic. From a community sample of 530 infants, 67 who met the ‘rule of threes’ definition of colic by fussing and crying for 3 or more hours per day at 4-5 weeks of age were chosen. To avoid confusion, these infants were called ‘persistent criers’. Groups of ‘evening criers’ (N = 38) and ‘moderate cries’ (N = 55) were also selected. These 160 infants were assessed by researcher measures of their consolability and by maternal diary measures of their amounts of fussing, crying and colic behaviour when 5-6 weeks old. The persistent and evening criers cried more than the moderate criers. However, irritable, ‘fussy’ behaviour was the predominant form of distress for all three groups of infants. Colic bouts–defined as ‘bouts of intense, unsoothable crying and other behaviour, perhaps due to stomach or bowel pain’–were rare even among the persistent criers and only 7% of these infants were found to be inconsolable. The results support growing evidence that normal infant developmental processes are central to this phenomenon. In addition, social interactions between infants and parents, and parental subjective variables, appear to be involved. Colic was distinguished as a rare and separate form of distress by the infants' mothers. Further evidence needs to determine whether colic is a distinct clinical phenomenon or an extreme degree of normal distress interpreted within a western cultural framework.     

Mutual regulation between infant facial affect and maternal touch in depressed and nondepressed dyads

The ability to regulate affect is important for later adaptive child development. In the first months of life, infants have limited resources for regulating their own affects (e.g. by gaze aversion), and for this reason they are dependent on external affect regulation from their parents. Previous research suggests that touch is an important means through which parents regulate their infants’ affects. Also, previous research has shown that post-partum depressed (PPD) mothers and nonclinical mothers differ in their touching behaviors when interacting with their infants. We examined the affect-regulating function of affectionate, caregiving and playful maternal touch in 24 PPD and 47 nonclinical mother-infant dyads when infants were four months old. In order to investigate the direction of effects and to account for repeated observations, the data were analysed using time-window sequential analysis and Generalized Estimating Equations. The results showed that mothers adapt their touching behaviors according to negative infant facial affect; thus, when the infant displays negative facial affect, the mothers were less likely to initiate playful touch and more likely to initiate caregiving touch. Unexpectedly, only in the PPD dyads, were the mothers more likely to initiate affectionate touch when their infants were displaying negative facial affect. Our results also showed that mothers use specific touch types to regulate infants’ negative and positive affects; infants are more likely to initiate positive affect during periods with playful touch, and more likely to terminate negative affect during periods with caregiving touch.     

“Hey mom, look at me!”

The degree to which infant and maternal characteristics were related to maternal psychological distress and play competence was examined in 40 mother preterm and full-term dyads. Measures of maternal psychological distress, self-efficacy, infant temperament, and mother-infant interaction in a play situation, were obtained at 4 months corrected for prematurity. Results revealed that maternal self-efficacy was the strongest correlate of maternal psychological distress but was not related to maternal play competence. Interaction effects for unadaptable temperament and infant behavioral involvement were found in the regressions predicting both maternal psychological distress and maternal play competence. Mothers of more adaptable and less behaviorally involved infants reported greater psychological distress and exhibited greater play competence than mothers of more adaptable and involved infants. The results suggest that a lack of concordance between mothers' perceptions of their infants' behavior and actual behavioral experiences adversely affects mothers' affect and the quality of their play interactions.     

Face-to-face interaction behavior across early infancy

Stability and change in mother-infant interaction behavior were assessed across early infancy. At 8 versus 4 months, the infants showed more smiling, vocalizing and motor-activity, and their mothers touched and moved their infants' limbs less often. Stability was noted only for infant distress-brow and mother's touching the infant. Although very few relationships were apparent between mother and infant behavior at 4 months, several maternal behaviors at 4 months were related to infant behaviors at 8 months, and several relationships were noted between maternal and infant behavior at 8 months.     

Depressed mothers' assessments of their neonates' behaviors

Neonates were assessed at delivery and again at 1 month by examiners and by their depressed or nondepressed mothers. Examiner assessments were conducted using the Brazelton Neonatal Behavioral Assessment Scale (NBAS). Maternal assessments were conducted by mothers using a simplified version of the NBAS, the Mother's Assessment of the Behavior of her Infant (MABI). Examiners rated neonates of depressed mothers lower than infants of nondepressed mothers on state organization. At delivery, newborn infants of depressed mothers were given lower state regulation scores by their mothers than by the examiners and, 1 month later, examiners’ state regulation ratings were as negative as those of the depressed mothers. Conversely, infants of nondepressed mothers were given higher social interaction scores by their mothers than by the examiners, and 1 month later, examiner ratings of social interaction were as positive as those of the nondepressed mothers. These findings suggest that infants of depressed mothers may be placed at risk by prenatal influences and by risks associated with maternal perceptions. Perceptions of infants appear to be colored by maternal depression status as early as the immediate postpartum period and, though “subjective,” these perceptions are predictive of infant outcomes.     

Bittersweet: a qualitative exploration of mothers’ experiences of raising a single surviving twin

Loss of a child from a multiple birth pregnancy is not uncommon yet the idiographic experience of parents who have lost a single twin from a multiple birth pregnancy is underexplored. This novel study sought to explore the experiences of mothers bereaved after loss of a twin from a multiple birth pregnancy, focusing on the dual challenges of parenting and grieving. Eighteen mothers at least 12 months post loss were recruited from a private UK based Facebook page dedicated to supporting parents after loss from a multiple birth. Eligible mothers completed an independent qualitative open-ended survey to explore maternal experiences of loss. Data were analysed using Thematic Analysis. Findings represented a sense of duality for participants, with mothers experiencing conflict between roles and identities as well as the nature of their loss. Key themes identified include ‘Narrating a story of family and loss’, ‘Finding a place for the twins within the family’ and ‘A changing sense of self’. Findings fit with theoretical conceptualisations of bereavement that acknowledge retaining relationships with the deceased. Practically, suggestions for supporting mothers to identify stock answers to often asked questions about family make up were suggested.     

The effects of maternal mood on mother-infant interaction

The effects of depressed mood on mother-infant interaction were studied in 30 mother-infant dyads using the Velten mood induction procedure. It was predicted that maternal depressed mood would induce dysphoria in the infants, disrupt the infants' natural responsiveness to their mothers, and interfere with the mothers' ability to manage the interaction. In addition, it was predicted that such deficits would be the result of depressed maternal mood and not simply due to any change in maternal mood. The results indicated that the infants were sensitive to depressed mood and were less contingently responsive to their mothers than were controls. Also, mothers in the depression induction condition were less successful in eliciting positive responses from their infants than were controls. These results have implications for the development of a helplessness vulnerability in infants and for the two-way direction of effect present in depressed mother-infant dyads.This research was partially funded by NIMH grant MH39283 and a Spelman-Rockefeller Seed Grant awarded to Michael O'Hara. We gratefully acknowledge the assistance of Joan Blackwood, Nancy Clift, Lynda Field, Darla Hauf, Randy Ross, Jane Ugland, and Jim Vincent in the data collection. We also thank Richard R. Hurtig, John F. Knutson, Donald K. Routh, Robert A. Forsyth, and Carolyn E. Cutrona for their helpful comments on an earlier version of this article.     

Some Personality Characteristics of the Culturally Disadvantaged

The relationship between sensitive maternal behavior and mother-infant vocalization during feedings was examined in an effort to determine this situational meaning of Ainsworth's concept of sensitivity. Ss were 28 white, middle-class mothers and their infants. Excerpts of home feedings videotaped at 6 and 9 months were coded for frequency of contingent vocal interaction and quality of vocal affect. Sensitive mothers were distinguished from insensitive mothers at each age period by differing vocal patterns. At 6 months, infants of sensitive mothers vocalized significantly less than did infants of insensitive mothers. Mothers in both groups responded to their infants' vocalizations equally as often. At 9 months, infants in both groups vocalized the same amount, while sensitive mothers vocalized more often in response to their infants than did insensitive mothers. The only significant difference in vocal affect was found in the greater positive affect among sensitive mothers at 9 months.