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

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

Perceptions of the Woman Who Breastfeeds: The Role of Erotophobia,Sexism, and Attitudinal Variables

Perceptions of breastfeeding women were studied in a sample of 201 predominately European American college students. Both men and women had very positive perceptions of breastfeeding women as compared to bottlefeeding women. As predicted, erotophobic women and men had less favorable impressions of the breastfeeding woman than did erotophilic individuals. Men, but not women, who scored high on Glick and Fiske's Benevolent Sexism or Hostile Sexism scales (Glick & Fiske, 1996) had more favorable impressions of the breastfeeding woman than did those with low scores. As predicted, this effect was larger for Benevolent Sexism than for Hostile Sexism. No relationships were found between impressions of breastfeeding women and the Hostility Toward Women Scale (Lonsway & Fitzgerald, 1995) or the Trait Guilt and Moral Standards scales (Jones, Schratter, & Kugler, 2000). The results supported hypotheses that sexualization of the breast, discomfort with sexual stimuli, and sexist attitudes are related to perceptions of the breastfeeding woman.     

Balancing Act: Career and Family During College-Educated Women’s 30s

We assessed career, marriage, and motherhood expectations of 118 White Women and 82 Women of Color in 1993, when they were seniors at five northeastern U.S. colleges. Sixteen years later, in 2009, 77.5 % responded to our survey and answered questions about their career, marriage, motherhood, attitudes, and life satisfaction outcomes. As seniors, they wanted it all, career, marriage, and motherhood. In 2009, nearly two thirds were employed full time, 91 % had married, nearly three quarters were mothers, and about 57 % were combining full-time employment and motherhood. Comparisons are made among three role-status outcome groups: Have It All (mothers, employed full time); Traditional (mothers, employed part time or not at all), and Employed Only (childfree, employed full time). Educational level of the women did not predict role status. Spouses’ educational level relative to the women’s predicted role status, with Have It All women more likely to be married to less educated spouses than Traditional or Employed Only women. The role-status groups did not differ in their attitudes toward women in general, but Have It All mothers had lower levels of employment-related concerns about separation from their children than Traditional mothers. Most of the women still wanted to have it all. Many Traditional women looked forward to returning to employment, and many of the Employed Only women wanted to have children. Being a mother was associated with higher life satisfaction than being childfree. Results are discussed in terms of multiple-role theory and the positive influence of having family roles in the mix.     

Spoiled milk: an experimental examination of bias against mothers who breastfeed

Drawing from the objectification literature, three experiments tested the hypothesis that breastfeeding mothers are the victims of bias. In Study 1, participants rated a woman who had breastfed as incompetent. Study 2 replicated these effects and determined that the bias was specific to conditions that sexualized the breast. In Study 3, participants interacted with a confederate in which attention was drawn to her as a mother, as a mother who breastfeeds, as a woman with sexualized breasts, or in a neutral condition. Results showed the breastfeeding confederate was rated significantly less competent in general, in math and work specifically, and was less likely to be hired compared to all other conditions, except for the sexualized breast condition. Importantly, the breastfeeding mother emphasis and the sexualized breast emphasis resulted in equally negative evaluations. Results suggest that although breastfeeding may be economical and healthy, the social cost is potentially great.     

Kasuistik zur Kindeswohlgefährdung bei postpartaler Depression

Postpartum psychiatric disorders adversely affect the relationship between the mother and her baby, frequently in a very serious way. It is common that both objective and subjective aspects of this relationship would be negatively influenced by the maternal pathology. The disturbances that arise from the psychiatric disorders could become a hostile and rejecting quality and could be unfavourable to the long-term development of the child. Obsessional impulses to harm the baby are not rare by mothers in the postpartum period. A large figure of severely depressed and psychotic mothers admited to have had some thoughts of harming or to killing the baby. Some of them have already done harmful things to their babies. Ideations of infanticide or child abuse are not always associated with psychiatric disorders (i.e. depressive symptoms or delusion). They could be a consequence of a severe Bonding disorder.     

Video Reviews

Abstract

This study examined, as a secondary analysis, whether a group interpersonal psychotherapy (IPT) intervention focused on preventing postpartum depression by strengthening social support and building interpersonal skills during the transition to motherhood positively affected breastfeeding outcomes among low-income women. The intervention–Reach Out, Stand strong, Essentials for new mothers (ROSE)–taught participants the importance of self-care and assertive help seeking to be better able to sustain breastfeeding practices. Ninety-nine pregnant women were randomized to ROSE plus standard care or to standard care alone. Though women in both conditions had similar breastfeeding initiation rates, women in ROSE had longer breastfeeding duration (median days breastfed: 54 vs. 21). Results suggest ROSE may positively affect breastfeeding.     

Women's new liberty of decision with regard to motherhood

Homologous (spouse) versus heterologous (anonymous donor) artificial insemination, which began in the 1950s, extracorporeal conception, in-vitro fertilization (test tube babies), and implantation of embryos in surrogate mothers are described. A government committee was formed to discuss medical, legal and ethical questions and to establish professional and medical guidelines. The status attached to motherhood in a modern emancipated society is given a fair evaluation. 30% of all sterility cases in women are assumed to derive from psychogenic factors and may be solved through psychoanalytic therapy. Hidden emotional motivations, negative or positive, may explain a willingness to put up with cost-intensive and time-consuming trials needed for extracorporeal conception. Sometimes subconscious aggression against the mate may trigger a decision for choosing heterologous conception. Women today have found a mighty ally in modern medicine which renders them virtually independent any specific male partner if they wish to become pregnant. Various degrees of emotional bonds exposed by mothers toward their artificially conceived babies are related to certain maternal archetypes. The prospect of a mother feeling thrill, awe and a sense of magic toward her newborn baby in spite of the blase "make-a-child" attitude that modern biotechnology might confer, is assessed optimistically.     

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.     

Introduction: babies in the consulting room: what happens when analyst, mother, and infant meet?

Analytic work with a pregnant woman may foster the psychological gestation of the self-as-mother. For the mother--as for the infant--the developmental process continues well beyond delivery. It should not surprise us, then, that many mothers continue to bring their babies to sessions after birth. Analytic work in this context can affect a patient's sense of herself, and perhaps her competence, as a mother. Yet the presence of babies in the consulting room is an underacknowledged feature of contemporary practice. For this section of JAPA, we have collected three papers that explore some of the unique challenges and opportunities that arise when a patient brings her baby to treatment. Earlier versions of each paper were first presented at a panel, "Babies in the Consulting Room," at the June 2011 meeting of the American Psychoanalytic Association in San Francisco.     

Correlation between maternal and infant cortisol varies by breastfeeding status

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

Coparenting in the Context of Mother–Father–Infant versus Mother–Grandmother–Infant Triangular Interactions in Turkey

In this report, coparenting behaviors during triangular interactions among families raising a 3-month-old infant in Turkey are examined. Given the significant role played by extended family members in Turkish culture, coparenting dynamics were examined as mothers and babies played together with grandmothers, as well as together with fathers. Forty-five families took part, and 42 father–mother–baby and 33 grandmother–mother–baby triangular interactions of approximately 10?min in length were filmed during the Lausanne Trilogue Play. From videotapes of the interactions, individual and mutual coparenting behaviors were evaluated using the Coparenting and Family Rating System: 3 Month Adaptation (CFRS3M). Results indicated that while mothers’ own parenting behavior when in the LTP role of Active Parent (AP) was comparable whether with fathers or grandmothers, their behavior when in the LTP role of third party parent (TPP) was comparatively more engaged while with fathers than while with grandmothers. Fathers were comparatively less engaged when occupying the TPP role than were mothers in the TPP role, while grandmothers showed more flirting and distracting behavior in the TPP role than did either fathers or mothers. These findings are significant in documenting meaningful distinctions in Turkish grandmothers’ as well as in Turkish fathers’ and mothers’ coparenting propensities when engaging in triangular interactions with babies during the LTP.     

Initial parenting attitudes of pregnant adolescents and a comparison with the decision about adoption

The Adult-Adolescent Parenting Inventory was used to examine the initial parenting attitudes of a sample of pregnant adolescents. In addition, the attitudes about parenting were correlated with the decision of the adolescent to either keep or place the baby for adoption. Pregnant adolescents scored significantly lower on the "expectations for children" construct than all groups of controls. They scored significantly higher than adolescent controls on the "empathy" construct but lower than the adult controls. On the "corporal punishment" construct, they scored significantly lower than nonabused adolescent controls but were similar to abused adolescent controls. On the "role-reversal" construct, they scored significantly higher than abused adolescent controls, lower than adult controls, and about the same as nonabused adolescent controls. Adolescents who placed their babies had significantly lower scores on the role-reversal measure, but the differences between keepers and placers on the expectations, empathy, and corporal punishment dimensions were not significant. The results are discussed in terms of (1) the areas where attitudes about parenting are below appropriate levels, (2) the possibility of competent teenage mothers, and (3) the groundwork necessary for preparing adolescents for parenthood should they elect to keep their babies.     

Attitudinal and demographic predictors of breast-feeding and bottle-feeding behavior by mothers of six-week-old infants

The demographic and attitudinal characteristics of 42 bottle feeding and 41 breast feeding mothers of 6 week old infants were compared. The women were patients of private physicians in Nashville, Tennessee. Data was obtained from self-administered questionnaires distributed through the physicians' offices. The women were primarily middle class whites and one-half of the women were multiparous and one-half were primiparous. On the basis of the information obtained in the questionnaires respondents were given scores on 13 demographic and family history characteristics and on 16 attitudinal scales which measured the mothers' preceptions of family life, child rearing, and breast feeding. Discriminant function analysis was used to assess the differences in the mean scores on each of the 29 variables for the 2 groups of mothers. Major findings were: 1) breast feeding mothers were significantly more educated and had significantly more breast feeding friends than bottle feeding mothers; 2) breast feeding mothers viewed their husbands as significantly more supportive of their feeding method than bottle feeding mothers; 3) bottle feeding mothers perceived more conflict in their marriages than breast feeding mothers; 4) bottle feeding mothers tended to favor accelerating the development of their infants more than the other mothers; and 5) breast feeding mothers had more positive attitudes toward breast beeding than bottle feeding mothers. Most of the women in both groups decided on their method of feeding prior to delivery, and complications during and following delivery did not alter their plans significantly. The 2 groups did not differ significantly in the degree to which they: 1) fostered dependency in their infants; 2) felt possessive toward their infants; 3) rejected the housewife role; and 4) were secluded at home.     

The early resumption of employment by mothers: Implications for parent-infant interaction

Home observations of mother-father-infant interaction and mother-infant interaction were contrasted in middle-class families in which the mother was employed or a full-time caregiver. First-born infants and their parents were observed at 3 months. The results indicate that when mother, father, and infant were together parents in the single wage-earner families provided more tactile stimulation to their babies; fathers in single wage-earner families tended to interact more with their infants than did mothers, while in dual wage-earner families mothers tended to interact more than fathers; and fathers in single wage-earner families exceeded fathers in dual wage-earner families in interactions with their infants. By contrast, mothers in the two groups showed very little difference in their interactions with their babies. No significant differences were found for maternal behavior in the three-person observation, and a single behavior differentiated between the groups in the mother-baby observation, with homemaker mothers more often making visual contact with their babies. The implications of these findings are discussed, both with respect to further research, and with regards to the development of children of employed mothers.     

Adult attachment styles,early relationships,antenatal attachment,and perceptions of infant temperament: A study of first‐time mothers

We explored the relative contributions of first‐time mothers’romantic attachment styles and early relations with their own mothers to the prediction of infant temperamental difficulty. A mediating role for mother's attachment to the unborn baby was assumed. In a prospective longitudinal study of 115 mothers of healthy babies, a structural model was delineated according to a conception of maternally reported infant temperament as a reflection of basic aspects of the mother's personality and mother‐infant relationships. Mothers’experiences with their own mothers as supportive and nonintrusive differentiated between securely and insecurely attached participants. Security of attachment was found to facilitate antenatal attachment and perceptions of the 4‐month‐old infant as easier. Findings indicate that the effects of the mothers’romantic attachment styles on their perceptions of temperamental difficulty are mediated by their antenatal attachment. Moreover, the pattern of findings obtained suggests a link among mothers’history of relationships, romantic attachment styles, and caregiving characteristics that is congruent with evolutionary theoretical assumptions.     

A randomized controlled trial of mother–infant psychoanalytic treatment: II. Predictive and moderating influences of qualitative patient factors

A randomized control trial was performed on 75 dyads in Stockholm, Sweden, with infants under 1½ years. It recruited mothers who worried about the babies, themselves as mothers, and/or the mother–baby relationship. Two groups of mother–infant dyads were compared. One received only Child Health Centre care (the “CHCC” group) while the other received mother–infant psychoanalytic treatment plus CHCC (the “MIP” group). Significant treatment effects were found on mother‐reported depression, interviewer‐rated dyadic relationship qualities and externally rated maternal sensitivity, and near‐significant effects on mother‐reported stress, all in favor of MIP. The objective of this study is to investigate the predictive and moderating influences on outcomes by qualitatively assessed maternal and infant characteristics. The qualitative factors covered maternal suitability for psychoanalysis, and “ideal types” of mother and child, respectively. Outcome measures from two interviews with a 6‐month interval were depression (Edinburgh Postnatal Depression Scale (J. Cox, J. Holden, & R. Sagovsky, 1987 ), stress (Swedish Parental Stress Questionnaire (M. Östberg, B. Hagekull, & S. Wettergren, 1997 ), distress (Swedish Symptom Checklist‐90 (SCL‐90; L.R. Derogatis, 1994 ; M. Fridell, Z. Cesarec, M. Johansson, & S. Malling Thorsen, 2002 ) and infant social and emotional functioning (Ages and Stages Questionnaire: Social–Emotional (J. Squires, D. Bricker, K. Heo, & E. Twombly, 2002 ), relationship qualities (Parent–Infant Global Assessment Scale (PIR‐GAS; ZERO TO THREE, 2005), and videotaped interactions (Emotional Availability Scales, Z. Biringen, J.L. Robinson, & R.N. Emde, 1998 ). Suitability for psychoanalysis predicted outcome only on the PIR‐GAS. Two overarching maternal ideal types were created, reflecting their attitude to the psychoanalytic process: “Participators” and “Abandoned.” The Participators benefited more from MIP than they did from CHCC on maternal interactive sensitivity. A contrasting, but nonsignificant, pattern was found among the Abandoned mothers. Two ideal types of babies emerged: those “Affected” and “Unaffected” by the disturbance, respectively. Among Affected babies, dyadic relationships and sensitivity among their mothers improved significantly more from MIP than they did from CHCC. The superior effects of MIP applied especially to Participator mothers and Affected infants. For Abandoned mothers and Unaffected infants, CHCC seemed to be of equal value.     

Sexual preference,feminism, and women's perceptions of their parents

In an attempt to clarify the relation between parental variables, sexual preference, and sex-role attitudes, three groups of women were studied: lesbian feminists, heterosexual feminists, and heterosexual traditional women. The women were asked about their perceptions of their parents when they were in high school. The groups differed more from each other with respect to their perceptions of their fathers than their mothers. The perceived attitudes of the father were much more important in differentiating lesbian feminists from heterosexuals than in differentiating heterosexual feminists from heterosexual traditionals. Both the heterosexual groups (feminist and traditionals) reported having a more affectionate and involved father who also encouraged them more in the expression of anger than the lesbian feminists reported. The results suggest women's father relationships must not be obscured in research and support Johnson's hypothesis that the father relationship is more central than the mother relationship in sex typing and especially in the specifically sexual aspects of sex typing.     

Expressive timing and interactional synchrony between mothers and infants: cultural similarities, cultural differences, and the immigration experience

The spontaneous vocal interactions of 30 mothers and their 2- to 5-month-old infants from India, France, and the United States were analyzed using an acoustic analysis method. Similarities and differences in vocal interactional patterns were highlighted between the three groups. On the one hand, in the three cultural contexts mother–infant vocal interaction was found to be organized around hierarchical temporal intervals of the same approximate length, had the same balance between regular rhythm and variation (“expressive timing”), and manifested the same coordination between mother and infant vocalization (“interactional synchrony”). On the other hand, the three groups also revealed cultural variability. The Indian mothers had more togetherness with their babies, as indexed by less space between vocal turns and more overlap of mother and baby vocalizations. They also produced a higher ratio of nonverbal to verbal vocalizations. The spontaneous vocal interactions of a group of 30 Indian immigrant dyads were also studied. With respect to culturally variable characteristics, the vocal interaction of immigrant dyads living in the United States showed signs of change in the direction of the host culture. With respect to characteristics shared by all three nonimmigrant groups, the immigrant dyads showed lower levels of expressive timing and interactional synchrony than the nonimmigrant group as a whole.