EARLY HOME INTERVENTION TO IMPROVE MOTHERING OF PREMATURES

Abstract

Prematurity predisposes to mothering disorders expressed in poorer care of infants at risk for developmental disability. Most efforts have been focused on mothers prior to nursery discharge. To improve the quality of nurture after discharge, weekly home visits were made in the first half year by PHNs specially trained in therapeutic and supportive techniques for mothers. Close backup was provided by a team of pediatrician, psychologist and social worker. Specific aims were to enhance maternal: attachment bonds to infants (AB), independent coping with develonmental aberrations (IC) and collaboration with professional care. 53 intervention cases and 47 matched controls were assessed by video measures of home infant care (feeding, bathing, clothing and playing) following intervention at 6 mos. and again at 12. Intervention appeared to benefit mothers of high but not low socioeconomic status (SES). Thus, at both ages, higher SES was associated with higher AB scores (p<.005) in the intervention group but not in controls (p<.60). Regardless of SES, intervention benefited mothers of infants bom 2 or more mos. early (AB p<.10), especially when primiparous and beyond high school age (AB p<.02), (IC p<.10), but effects at 6 mos were not sustained at 12. In summary, the intervention did not benefit mothers of low SES and led to only transient benefits in mothers of very premature infants. Both are groups where infants are known to be at particular risk from later disability.