‘I still have difficulties feeling like a mother’: The transition to motherhood of preterm infants mothers

Objective: The premature birth of their infant can constitute a sudden interruption of the transition to motherhood that requires a reorganisation of the process. The present study aimed to analyse the experience of the transition to motherhood of preterm infants’ mothers, framing it within Stern’s transition to motherhood theory.

Method: A semi-structured interview was administered to 30 mothers during the recovery of the infant in the Neonatal Intensive Care Unit. The interview explored the experience of mothers related to pregnancy, the infant’s birth and recovery.

Results: Thematic Analyses evidenced four interrelated themes: disconnection from the child, perception of maternal inadequacy, loss of parental role and temporal suspension. The themes showed that the mothers’ experience of preterm birth not only concerns the traumatic delivery, but is also embedded in the entire process of becoming a mother within an institutional context.

Conclusions: Results were connected to Stern’s theory. Findings revealed difficulties for preterm mothers that could affect the development of the maternal constellation and thus their transition to motherhood. These difficulties may influence the construction of maternal identity, mother’s representation of their child and the bond with their child.     

Preterm birth enhances the contribution of mothers’ mind-mindedness to infants’ expressive language development: A longitudinal investigation

Maternal mind-mindedness has been shown to be a powerful predictor of many developmental outcomes and to buffer the impact of psychosocial risk conditions, but no study has investigated whether this parental feature might support child development in the presence of biological risk, such as preterm birth. The present study addresses this gap, by investigating whether early maternal mind-mindedness contributes to the growth of a child’s linguistic abilities in the following two years of life, and if the contribution of this maternal feature might be stronger in the presence of preterm birth. Forty mother–child dyads (twenty with a preterm infant) were followed longitudinally, with maternal mind-mindedness assessed at 14 months of age and child’s expressive linguistic abilities at 24 and 36 months through observational measures. Multilevel models showed that linguistic abilities increased from 24 to 36 months of age, but that this increase was stronger in full-term infants. Maternal mind-mindedness also contributed to this growth, playing a stronger role in preterm infants than in full-term infants. Altogether, these findings contribute more deeply to the understanding of language development in preterm infants and of the joint contribution made by biological risk and environmental factors; from a practical standpoint, they suggest the importance of addressing mother’s mind-mindedness in order to support child’s language development.     

Are parenting interventions effective in improving the relationship between mothers and their preterm infants?

Aim

To systematically review the efficacy of parenting interventions in improving the quality of the relationship between mothers and preterm infants.

Method

Randomized or quasi-randomized controlled trials (RCT) of parenting interventions for mothers of preterm infants where mother–infant relationship quality outcomes were reported. Databases searched: The Cochrane Library, PubMed, CINAHL, PsycINFO and Web of Science.

Results

Seventeen studies met the inclusion criteria, 14 with strong methodological quality. Eight parenting interventions were found to improve the quality of the mother–preterm infant relationship.

Conclusions

Heterogeneity of the interventions calls for an integrated new parenting program focusing on cue-based, responsive care from the mother to her preterm infant to improve the quality of the relationship for these mother–preterm infant dyads.     

How do mothers signal shared feeling‐states to their infants? An investigation of affect attunement and imitation during the first year of life

The present study examined how mothers signal shared feeling-states to their infants. Affect attunement and imitation were investigated cross-culturally in 39 mother-infant dyads from Sweden (N = 22) and the former Yugoslavia (N = 17) during the first year of life. Video-recordings of playful interaction between mothers and their infants were analysed using the Affect Attunement Protocol. A significant negative association between imitation and age was found, while there was a significant positive association between affect attunement and age. Single occurrences of affect attunement appeared already at two or three months of age, and by 6 months of age episodes of affect attunement were more common than imitation. Frequencies of imitation and affect attunement were similar cross-culturally and in terms of gender, although there was a significant interaction between age and gender. The results suggest that the signalling of shared feeling-states is not a static process. Mothers do not signal shared feeling-states in the same manner at different ages. Imitation is the most important process during the earliest months, but is superseded by affect attunement earlier than previously thought. The functional implications of this developmental variation are discussed.     

Are mothers of stutterers different? An investigation of social-communicative integration

Many speech-language pathologists assume that parent-child communicative interactions are critical precipitating or maintaining factors in the onset and development of stuttering. Although parents are frequently counseled to alter their attitudes or behaviors, no studies have pinpointed specific parental behaviors as increasing children's disfluency. The purpose of this study was to analyze differences between 12 mothers of stutterers and 12 mothers of nonstutterers in their social-communicative interactions with their own child, an unfamiliar stutterer, and an unfamiliar nonstutterer. Ten minutes of free-play interaction between each mother and child were video recorded from behind a one-way mirror. Results indicate that the two groups of mothers differed significantly only in their use of routine statements. Other findings indicate that stuttering children used significantly more positive and imperative statements than nonstuttering children. All children asked significantly more questions of their own mothers than of unfamiliar mothers.     

Do infants have a sense of fairness?

Two experiments examined infants' expectations about how an experimenter should distribute resources and rewards to other individuals. In Experiment 1, 19-month-olds expected an experimenter to divide two items equally, as opposed to unequally, between two individuals. The infants held no particular expectation when the individuals were replaced with inanimate objects, or when the experimenter simply removed covers in front of the individuals to reveal the items (instead of distributing them). In Experiment 2, 21-month-olds expected an experimenter to give a reward to each of two individuals when both had worked to complete an assigned chore, but not when one of the individuals had done all the work while the other played. The infants held this expectation only when the experimenter could determine through visual inspection who had worked and who had not. Together, these results provide converging evidence that infants in the 2nd year of life already possess context-sensitive expectations relevant to fairness.     

What do mothers know? Maternal knowledge of child development

Maternal knowledge of child development has been shown to affect how mothers raise their children and the environments they provide. This study examines maternal knowledge of child development and whether level of knowledge varies by content area. Additionally, this study explored maternal characteristics that predict knowledge levels globally and by content area. Low‐income women (N = 203) in the waiting room of an obstetric clinic (n = 97) and pediatric clinic (n = 106) in a southern state were asked to complete questionnaires on typical child development and demographic characteristics. Overall, women correctly answered 65% of the criterion‐referenced knowledge questions. Mothers lacked the most knowledge about infant sleep patterns and developmental ability of 6‐month‐old infants. Maternal education, race, number of children, and assistance with childcare were significantly related to maternal knowledge. Identifying gaps in maternal knowledge and characteristics that correspond to knowledge deficits provides insight into how best to tailor educational interventions for mothers. ©2005 Michigan Association for Infant Mental Health.     

Responding to distressed infants: Does mothers’ positive versus negative affect matter for infants' behavior and physiology?

How mothers respond to infants’ distress has implications for infants’ development of self-regulation and social competence. In a sample of 35 mothers and their 4- to 8-month-old infants, we induced infant distress using an arm restraint task and compared infants’ observed affect and physiological responses under two conditions, when mothers were instructed to respond with: 1) positive affect and 2) negative affect. Based on theoretical and empirical support, we empirically evaluated two opposing hypotheses. Based on the Mutual Regulation Model and work on affect matching, we predicted that when mothers respond with negative affect versus positive affect, distressed infants’ duration of negative affect would be smaller, negative affect would be less intense, and respiratory sinus arrythmia (RSA) withdrawal would be lower. Based on social referencing theory and research, we expected that when mothers respond with positive affect versus negative affect, distressed infants’ duration of negative affect would be smaller, negative affect would be less intense, and RSA withdrawal would be lower. We found that when mothers responded to their distressed infants with negative affect versus positive affect, infants spent significantly more time in negative affect, their intensity of expressed negative affect was greater, and their RSA withdrawal was greater, suggesting that mothers’ display of mild positive affect when infants are distressed may be helpful for infants. The current findings add to accumulating evidence that mothers’ positive relative to negative affective response to their infants’ distress can produce observable differences in infants’ duration and intensity of negative affect, as well as their physiology. Findings have the potential to inform future research that investigates how mothers can most effectively reduce their infants’ distress and intervention that targets the moment-to-moment behaviors in mother-infant reciprocal interactions.     

The origins of touchscreen competence: Examining infants’ exploration of touchscreens

Infants’ exposure to images presented on screens is increasing with the accelerating use of technology in society and at home. Touchscreen technology provides numerous interactive screen opportunities geared toward infants and toddlers. Touchscreens are unique in that they possess the 2D qualities of a picture, but a set of manipulation possibilities similar to, but distinct from, a 3D object. Research comparing infants’ manual exploration of photographs, objects, and screen images has demonstrated that although 7–10-month-old infants direct different actions towards 3D objects, their exploration of screen images does not differ significantly from their exploration of 2D photographs (Ziemer & Snyder, 2016). The current investigation compares the ways in which 7–10-month-old infants and 15–18-month-old infants manually explore screen images, photographs, and objects. Infants in the older age group were shown examples of objects, photographs, and screen images presented within a well in a table with a Plexiglas® cover to create identical tactile feedback. Coders noted the presence or absence of appropriate actions displayed toward the various surfaces. Results were compared to data collected earlier (Ziemer & Snyder, 2016) to demonstrate the evolution of touchscreen competence across the first years of infant development. By 15–18 months, infants demonstrate an emerging repertoire of touchscreen-appropriate behaviors directed towards touchscreens that is not demonstrated by 7–10-month-old infants. Differences in haptic exploration suggest the beginnings of a touchscreen competence that enables infants to understand and interact with touchscreens in a new way.     

Effect of masker level on infants’ detection of tones in noise

In adult listeners, the signal-to-noise ratio at masked threshold remains constant with increases in masker level over a wide range of stimulus conditions. This relationship was examined in 7-month-old infants by obtaining masked thresholds for .5- and 4-kHz tones presented in four levels of continuous masking noise. Adults were also tested for comparison. Masker spectrum levels ranged from 5 to 35 dB/Hz for .5-kHz tones, and from ?5 to 25 dB/Hz for 4-kHz stimuli. Thresholds were determined for stimuli of both 10 and 100 msec in duration. The results indicated that infants’ performance was more adultlike for 4-kHz stimuli. Although mean thresholds for both 10- and 100-msec, 4-kHz tones were approximately 7 dB higher in infants than in adults, E/N₀ at threshold remained essentially constant over the 30-dB range of maskers employed. By contrast, infants’ thresholds for .5-kHz tones were exceptionally high at lower levels of the masker. Threshold E/N0 decreased significantly as masker level increased from 5 to 35 dB/Hz, and this decrease was significantly greater for 10- than for 100-msec stimuli. Temporal summation of .5-kHz tones, measured as the difference between thresholds obtained at the two signal durations, was greater for infants than for adults at low levels of the masker. However, because infants’ thresholds improved more rapidly with level for 10- than for 100-msec tones, age differences in temporal summation were no longer significant when masker spectrum level was 35 dB/Hz. These results suggest that the relationship between signal-to-noise ratio at masked threshold and level of the masker is dependent on both signal frequency and duration during infancy.     

The early ontogeny of infants’ imitation of on screen humans and robots

Traditionally, infants have learned how to interact with objects in their environment through direct observations of adults and peers. In recent decades these models have been available over different media, and this has introduced non-human agents to infants’ learning environments. Humanoid robots are increasingly portrayed as social agents in on screen, but the degree to which infants are capable of observational learning from screen-based robots is unknown. The current study thus investigated how well 1- to 3-year-olds (N = 230) could imitate on-screen robots relative to on-screen and live humans. Participants exhibited an imitation deficit for robots that varied with age. Furthermore, the well-known video deficit did not replicate as expected, and was weak and transient relative to past research. Together, the findings documented here suggest that infants are learning from media in ways that differ from past generations, but that this new learning is nuanced when novel technologies are involved.     

Meaning making in mothers’ and children's narratives of emotional events

Narrative coherence and the inclusion of mental state language are critical aspects of meaning making, especially about stressful events. Mothers and their 8- to 12-year-old children with asthma independently narrated a time they were scared, frustrated, and happy. Although mothers’ narratives were generally more coherent and more saturated with mental state language than children's narratives, for both mothers and children narratives of negative events were more coherent and contained more mental state language than narratives of positive events overall, and narratives of scary events contained more mental state language than narratives of frustrating events. Coherence appears to be multifaceted, in that the three dimensions of coherence coded, context, chronology, and theme were not strongly interrelated within narratives of the same event, but use of mental state language, including cognitive-processing and emotion words, appears to be more integrated. Moreover, while thematic coherence seems to be a consistent individual narrative style across valence of event being narrated, mental state language appears to be a consistent style only across the two stressful event narratives. Finally, and quite surprisingly, there were virtually no relations between mothers’ and children's narrative meaning making.     

The role of action effects in infants’ action control

In adults, the selection and the planning of actions are influenced by the anticipation of desired action effects. However, the role of action effects for action control in infants is still an unresolved issue. One important prerequisite for infants action control is that infants are able to relate certain movements to certain effects. To test this assumption, it was investigated how infants action control is affected by action effects. By applying an imitation paradigm, we studied 12- and 18-month-old infants who first observed an adult experimenter demonstrating a three-step action sequence on a toy bear. In three experimental groups, the second action step, the third action step, or no action step elicited an arbitrary sound as an additional acoustic action effect. It was coded how often each of the target actions was performed by the infant in a subsequent 90-s test phase. As predicted, the frequency of the infants target action varied depending on which action step elicited the action effect. In both age groups, the target action that was combined with an acoustical effect was not only produced more often but also occurred with lower latency and was in most cases the first target action shown by the infants. These results are interpreted as evidence of the important role of action effects in infants action control.     

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.     

Do infants discriminate non-linguistic vocal expressions of positive emotions?

Adults are highly proficient in understanding emotional signals from both facial and vocal cues, including when communicating across cultural boundaries. However, the developmental origin of this ability is poorly understood, and in particular, little is known about the ontogeny of differentiation of signals with the same valence. The studies reported here employed a habituation paradigm to test whether preverbal infants discriminate between non-linguistic vocal expressions of relief and triumph. Infants as young as 6 months who had habituated to relief or triumph showed significant discrimination of relief and triumph tokens at test (i.e. greater recovery to the unhabituated stimulus type), when exposed to tokens from a single individual (Study 1). Infants habituated to expressions from multiple individuals showed less consistent discrimination in that consistent discrimination was only found when infants were habituated to relief tokens (Study 2). Further, infants tested with tokens from individuals from different cultures showed dishabituation only when habituated to relief tokens and only at 10–12 months (Study 3). These findings suggest that discrimination between positive emotional expressions develops early and is modulated by learning. Further, infants' categorical representations of emotional expressions, like those of speech sounds, are influenced by speaker-specific information.     

Movement contributes to infants’ recognition of the human form

Three experiments demonstrate that biological movement facilitates young infants’ recognition of the whole human form. A body discrimination task was used in which 6-, 9-, and 12-month-old infants were habituated to typical human bodies and then shown scrambled human bodies at the test. Recovery of interest to the scrambled bodies was observed in 9- and 12-month-old infants in Experiment 1, but only when the body images were animated to move in a biologically possible way. In Experiment 2, nonbiological movement was incorporated into the typical and scrambled body images, but this did not facilitate body recognition in 9- and 12-month-olds. A preferential looking paradigm was used in Experiment 3 to determine if infants had a spontaneous preference for the scrambled versus typical body stimuli when these were both animated. The results showed that 12-month-olds preferred the scrambled body stimuli, 9-month-olds preferred the typical body stimuli and the 6-month-olds showed no preference for either type of body stimuli. These findings suggest that human body recognition involves integrating form and movement, possibly in the superior temporal sulcus, from as early as 9 months of life.     

Through babies’ eyes: Practical and theoretical considerations of using wearable technology to measure parent–infant behaviour from the mothers’ and infants’ view points

AimsTo explore the utility of first-person viewpoint cameras at home, for recording mother and infant behaviour, and for reducing problems associated with participant reactivity, which represent a fundamental bias in observational research.MethodsWe compared footage recording the same play interactions from a traditional third-person point of view (3rd PC) and using cameras worn on headbands (first-person cameras [1st PCs]) to record first-person points of view of mother and infant simultaneously. In addition, we left the dyads alone with the 1st PCs for a number of days to record natural mother–child behaviour at home. Fifteen mothers with infants (3–12 months of age) provided a total of 14 h of footage at home alone with the 1st PCs.ResultsCodings of maternal behaviour from footage of the same scenario captured from 1st PCs and 3rd PCs showed high concordance (kappa >0.8). Footage captured by the 1st PCs also showed strong inter-rater reliability (kappa = 0.9). Data from 1st PCs during sessions recorded alone at home captured more ‘negative’ maternal behaviours per min than observations using 1st PCs whilst a researcher was present (mean difference = 0.90 (95% CI 0.5–1.2, p < 0.001 representing 1.5 SDs).Conclusion1st PCs offer a number of practical advantages and can reliably record maternal and infant behaviour. This approach can also record a higher frequency of less socially desirable maternal behaviours. It is unclear whether this difference is due to lack of need of the presence of researcher or the increased duration of recordings. This finding is potentially important for research questions aiming to capture more ecologically valid behaviours and reduce demand characteristics.     

Addressing the needs of new mothers in a multi-cultural setting: an evaluation of home visiting support for new mothers – Mom to Mom (Negev)

This study evaluated the Mom to Mom (M2M) program operating in the Negev region of Israel, an area with a high proportion of immigrants. M2M helps women cope with the first year of parenting through home visits of volunteer mothers. Specific objectives were to evaluate (1) Participants’ motivations for joining M2M; (2) Gains from participation; and (3) The effect of participation on post-partum depression (PPD). Three stages included (1) Analysis of demographics of all 440 mothers in M2M; (2) A telephone survey of 51 mothers to assess gains from participation; and (3) 137 mothers filled out the Edinburgh Post-Natal Depression Scale (EPDS) and were followed for one year. Most mothers in M2M were first time mothers, with a high rate of perinatal complications (54.4%) and positive EPDS scores (38.7%). Two major reasons for participation were being an immigrant and having low income. The greatest gains from home visits were increased self-confidence, improved parenting skills and communication with the partner. Seventy-nine percent of mothers with PPD symptoms were functioning at work and at home after a year from joining the program. Our findings suggest that M2M has the capacity to address challenges in the post-natal period among women from diverse cultures.