Effects of massage intervention on discharged premature infants’ weight,parental stress,and parent–child attachment: A randomized controlled trial

Infant massage enhances the growth and development of premature infants and promotes parent–child bonding. However, its effects on parental stress and parent–child attachment in premature infants, as well as gender differences thereof, remain unclear. In this randomized controlled trial, we used a repeated-measures design and included 61 premature infants (mean gestational age: 35.1 ± 1.5 weeks). Weight, parental stress, and parent–child attachment were measured at multiple time points: before massage and 1, 4, 8, and 12 weeks after commencing infant massage. The results revealed that the massage group infants had significantly higher weight gain than the control (no massage) group infants at all four time points. Moreover, parents in the massage group reported notably lower levels of stress than those in the control group, particularly in the parental distress and difficult children subscales. No significant between-group differences were observed in parent–child attachment. Furthermore, no significant differences were observed between fathers and mothers in parental stress and parent–child attachment. However, fathers reported higher levels of distress than mothers at 4 and 12 weeks. In conclusion, infant massage led to increased infant weight and reduced parental stress over time, and differences between fathers and mothers were not significant, except fathers exhibiting higher levels of distress than mothers over time. Healthcare professionals should educate and support parents on infant massage before discharge of premature infants.     

Enhancing parental reflective functioning: A special tribute to the life and work of Nancy E. Suchman,PhD

Nancy E. Suchman's contributions to the fields of infant mental health, maternal reflective functioning, and attachment-based intervention will have long-lasting impacts. In particular, through the development and dissemination of her intervention program, Mothering from the Inside Out (MIO), she innovated a way of working with mothers with substance use disorders that represented a paradigm shift within the field of addiction. In this introduction to the special issue, written to honor her life and work, we review Nancy's background and briefly describe her academic accomplishments. The special issue contains nine qualitative and quantitative research reports written by Nancy's colleagues and their collaborators. All nine papers pertain to the theme of understanding, measuring, and promoting parents’ capacity for reflective functioning. Four provide findings that advance our understanding of parental reflective functioning. The other five highlight insights from continuing evaluations of MIO, including new adaptations of the model. To introduce the special issue, we provide an overview of the scope of the work done within these projects. Finally, the special issue concludes with two commentaries contributed by Linda Mayes and Arietta Slade, leading scholars within the field who were also Nancy's close colleagues. Both provide insight into Nancy's impact on the field.     

Looking is not enough: Multimodal attention supports the real-time learning of new words

Most research on early language learning focuses on the objects that infants see and the words they hear in their daily lives, although growing evidence suggests that motor development is also closely tied to language development. To study the real-time behaviors required for learning new words during free-flowing toy play, we measured infants’ visual attention and manual actions on to-be-learned toys. Parents and 12-to-26-month-old infants wore wireless head-mounted eye trackers, allowing them to move freely around a home-like lab environment. After the play session, infants were tested on their knowledge of object-label mappings. We found that how often parents named objects during play did not predict learning, but instead, it was infants’ attention during and around a labeling utterance that predicted whether an object-label mapping was learned. More specifically, we found that infant visual attention alone did not predict word learning. Instead, coordinated, multimodal attention–when infants’ hands and eyes were attending to the same object–predicted word learning. Our results implicate a causal pathway through which infants’ bodily actions play a critical role in early word learning.     

Measures of infant self-regulation during the first year of life: A systematic review

This study aimed to systematically review the measures used to assess infant self-regulation during the first 12 months of life. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement protocol. From 235 selected papers, 79 provided information on behavioural and physiological measures to assess infant self-regulation during the first 12 months of life. Thirty-six behavioural (30 observational and 6 parent-report) and five physiological different measures were identified. Studies with a longitudinal design, comprising larger samples, and aiming to assess infant self-regulation later in infancy, mostly used behavioural measures than physiological measures. Studies comprising lower samples and aiming to assess infant self-regulation earlier in infancy, mostly used observational than parent-reported measures. Studies targeting younger infants used physiological measures and studies targeting older infants used behavioural measures, with observational measures used with younger infants and parental-reported measures used with older infants during the first year of life. When measuring self-regulation is important to consider infant's age, to fit the measurement procedures with the self-regulation development level.     

States of identity: a perspective drawing upon Fordham's model and infant studies

This paper examines the Jungian concept of identity and distinguishes it from projective identification and participation mystique which also refer to non-differentiation between self and object but involve projective mechanisms. Clinical work by Fordham and a psychoanalytic infant observation are used to illustrate early perceptual operations defined by experimental researches. These operations are understood to be expressions of the primary self which manifest themselves before the structuring necessary for normal projective identification. This paper attempts to describe an intersubjective experience between mother and baby that allows for their separate ways of relating, but does not depend on projective mechanisms that can exist only after there has been adequate development.     

Precursors to infants'' perception of the causality of a simple event

Three habituation experiments examined the perception of causal and non-causal events by infants at 6 1/4, 5 1/2, and 4 months of age. Experiment 1 replicated previous studies showing that by 6 1/4 months, infants begin to respond to the interaction of simple objects in Michottian type launching events on the basis of causality. In Experiments 2 and 3, however, younger infants exposed to the identical event sequences responded on the basis of simpler perceptual features of the launching events, and not on the basis of causality. 4-month-old infants responded to continuous versus non-continuous movement. 5 1/2-month-old infants also responded somewhat on the basis of continuous movement. However, in addition they responded on the basis of the spatial and temporal perceptual features of the events. This change in the pattern of results over age suggests a multi-step developmental progression.     

Relations between infant irritability and maternal responsiveness in low-income families

Relations between infant irritability and maternal responsiveness at 12 and18 months were investigated in low-income mother-infant dyads. Emphasis was placed on whether results varied according to measurement strategies, infant gender, or level of maternal social support and satisfaction with that support. Irritability was measured separately through observation and maternal report, responsiveness was measured observationally, and maternal social support and satisfaction were self-reported via questionnaire. Concurrent relations between irritability and responsiveness were, in general, negative and were larger when irritability was measured observationally rather than by maternal report. Correlations were similar across gender. No longitudinal relations were found between irritability and responsiveness. Amount of maternal social support was weakly related to responsiveness and to responses to infant irritability, and the nature of these relations was unexpected. Irritability-responsiveness relations varied as a function of measurement strategies, which may in part explain mixed findings in the empirical literature.     

BEHAVIOR MANAGEMENT OF INFANT SLEEP DISTURBANCE

Using a nonconcurrent multiple baseline design, we evaluated the effects of extinction and stimulus control on nighttime sleep disturbances exhibited by 7 infants. Results showed that frequency and duration of night wakings decreased for all subjects, with corresponding improvements reflected through changes in responses to the sleep behavior scale. Observed improvements maintained at 3 and 24 months posttreatment.     

Longitudinal effects of contextual and proximal factors on mother-infant interactions among Brazilian adolescent mothers

Adolescent mothers often come from vulnerable backgrounds which might impact the quality of both maternal and infant behavior. Despite the negative impact of adolescent motherhood for maternal and infant behavior, social support may decrease the risks and promote maternal behavior toward the infant. The aim of this study was to investigate longitudinally the effects of proximal (maternal behavior) and distal (mother’s perceived social support) variables on infant development in a sample of Brazilian adolescent mothers and their infants. Thirty-nine adolescent mothers (M_age = 17.26 years; SD = 1.71) were observed interacting with their infants at 3 and 6 months postpartum and reported on social support. Results revealed that maternal and infant behavior were associated within and across times. Mothers’ perceived social support at 3 months had an indirect effect on infant behavior at 6 months, totally mediated by maternal behavior at 6 months. Our findings revealed the mutual influence between maternal and infant behavior, revealing a proximal process. The results also underscored the importance of the passage of time in the interplay between mother-infant interactions and their developmental context.