Early interactive behaviours in preterm infants and their mothers: Influences of maternal depressive symptomatology and neonatal birth weight

The study evaluated the quality of preterm infant–mother interactions, considering severity of birth weight (ELBW and VLBW) and maternal depression, compared to full term babies. 69 preterm infants (29 ELBW and 40 VLBW) and 80 full-term (FT) infants and their mothers were recruited. At 3 months of corrected age, the quality of mother–infant interaction was evaluated through Global Rating Scales; moreover, infant level of development and maternal depression were assessed through Griffith Development Mental Scales and Edinburgh Postnatal Depression Scale. Results showed adequate sensitivity in preterm infants’ mothers and higher involvement with their infants, compared to full term mothers, but ELBW ones exhibited an intrusive interactive pattern and a higher prevalence of depressive symptoms. The study underlined the relevance of paying special attention to both ELBW infants and their mothers, in order to support the parenting role and the co-construction of early interactions.     

Depressed mothers' and their infants' interactions with nondepressed partners

Twenty depressed adolescent mothers were videotaped interacting with their own infant and with the infant of a nondepressed mother. In addition, nondepressed mothers were videotaped with their own infant as well as with the infant of a depressed mother. Depressed mothers showed less facial expressivity than nondepressed mothers and received less optimal interaction rating scale scores (a summary score for state, physical activity, head orientation, gaze, silence during gaze aversion, facial expressions, vocalizations, infantized behavior, contingent responsivity, and gameplaying). This occurred independent of whether they were interacting with their own infant versus an infant of a nondepressed mother, suggesting that depressed mothers display less optimal behaviors to infants in general. The infants of both depressed and nondepressed mothers received better head orientation and summary ratings when they were interacting with another mother, perhaps because the other mother was more novel. Infants of nondepressed mothers, in particular, had better summary ratings (state, physical activity, head orientation, gaze, facial expressions, fussiness, and vocalizations) than the infants of depressed mothers when interacting with depressed mothers. Thus, it may be that infants of nondepressed mothers are generally better interaction partners than infants of depressed mothers. Another related possibility is that they persist longer in trying to elicit a response from mothers less responsive than their own, given that they have learned to expect a response to their behavior.     

The role of maternal responsiveness in predicting infant affect during the still face paradigm with infants born very low birth weight

There is limited empirical literature addressing infants' response to a standardized stressor with infants born very low birth weight (VLBW). The purpose of this study was to assess the relative strength of maternal responsiveness in predicting infant affect in response to the Still Face (SF) paradigm in a cross‐sectional cohort of ethnically diverse infants born VLBW and their mothers (N = 50; infants 6–8 months old). Infant affect and maternal responsiveness were coded in 1‐s intervals while dyads participated in the SF. In addition, perinatal medical status, developmental status, and infant temperament were assessed. Findings revealed that positive infant affect during and after the SF stressor were strongly associated with baseline infant positive affect and maternal responsiveness at the reunion episode, respectively. In contrast, when predicting negative infant affect during and after the SF stressor, prior infant negative affect was strongly and uniquely significant. Infant positive affect, negative affect, and maternal responsiveness were not significantly associated with gender, infant perinatal medical history, developmental status, or temperament. Future research is warranted to determine how these findings relate to infants' stress reactions in naturalistic settings and if relationship‐focused interventions may reverse infant negative emotionality, enhance positive emotionality, and thereby improve self‐regulation and longer term social and cognitive developmental outcomes in medically at‐risk infants.     

Motor activity and spatial proximity: Relationships to infant emotions and maternal postpartum depression

The ability to express emotions is a protective factor for infant development. Despite the multimodal nature of emotion expression, research has mainly focused on facial expressions of emotions. The present study examined motor activity and spatial proximity in relation to positive and negative infant facial expressions and maternal postpartum depression during face-to-face interactions at four months. Video cameras and a motion capture system recorded mother-infant interactions. Repeated measures ANOVAs were conducted to analyze the effect of micro-coded infant positive and negative facial affect and maternal depression diagnosis on automatically extracted measures of motor activity and spatial proximity, including speed of mothers’ arm movements (nondepressed = 32; PPD = 16), and infants’ arm movements (nondepressed = 29; PPD = 17), and head distance (nondepressed = 45; PPD = 27). Results showed that the speed of infants’ arm movements and head distance were greater during negative compared to positive infant affect. Further, the results demonstrated that the speed of PPD mothers’ arm movements was slower than the speed of nondepressed mothers’ arm movements. In the discussion, it is suggested that increased speed of infant arm movements during negative affect functions to elicit faster caregiving responses, and that increased head distance during negative infant affect functions to decrease the intensity of the interaction. Finally, the slower speed of arm movements in PPD mothers suggests psychomotor retardation, which is proposed to limit these mothers’ abilities to engage their infants during the interaction.     

The mediating role of maternal responsiveness in some longer term effects of postnatal depression on infant development

We hypothesized a mediating role for low maternal responsiveness in certain child developmental deficits found previously to be associated with postnatal depression. Forty depressed inpatients and 48 control (non-depressed) mothers and their infants were followed until 42 months postpartum. Mother–infant interactions were impaired at 6 months postpartum in the depressed group. Subsequent cognitive deficits were found in children's Full Scale IQ on the Wechsler Preschool Primary Scale of Intelligence (Revised) at 42 months of age. Statistical modeling of the mediation hypothesis confirmed that these effects were overwhelmingly explained by lowered maternal responsiveness at 6 months. Similarly, increased temperamental difficulties were apparent in children of depressed mothers but were not correlated with maternal responsiveness. Male infants of depressed mothers were disproportionately vulnerable (compared to females) to impaired cognitive abilities associated with maternal depression. The data concur with previous work and provide empirical support for the theoretical prediction that early disturbances of the mother–infant interaction will mediate some developmental deficits in the children of depressed mothers.     

Mother-infant responsiveness: timing, mutual regulation, and interactional context

Mutual regulation during the naturalistic interaction of 150 mothers and their 4-month-old infants was investigated from a dynamic systems perspective. Microanalyses of a wide range of behaviors and analysis of contingencies indicated that a 3-s time period best captured contingencies. Both mothers and infants communicated primarily through vocal signals and responses, although maternal touches and infant looks also elicited responses. Although more expressive mothers did not have infants who behaved similarly, levels of contingent responsiveness between partners were significantly associated and occurred within distinct behavioral channels, suggesting coregulated interactional processes in which contingently responsive mothers shape their infants' communications toward mutual similarity. Mothers were more influential than infants over object play, whereas infants were more influential than mothers over expressive behavior. Interactional context consistently influenced contingent responsiveness; there was less mutual responsiveness when the infant was exploring, being held, or looking.     

Interpreting infant emotional expressions: Parenthood has differential effects on men and women

Interpreting and responding to an infant's emotional cues is a fundamental parenting skill. Responsivity to infant cues is frequently disrupted in depression, impacting negatively on child outcomes, which underscores its importance. It is widely assumed that women, and in particular mothers, show greater attunement to infants than do men. However, empirical evidence for sex and parental status effects, particularly in relation to perception of infant emotion, has been lacking. In this study, men and women with and without young infants were asked to rate valence in a range of infant facial expressions, on a scale of very positive to very negative. Results suggested complex interaction effects between parental status, sex, and the facial expression being rated. Mothers provided more positive ratings of the happy expressions and more extreme ratings of the intense emotion expressions than fathers, but non-mothers and non-fathers did not. Low-level depressive symptoms were also found to correlate with more negative ratings of negative infant facial expressions across the entire sample. Overall, these results suggest that parental status might have differential effects on men and women's appraisal of infant cues. Differences between fathers’ and mothers’ perceptions of infant emotion might be of interest in understanding variance in interaction styles, such as proportion of time spent in play.     

You must have been a beautiful baby: ratings of infant facial attractiveness fail to predict ratings of adult attractiveness

Facial attractiveness has been studied extensively, but little research has examined the stability of facial attractiveness of individuals across different stages of development. We conducted a study examining the relationship between facial attractiveness in infants (age 24 months and under) and the same individuals as young adults (age 16–18 years) using infant and adult photographs from high school yearbooks. Contrary to expectations, independent raters’ assessments of infant facial attractiveness did not correlate with adult facial attractiveness. These results are discussed in terms of the adaptive function of heightened attractiveness in infancy, which likely evolved to elicit and maintain parental care.     

Mothers' Perceptions of Infants Labelled ‘Depressed’

Forty-four depressed and non-depressed mothers participated in a videotaped interaction with their own infant and then rated the videotape using the Infant Stereotyping Scale and the Interaction Rating Scale. In addition, one half of the mothers rated a videotape of an unfamiliar infant who was labelled psychologically ‘depressed’ and the other half rated a videotape of the same infant with no label given. Both the depressed and non-depressed mothers rated the ‘depressed’ labelled infant more negatively than the non-labelled infant on the attributes of physical potency, cognitive competence, sociability and difficult behaviour. Physical appearance was the only rating that was not biased by the ‘depressed’ label. Mothers' ratings of their own infants were more positive than their ratings of the non-labelled stimulus infant. Depressed mothers did not see their infants more negatively except on one rating. They rated the physical appearance of their own infant more negatively than non-depressed mothers.     

Infant characteristics and parental engagement at the transition to parenthood

Positive engagement activities support children's adaptive development and new parents are encouraged to be highly engaged with infants. Yet, fathers’ engagement is widely understudied and maternal engagement quantity is frequently overlooked. Our study contributes to growing knowledge on associations between infant temperament and parental engagement by testing transactional and moderation models in a recent sample of first-time parents when infants were 3, 6, and 9 months old. Stringent longitudinal, reciprocal structural equation models partially confirmed an engagement “benefit”. Mothers’ engagement marginally contributed to their children's gains in effortful control from 3 to 6 months regardless of child gender. Further, mothers’ engagement reduced infant negative affect from 6 to 9 months regardless of child gender. Mothers’ ratings of infant negative affect were gendered; mothers’ ratings of infant negative affect increases more from 3 to 6 months for boys. Fathers’ engagement was contextually sensitive; child gender moderated the link between negative affect and engagement from 6 to 9 months, such that fathers became more engaged with boys whom they rated higher on negative affect; there was no effect for daughters. Finally, we found that effortful control moderated associations between negative affect and maternal engagement; mothers’ engagement increases from 3 to 6 months were greater for children initially rated lower in effortful control. Implications for future research and parenting education and support services are discussed.     

The impact of postpartum depressed mood on mother-infant interaction: Like mother like baby?

The purpose of this study was to test the hypothesis that mothers with depressed mood would exhibit less optimal interaction than their nondepressed counterparts and that their infants would show similar deficits in interactional behavior. Twenty-two mothers and their 2-month-old infants were videotaped in to-minute free-play segments in a laboratory playroom, and their interactions were coded using both time-sampling and global clinical ratings of behavior. Mothers with depressed mood were judged significantly lower on overall positive interaction, Expressivity/Affective Involvement, and Responsivity/ Sensitivity than were nondepressed mothers. Infants of mothers with depressed mood were rated significantly lower than infants of nondepressed mothers on corresponding interaction domains. Mothers with depressed mood were also rated as more variable than nondepressed mothers along a continuum of withdrawal to controlling/intrusive behavior. Contrary to prediction, level of maternal stimulation and infant activity did not differ as a function of depression in maternal mood. We conclude that mild to moderate symptoms of maternal depression may have salient but selective effects on mother-infant interaction.     

Attention-getting vs. imitation effects on depressed mother-infant interactions

The effects of instructing mothers to “imitate” their infant versus “keep their infant's atten tion” were examined during mother-infant face-to-face interactions of 18 mothers reporting depressive symptoms as compared with 22 mothers who did not report such symptoms. Mothers were generally rated as showing more positive facial expressions and more game playing (particularly the depressed mothers) during the attention-getting versus the imitation sessions. The infants received more optimal physical ac tivity, and facial expression ratings during attention getting, and the infants of depressed mothers, in par ticular, showed more positive facial expressivity and more joy expressions. As might be expected for the imitation condition, mothers showed more imitative behavior, contingent responsivity, and silence during gaze aversion. Infants generally showed more disinterest and self-comfort behaviors, and the infants of depressed mothers, in particular, showed more anger expressions, fussiness, and squirming during the imitation condition. The data suggest that the attention-getting condition was the most effective “intervention” for eliciting positive behavior in the depressed mother-infant dyads.     

The City Infant Faces Database: A validated set of infant facial expressions

Adults need to be able to process infants’ emotional expressions accurately to respond appropriately and care for infants. However, research on processing of the emotional expressions of infant faces is hampered by the lack of validated stimuli. Although many sets of photographs of adult faces are available to researchers, there are no corresponding sets of photographs of infant faces. We therefore developed and validated a database of infant faces, which is available via e-mail request. Parents were recruited via social media and asked to send photographs of their infant (0–12 months of age) showing positive, negative, and neutral facial expressions. A total of 195 infant faces were obtained and validated. To validate the images, student midwives and nurses (n = 53) and members of the general public (n = 18) rated each image with respect to its facial expression, intensity of expression, clarity of expression, genuineness of expression, and valence. On the basis of these ratings, a total of 154 images with rating agreements of at least 75% were included in the final database. These comprise 60 photographs of positive infant faces, 54 photographs of negative infant faces, and 40 photographs of neutral infant faces. The images have high criterion validity and good test–retest reliability. This database is therefore a useful and valid tool for researchers.     

The Ages & Stages Questionnaire: Social–Emotional: A validation study of a mother‐report questionnaire on a clinical mother–infant sample

Mother‐report questionnaires of infant socioemotional functioning are increasingly used to screen for clinical referral to infant mental health services. The validity of the Ages & Stages Questionnaire: Social Emotional (ASQ:SE; J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002) was investigated in a sample of help‐seeking mothers with young infants. It was compared with independent observer‐rated dyadic interactions, and the quality of dyadic relationships was rated by expert clinicians. The ASQ:SE ratings also were compared with questionnaires on maternal psychological stress and distress. The ASQ:SE did not correlate significantly with either external ratings of dyadic interaction or clinically assessed relationship qualities, though the latter two were strongly associated with each other. In contrast, ASQ:SE scores were associated with questionnaires relating to maternal psychological distress. This was especially true for mothers classified as depressed. Furthermore, reports on the ASQ:SE were strongly predicted by maternal stress. The study points to some problems with the concurrent validity of the ASQ:SE in clinical samples. It also demonstrates a close link between mothers' psychological distress and their ratings of infant social and emotional functioning. Further research should investigate the extent to which the ASQ:SE specifically measures infant functioning or maternal distress, and how it functions in clinical versus nonclinical samples.     

The relative influence of facial neoteny and waist-to-hip ratio on judgements of female attractiveness and fecundity

Numerous studies have demonstrated that waist-to-hip ratio (WHR) affects perceptions of female physical attractiveness and fecundity. This study tested the assumption that facial attractiveness explained more variance in overall ratings and fecundity than WHR, when the latter is manipulated within the normal range (0.67 - 0.85). One hundred and sixty-one participants (mean age = 21.5) rated the attractiveness, youthfulness, fertility, healthiness and likelihood of being pregnant for 27 photographs of three females in which facial attractiveness in terms of neoteny (three levels) and WHR (three levels) had been systematically digitally manipulated. Facial attractiveness exerted a significant influence on judgements of attractiveness, youthfulness, fertility and healthiness, whereas WHR only affected likelihood of being pregnant. Results are interpreted in terms of neotenous facial attractiveness providing potential mates with information concerning phenotypic and genetic quality.     

Culture,carrying, and communication: Beliefs and behavior associated with babywearing

Ethnographic research suggests mother-infant physical contact predicts high levels of maternal responsiveness to infant cues, yet it is unclear whether this responsiveness is driven by the act of physical contact or by underlying beliefs about responsiveness. We examine beliefs and behavior associated with infant carrying (i.e., babywearing) among U.S. mothers and experimentally test the effect of mother-infant physical contact on maternal responsiveness. In Study 1 (N = 23 dyads), babywearing mothers were more likely to interact contingently in response to infant cues than non-babywearing mothers during an in-lab play session. In Study 2 (N = 492 mothers), babywearing predicted maternal beliefs emphasizing responsiveness to infant cues. In Study 3 (N = 20 dyads), we experimentally manipulated mother-infant physical contact in the lab using a within-subjects design and found that babywearing increased maternal tactile interaction, decreased maternal and infant object contact, and increased maternal responsiveness to infant vocalizations. Our results motivate further research examining how culturally-mediated infant carrying practices shape the infant’s early social environment and subsequent development.     

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.     

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.     

Infant and maternal responses to emotional facial expressions: A longitudinal study

The current longitudinal study (N = 107) examined mothers’ facial emotion recognition using reaction time and their infants’ affect-based attention at 5, 7, and 14 months of age using eyetracking. Our results, examining maternal and infant responses to angry, fearful and happy facial expressions, show that only maternal responses to angry facial expressions were robustly and positively linked across time points, indexing a consistent trait-like response to social threat among mothers. However, neither maternal responses to happy or fearful facial expressions nor infant responses to all three facial emotions show such consistency, pointing to the changeable nature of facial emotion processing, especially among infants. In general, infants’ attention toward negative emotions (i.e., angry and fear) at earlier timepoints was linked to their affect-biased attention for these emotions at 14 months but showed greater dynamic change across time. Moreover, our results provide limited evidence for developmental continuity in processing negative emotions and for the bidirectional interplay of infant affect-biased attention and maternal facial emotion recognition. This pattern of findings suggests that infants’ affect-biased attention to facial expressions of emotion are characterized by dynamic changes.     

Mothers with Depressive Symptoms Touching Newborns

Previous research has demonstrated the positive effects of early contact on mother–infant touching behaviours. The present study investigated whether the type of maternal touching, shortly after birth, is also determined by the mother's mood state. Mothers with depressive symptoms were compared to non-depressive mothers 1 day after delivery on how they touched their newborns following an initial feeding. The results were counter-intuitive in that no differences were found between mothers with depressive symptoms and non-depressive mothers in type of maternal touching. However, mothers with depressive symptoms talked to their infants less often and talked on the phone more often. In addition, mothers with depressive symptoms showed more neutral and negative facial expressions and fewer positive and more neutral vocal expressions.