The impact of breastfeeding on mothers' attentional sensitivity towards infant distress

Background

Maternal response towards infant distress has an important impact on infant development. In animals it is established that lactation and pup suckling plays an important role in maintaining maternal responses. Previous research suggests that breastfeeding is associated with sensitive maternal responses in human mothers. However, this may be because women who are more sensitive to their infant choose to breastfeed. The current study investigated the attentional sensitivity towards infant distress in women who went on to breast or formula feed during pregnancy as well as after birth. We hypothesised that differences in breast and formula feeding mothers would only emerge after birth once feeding had commenced.

Method

Women were recruited during pregnancy through community midwives as part of a longitudinal study. 51 women were seen during late pregnancy and between 3 and 6 months after birth (27 were breast and 24 were formula feeding). Sensitivity to infant distress was measured as the extent of women's attentional bias towards infant distress stimuli.

Results

After birth, we found that our index of attentional bias towards infant distress was 37 ms (0.5 S.D.s) (CI; 6-69, p = 0.021) higher in breastfeeding compared to formula feeding mothers. However, mothers who went on to breastfeed did not show greater attentional bias towards infant distress already during late pregnancy.

Conclusions

Our results suggest that the act of breastfeeding may influence mothers’ attentional sensitivity towards infant distress. Previous research suggests breastfeeding is indicative of sensitive parenting. The current findings may suggest a mechanism by which breastfeeding and/or associated infant interaction could contribute to this sensitivity.     

The Baby Care Questionnaire: A measure of parenting principles and practices during infancy

The current report provides a new framework to explore the role of parenting practices and principles during infancy. We identify structure and attunement as key parenting principles during infancy. Structure represents reliance on regularity and routines in daily life. Attunement represents reliance on infant cues and close physical contact. We suggest parents’ relative endorsement of these parenting principles is related to their choices about practices such as feeding, holding and night-time sleeping. We designed the Baby Care Questionnaire to measure parents’ endorsement of structure and attunement, as well as their daily parenting practices. We report data demonstrating the factor structure, reliability and validity of the BCQ. The BCQ, to our knowledge, is the first comprehensive measure of parenting practices and principles during infancy. We conclude with a discussion of future directions for the measure.     

Development of mental rotation in 3- to 5-year-old children

We assessed 3- to 5-year-olds’ mental rotation abilities using a new puzzle paradigm. It allows for assessment of mental rotation abilities in children younger than 5 years, using a task comparable to ones used with older children and adults. Children saw pairs of asymmetrical ghost figures, either as three-dimensional cut-outs or two-dimensional paper versions, in seven orientations. One of the ghosts fit into a hole if rotated right-side up – the other ghost was its mirror image and would not fit. Children were asked to turn the ghosts in their heads and choose the one that would fit into the hole. The number of children who chose the correct ghost above chance in the three-dimensional version of the task increased dramatically from 10% of 3-year-olds to 95% of 5-year-olds; average accuracy also increased significantly, from 54% to 83%. The two-dimensional paper version yielded similar results. These results indicate considerable development in mental rotation between 3 and 5 years.     

Effects of iron deficiency in infancy on patterns of motor development over time

This longitudinal study of the effects of iron deficiency in infancy assessed motor development over time in 185 healthy Costa Rican children who varied in iron status at 12-23 months. Longitudinal analyses (hierarchical linear modeling) used the Bayley Psychomotor Index before and both 1 week and 3 months after iron treatment in infancy and the Bruninks-Oseretsky Test of Motor Proficiency - long form at 5 years and short form at 11-14 years. Children with chronic severe iron deficiency in infancy had lower motor scores at the beginning of the study and a lower but parallel trajectory for motor scores through early adolescence. Thus, there was no evidence of catch-up in motor development, despite iron therapy in infancy that corrected iron deficiency anemia in all cases.     

Classifying emotion: a developmental account

The aim of this paper is to propose a systematic classification of emotions which can also characterize their nature. The first challenge we address is the submission of clear criteria for a theory of emotions that determine which mental phenomena are emotions and which are not. We suggest that emotions as a subclass of mental states are determined by their functional roles. The second and main challenge is the presentation of a classification and theory of emotions that can account for all existing varieties. We argue that we must classify emotions according to four developmental stages: 1. pre-emotions as unfocussed expressive emotion states, 2. basic emotions, 3. primary cognitive emotions, and 4. secondary cognitive emotions. We suggest four types of basic emotions (fear, anger, joy and sadness) which are systematically differentiated into a diversity of more complex emotions during emotional development. The classification distinguishes between basic and non-basic emotions and our multi-factorial account considers cognitive, experiential, physiological and behavioral parameters as relevant for constituting an emotion. However, each emotion type is constituted by a typical pattern according to which some features may be more significant than others. Emotions differ strongly where these patterns of features are concerned, while their essential functional roles are the same. We argue that emotions form a unified ontological category that is coherent and can be well defined by their characteristic functional roles. Our account of emotions is supported by data from developmental psychology, neurobiology, evolutionary biology and sociology.     

The representation of multiplication facts: developmental changes in the problem size, five, and tie effects

In this study, we investigated the development of basic effects that have been found in single-digit multiplication arithmetic: the problem size, five, and tie effects. Participants (9-, 10-, and 11-year-olds and adults) performed a production task on simple multiplication. The procedure replicated study [Canadian Journal of Psychology, Vol. 39, pp. 338-366], but the results show that the gradual decrease of the problem size effect ends in sixth grade. We report analyses on raw latencies and state trace analyses that take into account reaction time scaling as a function of age. The results show that 11-year-olds do not differ significantly from adults on any of the three effects. Before 11 years of age, interesting developmental changes occur.     

When do infants understand that they can obtain a desired part of a composite object by grasping another part?

When do infants start to understand that they can grasp an object by its handle when the interesting part is out of reach? Whereas it is known from preferential looking tasks that already at three months of age infants show surprise when all parts of an object do not move together, little is known about when infants are able to use such knowledge in an active grasp situation. To answer this question we presented six, eight, and 10 month-old infants in a cross-sectional and a longitudinal study with a white cardboard handle within reach and a bright ball at the end of the handle and out of reach. A trick condition, where the handle and the ball seem attached but were not, was added to get an indication of the infant's expectation by observing a possible surprise reaction.Results show that 6-month-olds’ most frequent first behaviors consisted in pointing toward the ball without grasping the handle, or grasping the handle without looking at the ball until it moved. In addition, they often did not look surprised in the trick condition. Eight- and 10-month-olds most often grasped the handle while looking at the ball, and showed clear surprise in the trick condition. This was interpreted as showing that around eight or 10 months, infants take a significant step in understanding the cohesiveness of composite objects during grasping.     

The impact of parents’ mental health on parent–baby interaction: A prospective study

The aims of the current study were to examine the effect of fathers’ and mothers’ pre and postnatal mental health on mother–infant and father–infant interactions. Mental health was broadly defined to include anxiety, depression and PTSD. A community sample of 44 mothers and 40 fathers from 45 families completed questionnaire measures of mental health in late pregnancy and three months postpartum. Mother–infant and father–infant interactions were observed and videoed three months postpartum and analysed using the CARE-index. Results showed that prenatal mental health, in particular anxiety, was associated with parent–infant interactions to a greater extent than postnatal mental health. Fathers’ prenatal symptoms were associated with higher paternal unresponsiveness and infant passivity whilst fathers’ postnatal symptoms were associated with higher levels of infant difficulty in the father–baby interaction. The results also indicated that mothers and fathers interaction with their babies were similar, both on average and within the couples, with 34% being inept or at risk. These findings highlight the need for early detection and prevention of both mental health and parent–infant relationship problems in fathers as well as mothers. However, further prospective and longitudinal studies are needed to understand the influences of parental mental health on the parent–infant interactions further. Also it should be noted that the mental health scores were low in this sample, which may reflect the sample characteristics. Future studies therefore would benefit from focusing on more vulnerable groups of parents.     

Breastfeeding and the mother–infant relationship—A review

A positive effect of breastfeeding on the mother–infant relationship is often assumed in the scientific literature, but this has not been systematically reviewed. This review aims to clarify the role of breastfeeding in the mother–infant relationship, which is conceptualized as the maternal bond toward the infant and infant attachment toward the mother. Our findings indicate that theoretical mechanisms through which breastfeeding may enhance the maternal bond or infant attachment (i.e., endocrine and sensory factors involved in breastfeeding) can be found in both humans and animal models. However, the few empirical studies investigating this association have not found convincing support for a relation between breastfeeding and the quality of the mother–infant relationship. We therefore conclude that assumptions on a positive role of breastfeeding on the mother–infant relationship are not supported by empirical evidence, and recommendation of breastfeeding should solely be based on its well-documented positive effects on infant and maternal health.     

Detection of visual-tactile contingency in the first year after birth

It is well documented that in the first year after birth, infants are able to identify self-performed actions. This ability has been regarded as the basis of conscious self-perception. However, it is not yet known whether infants are also sensitive to aspects of the self when they cannot control the sensory feedback by means of self-performed actions. Therefore, we investigated the contribution of visual–tactile contingency to self-perception in infants. In Experiment 1, 7- and 10-month-olds were presented with two video displays of lifelike baby doll legs. The infant’s left leg was stroked contingently with only one of the video displays. The results showed that 7- and 10-month-olds looked significantly longer at the contingent display than at the non-contingent display. Experiment 2 was conducted to investigate the role of morphological characteristics in contingency detection. Ten-month-olds were presented with video displays of two neutral objects (i.e., oblong wooden blocks of approximately the same size as the doll legs) being stroked in the same way as in Experiment 1. No preference was found for either the contingent or the non-contingent display but our results confirm a significant decrease in looking time to the contingent display compared to Experiment 1. These results indicate that detection of visual–tactile contingency as one important aspect of self-perception is present very early in ontogeny. Furthermore, this ability appears to be limited to the perception of objects that strongly resemble the infant’s body, suggesting an early sensitivity to the morphology of one’s own body.     

The Portuguese version of the Knowledge of Infant Development Inventory-P (KIDI-P)

Several studies show that parental knowledge about child development and education is relevant to parenting actions. Considering that the lack of assessment instruments specific to this domain in Portugal is an obstacle to cross-cultural research and programme evaluation, the objective of this study was to make available a Portuguese version of the Knowledge of Infant Development Inventory-P (KIDI-P). This inventory (58 items) allows for the calculation of three summary scores (Attempted, Accuracy and Total) that reflect correctness and confidence in one's knowledge. The Portuguese version of the KIDI-P confirmed a unidimensional structure and revealed good internal consistency (α = .89). In a sample of 252 mothers and fathers, educational level showed to be related to KIDI-P scores, unlike parents’ sex and age.     

Infant feeding and HIV in Sub-Saharan Africa: what lies beneath the dilemma?

The debate over how to best guide HIV-infected mothers in resource-poor settings on infant feeding is more than two decades old. Globally, breastfeeding is responsible for approximately 300,000 HIV infections per year, while at the same time, UNICEF estimates that not breastfeeding (formula feeding with contaminated water) is responsible for 1.5 million child deaths per year. The largest burden of these infections and deaths occur in Sub-Saharan Africa. Using this region as an example of the burden faced more generally in other resource-poor settings, we contrast the evolution of the clinical standard of care for infant feeding with HIV-infected mothers in high-income countries to the current international clinical guidelines for HIV-infected mothers and infant feeding in resource-poor settings. While the international guidelines of exclusive breastfeeding for a 6-month period seem to offer the least-worst strategy for reducing mother-to-child transmission of HIV during infancy while conferring some immunity through breastfeeding post-6 months, we argue that the impact of the policy on mothers and healthcare workers on the ground is not well understood. The harm reduction approach on the level of health policy translates into a complicated, painful moral dilemma for HIV-positive mothers and those offering them guidance on infant feeding. We argue that the underlying socio-economic disparities that continue to fuel the need for a harm reduction policy on infant feeding and the harm to women and children justify: (1) that higher priority be given to solving the infant feeding dilemma with improved data on safe feeding alternatives, and (2) support of innovative, community-driven solutions that address the particular economic and cultural challenges that continue to result in HIV-transmission to children within these communities.