The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome

The impact of maternal depression and adversity on mother-infant face-to-face interactions at 2 months, and on subsequent infant cognitive development and attachment, was examined in a low-risk sample of primiparous women and their infants. The severe disturbances in mother-infant engagement characteristic of depressed groups in disadvantaged populations were not evident in the context of postpartum mood disorder in the present study. However, compared to well women, depressed mothers were less sensitively attuned to their infants, and were less affirming and more negating of infant experience. Similar difficulties in maternal interactions were also evident in the context of social and personal adversity. Disturbances in early mother-infant interactions were found to be predictive of poorer infant cognitive outcome at 18 months. Infant attachment, by contrast, was not related to the quality of 2-month interactions, but was significantly associated with the occurrence of adversity, as well as postpartum depression.     

Contextual basis of maternal perceptions of infant temperament.

To elucidate the differential saliency of infant emotions to mothers across interactive contexts, the authors examined the moderating role of observed infant affect during interactions with mother in the relation between maternal and laboratory-based ratings of infant temperament. Fifty-nine developmentally healthy 9-month-old infants were judged for degree of infant positive, infant negative, and mother-infant mutually positive affect during the course of object-focused and routine home-based activities with mother. Mothers completed the Infant Behavior Questionnaire (M. K. Rothbart, 1981), and infants underwent the Laboratory Temperament Assessment Battery (H. H. Goldsmith & M. K. Rothbart, 1999). Results revealed that maternal and observer ratings of infant negativity converged when infants manifested high degrees of negative affect during routine home-based activities. Maternal and observer ratings of infant positivity converged when infants experienced low mutually positive affect during play. These findings support the hypothesis that maternal perceptions are based on mothers' experiences with their infants but that the salience of infant temperamental characteristics to mothers varies across emotion and interactive context. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal adjustment and infant outcome in medically defined high-risk pregnancy.

Biological and psychosocial risk factors in high-risk pregnancy and their relation to infant developmental outcomes were explored in a sample of 153 pregnant Israeli women who had pregestational diabetes melfitus, gestational diabetes mellitus, or were nondiabetic. Questionnaires on coping and resources as well as well-being and distress during the 2nd trimester were administered. Estimates of maternal fuels (HbAlc and fructosamine) were obtained throughout pregnancy. At 1 year, offspring were administered the Bayley Scales of Infant Development and mother-infant interactions were observed. Infants of mothers in the diabetic groups scored lower on the Bayley Scales and revealed fewer positive and more negative behaviors than did infants of mothers in the nondiabetic group. Infant outcomes in the maternal diabetic groups were associated with maternal metabolism. Maternal coping and resources differed in the 3 groups and differentially predicted infant development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal directiveness and infant compliance at one year of age: a comparison between mothers and their developmentally-delayed infants and mothers and their nondelayed infants

Maternal directiveness and infant compliance at one year of age were observed in social interactions between mothers and their handicapped and nonhandicapped infants. Eleven nondelayed, typically developing infants, and nine developmentally delayed infants, matched for chronological age, were observed in a free play situation with their mothers. Mothers of the delayed infants attempted to direct their children's play significantly more than those with nondelayed infants, and they engaged more frequently in social play involving physical contact with their infants. Nondelayed infants complied with their mothers' directives more than the developmentally delayed infants. Further study of infant capabilities and maternal affect and behaviors with this age group is suggested.     

Infant affect and affect regulation during the still-face paradigm with mothers and fathers: the role of infant characteristics and parental sensitivity

This laboratory study examined mothers' and fathers' sensitivity during face-to-face interactions with their infants as well as infants' affective and regulatory responses during mother-infant versus father-infant still face (SF). The degree to which infant gender and temperament as well as parental sensitivity predicted SF responses was also examined. Participants included 94 healthy, primarily White, middle-class 4-month-olds and their parents. Results indicated that mothers and fathers were equally sensitive toward their infants. Infants' affect and regulatory behaviors were also significantly stable across mother- and father-infant SF situations, although several differences in mean levels of regulation emerged. Finally, the extent to which exogenous and endogenous variables predicted infant SF responses differed as a function of which affect or regulatory variable was being examined and with which parent the infant was experiencing SF.     

Infant day care and infant-care leaves: A policy vacuum.

Current US policy supports neither high-quality infant daycare nor alternatives, such as paid leaves for infant care. Psychologists, on the basis of research showing the importance of quality care for infants, should support measures to protect daycare quality and to help families afford decent care. At the same time, there are compelling child and family health reasons for psychologists to support voluntary, part-paid, 6-mo leaves for infant care. For 4 wks preceding and 6 wks following childbirth, working mothers should be eligible for a fully paid maternity leave. The remainder of the leave would be made available on a part-paid basis to either parent in any combination they chose to facilitate the parent–infant relationship. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual model for maternal behavior among polydrug cocaine-using mothers: The role of postnatal cocaine use and maternal depression.

This study examined the association between maternal cocaine use and maternal behavior and tested a conceptual model predicting maternal insensitivity during mother-infant interactions. Participants included 130 mother-infant dyads (68 cocaine-exposed and 62 noncocaine-exposed) who were recruited after birth and assessed at 4-8 weeks of infant age. Results of model testing indicated that when the effects of prenatal cocaine use were examined in the context of polydrug use, maternal psychopathology, maternal childhood history, and infant birth weight, only postnatal cocaine use and maternal depression/anxiety were unique predictors of maternal insensitivity during mother-infant interactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal attachment representations, maternal sensitivity, and the infant–mother attachment relationship.

The role of maternal sensitivity as a mediator accounting for the robust association between maternal attachment representations and the quality of the infant-mother attachment relationship was examined. Sixty mother-infant dyads were observed at home and in the Strange Situation at 13 months, and mothers participated in the Adult Attachment Interview (AAI) within the next 6 months. A strong association was found between AAI and Strange Situation classifications. and autonomous mothers were more sensitive at home than were nonautonomous mothers. Mothers in secure relationships were more sensitive at home than mothers in nonsecure relationships. Likewise, infants in secure relationships were more secure as assessed by the Waters' Attachment Q sort than infants in nonsecure relationships. A test of the mediational model revealed that maternal sensitivity accounted for 17% of the relation between AAI and Strange Situation classifications. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternity leave, women's employment, and marital incompatibility.

This research investigated the relationship between the length of women's maternity leave and marital incompatibility, in the context of other variables including the woman's employment, her dissatisfaction with the division of household labor, and her sense of role overload. Length of leave, work hours, and family salience were associated with several forms of dissatisfaction, which in turn predicted role overload. Role overload predicted increased marital incompatibility for experienced mothers but did not for first-time mothers, for whom discrepancies between preferred and actual child care were more important. Length of maternity leave showed significant interactions with other variables, supporting the hypothesis that a short leave is a risk factor that, when combined with another risk factor, contributes to personal and marital distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationships between neonatal characteristics and mother-infant interaction.

Studied 51 mothers and their newborn infants to evaluate the relationship between neonatal style and the early mother-infant relationship. The procedure included an infant assessment with the Brazelton Neonatal Behavioral Assessment Scale, a mother-infant interaction observation during feeding, and an interview concerning maternal attitudes and perceptions. Findings suggest that there are consistencies in infant state and behavioral measures across situations: e.g., the infant who was alert and responded to auditory cues during the Brazelton assessment looked at the mother a great deal during the feeding observation. Data also suggested consistent and interactive relationships between patterns of maternal stimulation and infant behavior in corresponding areas: e.g., the attentive sensitive mother tended to have a responsive baby and vice versa. Findings provide additional information about the early development of the complex relationship between children and parents. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Parents' emotional availability and infant emotional competence: Predictors of parent-infant attachment and emerging self-regulation.

One-year-old infants (N=62) and their mothers and fathers were observed in free play and teaching sessions in order to examine parents' emotional availability and the infant's emotional competence. Mothers were more emotionally available than fathers, and infants exhibited more effortful attention with mothers than with fathers. Similar relations between parental emotional availability and infant emotional competence were found for mother-infant and father-infant dyads. Change in parental emotional availability covaried with change in infant emotional competence. Individual differences in parental emotional availability and Infant emotional competence were more consistent across contexts than across parents. Infant effortful attention at 12 months was a mediator between maternal emotional availability at 12 months and toddler situational compliance at 16 months. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Another Look Inside the Gap: Ecological Contributions to the Transmission of Attachment in a Sample of Adolescent Mother-Infant Dyads.

Ecological contributions to attachment transmission were studied in a sample of 64 adolescent mother-infant dyads. Maternal sensitivity was assessed when infants were 6 and 10 months old, and infant security was assessed at 15 and 18 months. Maternal attachment state of mind was measured with the Adult Attachment Interview (AAI) after the 1st assessment. Ecological variables considered were maternal education and depression, paternal support, and infant maternal grandmother support. Results indicated that when the contribution of ecological variables was statistically controlled for, sensitivity was a significant mediator and state of mind no longer contributed to infant security. Sensitivity also mediated an association between maternal education and infant attachment, suggesting that attachment transmission is embedded in a more global process of infant attachment development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unresolved states of mind, disorganized attachment relationships, and disrupted interactions of adolescent mothers and their infants.

The links between unresolved maternal attachment status, disrupted maternal interaction in play situations, and disorganized attachment relationships were examined in a study of 82 adolescent mother-infant dyads. Maternal interactive behavior was measured using the Atypical Maternal Behavior Instrument for Assessment and Classification coding system. Additional rating scales were developed to correspond to the 5 dimensions of disrupted maternal behavior outlined by E. Bronfman, E. Parsons, and K. Lyons-Ruth (1999). A robust association was observed between disrupted maternal behavior and disorganized attachment. Ratings of disrupted maternal behavior revealed that disorganized attachment relationships were strongly related to ratings of fearful/disoriented behavior. Moreover, mothers who were unresolved were more likely than not-unresolved mothers to show disrupted patterns of interaction with their infants. Regression analyses suggested that disrupted behavior statistically mediated the association between unresolved status and disorganized attachment relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social network relationships as sources of maternal support and well-being.

Explored the social networks available to mothers of infants, focusing on the contribution of specific relationships to maternal well-being. 43 mothers (aged 21–39 yrs) of 13-mo-old infants were asked to position individuals who were close to them in a network diagram and to indicate which of those individuals provided support. The mother's relationship with her husband and with the infant's maternal grandparents, mother's well-being in terms of affect and life satisfaction, and infant temperamental difficulty and infant–mother attachment security were assessed. Results reveal that mothers reported an average of 13 persons in their networks, but support was provided primarily by the husband, followed by the infant's maternal grandmother (particularly when there was more than 1 child), and 1 or 2 other family members and friends. Maternal affect and life satisfaction were related to infant difficulty and to support from and satisfaction with the spouse. Negative maternal affect was related to anxious/resistant attachment. Results affirm the importance of spousal support for mothers of infants in intact families. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sleeping position, orientation, and proximity in bedsharing infants and mothers

The impact of mother-infant bedsharing on infant sleeping position, orientation, and proximity to the mother was assessed in 12 breast-feeding Latino mother-infant pairs. Six routinely bedsharing and six routinely solitary-sleeping pairs slept 3 nights in the sleep laboratory. The first night matched the routine home condition, followed by 1 bedsharing night and 1 solitary-sleeping night in random order. During bedsharing infants were never placed prone, regardless of their routine sleeping condition. On the bedsharing night, mothers and infants spent most of the night oriented toward each other; seven of 12 infants remained oriented toward their mothers the entire night. While sleeping in a face-to-face orientation, most pairs slept most of the time less than 30 cm apart with appreciable amounts of time at less than 20 cm. This orientation and proximity should facilitate sensory exchanges between mother and infant which, we hypothesize, influence the infant's sleep physiology and nocturnal behavior. We conclude that bedsharing minimizes the use of the prone infant sleeping position, probably in part to facilitate breast feeding. By promoting nonprone positions, bedsharing may protect some infants from sudden infant death syndrome (SIDS), since prone sleeping is a known risk factor for SIDS. The large percentage of the night that mothers spent oriented toward their infants suggests that a higher degree of maternal vigilance may also result from bedsharing.     

Skin-to-skin contact (kangaroo care) promotes self-regulation in premature infants: Sleep-wake cyclicity, arousal modulation, and sustained exploration.

The effect of mother-infant skin-to-skin contact (kangaroo care, or KC) on self-regulatory processes of premature infants was studied. Seventy-three infants who received KC were compared with 73 infants matched for birth weight, gestational age, medical risk, and family demographics. State organization was measured in 10-s epochs over 4 hr before KC and again at term. No differences between KC infants and controls were found before KC. At term, KC infants showed more mature state distribution and more organized sleep-wake cyclicity. At 3 months, KC infants had higher thresholds to negative emotionality and more efficient arousal modulation while attending to increasingly complex stimuli. At 6 months, longer duration of and shorter latencies to mother-infant shared attention and infant sustained exploration in a toy session were found for KC infants. The results underscore the importance of maternal body contact for infants' physiological, emotional, and cognitive regulatory capacities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Persistent crying in early infancy: a non-trivial condition of risk for the developing mother-infant relationship

Infants between 1 and 6 months of age (mean age 3.6 months) who were referred to the Munich Interdisciplinary Research and Intervention Programme because of persistent crying and their mothers were examined and compared with an age-matched community-based control sample with no current cry problem. Three groups, referred extreme criers, referred moderate criers, and controls, were compared with regard to measures of psychosocial and organic risks, the mothers' perception of her own psychological state and infant temperament, the quality of mother-infant relationship, and intuitive parenting in mother-infant face-to-face interactions. In comparison with general-community samples of infants with persistent crying, the present clinical sample represents a biased group with particularly high levels of infant distress for long periods of time, with problems of sleep-wake organization, neuromotor immaturity, and difficult temperament. Moreover, extreme crying was associated with a cumulation of organic and psychosocial risks, including high rates of prenatal stress and anxiety, maternal psychopathology and partnership conflicts. Mothers in both referred groups scored similarly low on feelings of self-efficacy, and high on depression, anxiety, exhaustion, anger, adverse childhood memories, and marital distress. Mother-infant relationships were more often distressed or disturbed among referred dyads than among controls, and 40% as compared with 19% showed dysregulatory patterns of interactional failures in face-to-face contexts. The findings suggest that factors related to parental care did not cause persistent crying, but functioned as maintaining or exacerbating factors. Dynamic interactions between persistent crying, difficult temperament, and parenting factors which compromise maternal resources and intuitive parenting may put such families at long-term risk for both relationship and behaviour problems.     

Links between maternal care and persistent infant crying in the early months

A community sample was screened to select three groups of infants and their mothers according to how much the babies cried at 6 weeks of age, the peak age for infant crying. The three groups--of moderate (n = 55), evening (n = 38) and persistent criers (n = 67) and their mothers--were assessed by diary, observation and questionnaire measures of mother and infant characteristics and interactions at 6 weeks and 5 months of infant age. At 6 weeks, mothers of persistent criers spent more time interacting with and physically stimulating their babies. Below-optimum maternal sensitivity/affection was linked to moderately increased crying in the infants overall. However, most mothers of persistent criers showed optimum sensitivity and affection, while no significant links between maternal sensitivity/affection and infant crying were found in the persistent crying group. By 5 months, when infant crying declined, the range and size of differences between mothers of persistent criers and other mothers declined. Home observations and a standard play measure failed to show group differences in maternal sensitivity, affection and intrusiveness at this age. The findings show that persistent infant crying in the early months often occurs in spite of high quality maternal care, so that in most cases the crying is probably not due to inadequate parenting. The need to distinguish general community cases from those at social or medical risk is emphasized and the findings' implications for professionals are discussed.     

The Mother-Infant Relationship in Single, Cohabiting, and Married Families: A Case for Marriage?

Single-mother, cohabiting 2-parent, and married 2-parent families with infants were compared on maternal and infant behavior, Home Observation for Measurement of the Environment (HOME) scores, and infant's security of attachment. Married mothers and their infants demonstrated more positive behavior and received higher HOME scores when the infant was 6 and 15 months old than did their cohabiting and single counterparts. Married families were also better off than single and cohabiting families on several demographic, parent personality, financial, and social context measures. Single and cohabiting families were similar across most measures. Selection variables (maternal age, ethnic group, and education) explained much, but not all, of the family structure differences in the mother-infant relationship and the HOME. Maternal psychological adjustment, attitudes about child rearing, income, and social support explained little of the family structure variation, suggesting that characteristics that preceded marriage and conception were important determinants of family structure differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)