Infant Behavior Research Articles

Association between infant feeding behavior and maternal choice of breastfeeding type

Abstract Introduction Feeding in infants is a fundamental process influenced by the mother-child relationship during the early months of life. The regulation of feeding behavior, and hunger and satiety cues may be interpreted by the mother, potentially relating to the type of feeding chosen. Objectives To determine the association between infant feeding behavior and the type of breastfeeding chosen by the mother. Methods A cross-sectional and prospective study was conducted, including mothers with children aged between 6 and 18 months. Those with medical contraindications for immediate postpartum breastfeeding or with suspension of exclusive breastfeeding during the first 6 months of life due to medical prescription were excluded. The Baby Eating Behavior Questionnaire was used to evaluate the baby’s enjoyment of food, appetite response, eating speed, and satiety response. Results 108 mothers were included, with 87% in agreement with exclusive breastfeeding (EBF), 43.3% using breastfeeding as the primary feeding method, and only 33.3% practicing EBF during the first 6 months. Food response (FR) scored 19.6 (±4.3), enjoyment of food (EF) 17.6 (±2.1), satiety response (SR) 7.1 (±2.0), eating speed (ES) 8.8 (±2.3), and appetite (AP) 4.2 (±0.7). Comparing FR, EF, SR, ES, and AP scores between those who practiced EBF and those who did not showed p > 0.05. sociodemographic characteristics, perinatal factors, stance on EBF, number of hours per day with the child, feeding location, poor technique, breastfeeding pain and lack of medical guidance, all showed p > 0.05 when comparing between those who practiced EBF and those who did not; in contrast to perceiving that the baby wanted to breastfeed (2.5/1.0-6.2), having time to feed (3/1.2-7.2) and having no health problems (10/1.2-78.7) all with p-value <0.05. Conclusions The mother’s perception identifying the baby’s desire to breastfeed, having time to feed the baby and not having health problems favor exclusive breastfeeding. Key messages • Maternal perception plays an important role in deciding to give SCI, so it is the physician’s job to educate the mother so that she has additional arguments for choosing SCI. • The infant’s feeding behavior does not have a significant impact on the mother’s behavior in choosing SCI feeding.

Delay of Gratification in Preschoolers with Autism and Concerns for ADHD.

Self-regulation abilities in childhood are predictive of a range of challenges later in life, making it important to identify difficulties in this area as early as possible. Autistic children and those with attention-deficit/hyperactivity disorder (ADHD) often have difficulties with self-regulation, but little is known about the similarities and differences in such abilities across neurodevelopmental conditions. We examined self-regulation using a delay of gratification task in 36-month-old autistic children (n = 20), those showing clinically relevant concerns for ADHD (i.e. ADHD Concerns; n = 24), and Comparison children without these conditions (n = 130); early predictors of self-regulation were also assessed. Both the Autism and ADHD Concerns groups had greater difficulty waiting for a desired snack than the Comparison group. At the longest delay trial (30 seconds), a substantial percentage of autistic children (50%) and those with ADHD Concerns (35%) consumed the snack prematurely, in contrast to only 16% of the Comparison group. Parent-reported temperament-based impulsivity at 18 months and examiner-observed ADHD-like traits at 24 months were associated with increased self-regulation challenges at 36 months, regardless of group. Adjusting for verbal abilities attenuated some of these differences and associations, suggesting that language may be an important mechanism undergirding early self-regulatory abilities. Given possible links between preschool self-regulation and a range of critical functional outcomes, future studies may explore the efficacy of early interventions targeting impulsivity and regulatory behaviors in infants and toddlers at elevated likelihood for developing self-regulation challenges to potentially reduce the impact of these difficulties later in life.

Practical Resources for Effective Postpartum Parenting (PREPP): a randomized controlled trial of a novel parent-infant dyadic intervention to reduce symptoms of postpartum depression: RCT of the PREPP intervention for postpartum depression

BackgroundThere is little known about the effectiveness of psychological interventions to prevent postpartum depression that focus on the birthing parent and infant dyad. Risk factors for PPD include depression during pregnancy, low parenting self-efficacy, and disrupted parental nocturnal sleep. The brief Practical Resources for Effective Postpartum Parenting (PREPP) intervention is designed for pregnant individuals at-risk for postpartum depression, providing them with 1) caregiving strategies aimed at reducing infant fuss and cry behavior and increasing infant sleep, 2) self-reflection and mindfulness skills and 3) psychoeducation about the postpartum period and infant behavior. The aims are to set more realistic postpartum expectations, enhance parenting confidence and sleep via supporting infant regulatory behavior, improve parental affect regulation and ultimately reduce the risk of postpartum depression. ObjectivesAssess the effectiveness of PREPP compared to enhanced treatment as usual in reducing symptoms of depression and anxiety and episodes of infant fuss and cry behavior and improving parental and infant sleep in the early postpartum. Study designA randomized controlled trial was conducted of 175 pregnant individuals. Inclusion criteria were standard prenatal care for a singleton pregnancy, aged 18 to 45 and at increased risk of PPD as determined by a score of ≥19 on the Predictive Index of Postnatal Depression or ≥7 on the Edinburgh Postnatal Depression Scale. Participants assigned to the PREPP group (n=88) received three coaching sessions and two phone check-ins. Participants assigned to the enhanced treatment as usual group (n=87) received three sessions which included psychoeducation, mood assessments, and clinical referral and follow-up as indicated. Assessments were conducted at 28 to 32 weeks and 34 to 39 weeks gestation, and at six, 12 and 16 weeks postpartum and included measures of parental depression, anxiety and sleep (Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9), Hamilton Rating Scales of Depression and Anxiety and Pittsburgh Sleep Quality Index) and infant sleep and fuss and cry behavior (Baby Day Diary). ResultsCompared to enhanced treatment as usual, PREPP significantly reduced depressive symptoms at six, 12 and 16 weeks postpartum with medium to large effect sizes (d=0.7-0.98). Compared to enhanced treatment as usual, participants receiving PREPP reported less of a decline in sleep quality at six weeks postpartum (p=0.035) and the effect size was large (d=0.83). Moreover, parents receiving the PREPP intervention reported less infant fussing and crying, with the largest effect for morning crying (p<0.001; d=-1.48). ConclusionsThe results provide evidence that PREPP, initiated during pregnancy, reduced symptoms of parental depression and infant fuss and cry behavior in the early postpartum, compared to enhanced treatment as usual, in a sample at-risk for postpartum depression.

The Impact of Mothers’ Smartphone Use, eHealth Literacy, Maternal Role Performance Confidence, and Online Social Support on Health Promotion Behavior for Infants and Toddlers

Background: This study aimed to identify the factors influencing health promotion behaviors for infants and toddler, focusing on the time spent by mothers using smartphone, eHealth literacy, maternal role performance confidence, and online social support.Methods: This study surveyed 136 women who gave birth to a child in 2023. For this study, recruitment announcements were made on popular parenting websites. Multiple regression analysis was performed to identify the factors affecting health promotion behaviors.Results: The mean age of the participants was 33.8 years, and the mean age of the children was 13.3 months old. Mothers spent 20.2 hours weekly on smartphone to access health information. A total of 86.7% of the respondents indicated that they primarily used the Internet to make health decisions. Factors that influenced health promotion behaviors were role performance confidence (β=0.54, P&lt;0.001), eHealth literacy (β=0.18, P=0.015), online social support (β=0.16, P=0.022), and time spent on smartphone (β=-0.17, P=0.006), with an explanatory power of 51.3% (F=29.43, P&lt;0.001).Conclusions: To improve the health promotion behaviors of mothers for their infants and young children, it is believed that interventions that increase confidence in their roles, online social support, and eHealth literacy are required, and that smartphone screen time should be limited. These baseline data can guide the development of effective intervention programs to improve healthcare for infants and toddlers.

Commercial milk formula marketing entry points: setting the course of infant and young child feeding trajectories

BackgroundThere is a limited understanding of the dynamic influences that shape infant and young child feeding (IYCF) decisions over time. We conducted an innovative qualitative study to reconstruct IYCF trajectories across early life course phases, in the context of the socioecological model (SEM) and the commercial determinants of IYCF.MethodsWomen of different socioeconomic status were interviewed in two large metropolitan areas in Mexico. Our specific goal was to allow us to better understand if and how the commercial milk formula (CMF) marketing influenced breastfeeding decisions in a complex dynamic way involving the individual, relational, community and societal levels.ResultsHospitals, health professionals, and interactions with social media were key category entry points throughout the prenatal, perinatal, early infancy period and beyond. The CMF industry interfered by engaging a wide array of actors across the different layers of the SEM, most prominently the health care system and the workplace. Through its marketing strategies the CMF operates subconsciously and its messages are most effective when health institutions, health care providers, workplace spaces and social norms are weak in their support for breastfeeding.ConclusionsThe cases in our study highlight how, together with a weak breastfeeding counseling system, and health professionals who lack training in breastfeeding and normal infant behavior, lead to the opportunity for CMF marketing to shape infant feeding, and ultimately to the decision to feed formulas that some mothers were not planning to use and cannot afford.

Maternal high BMI: Sex-dimorphic alterations in maternal and offspring stress indices

Maternal body mass index (BMI) influences pregnancy and birth outcomes along with child metabolic and neurodevelopmental health and fetal sex may be a moderating factor in these effects. Alternations in autonomic nervous system (ANS) functioning, identified in heart rate (HR) measurements, could present early markers of these prenatal programming effects in both the mother and the developing fetus. This study examines the associations between pre-pregnancy BMI and maternal and fetal ANS functioning and infant postnatal behavioral outcomes stratified by fetal sex. Pregnant women (N=176) were recruited at gestational week (GW) T1: 12–22 and categorized into Normal (BMI< 25) or High BMI (BMI > 25). Women attended laboratory sessions at T2: GW 23–28, and T3: GW 34–36 to assess maternal and fetal HR and HR variability (HRV) at baseline and after a stressor at T3. Infant behavior was assessed at 4 months using the Infant Behavior Questionnaire-Revised. Women with high BMI bearing female fetuses had higher HR and lower HRV at both gestational time points. Later in the third trimester, female fetuses of high BMI women exhibited lower HRV when challenged with a stressor. At 4 months, female infants were rated as having lower scores on the Orienting/Regulatory scale. Our findings provide evidence of female sex-specific programming of maternal pre-pregnancy BMI on maternal ANS regulation and neurodevelopment identified in-utero and continuing into early infancy.

Childhood anaesthesia and autism risk: population and murine study.

Early childhood exposure to general anaesthesia has been linked to potential changes in infant brain morphology and behaviour in preclinical studies, contributing to long-term behaviours associated with autism spectrum disorder. This study investigates the association between early childhood exposure to general anaesthesia and the risk of autism, using a population-based cohort study with matching for baseline characteristics and evaluates the effect of sevoflurane exposure on autism-like behaviour in mice, using the Taiwan Maternal and Child Health Database. Children aged 0-3 who received at least one exposure to general anaesthesia between 2004 and 2014 were matched 1:1 with children who were not exposed. Risk ratios and confidence intervals were used to assess the relationship between general anaesthesia and the occurrence of autism. Additionally, mice were exposed to sevoflurane for 2 h on postnatal days 5-7, and changes in behaviour related to autism were evaluated. Propensity score matching resulted in 7530 children in each group. The incidence rates (IRs) of autism were 11.26 and 6.05 per 100 000 person-years in the exposed and unexposed groups, respectively. The incidence ratio for autism following exposure to general anaesthesia was 1.86 (95% confidence interval, 1.34-2.59). In mice, sevoflurane exposure induced autism-like behaviours and led to the downregulation of high-risk autism genes, including ARID1B, GABRA5, GABRB3, GRIN2B, SHANK3 and SUV420H1. Early childhood exposure to general anaesthesia is associated with an increased risk of autism. Repeated exposure to sevoflurane in mice induces autism-like behaviours, suggesting a potential link between anaesthesia and the development of autism.

Infant Temperament Is Associated With Milk Cortisol but Not With Maternal Childhood Trauma.

Previous studies have suggested that maternal childhood trauma (MCT) may influence infant temperament, but the underlying physiological mechanisms remain unclear. This study sought to confirm the involvement of breast milk cortisol in the link between MCT and infant temperament. The study sample included 90 mother-infant dyads recruited from the urban Polish population. MCT was assessed based on the Early Life Stress Questionnaire (ELSQ) and infant temperamental factors (surgency/extraversion, negative affectivity, and orienting/regulation) using the Infant Behavior Questionnaire-Revised at 12 months of life. Cortisol was assayed in milk samples collected at 5 months of life using the ELISA method. Based on the ELSQ median, the sample was divided into low and high MCT groups. The ANCOVA models with milk cortisol as a covariant were run to check the effect of low versus high MCT on infant temperament. We found a positive association between milk cortisol and orienting/regulation. Surprisingly, the low and high MCT groups did not significantly differ in milk cortisol. Furthermore, we found that MCT was unrelated to any infant temperamental factor. While recent literature on the association between milk cortisol and infant temperament is inconsistent, our results suggest that high orienting/regulation might be an adaptation to adverse environments such as stress. Moreover, the infant's temperament appears to be more responsive to the current exposition to maternal stress than her experience of traumatic stress.

Infant sensitivity to social contingency moderates the predictive link between early maternal reciprocity and infants' emerging social behavior.

The scientific study of love underscores the importance of dyadic reciprocity in laying the foundation for infants' social development. While research establishes links between early reciprocity and children's social capacities, some infants appear to benefit from reciprocity more than others. A central feature of reciprocity is its contingent structure, that is, the extent to which maternal behaviors are temporally associated with and contingent upon infants' dynamically changing cues. As such, infants' sensitivity to social contingencies may define the extent to which an infant benefits from maternal reciprocity. The current study examined the role of infants' sensitivity to social contingency (SC) in moderating associations between early maternal reciprocity and subsequent infants' social behavior. The study followed 157 children (47% females), across the first year of life (4, 10, and 12 months) and at preschool age (48 months). Infants' SC at 4 and 10 months moderated the link between early maternal reciprocity and infants' prosocial behavior observed at 12 months. SC at 10 months moderated the link between early reciprocity and reported peer problems at 48 months. Maternal reciprocity predicted more helping behavior in infancy and fewer peer problems at preschool, but only for infants who displayed high SC. Findings highlight the contingent nature of reciprocal mother-infant interactions revealing that an infant's sensitivity to breaks in social-contingency moderates the developmental benefit of reciprocity. Future research is necessary to directly test the underlying mechanisms of these processes and better understand the individual characteristics of infants' sensitivity to social contingency and its' role in typical and atypical development. RESEARCH HIGHLIGHTS: Individual differences in infants' sensitivity to breaks in social contingencies may moderate the extent to which infants benefit from contingent reciprocal maternal behavior (i.e., maternal reciprocity). Maternal reciprocity predicted more helping behavior in infancy and fewer peer problems at preschool, but only for infants who displayed high sensitivity to breaks in social contingency. Findings highlight the contingent nature of reciprocal mother-infant interactions revealing that infants' sensitivity to breaks in social-contingency moderates the developmental benefit of reciprocity. Findings emphasize the need to develop measurement methods and direct empirical attention to the important yet understudied individual characteristic of infants' sensitivity to social contingency and its role in shaping social development.

Oral feeding challenges of infants of diabetic mothers.

The presence of diabetes before or during pregnancy can increase perinatal mortality and morbidities. It is well known an infant of a diabetic mother (IDM) may experience complications such as macrosomia, hypoglycemia, respiratory distress syndrome, cardiac anomalies, and other abnormalities of organogenesis. Medical providers including physicians, nurses, and speech therapists have experienced challenges with helping IDMs orally feed. Challenges with oral feeding can lead to prolonged hospital stays and placement of supplemental feeding devices. The etiology of an IDM's oral feeding delays is not well understood and does not necessarily affect all infants. This descriptive review explores what is known about potential contributing factors to feeding difficulty in IDMs, including differences in infant behavior and swallowing mechanics. Some IDMs are unable to maintain active alert states and have decreased autonomic regulation and motor control. Studies of sucking and swallowing demonstrate reduced sucking pressure, fewer sucking bursts, and slowing of esophageal sphincter function. The increasing prevalence of diabetes during pregnancy makes further investigations into the characteristics and trajectories of state, behavior, and oral feeding of IDMs imperative.

35 - Integrating health literacy and cultural considerations into a web-based program promoting healthy behaviours in infants

35 - Integrating health literacy and cultural considerations into a web-based program promoting healthy behaviours in infants

Impaired motor and social skill development in infancy predict high autistic traits in toddlerhood

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder. Early diagnosis in the critical period is important for ASD children. Recent studies of neurodevelopmental behavioral features and joint attention in high-risk infants showed there are some special cues which can distinguish ASD from typical development infant. But the findings of high-risk population may not be applicable to the general population. It is necessary to “analogically” study the potential warning traits of ASD in infancy in the general population. We did a nested case-control study from June 2019 to November 2022 in Tianjin, China, including 76 general infants whom completed the neurodevelopmental evaluation, the Checklist for Autism in Toddlers-23 (CHAT-23) screening, and eye tracking task. Social behavior quotient in infancy was negatively correlated to CHAT-23 total scores in toddlerhood. Social behavior quotient in infancy was positively correlated to initiating joint attention in toddlerhood. Regression model showed that high fine motor scale and social behaviour scale quotient in infancy were associated with an decreased risk of the total score of CHAT-23 ≥ 2 in toddlerhood. The Receiver operating characteristic curve showed the social behaviour in infancy alone and the combination of fine motor and social behaviour in infancy contributed to auxiliary diagnosis of higher level of autistic traits in toddlerhood. These findings suggest that Impaired development of fine motor and social behavior in infancy are potential warning features of high autistic traits in general population.

Protocol for an intervention for new parents experiencing moderate psychosocial adversity: pilot feasibility randomised trial

ABSTRACT Background Parents exposed to psychosocial adversities often experience challenges which, combined with the needs of a new-born infant, can be difficult to manage and increase the risk of poor outcomes for both parents and infants. Psychosocial adversity can disrupt the development of parental-foetal attachment to the baby during pregnancy, which can have a negative effect on parental care and quality of interaction during the postnatal period. This intervention is based on the proposition that enhanced parental capacity to mentalise and emotionally connect to unborn children during pregnancy, and better understanding about how to manage distressing infant behaviour (i.e., persistent crying and sleep problems) will: (i) promote the development of secure parent-infant attachment; (ii) improve antenatal bonding and postnatal parenting; and, (ii) reduce parental distress. Method This protocol is for a pilot randomised control trial evaluating a new intervention, which makes use of innovative technologies to support parents experiencing moderate psychosocial adversity (Australian New Zealand Clinical Trials Registry: ACTRN12622000287730). The New Technology for New Parents (NTNP) intervention provides support using antenatal ultrasound scans and ‘virtual home visits’ during the perinatal period. Quantitative outcomes include mentalising capacity, parental-foetal/infant attachment, and parental competence. Conclusion To the best of our knowledge, no study has evaluated the combined effectiveness of two novel technologies (3D/4D ultrasound scans and virtual home visits) to support parents across the antenatal and postnatal periods. This protocol, which includes the rationale for this innovative intervention, addresses a gap in services for parents experiencing moderate psychosocial adversity.

Mothers' experience seeking healthcare advice for their unsettled infants in Victoria, Australia.

Unsettled infant behaviours are highly prevalent in the postnatal period and constitute a significant proportion of visits to healthcare services. Unsettled infant behaviours can be highly distressing for parents and are identified as a significant risk factor for postnatal depression. Understanding parents' experiences is paramount to reducing the gap between consumer expectations and service delivery. This study employed a qualitative descriptive approach to explore parents' experiences seeking healthcare advice for their infant with unsettled behaviours. Semi-structured interviews were conducted with 20 mothers. Inductive thematic analysis yielded two overarching themes: (1) 'the journey for answers', consisting of five sub-themes, and (2) 'parents' knowledge and behaviours', consisting of six sub-themes. Despite some positive interactions with healthcare services, mothers generally spoke negatively of their overall experience seeking answers and receiving care for their infant, and they felt the healthcare services they attended were not equipped to meet their needs. To address the gap between service delivery and consumer expectations, mothers relied on online communities for advice and emotional support. The findings of this study highlight several discrepancies between mothers' expectations and service delivery in the context of unsettled infant behaviours, and this paper makes recommendations to address identified shortcomings in approaches to care.

Impact of a Brief Parenting Intervention on Parent and Infant Imitation

Research examining the effect of behavioral parenting interventions, such as parent–child interaction therapy (PCIT), on parent and child imitation is limited despite known benefits to early child development. We examined the effect of a brief, home-based adaptation of PCIT, the Infant Behavior Program (IBP), on changes in observed frequency of parent and infant imitation, moderating effects of parent language (English, Spanish), and mediational effects of parent and infant imitation on the effect of intervention on infant behavior problems. Participants were 60 12- to 15-month-olds with elevated behavior problems and their primary caregiver, all of which were mothers. Parent–infant dyads were randomly assigned to receive either the IBP or standard pediatric primary care. Parents receiving the IBP demonstrated significantly higher rates of observed imitation at postintervention and at the 3-month follow-up compared to those receiving standard care, and the effect at postintervention was stronger for English-speaking than for Spanish-speaking families. Although the IBP did not directly affect changes in infant imitation at postintervention or the 3-month follow-up, rates of infant imitation increased significantly for those who received the IBP at the 6-month follow-up. Additionally, moderation results suggested that the IBP led to improvements in infant imitation at post for Spanish-speaking families but not for English-speaking families. There were no significant mediational effects of parent or infant imitation. Future research is needed to examine the impact of increases in imitation on other aspects of child development, such as social–cognitive and language abilities, and to examine how cultural factors may play a role in individual differences in imitation.

Associations Among Caregiver Child-Oriented Behavior, Infant Social Engagement, &amp; Child Joint Engagement

Abstract Date Presented 03/21/24 This study investigated associations between caregiver and infant behaviors from 2 to 18 months and child engagement at 24 months. Caregiver child-oriented behaviors should be considered during intervention to promote child engagement in co-occupation. Primary Author and Speaker: Cristin M. Holland Contributing Authors: John Sideris, Pat Levitt, Barbara L. Thompson, Grace Baranek

How strong is the evidence supporting the WHO guidelines on physical activity, sedentary behaviour and sleep in early childhood?

The WHO issued recommendations about the ideal amount of physical activity, sedentary behaviour and sleep in infants, toddlers and preschool children. To facilitate their interpretation and translation into public health policies, we analysed the quantity and quality of the evidence that supported the development of each WHO recommendation. All data for each exposure-outcome pair analysed in the studies informing WHO guidelines were extracted, and predefined criteria, based upon GRADE methodology, were used to classify each outcome and study result. Among the 237 studies that could be included, 37 were experimental and 200 were observational, yielding 920 analyses of exposure-outcome associations. Sixty-two analyses used a relevant outcome, with or without significant results. Five of the 10 WHO recommendations were based upon zero analyses with significant results on relevant health outcomes. The remaining recommendations were mostly based upon analyses evaluating obesity-related outcomes. Eight of the 10 GLs thresholds were not supported by any significant analysis on clinically relevant outcomes. While these findings should not be interpreted as an attempt to disprove the benefits of healthy lifestyle habits in early childhood, neither to minimize the work of the experts in this complex research field, very limited evidence currently supports the adoption of recommended thresholds as behavioural surveillance and public health interventions targets. Therefore, until further data are available, public health interventions should be developed balancing whether to focus on the achievement of specific targets that are still not supported by high-quality evidence or on the general promotion of healthy behaviours.

Neurons for infant social behaviors in the mouse zona incerta.

Understanding the neural basis of infant social behaviors is crucial for elucidating the mechanisms of early social and emotional development. In this work, we report a specific population of somatostatin-expressing neurons in the zona incerta (ZISST) of preweaning mice that responds dynamically to social interactions, particularly those with their mother. Bidirectional neural activity manipulations in pups revealed that widespread connectivity of preweaning ZISST neurons to sensory, emotional, and cognitive brain centers mediates two key adaptive functions associated with maternal presence: the reduction of behavior distress and the facilitation of learning. These findings reveal a population of neurons in the infant mouse brain that coordinate the positive effects of the relationship with the mother on an infant's behavior and physiology.

Soothing and Distress Behaviors of Infants, Parents, and Clinicians During Childhood Vaccinations

ObjectivesThe purpose of this study is to describe the behaviours of infants who were born preterm, their parent, and clinicians during two-, six-, twelve- and eighteen-month vaccinations. MethodsVaccination sessions were video recorded for 3-5 minutes. The proportion of five-second intervals in which distress and soothing behaviour occurred for infants, parents, and clinicians was coded using the Measure of Adult and Infant Soothing and Distress. Coding consisted of three phases: baseline/anticipatory (60 seconds prior to first needle), procedure (first needle to removal of final needle), recovery (up to 180 seconds after removal of final needle). Results64 infants were included. Distress behaviour for infants during baseline ranged from 13% (twelve-month) to 29% (two-month). There was limited anticipatory soothing behaviour from parents (10% (twelve-month) to 50% (two-month)) and clinicians (6% (twelve-month) to 17% (two-month)). Distress behaviour in infants during procedure ranged from 43% (eighteen-month) to 96% (two-month). There was limited soothing behaviour during procedure from parents (10% (twelve-month) to 81% (twelve-month)) and clinicians (13% (twelve-month) to 71% (two-month)). Few infants received additional pain reducing interventions of skin-to-skin contact, 24% oral sucrose, and topical anesthetic. DiscussionDespite infant distress, there was limited anticipatory behaviour from parents and clinicians. Two-month infants displayed the most distress across all timepoints yet received the least amount of treatment and proximal parent and clinician behaviour. Additional implementation efforts are required to increase awareness and practice uptake among parents and clinicians to ensure infants receive equitable and effective pain management.

Artificial intelligence detects awareness of functional relation with the environment in 3 month old babies

A recent experiment probed how purposeful action emerges in early life by manipulating infants’ functional connection to an object in the environment (i.e., tethering an infant’s foot to a colorful mobile). Vicon motion capture data from multiple infant joints were used here to create Histograms of Joint Displacements (HJDs) to generate pose-based descriptors for 3D infant spatial trajectories. Using HJDs as inputs, machine and deep learning systems were tasked with classifying the experimental state from which snippets of movement data were sampled. The architectures tested included k-Nearest Neighbour (kNN), Linear Discriminant Analysis (LDA), Fully connected network (FCNet), 1D-Convolutional Neural Network (1D-Conv), 1D-Capsule Network (1D-CapsNet), 2D-Conv and 2D-CapsNet. Sliding window scenarios were used for temporal analysis to search for topological changes in infant movement related to functional context. kNN and LDA achieved higher classification accuracy with single joint features, while deep learning approaches, particularly 2D-CapsNet, achieved higher accuracy on full-body features. For each AI architecture tested, measures of foot activity displayed the most distinct and coherent pattern alterations across different experimental stages (reflected in the highest classification accuracy rate), indicating that interaction with the world impacts the infant behaviour most at the site of organism~world connection.