The Shared Pleasure Paradigm: A study in an observational birth cohort in South Africa

Anusha Lachman,Esme R Jordaan,Dan J Stein,Dana J H Niehaus,Kaija Puura,Nadia Hoffman,Kirsten A Donald,Marilyn T Lake,Heather J Zar,Micky Stern

doi:10.1007/s00737-021-01199-0

Abstract

Mother–infant dyads in low- and middle-income countries (LMICs) may be exposed to a range of factors associated with suboptimal development. Optimal infant development is likely supported by synchronicity in the early mother–infant relationship, but limited corroborative research is available in LMICs. The Drakenstein Child Health Study (DCHS) provided an opportunity to study this synchronicity and its associations in South Africa. A South African birth cohort study investigating early-life determinants of child health in a LMIC context provided participants. The Shared Pleasure (SP) paradigm helped assess early mother–infant synchronicity in videos of a sub-set of 291 mother–infant dyads at their 14-week well baby visit. General linear regression models investigated the relationship between selected maternal and infant characteristics and the presence of Shared Pleasure moments. Out of a possible 291 dyads, 82% (n = 239) yielded Shared Pleasure moments. The mean age of mothers was 27 years, while infant sex distribution comprised 54% females and 46% males. The shortest single Shared Pleasure moment lasted at least 0.5 s and the longest 28 s. Shared Pleasure moments were associated with higher gestation age at delivery (p = 0.008) and higher infant birth weight (p = 0.006), but were not related to mother's mental health and infant health outcomes at 14 weeks. The high frequency of positive Shared Pleasure moments in reciprocal dyadic interactions in this sample suggests that significant disruption in shared pleasure may be present only in extreme cases (e.g. mothers with severe mental disorders). Further work is needed to investigate the mechanisms underlying the associations between early mother–infant synchronicity and better outcomes noted here, and to assess whether SP may serve as a culturally appropriate screen for assessing connectedness.

Highlights

Mother–infant dyads in low- and middle-income countries (LMICs) may be exposed to a range of factors associated with suboptimal developmental outcomes
The current study aimed to explore the prevalence of shared pleasure moments in mother–infant dyads, to investigate associations of maternal and infact characteristics with the frequency and occurrence of shared pleasure
This study demonstrated 1) a high occurrence of positive interactional affectivity in a general population sample, 2) Shared Pleasure (SP) moments associated with higher age of gestation at delivery and infant birth weight, and 3) SP moments unrelated to maternal mental health or infant developmental outcomes in this cohort

Summary

Introduction

Mother–infant dyads in low- and middle-income countries (LMICs) may be exposed to a range of factors associated with suboptimal developmental outcomes. The early social environment fundamentally determines early child development and influences long-term child health outcomes (Maggi et al 2010; Richter et al 2020). Risk factors such as socio-economic stressors, poor social support and substance use, perinatal mental health disorders may impact and undermine mothers’ capacity to respond optimally to infants’ needs (WHO 2018). Adverse conditions like poverty inhibit parents’ capacity for providing security and assuring good developmental outcomes, especially for mothers vulnerable to mental health disorders (Patel et al 2008). Parent–infant relationships are key contributors to the socio-emotional development of growing children (Wachs et al 2009; Richter et al 2017)

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