Relative effects of breastfeeding intention and practice on maternal responsiveness

Our objective was to examine the differential effects of antenatal breastfeeding intention (BI) and breastfeeding practice (BP) on maternal postnatal responsiveness. We conducted a secondary analysis of longitudinal data from a subsample of 962 mother–infant dyads from a U.K.-based birth cohort study the Avon Longitudinal Study of Parents and Children. Exposures were BI and BPs measured at 32 weeks of gestation and 18 months’ postpartum. The outcome was maternal responsiveness assessed at 12 months’ postpartum. We used logistic regression analyses unadjusted and adjusted for confounders. Intention to breastfeed was associated with increased odds of postnatal maternal responsiveness independent of BP, adjusted odds ratio (OR) = 2.34, 95% CI [1.42, 3.86]. There was no evidence that BP was an independent predictor of maternal responsiveness, OR = 0.93, 95% CI [0.55, 1.57]. Life-course epidemiology analyses demonstrated that maternal responsiveness is most positive when both BI and BP are present. This is the first population-based study to provide evidence that BI during pregnancy is more strongly associated with maternal postnatal responsiveness than is BP. Further research is needed to understand the determinants of BI in pregnancy and its relationships with maternal responsiveness.     

MOTHER–CHILD AND FATHER–CHILD PLAY INTERACTION: THE IMPORTANCE OF PARENTAL PLAYFULNESS AS A MODERATOR OF THE LINKS BETWEEN PARENTAL BEHAVIOR AND CHILD NEGATIVITY

Based on the premise that father–child play is an important context for children's development and that fathers “specialize” in play, similarities and differences in the role of playfulness in the father–child and mother–child relationship were examined. Participants in this study included 111 families (children's age: 1–3 years). Father–child and mother–child play interactions were videotaped and coded for parental playfulness, sensitivity, structuring, and nonintrusiveness as well as child negativity. Results indicated that mothers and fathers did not differ in playfulness and that mothers and fathers who were higher in playfulness had children with lower levels of negativity. However, playfulness differently moderated the links between parents’ and children's behaviors for mothers and fathers. A double‐risk pattern was found for mothers, such that the links between child negativity and maternal sensitivity, structuring, and nonintrusiveness were significant only for the subgroup of mothers with low levels of playfulness. When mothers had high levels of playfulness, these effects were negligible. For fathers, a double‐buffer pattern was revealed, indicating that the links between child negativity and paternal sensitivity and structuring were significant only for fathers with high levels of playfulness. When fathers had low levels of playfulness, these effects were negligible. These findings demonstrate the important role that parental playfulness has on parent–child interaction as well as the need to examine moderation patterns separately for fathers and mothers.     

“There's more love between us”: The parental experience of attending Mellow Babies,a targeted,early intervention program for parents and their babies

It is recognized that parenthood in the context of psychosocial adversity can have negative implications for infant development. Parenting programs are the first line of intervention to improve outcomes for families; however, evidence for the effectiveness of group-based, targeted early interventions is still scarce. Preliminary findings indicate Mellow Babies (MB) as a promising group-based parenting program for families at risk for parenting difficulties. Using thematic analysis, we aimed to understand: (i) the aspects of the intervention that enabled parents to complete the program and (ii) the relational and behavioral changes perceived as valuable for parents and their babies post-intervention. In total, 68 parents residing in the United Kingdom were interviewed after completing MB (49 mothers and 19 fathers; 88% self-identified as British). Three themes and six subthemes were generated from the data. Parents identified several intervention components as beneficial, including the facilitators' interpersonal skills and multi-dimensional, group-based approach. Participant reflections highlighted three underlying mechanisms that enabled positive change: (i) the sense of community cultivated within the group, (ii) the process of formulating and re-conceptualizing one's difficulties, and (iii) the opportunity to reshape interpersonal interactions. Findings are discussed within the context of perinatal and infant mental health.     

Bringing a mentalizing framework to understanding mothers with addiction: The groundbreaking work of Nancy E. Suchman

Nancy Suchman is remembered as a pioneer whose mentalization-based intervention—Mothering from the Inside Out (MIO)—transformed the treatment of parents struggling with substance use disorders. Specifically, Suchman's work highlighted the neural mechanisms underlying substance use disorders and identified the promotion of parental mentalizing as a key therapeutic focus in enhancing early parent-child relationships. Her work transformed parenting support models for this population of parents. Several randomized controlled trials (RCT) show the effectiveness of MIO in promoting parental reflective functioning (PRF) and positive relational outcomes in parents with substance use disorders and their children. Suchman's MIO model has since been extended to parenting in many contexts. She is also remembered as a generous colleague, a gifted researcher and clinician, and an inspiration to generations of researchers and practitioners working with parents who aspire to raise healthy, secure children despite multiple challenges and adversities. This special issue compiles the work of researchers inspired by Suchman as they carry on her legacy in examining aspects of parental mentalization. Collectively, the research presented yields confirmation of MIO core assumptions, offers new insights into roles of positive sentiment and savoring in mentalization processes, and presents evaluations of MIO in multiple contexts and with new adaptations.     

Short‐term psychodynamic infant–parent interventions at Child health centers: Outcomes on parental depression and infant social–emotional functioning

Randomized controlled trials (RCTs) demonstrate efficacy of parent–infant psychotherapy, but its applicability and effectiveness in public health care are less known. The method followed is Naturalistic study evaluating Short‐term Psychodynamic Infant–Parent Interventions at Child Health Centers (SPIPIC) in Stockholm, Sweden. One hundred distressed mothers with infants were recruited by supervised nurses. Six therapists provided 4.3 therapy sessions on average (SD = 3.3). Sessions typically included the mothers, often with the baby present, while fathers rarely attended sessions. The Edinburgh Postnatal Depression Scale (EPDS) and the Ages and Stages Questionnaire: Social–Emotional (ASQ: SE) were distributed at baseline and at 3 and 9 months later. Data from a nonclinical group were collected simultaneously to provide norm data. Multilevel growth models on the mothers’ questionnaire scores showed significant decreases over time on both measures. Nine months after baseline, 50% achieved a reliable change on the EPDS and 14% on the ASQ: SE. Prepost effect‐sizes (d) were 0.70 and 0.40 for EPDS and ASQ: SE, figures that are comparable to results of other controlled studies. Psychotherapists integrated with public health care seem to achieve good results when supporting distressed mothers with brief interventions in the postnatal period. SPIPIC needs to be compared with other modalities and organizational frameworks.     

Cognitively-Based Compassion Training for parents reduces cortisol in infants and young children

This study tests a group-based secular contemplative practice intervention, Cognitively-Based Compassion Training (CBCT), with parents of young children. We report on a randomized controlled preliminary efficacy study. Certified teachers administered CBCT for 20 hr across 8 to 10 weeks in two cohorts of parents with infants and young children. The intervention group was compared to a waitlist control group. Thirty-nine parents and their children, who ranged in age from 4 months to 5 years, were evaluated at pre- and postintervention (n = 25 intervention, n = 14 waitlist control) on hair cortisol concentration. Parents also completed self-administered questionnaires at both time points regarding demographics, physical symptoms of stress, parenting stress, self-compassion, and mindfulness. Children of parents in the CBCT group experienced significant decreases in cortisol at the postintervention assessment, as compared with the control group. However, parent cortisol and self-report measures did not significantly change other than a small effect on clinical levels of parenting stress. CBCT may be a positive new way to intervene with parents to lower infants’ and young children's cumulative physiological stress.     

Translation and preliminary validation of a Korean version of the parental reflective functioning questionnaire

This study aimed to explore the factor structure, reliability, and validity of a Korean translation of the Parental Reflective Functioning Questionnaire (PRFQ). The PRFQ consists of three subscales: prementalizing modes, certainty about mental states, and interest and curiosity in mental states. A convenience sample of 163 Korean parents completed the K‐PRFQ. Exploratory factor analysis showed three factors mapped on to the original PRFQ factors, but items from the original prementalizing modes subscale clustered into two additional factors. Data from a subsample (n = 67) showed that the certainty about mental states and interest and curiosity in mental states subscales correlated positively with more optimal self‐reported parenting. We discuss the validity of using the PRFQ in collectivistic cultures.