Infant face interest is associated with voice information and maternal psychological health

Early infant interest in their mother's face is driven by an experience based face processing system, and is associated with maternal psychological health, even within a non clinical community sample. The present study examined the role of the voice in eliciting infants’ interest in mother and stranger faces and in the association between infant face interest and maternal psychological health.Infants aged 3.5-months were shown photographs of their mother's and a stranger's face paired with an audio recording of their mother's and a stranger's voice that was either matched (e.g., mother's face and voice) or mismatched (e.g., mother's face and stranger's voice). Infants spent more time attending to the stranger's matched face and voice than the mother's matched face and voice and the mismatched faces and voices. Thus, infants demonstrated an earlier preference for a stranger's face when given voice information than when the face is presented alone. In the present sample, maternal psychological health varied with 56.7% of mothers reporting mild mood symptoms (depression, anxiety or stress response to childbirth). Infants of mothers with significant mild maternal mood symptoms looked longer at the faces and voices compared to infants of mothers who did not report mild maternal mood symptoms. In sum, infants’ experience based face processing system is sensitive to their mothers’ maternal psychological health and the multimodal nature of faces.     

Synchrony,complexity and directiveness in mothers’ interactions with infants pre- and post-cochlear implantation

This study investigated effects of profound hearing loss on mother–infant interactions before and after cochlear implantation with a focus on maternal synchrony, complexity, and directiveness. Participants included two groups of mother–infant dyads: 9 dyads of mothers and infants with normal hearing; and 9 dyads of hearing mothers and infants with profound hearing loss. Dyads were observed at two time points: Time 1, scheduled to occur before cochlear implantation for infants with profound hearing loss (mean age = 13.6 months); and Time 2 (mean age = 23.3 months), scheduled to occur approximately six months after cochlear implantation. Hearing infants were age-matched to infants with hearing loss at both time points. Dependent variables included the proportion of maternal utterances that overlapped infant vocalizations, maternal mean length of utterance, infant word use, and combined maternal directives and prohibitions. Results showed mothers’ utterances overlapped the vocalizations of infants with hearing loss more often before cochlear implantation than after, mothers used less complex utterances with infants with cochlear implants compared to hearing peers (Time 2), and mothers of infants with profound hearing loss used frequent directives and prohibitions both before and after cochlear implantation. Together, mothers and infants adapted relatively quickly to infants’ access to cochlear implants, showing improved interactional synchrony, increased infant word use, and levels of maternal language complexity compatible with infants’ word use, all within seven months of cochlear implant activation.     

Risks and realities: dyadic interaction between 6-month-old infants and their mothers in opioid maintenance treatment

A number of studies point to methadone exposure in utero as a possible risk factor in the developing mother–infant relationship in the first year of life. This study is part of a larger, national follow-up of 38 infants prenatally exposed to methadone or buprenorphine and 36 comparison, low-risk infants. The aim of the present paper is to assess the quality of mother–infant relationship when the infants are 6 months old. Videotaped mother–infant interactions were rated in a global scale (NICHD). Maternal and infant contributions collapsed into the variables “infant style” and “maternal style” showed that the only factor making significant contribution to the outcome measure “dyadic mutuality” was maternal style. The importance of group membership (exposed versus non-exposed), was reduced when controlling for maternal drug use prior to opioid maintenance treatment (OMT), maternal depression and parenting stress as well as infants’ developmental status and sensory-integrative functions. This suggests that prediction of dyadic mutuality should be based on individual characteristics rather than group characteristics. These results support previous research findings that methadone and buprenorphine use per se does not have direct influence on the quality of early mother–infant relationship, but tailored follow-up procedures targeting drug-free pregnancies and parenting support are beneficial for women in OMT and their children.     

Infant behaviors influence mothers’ provision of responsive and directive behaviors

Mother–infant interactions are important to infant development because they are predictive of infants’ social, cognitive, and language development (0070 and 0150). Because maternal responsive and directive behaviors are associated with differential infant outcomes, it is important to investigate influences on mothers’ provision of responsive and directive behaviors. Yet, the dyadic interaction literature is predominantly unidirectional from maternal behavior to infant outcomes. Therefore, the current study examined infant initiating behaviors and consequent maternal responses in a sample of 26 13-month-old infants and their mothers, videotaped during 5 min of free-play. Findings revealed that infants produced a variety of initiatives, and that these different infant initiatives prompted differential patterns of maternal responsive versus directive behaviors. Further, results of analyses of divergent types of maternal directive behaviors – Responsive Directives, ReDirectives, and Intrusive Directives – also may help clarify major discrepancies in the current literature regarding the positive and negative effects of maternal directiveness.     

Tolerance of geometric distortions in infant's face recognition

The aim of the current study is to reveal the effect of global linear transformations (shearing, horizontal stretching, and vertical stretching) on the recognition of familiar faces (e.g., a mother's face) in 6- to 7-month-old infants. In this experiment, we applied the global linear transformations to both the infants’ own mother's face and to a stranger's face, and we tested infants’ preference between these faces. We found that only 7-month-old infants maintained preference for their own mother's face during the presentation of vertical stretching, while the preference for the mother's face disappeared during the presentation of shearing or horizontal stretching. These findings suggest that 7-month-old infants might not recognize faces based on calculating the absolute distance between facial features, and that the vertical dimension of facial features might be more related to infants’ face recognition rather than the horizontal dimension.     

Maternal posttraumatic stress symptoms and infant emotional reactivity and emotion regulation

The current study examined associations between maternal posttraumatic stress disorder (PTSD) symptoms and infant emotional reactivity and emotion regulation during the first year of life in a primarily low-income, urban, ethnic/racial minority sample of 52 mother–infant dyads. Mothers completed questionnaires assessing their own trauma exposure history and current PTSD and depressive symptoms and their infants’ temperament when the infants were 6 months old. Dyads participated in the repeated Still-Face Paradigm (SFP-R) when the infants were 6 months old, and infant affective states were coded for each SFP-R episode. Mothers completed questionnaires assessing infant trauma exposure history and infant current emotional and behavioral symptoms when the infants were 13 months old. Maternal PTSD symptoms predicted infants’ emotion regulation at 6 months as assessed by (a) infant ability to recover from distress during the SFP-R and (b) maternal report of infant rate of recovery from distress/arousal in daily life. Maternal PTSD symptoms also predicted maternal report of infant externalizing, internalizing, and dysregulation symptoms at 13 months. Maternal PTSD was not associated with measures of infant emotional reactivity. Neither maternal depressive symptoms nor infant direct exposure to trauma accounted for the associations between maternal PTSD symptoms and infant outcomes. These findings suggest that maternal PTSD is associated with offspring emotion regulation difficulties as early as infancy. Such difficulties may contribute to increased risk of mental health problems among children of mothers with PTSD.     

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.     

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.     

The impact of prenatal serotonin reuptake inhibitor (SRI) antidepressant exposure and maternal mood on mother–infant interactions at 3 months of age

Exposure to maternal depression increases risks for altered mother–infant interactions. Serotonin reuptake inhibitor (SRI) antidepressants are increasingly prescribed to manage antenatal maternal illness. The impact of SRIs on early mother–infant interactions was unknown. Three-month-old infants of 32 depressed mothers treated with SRI medications during pregnancy and 43 non-medicated mothers were studied. Using an established face-to-face mother–infant interaction paradigm, dyad interactions were studied with and without a toy. Videotaped sessions yielded 4 measures: maternal sensitivity, dyadic organization, infant readiness to interact, and maternal interruptive behaviors. Even with prenatal SRI treatment, depressed mothers interrupted their infants more during toy play. In the absence of prenatal SRI treatment, maternal postnatal depression adversely influenced infant behavior. Higher levels of maternal depression symptoms at 3 months predicted poorer infant readiness to interact during the toy session. Conversely, in the SRI-exposed group, higher prenatal depression scores predicted greater infant readiness to interact at 3 months. Increased infant readiness with SRI exposure suggests a “fetal programming effect” whereby prenatal maternal mood disturbances shaped a future response to a postnatal depressed maternal environment.     

Evaluating a home‐based dyadic intervention: Changes in postpartum depression,maternal perceptions,and mother–infant interactions

Psychotherapeutic treatments that focus on improving the relational processes between mothers with postpartum depression (PPD) and their infants, as well as the mother's individual therapeutic needs, have a great potential to positively impact the mother, her infant, and their relationship (K.J. Nylen, T.E. Moran, C.L. Franklin, & M. O'Hara, 2006 ). Utilizing pilot data from an evaluation of a home‐based dyadic therapy for mothers with PPD and their infants, this article reports on a recent academic–community partnership study. The effectiveness of the intervention was examined, specifically regarding changes in mother's mood, parenting experience, and relationship with her infant. In addition, associations were examined among maternal self‐report variables measuring change from pre‐ to posttreatment in PPD, psychological distress, and maternal perceptions of parenting and those variables measuring change in observer ratings of maternal–infant interactions. Results showed improvements in mothers' depression, distress, and perceptions of parenting as well as many ratings of mothers' interactions with their infants. However, only improvements in maternal perceptions of parenting, such as maternal self‐esteem and parenting stress, were associated with better mother–‐infant interactions. Importance of this research for the field of infant mental health as well as clinical implications are discussed.     

Mother's prenatal and postpartum depression symptoms and infant's sleep problems at 6 months

Mother's prenatal and postpartum depression have been associated with infant's sleep problems. This study aimed to analyze (a) the effects of mother's prenatal and postpartum depression symptoms, including the effects of prenatal and postpartum anxiety and depression scores of the Edinburgh Postnatal Depression Scale (EPDS), on infant's sleep problems at 6 months, and (b) the interaction effect between mother's prenatal and postpartum depression symptoms and infant's sex on infant's sleep problems at 6 months. The sample was comprised of 164 mother–infant dyads whose mothers completed measures of depression at the third trimester of pregnancy, 2 weeks, 3 and 6 months postpartum and a measure of infant's sleep problems at 6 months (CSHQ-I). Mother's prenatal depression symptoms, specifically depression scores of the EPDS, predicted more infant's sleep anxiety and daytime sleepiness, while mother's depression symptoms at 2 weeks postpartum, specifically anxiety scores of the EPDS, predicted more bedtime resistance and CSHQ-I total scores at 6 months. Boys of mothers with more prenatal depression symptoms presented more sleep anxiety at 6 months. Both mother's prenatal and early postpartum depression symptoms have a negative effect on the emergence of infant's sleep problems. Additionally, boys seem more vulnerable to mother's prenatal depression symptoms.     

Social referencing in infants of mothers with symptoms of depression

The present study examined the acquisition of social referencing skills in infants of mothers with symptoms of depression (n = 44). We aimed to determine if a short discrimination training could facilitate infants’ social referencing. Mothers were instructed to pose either joyful or fearful facial expressions to cue infants’ approach/avoidance responses toward an ambiguous object. Maternal expressions were correlated with pleasant or unpleasant events occurring after the infant's response. The results showed that after the intervention, infants looked at their mothers more frequently and reached or avoided the ambiguous object based on the preceding maternal expression. The results suggest that discrimination training procedures can establish social referencing in infants of mothers with symptoms of depression.     

Stability of maternal postnatal bonding between 3 and 6 months: Associations with maternal mental health and infant temperament

Maternal bonding is key for infant development and well-being. Research to date focused on prenatal bonding experience, with fewer studies looking at the postnatal period. Moreover, evidence suggests significant associations among maternal bonding, maternal mental health, and infant temperament. The joint impact of maternal mental health and infant temperament on maternal postnatal bonding remains unclear, with limited research reporting longitudinal data. Hence, the present study aims (1) to explore the impact of maternal mental health and infant temperament on postnatal bonding at both 3 and 6 months of age, (2) to explore postnatal bonding stability from 3 to 6 months, and (3) to determine which factors are linked with 3-to-6-month changes in bonding. At the infants' 3 months (n = 261) and 6 months of age (n = 217), mothers provided measures of bonding, depressive and anxious symptoms, and infant temperament via validated questionnaires. At 3 months, higher levels of maternal bonding were predicted by lower levels of anxiety and depression in the mothers and by higher infants' regulation scores. At 6 months, lower levels of anxiety and depression predicted higher levels of bonding. Moreover, mothers showing decreases in bonding were characterized by 3-to-6-month increases in depression and anxiety, as well as increased reported difficulties in regulation dimensions of infant temperament. This study highlights the impact of both maternal mental health and infant temperament on maternal postnatal bonding in a longitudinal sample and could offer useful information for early childhood prevention and care.     

The Still-Face Paradigm and bidirectionality: Associations with maternal sensitivity,self-esteem and infant emotional reactivity

The Still-Face Paradigm (SFP) is a structured stressful event within which researchers have investigated the influence of maternal psychological and behavioral characteristics on infant behavior. The present investigation contributes to this body of work by examining the joint contributions of maternal and child behavioral and affective characteristics on subsequent behaviors and affectations following the SFP. A sample of non-clinically depressed mothers and their infants (n = 31) engaged in a modified Still-Face Paradigm (SFP), followed by a period of toy play. These interactions were videotaped and behaviorally coded along the following dimensions: maternal sensitivity prior to the SFP and during toy play, infant negative emotional reactivity during the still-face, and infant resistance during the reunion phase. Additionally, mothers reported global self-esteem and this was examined as a predictor of infant behavior. Results revealed significant bidirectional influences such that maternal self-esteem predicted infant emotional reactivity, maternal sensitivity pre-SFP predicted infant resistance during the reunion phase, and infant resistance predicted subsequent levels of maternal sensitivity. Indirect effects were also examined, and provided additional support for bidirectionality in mother–infant interactions. Implications for clinical practice are discussed in light of these findings.     

Kangaroo mother care and mother‐premature infant dyadic interaction

The aim of this study was to investigate the psychological impact of Kangaroo Mother Care (KMC) on mother‐infant bonding in cases of premature delivery. Examined variables were mother‐infant relationships, maternal anxiety levels, and infant interactive signals. The KMC method requires that babies be undressed and held upright between their mother's breasts for a minimum of 1 hr a day, from birth until they are discharged from hospital. The present study examined 40 premature infants and their mothers, with 21 dyads experiencing KMC and 19 receiving traditional care (TC). Maternal emotional stress was assessed with the Parent Stress Index‐Short Form questionnaire (Abidin, 1990), and mother‐newborn interactive style was assessed with the Nursing Child Assessment Feeding Scale (Barnard, 1975). Results revealed a better mother‐infant interactive style, a significant decrease in maternal emotional stress, and better infant ability to make requests and respond to parental interactive style in the KMC group.     

Mother–infant interaction improves with a developmental intervention for mother–preterm infant dyads

While premature infants have a high need for positive interactions, both infants and their mothers are challenged by the infant‘s biological immaturity. This randomized clinical trial of 198 premature infants born at 29–34 weeks gestation and their mothers examined the impact of the H-HOPE (Hospital to Home: Optimizing the Infant's Environment) intervention on mother–premature infant interaction patterns at 6-weeks corrected age (CA). Mothers had at least 2 social environmental risk factors such as minority status or less than high school education. Mother–infant dyads were randomly assigned to the H-HOPE intervention group or an attention control group. H-HOPE is an integrated intervention that included (1) twice-daily infant stimulation using the ATVV (auditory, tactile, visual, and vestibular-rocking stimulation) and (2) four maternal participatory guidance sessions plus two telephone calls by a nurse-community advocate team. Mother–infant interaction was assessed at 6-weeks CA using the Nursing Child Assessment Satellite Training–Feeding Scale (NCAST, 76 items) and the Dyadic Mutuality Code (DMC, 6-item contingency scale during a 5-min play session). NCAST and DMC scores for the Control and H-HOPE groups were compared using t-tests, chi-square tests and multivariable analysis. Compared with the Control group (n = 76), the H-HOPE group (n = 66) had higher overall NCAST scores and higher maternal Social-Emotional Growth Fostering Subscale scores. The H-HOPE group also had significantly higher scores for the overall infant subscale and the Infant Clarity of Cues Subscale (p < 0.05). H-HOPE dyads were also more likely to have high responsiveness during play as measured by the DMC (67.6% versus 58.1% of controls). After adjustment for significant maternal and infant characteristics, H-HOPE dyads had marginally higher scores during feeding on overall mother–infant interaction (β = 2.03, p = 0.06) and significantly higher scores on the infant subscale (β = 0.75, p = 0.05) when compared to controls. In the adjusted analysis, H-HOPE dyads had increased odds of high versus low mutual responsiveness during play (OR = 2.37, 95% CI = 0.97, 5.80). Intervening with both mother and infant is a promising approach to help premature infants achieve the social interaction patterns essential for optimal development.     

Maternal stress and behavioral adaptation in methadone- or buprenorphine-exposed toddlers

The current study examined the relationship between early interaction, parenting stress, maternal psychological distress symptoms, and behavior problems and health-related quality of life among children born to mothers in opioid maintenance treatment (OMT) in Norway during the period 2005–2007 (N = 36). This group was compared with a normative sample of mothers without substance abuse problems and their children (N = 36). There were significant group differences (p < .01) in perceived child problems in toddlerhood. In a regression model, mothers’ self-reported psychological distress symptoms in terms of depression and anxiety symptoms significantly predicted child behavior problems (p < .01) and health-related quality of life (p < .01) rather than parenting stress. No significant, unique effect of exposure was found after controlling for other factors that could influence developmental outcomes. These findings add to the growing evidence on the importance of maternal psychological well-being for child development, and underscore the need to address opioid-maintained women's personal maladjustment and the constellation of stress experienced by mothers in recovery.     

Maternal perinatal mental health: Associations with bonding,mindfulness, and self-criticism at 18 months’ postpartum

The perinatal period is a time of significant transition for women, with changes in maternal mental health from pregnancy to 18 months’ postpartum. This study specifically analyzes maternal self-criticism and mindfulness during pregnancy and at 18 months’ postpartum, and their associations with bonding. A longitudinal study (30 weeks’ gestation–18 months’ postpartum) assessed 32 mother–infant dyads, examining changes in maternal depression, anxiety, self-criticism, and mindfulness. In addition, associations between maternal variables during pregnancy and bonding were investigated. Maternal depression and self-criticism significantly increased from pregnancy to postpartum. Maternal anxiety, self-criticism, and facets of mindfulness during pregnancy were also associated with mother–infant bonding at 18 months. Maternal mental health during pregnancy is subject to change postchildbirth. The lack of control and autonomy accompanying motherhood may result in an increase in self-criticism during this period. Such feelings may elevate a woman's vulnerability to postpartum depression and have consequences for later maternal bonding. Early identification of at-risk mothers is important to increase likelihood of positive outcomes.     

Separation anxiety in first-time mothers: infant behavioral reactivity and maternal parenting self-efficacy as contributors

This short-term longitudinal study examined the contribution of infant behavioral reactivity and maternal parenting self-efficacy to first-time mothers’ (total n = 32) separation anxiety. Infants’ behavioral reactivity indexed by gaze and facial affect were observed in the conditions of routine play and maternal still face at 3 months. Mothers reported their self-perceived parenting efficacy at 3 months and separation anxiety at 6 months. Results revealed that infants’ frequent gazing at their mother, greater negative affect, and less positive affect observed during the still face, but not during the routine play, contributed to heightened maternal separation anxiety. In addition to a direct link between low maternal parenting self-efficacy and high maternal separation anxiety, maternal parenting self-efficacy buffered against the impact of infant negative reactivity on maternal separation anxiety. The role of infant reactivity and maternal self-efficacy in parenting was discussed.