Infant Behavior Research Articles

Associations between a metal mixture and infant negative affectivity: Effect modification by prenatal cortisol and infant sex.

In-utero exposures interact in complex ways that influence neurodevelopment. Animal research demonstrates that fetal sex moderates the impact of joint exposure to metals and prenatal stress measures, including cortisol, on offspring socioemotional outcomes. Further research is needed in humans. We evaluated the joint association of prenatal exposures to a metal mixture and cortisol with infant negative affectivity, considering sex differences. Analyses included 226 (29% White, Non-Hispanic) mother-infant pairs with data on exposures and negative affectivity assessed using the Infant Behavior Questionnaire-Revised in 6-month-olds. Results showed that girls whose mothers had higher cortisol had significantly higher scores of Fear and Sadness with greater exposure to the mixture. Examining higher-order interactions may better elucidate the effects of prenatal exposure to metals and cortisol on socioemotional functioning.

Consensus Panel Recommendations for the Pharmacological Management of Pregnant Women with Depressive Disorders.

The initiative of a consensus on the topic of antidepressant and anxiolytic drug use in pregnancy is developing in an area of clinical uncertainty. Although many studies have been published in recent years, there is still a paucity of authoritative evidence-based indications useful for guiding the prescription of these drugs during pregnancy, and the data from the literature are complex and require expert judgment to draw clear conclusions. For the elaboration of the consensus, we have involved the scientific societies of the sector, namely, the Italian Society of Toxicology, the Italian Society of Neuropsychopharmacology, the Italian Society of Psychiatry, the Italian Society of Obstetrics and Gynecology, the Italian Society of Drug Addiction and the Italian Society of Addiction Pathology. An interdisciplinary team of experts from different medical specialties (toxicologists, pharmacologists, psychiatrists, gynecologists, neonatologists) was first established to identify the needs underlying the consensus. The team, in its definitive structure, includes all the representatives of the aforementioned scientific societies; the task of the team was the evaluation of the most accredited international literature as well as using the methodology of the "Nominal Group Technique" with the help of a systematic review of the literature and with various discussion meetings, to arrive at the drafting and final approval of the document. The following five areas of investigation were identified: (1) The importance of management of anxiety and depressive disorders in pregnancy, identifying the risks associated with untreated maternal depression in pregnancy. (2) The assessment of the overall risk of malformations with the antidepressant and anxiolytic drugs used in pregnancy. (3) The evaluation of neonatal adaptation disorders in the offspring of pregnant antidepressant/anxiolytic-treated women. (4) The long-term outcome of infants' cognitive development or behavior after in utero exposure to antidepressant/anxiolytic medicines. (5) The evaluation of pharmacological treatment of opioid-abusing pregnant women with depressive disorders. Considering the state of the art, it is therefore necessary in the first instance to frame the issue of pharmacological choices in pregnant women who need treatment with antidepressant and anxiolytic drugs on the basis of data currently available in the literature. Particular attention must be paid to the evaluation of the risk/benefit ratio, understood both in terms of therapeutic benefit with respect to the potential risks of the treatment on the pregnancy and on the fetal outcome, and of the comparative risk between the treatment and the absence of treatment; in the choice prescription, the specialist needs to be aware of both the potential risks of pharmacological treatment and the equally important risks of an untreated or undertreated disorder.

Babies, bugs and brains: How the early microbiome associates with infant brain and behavior development.

Growing evidence is demonstrating the connection between the microbiota gut-brain axis and neurodevelopment. Microbiota colonization occurs before the maturation of many neural systems and is linked to brain health. Because of this it has been hypothesized that the early microbiome interactions along the gut-brain axis evolved to promote advanced cognitive functions and behaviors. Here, we performed a pilot study with a multidisciplinary approach to test if the microbiota composition of infants is associated with measures of early cognitive development, in particular neural rhythm tracking; language (forward speech) versus non-language (backwards speech) discrimination; and social joint attention. Fecal samples were collected from 56 infants between four and six months of age and sequenced by shotgun metagenomic sequencing. Of these, 44 performed the behavioral Point and Gaze test to measure joint attention. Infants were tested on either language discrimination using functional near-infrared spectroscopy (fNIRS; 25 infants had usable data) or neural rhythm tracking using electroencephalogram (EEG; 15 had usable data). Infants who succeeded at the Point and Gaze test tended to have increased Actinobacteria and reduced Firmicutes at the phylum level; and an increase in Bifidobacterium and Eggerthella along with a reduction in Hungatella and Streptococcus at the genus level. Measurements of neural rhythm tracking associated negatively to the abundance of Bifidobacterium and positively to the abundance of Clostridium and Enterococcus for the bacterial abundances, and associated positively to metabolic pathways that can influence neurodevelopment, including branched chain amino acid biosynthesis and pentose phosphate pathways. No associations were found for the fNIRS language discrimination measurements. Although the tests were underpowered due to the small pilot sample sizes, potential associations were identified between the microbiome and measurements of early cognitive development that are worth exploring further.

Early social referencing predicts object mastery motivation in infancy: Social antecedents of object mastery motivation.

The researchers sought to understand the typical development of social referencing and object mastery motivation in infancy and to determine the relationship between social referencing and object mastery behaviors in infants from 7 to 22months of age. The study included 36 infants who were followed as part of a longitudinal study of at-risk infants but were not determined to need care in the neonatal intesive care unit at birth. Both mastery behaviors of persistence and success showed a statistically significant effect of age, while social behaviors remained stable from 7 to 22months. Social behaviors at 7 and 10months were correlated with persistence at 22months and success at 16 to 22months demonstrating that early social referencing predicts object mastery behaviors in later infancy. Further research should determine if this trend extends to early childhood.

The impact of thawing duration on leptin and adiponectin levels in frozen human milk samples.

Measurements of hormone concentrations in human milk from understudied populations across the world is of growing scientific interest. Due to limited access to suitable laboratory facilities at many research sites, human milk samples are often shipped frozen to distant laboratories for analysis. Shipping and handling exposes samples to the risk of thawing and degradation as the results of delays, mishandling, or other unforeseen circumstances. Similar degradation risk factors are well known in serum samples. However, the vulnerability of hormone degradation in human milk to thawing during transportation is largely unexplored. Leptin and adiponectin are of particular importance due to their roles in feeding behavior and metabolism in infants, hence our focus on these two hormones. In addition, leptin and adiponectin have been shown to be vulnerable to pasteurization temperature degradation in human milk samples. We tested the degradation of human milk metabolic hormones - leptin and adiponectin - in a controlled environment in response to a variety of freeze/thaw conditions that are reflective of potential temperature fluctuations during transportation. Human milk samples were experimentally subjected to thaw durations ranging from 4 to 16 h and assayed for hormonal levels to observe changes from baseline. Samples were also subjected to two additional experimental conditions, re-freezing after an extended period outside freezers or remaining thawed with additional ice packs, to investigate the impact of common transportation conditions. We found the assayed levels of leptin were not significantly impacted by an extended thaw cycle of 16 h. However, leptin levels were impacted by the extended period of 40 h outside of the freezer. Adiponectin showed a decrease in concentration percentage after the initial 16-h thaw period, but the increased degradation between 0-16 h and 16-40 h was not as severe as that seen in the leptin samples. The results of this experiment can be used to inform hormone measurement consistency given different thawing lengths or freezing conditions during transportation. Additionally, this research informs decisions regarding transportation, storage/handling, and data analysis in human milk research.

Preterm-birth alters the development of nodal clustering and neural connection pattern in brain structural network at term-equivalent age.

Preterm-born neonates are prone to impaired neurodevelopment that may be associated with disrupted whole-brain structural connectivity. The present study aimed to investigate the longitudinal developmental pattern of the structural network from preterm birth to term-equivalent age (TEA), and identify how prematurity influences the network topological organization and properties of local brain regions. Multi-shell diffusion-weighted MRI of 28 preterm-born scanned a short time after birth (PB-AB) and at TEA (PB-TEA), and 28 matched term-born (TB) neonates in the Developing Human Connectome Project (dHCP) were used to construct structural networks through constrained spherical deconvolution tractography. Structural network development from preterm birth to TEA showed reduced shortest path length, clustering coefficient, and modularity, and more "connector" hubs linking disparate communities. Furthermore, compared with TB newborns, premature birth significantly altered the nodal properties (i.e., clustering coefficient, within-module degree, and participation coefficient) in the limbic/paralimbic, default-mode, and subcortical systems but not global topology at TEA, and we were able to distinguish the PB from TB neonates at TEA based on the nodal properties with 96.43% accuracy. Our findings demonstrated a topological reorganization of the structural network occurs during the perinatal period that may prioritize the optimization of global network organization to form a more efficient architecture; and local topology was more vulnerable to premature birth-related factors than global organization of the structural network, which may underlie the impaired cognition and behavior in PB infants.

Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial

BackgroundSubstantial evidence indicates that maternal depression during pregnancy (i.e., antenatal depression) is associated not only with maternal wellbeing but also with child emotional and behavioural development. Children of antenatally depressed women are at risk of emotional and behavioural problems, including internalising problems (e.g., anxiety and depression) and externalising problems (e.g., attention problems), that may last at least to adolescence. These enduring effects also constitute an enormous economic cost. Despite the seriousness of this problem, until recently there existed very few controlled studies evaluating whether active psychological treatment for antenatal depression can prevent adverse child outcomes. Our previous pilot randomised controlled trial (RCT) exploring the effect of cognitive behavioural therapy (CBT) for antenatal depression on child outcomes showed promising results. We aim to assess whether treating antenatal depression with an evidence-based 8-week structured CBT program can prevent or ameliorate adverse child developmental outcomes at 2 years of age.MethodsPregnant women ≤ 30 weeks gestation diagnosed with a depressive disorder are recruited and randomised to CBT or treatment as usual (TAU). The target sample size is 230 and the primary outcome measure is the infant Internalising scale of the Child Behaviour Checklist (CBCL) at 24 months of age. Secondary infant outcome measures at 24 months are the Externalising scale of the CBCL and the motor and cognitive development subscales of the Ages & Stages Questionnaire (ASQ-3). Additional secondary outcome measures are subscales of the Revised Infant Behaviour Questionnaire (IBQ-R), ASQ-3 and the ASQ-Socio-Emotional (ASQ-SE) at 3 and 12 months of age and the quality of mother-infant interaction at 3 and 24 months. Maternal measures, including demographic data, depression diagnosis, depressive and anxiety symptoms, perceived stress and parenting stress, are collected across all time points.DiscussionThe trial is ongoing and recruitment was slowed due to the COVID-19 pandemic. If results suggest a beneficial effect of antenatal depression treatment on infant outcomes, the project could have repercussions for standard antenatal care, for maternal and infant health services and for preventing the intergenerational transmission of mental health disorders.Trial registrationAustralia and New Zealand Clinical Trials Register: ACTRN12618001925235 Date Registered: 27 November 2018.

New perspectives on responsive infant care: A qualitative study of the ways in which Neuroprotective Developmental Care (NDC) shapes mother-infant co-occupations

ABSTRACT Background Becoming a parent is a significant occupational transition. Many contemporary approaches to infant care focus on algorithmic schedules and rigid routines for sleep and feeding; delayed responses to cues related to feeding, sleep, and cry-fuss communication; minimising sensory stimulation for feeding, sleep, and to address cry-fuss communication; and sometimes highly medicalized approaches to unsettled infant behaviour via lenses of reflux, allergy, and tongue-tie, often without a supportive evidence-base or adequate assessment. Such interventions are at odds with a co-occupation perspective. Neuroprotective Developmental Care (NDC) provides information and guidance to support evidence-based infant care that supports caregivers to respond to their infant’s communication cues. This research aimed to explore how day-to-day co-occupations of parents and infants are shaped by accessing NDC. Methods This qualitative thematic analysis was guided by interpretive description. Twelve mothers who had accessed NDC with their infant in Australia participated in semi-structured telephone/Zoom video interviews. Findings Flexibility across the days was identified as the overarching theme regarding mother-infant co-occupations within the data. Three sub-themes describe how mothers changed the ways they put together their daily occupations with their babies in relation to 1) sleep, 2) feeding, and 3) calming through sensory nourishment. Conclusion This research offers novel insights into responsive care from the perspective of the ways in which mothers flexibly orchestrate their days so that they can respond to their infants’ communication throughout the days. Mothers’ responses offered insights regarding an occupational approach to responsive infant care which warrants further research.

The effects of Yakson touch and gentle human touch on preterm infants: A systematic review and meta-analysis.

We aim to collect the evidence of efficacy of Gentle Guman Touch (GHT) and Yakson Touch in preterm neonates as pain relief, heart rate, oxygen saturation, and urine cortisol level. We made our search through PubMed, Web of Science, Scopus, and Cochrane by the mid of March 2023. Randomized control trials (RCTs) were included, and the Cochrane risk of bias tool was utilized to assess their quality. Using Review Manager software, a meta-analysis was conducted. We computed the mean difference (MD) with a 95% confidence interval (CI) for the continuous data. During the examination, the Neonatal Infant Pain Scale (NIPS) was significantly reduced in the touch group compared to the control group (MD = -3.40, 95% CI [-4.15 to -2.64], P-value= 0.00001). After the examination, the NIPS score was also reduced by both Yakson touch and GHT compared to the control (MD = -2.14, 95% CI [-3.42 to -0.85], P-value <0.00001). Yakson touch and GHT are non-pharmacological, easy, and safe methods that can be used for painful interventions to reduce the pain experience of preterm infants from variable interventions. Both methods improved infant sleep and behavior. Preterm infants' heart rates and oxygen saturation were unaffected by Yakson touch or GHT.

Maternal perceived stress and infant behavior during the COVID-19 pandemic

BackgroundMaternal stress has negative consequences on infant behavioral development, and COVID-19 presented uniquely stressful situations to mothers of infants born during the pandemic. We hypothesized that mothers with higher levels of perceived stress during the pandemic would report higher levels of infant regulatory problems including crying and interrupted sleep patterns.MethodsAs part 6 sites of a longitudinal study, mothers of infants born during the pandemic completed the Perceived Stress Scale, the Brief Infant Sleep Questionnaire, and an Infant Crying survey at 6 (n = 433) and 12 (n = 344) months of infant age.ResultsMaternal perceived stress, which remained consistent at 6 and 12 months of infant age, was significantly positively correlated with time taken to settle infants. Although maternal perceived stress was not correlated with uninterrupted sleep length, time taken to put the infant to sleep was correlated. Perceived stress was also correlated with the amount of infant crying and fussiness reported at 6 months.ConclusionsMothers who reported higher levels of perceived stress during the pandemic reported higher levels of regulatory problems, specifically at 6 months. Examining how varying levels of maternal stress and infant behaviors relate to overall infant developmental status over time is an important next step.ImpactWomen giving birth during the COVID-19 pandemic who reported higher levels of stress on the Perceived Stress Scale also reported higher levels of infant fussiness and crying at 6 months old, and more disruptive sleep patterns in their infants at 6 months and 12 months old. Sleeping problems and excessive crying in infancy are two regulatory problems that are known risk factors for emotional and behavioral issues in later childhood. This paper is one of the first studies highlighting the associations between maternal stress and infant behaviors during the COVID-19 pandemic.

Feeding behaviours in infancy of children later diagnosed with autism spectrum disorder

Background: Autism spectrum disorder, the fastest growing childhood neurodevelopmental diagnosis, shows good outcomes with early intervention. The search for behavioral early markers is an important area of research. Studies of breastfeeding and weaning behaviours in autism have reported characteristic patterns which could be early indicators of this condition. Methods: The study was a cross sectional survey of breastfeeding and weaning patterns during the first year of life in 50 children aged 15 months to 5 years, including 25 with ASD and 25 Neurotypical children. A semi-structured interview schedule and the brief assessment of mealtime behavior in children scale was used to elicit feeding history from their mothers. Data was analysed using descriptive statistics and tests of significance. Results: There were significant differences in the patterns of early feeding of children with ASD, compared to the NT children. 64% ASD children showed dysregulated vigorous sucking during breastfeeding, without knowing when to stop. 52% of them breast fed for more than 40 minutes per feed. 68% continued to breastfeed beyond the age of 2 years. A significant proportion of ASD children also showed weaning difficulties such as limited variety (40%), food refusal (36%) and disruptive mealtime behaviour (32%). Conclusions: Children with ASD show significantly more challenging breastfeeding and weaning behaviours in infancy, compared to NT children. These patterns could be identified by parents and health workers in early child development as possible early signs of ASD and prompt referral for further diagnostic evaluation.

Mother-blaming revisited: Gender, cinematography, and infant research in the heyday of psychoanalysis.

This article examines cinematographic observational studies of infants conducted by a loosely connected group of female psychologists and physicians in the USA from the 1930s to the 1960s. Largely forgotten today, these practitioners realized detailed and carefully planned research projects about infant behavior in a variety of settings-from the laboratory to the well-baby clinic. Although their studies were in conversation with better-known works, such as John Bowlby's research on attachment and René Spitz's films on institutionalized infants, they differed in a close examination of individual characteristics of babies and a critical attitude toward contemporary notions of 'pathological mothering'. In closely following the work of several researchers, including but not limited to pediatrician Margaret Fries (1898-1987), the clinical psychologist Sibylle Escalona (1915-96) and her team members-child psychiatrist Mary Leitch (1914-?) and avant-garde photographer Ellen Auerbach (1906-2004)-and psychologist Anneliese Korner (1918-2010), I argue that their cinematographic works shed a more nuanced light on the landscape of infant research and child psychiatry in the mid 20th century, and open a way for alternative readings of gender, psychoanalysis, and scientific observation at that time.

Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy

Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.

Rehabilitation using neurodevelopmental and sensory integration therapy approaches in an 8-month-old infant with self-gratification behavior: A case report

Self-gratification behavior is a normal behavior in infants or children and is usually misdiagnosed with dystonic development delays, repeated movement disorders, or even epilepsy. This case report aims to share our clinical experience in managing a child with self-gratification disorder through physical therapy techniques. An 8-month-old female infant presents with concerns related to poor social interaction, reduced play, irritable behavior, frequent crossing, and stiffness in the legs which she started showing at 3 months of age. She was earlier diagnosed with dystonic developmental delay and referred for a thorough development and sensory assessment. Rehabilitation with sensory integration and neurodevelopmental techniques was delivered to the child. Ages and Stages Questionnaire, Denver’s score, and Sensory profile were assessed at 8–9 months, 9–10 months, and 10–11 months to monitor prognosis. There was a significant improvement in self-gratification habits and improved attention in the child. Self-gratification behavior is a normal behavior in infants or children and is usually misdiagnosed. Treatment mainly constitutes neurodevelopment, sensory integration techniques, and parent education.

'She was hungry'-Croatian mothers' reasons for supplementing their healthy, term babies with formula during the birth hospitalisation.

To explore why Croatian mothers request formula for their healthy, term newborn infants during the postnatal hospital stay. Four focus groups discussions were conducted with a total of 25 women who gave birth to healthy newborn infants, between May and June 2021 in Split, Croatia. A homogenous, non-random purposive sampling technique was used. The semi-structured interview schedule contained 15 open-ended questions. Reflexive thematic analysis was applied. Three themes were generated. The first theme fear of hunger referred to the mothers' fears arising from difficulties in interpreting newborn infant behaviour and finding solace in giving formula. The second theme too little support-too late reflected participants' unrealised expectations of hospital staff. The third theme non-supportive communication addressed mother's need for empathy during the postpartum hospital stay. Croatian mothers want to breastfeed, but often feel unsupported in doing so in the maternity hospital setting. Antenatal education of expectant mothers and training of maternity staff in breastfeeding counselling, with a strong emphasis on communication skills, as well as employment of International Board Certified Lactation Consultants and/or volunteer breastfeeding counsellors, were perceived by participants as a way to decrease mothers' requests for formula for their healthy, newborn infants.

Postpartum Depression and Maternal Care: Exploring the Complex Effects on Mothers and Infants.

Postpartum depression (PPD) is a common and debilitating mental health condition affecting many mothers worldwide. This review article aims to explore the complex effects of PPD on mothers and infants, focusing on maternal care. The transition to motherhood is a critical period characterized by numerous physical, psychological, and social changes, making women vulnerable to the onset of PPD. Consequently, PPD can significantly impact a mother's ability to provide optimal care for her infant, leading to potential adverse consequences for both parties. The article synthesizes existing research literature on the topic, encompassing studies from various disciplines, including psychology, psychiatry, obstetrics, and pediatrics. It begins by providing an overview of the prevalence and risk factors associated with PPD, emphasizing the importance of early detection and intervention. The impact of PPD on maternal caregiving behaviors, such as bonding, sensitivity, and responsiveness, is then examined, highlighting the potential disruptions in the mother-infant relationship. Furthermore, the article delves into the potential consequences of impaired maternal care on infant development, including emotional, cognitive, and social domains. Several factors contributing to the complex interplay between PPD and maternal care are discussed, including hormonal changes, psychosocial stressors, and the influence of social support networks. The review also addresses the bidirectional nature of the mother-infant relationship, whereby infant characteristics and behaviors can exacerbate or mitigate the effects of PPD on maternal care. Moreover, the article explores the role of healthcare providers and the importance of implementing effective screening, assessment, and treatment strategies for PPD to promote optimal maternal-infant outcomes. By consolidating current knowledge on the topic, this review article provides valuable insights into the multifaceted effects of PPD on both mothers and infants. Recognizing the significance of maternal care and understanding the mechanisms through which PPD disrupts it can inform the development of targeted interventions to promote early detection, effective treatment, and supportive interventions for mothers experiencing PPD. Ultimately, improving maternal mental health and enhancing maternal-infant relationships can yield long-term positive effects on mothers' and infants' well-being and development.

The Evidence-Base for Psychodynamic Interventions with Children Under 5 Years of Age and Their Caregivers: A Systematic Review and Meta-Analysis

ABSTRACT Experiences in the first years of life can shape a range of outcomes throughout the lifespan. Effective early interventions have the potential to offset negative outcomes associated with early adversity. A broad range of psychodynamic interventions are available to children under five and their caregivers but there is a lack of research synthesizing the current evidence for their effectiveness. This paper presents a systematic review and meta-analysis of the evidence for the effectiveness of psychodynamic interventions for children under 5 years of age and their caregivers. Following a systematic search of 10 databases and screening for eligibility, 77 papers were included in the review. Most studies reported positive outcomes on a range of parent and infant domains. The meta-analyses of controlled studies found significant effects of psychodynamic interventions compared to control conditions on parental reflective functioning, maternal depression, infant behavior, and infant attachment. No significant differences between psychodynamic and control interventions were found for parental stress, and parent-infant interactions. Very few studies were rated as good quality and further high-quality research is needed.

Increased parental perception of sleep disordered breathing in a cohort of infants with ALTE/BRUE events.

An apparent life-threatening event (ALTE) describes an acute, unexpected change in an infant's breathing, aspect, or behavior frightening to the parent or caretaker. According to the new recent terminology, clinicians should use the term brief resolved unexplained event (BRUE) to describe an event occurring in an infant <1 year of age when the observer reports a sudden, brief, and now resolved episode. The aims of the present study in infants were to investigate sleep disturbances in both ALTE event and after their classification according the new BRUE criteria. We enrolled (from April to May 2016) 32 consecutive infants referred to our ambulatory for sleep disorders for follow-up after an ALTE episode and 32 pair healthy controls. We administered to parents the adapted questionnaire "Sleep Disturbance Scale for Children - SDSC." Among enrolled infants with ALTE, there were 26 infants in line with the new BRUE definition, of which 10 at low risk and 16 at the high-risk event. Infants with ALTE and BRUE had more referred-by-parents' sleep symptoms than controls. In particular, sleep disordered breathing wa prevalent in both, requiring a longer follow-up for this disturbance.

Do infant behaviors mediate the relationship of prenatal cocaine exposure (PCE) to adult perceptual reasoning deficits?

Do infant behaviors mediate the relationship of prenatal cocaine exposure (PCE) to adult perceptual reasoning deficits?

Feasibility of wearable sensors in the NICU: Psychophysiological measures of parental stress

BackgroundParents report elevated stress during their infant's NICU hospitalization. Real-time measures may improve our understanding of parental stress in the NICU. AimExamine the feasibility of wearable sensors to describe parental stress in the NICU. Study designIn this prospective feasibility study of 12 parent-infant dyads, parents wore an Empatica E4 wristband to measure psychophysiological stress via electrodermal activity (EDA) during sensory interventions (holding, massage, reading, touch, etc) with their babies. Baseline and intervention periods were delineated during which concurrent monitoring and clinical observations of infant behavior and environmental factors were recorded. Feasibility was assessed by investigating recruitment/enrollment, retention/adherence, acceptability, sensor usability, and changes in EDA waveforms based on potential stressors. For the latter, independent samples t-tests and ANOVA were used to examine differences in EDA from baseline to intervention, and the impact of environmental and infant factors on parent stress were visually analyzed against EDA waveforms. ResultsWearable sensor use in the NICU appeared feasible as assessed by all methods. Preliminary data analysis indicated that overall parent EDA levels during parent-infant interactions were low, and engagement in sensory intervention(s) led to a non-significant increase in parental EDA, measured by both skin conductance levels and non-specific skin conductance responses. Three main patterns of EDA emerged: a temporary increase in EDA at the beginning of the intervention followed by a decrease and plateau, a plateau in EDA from baseline to intervention, and a gradual rise in EDA throughout intervention. Specific environmental and infant factors, such as infant stress and health care providers entering the room, appeared to impact parent stress levels. ConclusionAlthough these preliminary findings provide support for use of EDA in the NICU, future studies are needed.