Maternal-infant Attachment Research Articles

Effects of an App-Based Visitation Program for Mothers of High-Risk Infants in the Neonatal Intensive Care Unit: A Quasi-Experimental Study.

This study established an app-based visitation program for mothers of infants admitted to the neonatal intensive care unit (NICU)-constrained by COVID-19 visitation restrictions-and assessed its impact on neonatal perception, maternal-infant attachment, and parental stress. High-risk infants in the NICU encounter heightened challenges, exacerbated by COVID-19 restrictions, leading to heightened maternal stress, impaired neonatal perception, and hindered mother-infant attachment. A quasi-experimental study was conducted with 40 mothers (20 in the experimental group and 20 in the control group) unable to visit the NICU of a tertiary general hospital in South Korea. The experimental group utilized the Dodam-Dodam smartphone application, while the control group received neonatal information through telephone calls and text messages. Data collection occurred in July 2022 (control) and September 2022 (experimental) using research instruments (parent's neonatal perception, maternal-infant attachment, and parental stressor scale: NICU, visiting program satisfaction). Descriptive statistics and tests (χ2, Fisher's exact, Shapiro-Wilk, parametric independent t and paired t tests, and nonparametric tests: Mann-Whitney and Wilcoxon's signed-rank) were employed for analysis. The Dodam-Dodam application significantly impacted maternal-infant attachment parental stress scores and program satisfaction in the experimental group, except for neonatal perception. The Dodam-Dodam application was more efficacious than traditional visiting programs in enhancing maternal-infant attachment, increasing maternal satisfaction and reducing parental stress within NICU settings amid restricted visitation. Recommendations include app-based NICU visitation, exploring app variations, studying diverse populations, and providing optimal information provision.

Maternal mind-mindedness and infant oxytocin are interrelated and negatively associated with postnatal depression.

Previous studies show that maternal mind-mindedness positively impacts children's social development. In the current studies, we examine the relation between mind-mindedness during parent-child interaction, oxytocin (OT), and postnatal depression in a sample of mothers (N = 62, ages 23-44) and their infant (ages 3-9 months). In Study 1, infant salivary OT was positively correlated with mothers' appropriate mind-related comments, and negatively correlated (at trend level) with maternal depression scores. Mothers experiencing symptoms of depression used fewer appropriate mind-related comments than controls. Study 2 was a double-blind, placebo-controlled, experimental study, in which the same women who participated in Study 1 were administered nasal OT. This did not significantly influence levels of mind-mindedness. Study 2 warrants a larger trial to investigate the effect of OT on mind-mindedness further. Study 1 is the first to demonstrate an association between maternal mind-mindedness and variation in children's OT levels. Since both OT and mind-mindedness have been repeatedly implicated in processes of maternal-infant attachment, this association highlights the centrality of mothers' caregiving representations in facilitating the parent-child relationship and children's early development.

Perinatal mental health and active-duty military spouses: a scoping review

IntroductionMental health conditions (i.e. depression or anxiety) are the most common complication of pregnancy and childbirth in the United States (U.S.) and are associated with increased maternal and infant morbidity and mortality. Research has demonstrated a relationship between stress and mental health diagnoses in pregnancy; therefore, it is concerning that military families face unique challenges which contribute to additional stressors among spouses of active-duty (AD) military personnel during the perinatal period. The objective of this scoping review was to understand the current state of research on perinatal stress or perinatal mental health among American spouses of AD military personnel.MethodsThe Boolean phrase was created in consultation with 2 health science librarians and the following databases searched in October 2023: PubMed, Embase, Military and Government Collection, CINAHL, and PsychINFO. 2 reviewers identified 481 studies for screening once duplicates were removed. After applying inclusion and exclusion criteria, 21 studies remained for data extraction and analysis.ResultsMost of the studies were quantitative, took place in the southern U.S., and the most represented military branch was Air Force. Most of the studies included both AD military members and AD spouses; 28% focused solely on AD spouses. Samples were not racially diverse, and findings identified racial disparities in perinatal mental health conditions. There was a wide variety in outcome measures, including the following general categories: (1) stress, anxiety, and/or depression, (2) maternal-infant attachment, (3) group prenatal care, and (4) deployment focus. Our review identified the following concepts: spouses most at risk for perinatal mental health conditions, the need for perinatal mental health screening, and the need for social support.ConclusionsFindings from the identified studies indicate a need for additional research in this area. Additionally, findings highlight circumstances unique to this population that result in an increased risk of stress and/or mental health conditions during the perinatal period. Such challenges demand improved mental health screening and additional resources for this population. Meeting the needs of this unique population also requires significant funding and policy change to allow for increased access to mental health resources and to ensure the health of the birthing person and infant.

Https://scibasejournals.org/scibase-human-nutrition-and-food-science.html

Background: Breastfeeding is recognized as the ideal feeding choice for early and later-life health benefits to the child by providing proper nutrition and protection from infections, diarrhea, diseases and building healthy maternal infant attachment. The objective of this review is to examine the various breastfeeding support regulations and their impacts on infant health, with a view to identifying best practices and potential policy enhancements.

EFFECT OF KANGAROO MOTHER CARE (KMC) ON THE FORMATION OF MATERNAL-INFANT ATTACHMENT BETWEEN MOTHERS AND PREMATURE BABIES: A LITERATURE REVIEW

Background: Nursing care of premature babies in the Neonatal Intensive Care Unit (NICU) setting can inhibit the maternal-infant attachment. One of the evidence-based interventions for premature babies is Kangaroo Mother Care (KMC). KMC needs to be further studied and researched through a review of previous articles to ensure the effectiveness of that implementation. However, there is a very limited review that specifies the effect of KMC on the formation of maternal-infant attachment. Objective: This study was conducted to assess the effect of KMC on maternal-infant attachment between mothers and premature babies. Design: The design of this study uses a literature review. Data Sources: Initial searches of journal articles were performed on the Pubmed, ScienceDirect, and CINAHL search databases. The study found 676 articles but only 7 journal articles that met the search inclusion criteria. Review Methods: A literature review procedures were used to collect library data, reading and taking notes, as well as critical assessment of managing research materials. Results: The results of this review showed that KMC has been shown to have a positive impact on improving attachment status and resulting in a lower risk of bonding failure between mothers and premature babies. Conclusion: It is recommended that health workers can provide treatment using KMC as an intervention to improve the formation of maternal-infant attachment between mothers and premature babies. The policies related to the implementation of KMC as standard operating procedures are also important.

The Effect of Hospitalization in the Neonatal Intensive Care Unit on Maternal Stress and Attachment: Neonatal Intensive Care Unit Environment Effect.

This study investigated the effects of hospitalization in the neonatal intensive care unit (NICU) due to congenital pneumonia (CP) on maternal stress and attachment, focusing on how the duration of invasive and noninvasive mechanical ventilation, length of NICU stay, and postpartum breastfeeding initiation time influence mother-infant attachment. Conducted among 30 mothers of 3-month-old infants admitted to the NICU with CP and a control group (n = 30), it analyzed the impact of medical intervention durations and breastfeeding initiation on maternal stress and attachment using statistical methods. The maternal stress in the NICU group was significantly higher than in the control group (P = .014). However, there was no significant difference between the groups in attachment scores (P = .141). The study revealed that longer invasive mechanical ventilation (P < .001) and NICU stay (P < .001) significantly increased maternal stress. Maternal stress (P < .001) and breastfeeding initiation time(P < .001) exhibit a negative correlation with attachment scores (P < .001). It is crucial to implement interventions aimed at reducing maternal stress and fostering maternal-infant attachment for mothers of newborns admitted to the NICU. The sustained application of these interventions post discharge holds significance for the mental health of mothers and mother-infant attachment.

Precursors of Prenatal Attachment and Anxiety during Pregnancy in Women Who Procreate Naturally and Pregnant Women following Assisted Reproduction Technology.

The process of adaptation of the woman to pregnancy seems to be influenced by many factors, such as the type of conception, the mother's age, the possible presence of other children, and socio-cultural factors. Women who conceived with an assisted reproductive technique are emotionally vulnerable; compared with pregnant women who procreated naturally, they manifest elevated anxiety, which seems to be correlated to the fright of being separated from their child. Objectives of the present research are as follows: (1) to analyze the relationship between age, gestational age, time expectancy, previous failed attempts, perception of a high-risk pregnancy, and presence of other children, with the level of maternal-fetal attachment (MFA); (2) explore the level of maternal-infant attachment and anxiety by comparing the control and experimental group; (3) to measure a possible relationship between anxiety levels and MFA in ART pregnant women; (4) to identify variables predictive of prenatal attachment. The study group is formed by ninety-five women aged between 18-42 years (M = 30.57; S.D. = 5.47), pregnant from the 23rd to the 37th week (M = 28.95; S.D. = 3.99); on which 50 women who procreate naturally and 45 pregnant women following assisted reproductive technology. They completed: Maternal-Fetal Attachment Scale (MFAS), State-Trait Anxiety Inventory (STAI), and ad hoc questionnaire to collect anamnestic data. The results show the presence of a correlation between gestational age and waiting period, between the number of assisted fertilization attempts with the worry about their ability to become pregnant, but a negative correlation between pregnancy weeks and the level of maternal-fetal attachment. The study shows the predictive role of anxiety on the MFA. The applications and indications for future research are analyzed.

Effects of massage therapy on preterm infants and their mothers: a systematic review and meta-analysis of randomized controlled trials.

Massage therapy for preterm newborns has received increasing attention in recent years due to its beneficial clinical outcomes. However, disagreements persist in different investigations. We performed a systematic literature search in the Cochrane Library, Embase, PubMed, Web Science, and CINAHL to retrieve randomized controlled trials of premature infants receiving massage therapy and its impact on maternal and infant outcomes. Outcomes were mother-infant attachment, oxygen saturation, motor funtion, reflex, temperature, and calorie intake. The tool developed by the Cochrane collaboration assessed risk bias. With a 95% confidence interval (CI), the integration's results were presented as the mean difference or standardized mean difference. The registration number was CRD42022337849. Of 940 records retrieved, 15 trials were included. Massage therapy increased oxygen saturation (standardized mean difference (SMD) = 2.00, 95% CI [1.17 to 2.83], P < 0.0001). Massage therapy can strengthen mother-infant attachment [SMD = 2.83, 95% CI (2.31 to 3.35), P < 0.00001]. Other outcomes, including motor activity, relaxation, caloric intake, and temperature, did not differ significantly. Massage therapy can significantly improve oxygen saturation and strengthen maternal-infant attachment. However, prior to making a recommendation, additional research with a larger sample size and more rigorous design should be conducted due to the heterogeneity of studies in several outcomes.

EEtkili Emziren ve Emzirmede Yeterli Olduğunu Düşünen Annelerin Bebekleriyle Bağlanma Düzeyinin Belirlenmesi: Kesitsel Tipte Çalışma

Objective: This study aims to determine the relationship between breastfeeding success and breastfeeding self-efficacy and maternal infant attachment.&#x0D; Methods: The study was conducted in xxx Family Health Center between March -June 2017. The questionnaire form, the LATCH Breastfeeding Identification and Assessment Scale, the Breastfeeding Self-Efficacy Scale, and the Maternal Attachment Inventory were used to collect data in the study. The Kruskall Wallis Analysis Mann, Whitney-U Analysis, Spearman Correlation and Kurtosis and skewness coefficients, Internal consistency Cronbach α coefficient were used in data analysis.&#x0D; Results: The women who participated in the study had an average score of 9.87±0.42 in the LATCH Breastfeeding Identification and Assessment Scale, 63.51±10.71 in the Breastfeeding Self-Efficacy Scale and 101.58±2.28 in the Maternal Attachment Inventory. The difference between the average Breastfeeding Self-Efficacy Scores according to the level of education and time when breastfeeding started was statistically significant (p

Antenatal predictors of postnatal maternal attachment and competence after assisted conception-a prospective cohort study in South India.

The aim of this study is to examine the influence of antenatal factors suchas anxiety, depression, perceived stress, marital satisfaction, maternal antenatal attachment, and social support on postnatal maternal attachment and competence in women whoreceived assisted reproductive treatment. A prospective longitudinal cohort design was adopted with two groups-50 women who received assisted reproductive treatment and 50 women who had natural conception. Both the groups were assessed using self-report measures over three time points: T1, 7th month of pregnancy; T2, 2weeks postpartum; and T3, 3months postpartum.Afinal sample of44 women who had assisted conception and 47 women who had natural conception completed assessments across all three time points. Descriptive, bivariate analyses, and stepwise multiple linear regression analyseswerecarried out.In the assisted conception group, maternal antenatal attachment, depression, and marital satisfaction significantly predicted postnatal maternal-infant attachment. Perceived social support, depression, and duration of marriage significantly predicted postnatal maternal competence. In the naturally conceived group, maternal antenatal attachment and social support significantly predicted postnatal maternal-infant attachment;perceived stresssignificantly predicted postnatal maternal competence. Antenatal depressive symptoms and relational factors significantly influenced postnatal maternal attachment and competence highlighting the need for screening and targeted psychological interventions during pregnancy.

Investigating the Effect of Kangaroo Mother Care on Maternal-Infant Attachment: A Systematic Review and Meta-Analysis Study

Background: Maternal-infant attachment is the first social relationship between mother and baby that keeps the baby close to the mother. The conflicting results of the studies regarding the effect of kangaroo mother care (KMC) on maternal-infant attachment show the necessity of conducting a meta-analysis study. Objective: The study aimed to investigate the effects of KMC on mother-infant attachment through a systematic review and meta-analysis of randomized controlled trials. Methods: Web of Science, PubMed, Scopus, Cochrane Library, EMBASE, ProQuest, SID, and Iranmedex databases were searched to find clinical trial studies in English and Persian without a time limit. The Cochrane checklist was used to check the bias of the articles. Data analysis was performed using STATA. I2 index was used in order to assess the heterogeneity, and the funnel plot and the Egger test were used in order to examine the publication bias. Standardized mean difference (SMD) and random effects models were used to combine the studies and perform a meta-analysis. Results: In this study, 10 articles were selected for the systematic review and meta-analysis. The results of the present meta-analysis based on the random model showed SMD as -1.33 (95% CI: (-2.12, - 0.54), P = 0.001), and there was observed a statistically significant relationship between the control and intervention groups. So, the mother-infant attachment in the intervention group was higher than in the control group. Conclusion: This study showed that KMC improves mother-infant attachment. The results of this study can be applied to evidence-based decision-making by healthcare providers, and can also be suggested as a method to develop mother-infant attachment.

Effect of auricular acupressure on postpartum blues: A randomized sham controlled trial

AimTo investigate the effect of auricular acupressure on the severity of postpartum blues. MethodsA randomized sham controlled trial was conducted from February to November 2021, with 74 participants who were randomly allocated into two groups of either routine care + auricular acupressure (n = 37), or routine care + sham control (n = 37). Vacaria seeds with special non-latex adhesives were used to perform auricular acupressure on seven ear acupoints. There were two intervention sessions with an interval of five days. In the sham group, special non-latex adhesives without vacaria seeds were attached in the same acupoints as the intervention group. Severity of postpartum blues, fatigue, maternal-infant attachment, and postpartum depression were assessed. ResultsAuricular acupressure was associated with significant effect in reduction of postpartum blues on 10th and 15th days after childbirth (SMD = −2.77 and −2.15 respectively), postpartum depression on the 21st day after childbirth (SMD = −0.74), and maternal fatigue on 10th, 15th and 21st days after childbirth (SMD = −2.07, −1.30 and −1.32, respectively). Also, maternal-infant attachment was increased significantly on the 21st day after childbirth (SMD = 1.95). ConclusionAuricular acupressure was effective in reducing postpartum blues and depression, reducing maternal fatigue, and increasing maternal-infant attachment in the short-term after childbirth. Trial registrationRegistered prospectively in Iranian Registry of Clinical Trials (ID: IRCT20180218038789N2).

Maltreatment and NICU Infants

Child maltreatment is a concern for NICU infants who have special care needs at discharge. Improving mother-infant attachment through breastfeeding in a NICU environment may reduce maltreatment for this high-risk, vulnerable population. Breastfeeding an infant in the NICU is a complicated caretaking task yet provides an opportunity to overcome parenting challenges associated with a medically fragile infant by promoting the development of the maternal-infant attachment bond. Breastfeeding can serve as a prevention strategy for child maltreatment by improving attachment and bonding that is oftentimes disrupted between the NICU infant and mother due to the hospitalization. Social workers serve a pivotal role in preventing child maltreatment through education, promotion, and support of breastfeeding policies. This article highlights the role of social work in enhancing mother-infant attachment and advocating for NICU policies that support attachment therefore preventing maltreatment.

Disrupted maternal communication and disorganized attachment in the Arab society in Israel.

Disrupted maternal communication during mother-infant interaction has been found to be associated with infants' disorganized attachment, but has been studied primarily in North American and European samples and not in Arab samples. To address this gap the study examined the association between disrupted maternal communication and infant attachment in a sample of 50 Arab mothers and their one-year-old infants in Israel. Attachment was assessed with the Strange Situation Procedure (SSP), and disrupted communication with the AMBIANCE. Disrupted communication was higher in mothers of infants with disorganized and ambivalent attachment than in mothers of securely attached infants. The findings support the link between disrupted communication and disorganized attachment in the Arab society in Israel and add to our understanding of maternal behavior associated with ambivalent attachment.

Systematic Review of Kangaroo Care Duration's Impact in Neonatal Intensive Care Units on Infant-Maternal Health.

Kangaroo care (KC), skin-to-skin contact between infants and caregivers, is encouraged in neonatal intensive care units (NICUs) to support health through improved weight, growth, and infant-maternal attachment while reducing the incidence of sepsis and infant pain. However, the optimal duration and frequency of KC to maximize health outcomes is unknown. Given parents' time stressors, identifying optimal KC time is critical. A literature review was undertaken on May 28, 2021 via querying the PubMed database from January 1, 1995, to May 28, 2021, regarding KC and NICUs with 442 results. Eleven studies met the eligibility criteria of (1) comparative KC between infants and adult caregivers in NICUs as a randomized controlled trial, (2) peer-reviewed articles in English, (3) study subjects ≥5, (4) health outcomes, and (5) KC sessions >1. Infant physical growth parameters, infant neurodevelopment, infant stress via salivary cortisol levels, and breastfeeding outcomes appear to increase with KC as compared with standard care (SC) without KC. Improvements were observed with longer KC duration, 2 h/d as compared with 1 h/d, for neurodevelopment and breastfeeding outcomes, but no greater improvement with longer KC duration was shown for reducing infant stress through salivary cortisol levels. Regarding maternal stress, the influence of KC duration showed mixed Parental Stressor Score: NICU scores. Further study on the impact of KC duration and frequency on health outcomes and dose-response relationship would help determine how much and how frequent KC is needed to improve specific health outcomes for infants and their mothers. KEY POINTS: · Data on kangaroo care duration's health impacts is lacking.. · Establishing dose-response for kangaroo care is needed.. · Kangaroo care for longer improves some but not all outcomes..

The effect of maternal empathy on infants' attachment security: Moderation by maternal emotion regulation and infant temperament.

This study examined the relationship between maternal empathy and infants' attachment security and tested the moderating effects of maternal emotion regulation and infant negative emotional temperament. Participants were sampled from 215 families whose infants were 6months old (T1) and from 170 families of the same cohort whose infantswere 14 months old (T2). At T1, mothers were measured for their empathy (empathic concern and perspective taking), emotion regulation (reappraisal and suppression), and infant negative emotional temperament (sadness, falling reactivity, fear, and distress to limitations). At T2, mothers were again measured for their emotion regulation, and infant attachment was measured using the Strange Situation Procedure. Maternal empathic concern (EC) and perspective taking (PT) were found to be positively related to infant attachment security, while maternal reappraisal and infant temperamental sadness moderated the relationship between maternal PT and infant attachment security. No significant moderation effects were found between maternal EC and infant attachment security. Simple slope results showed that for infants with higher maternal reappraisal or infant sadness, maternal PT could positively predict infant attachment security. These findings highlight the importance of how the individual characteristics of mothers and infants may interact with maternal empathy during the critical period of infant attachment formation.

Factors Associated with Postpartum Maternal Functioning in Black Women: A Secondary Analysis.

In the United States, 29-44% of Black women experience postpartum depressive symptoms (PDS), yet few are properly identified and/or connected to mental care services. The purpose of this secondary analysis was to examine the relationship between maternal functioning and clinical variables (PDS, maternal-infant attachment), racial variable (Black racial identity types-low race salience, assimilated and miseducated, self-hating, anti-White, multiculturalist, and conflicted), and sociodemographic characteristics (relationship status, education, insurance, childbirth type). A total of 116 women living in the southern United States were included in the analysis. Multivariate analyses revealed that Black racial identity (p = 0.02), PDS (p &lt; 0.0001), maternal-infant attachment (p &lt; 0.0001), and educational level (p = 0.03) were independently associated with maternal functioning. This work provides new evidence regarding the role of various clinical and racial factors on Black postpartum women's adjustment to motherhood. This analysis also adds to the growing body of evidence of reliability for the BIMF in Black postpartum women.

Maternal-Infant Attachment and its Relationships with Postpartum Depression, Anxiety, Affective Instability, Stress, and Social Support in a Canadian Community Sample.

As a crucial component of child development, maternal-infant attachment influences a child's cognitive, psychological, and social development. Maternal depression, anxiety, stress, and social support have been identified as risk factors for poor maternal-infant attachment in some studies, while others did not find such relationships. The aim of this study was to examine the associations of maternal-infant attachment with depression, anxiety, affective instability, stress, social support, and other variables in a community sample of Canadian postpartum women. A total of 108 Canadian postpartum women participated in this cross-sectional study. The Depression, Anxiety, and Stress Scale-21 (DASS-21) assessed depression, anxiety, and stress, and the Affective lability Scale-18 measured affective instability (AI). Multiple linear regression was conducted to examine the association between maternal-infant attachment and other variables. The findings revealed a significant association of maternal-infant attachment with postpartum depression, and infant temperament, while anxiety, AI, stress, and social support were not identified as predictors for maternal-infant attachment. The results implicate the importance of addressing maternal depression and maternal-infant attachment, consequently decreasing the risk for childhood psychopathology.

Associations between postpartum pain, mood, and maternal–infant attachment and parenting outcomes

Pain and depression are interrelated, and worse postpartum pain has been associated with postpartum depression. It remains unclear whether improved pain and mood after delivery can also improve maternal parenting. Few studies have examined relationships between postpartum pain and negative mood (anxiety or depression) or their effects on parent–infant relationship outcomes. The purpose of this study was to explore the relationships between postpartum pain, mood, parent–infant attachment, parenting self-efficacy, and infant development. This was a prospective longitudinal observational pilot study of nulliparous women enrolled at the third trimester and presenting for labor and delivery at term gestation. Baseline third trimester assessments included validated inventories of pain (the brief pain inventory, BPI), depression (the Edinburgh postnatal depression screen, EPDS), anxiety (the state trait anxiety inventory, STAI), multidimensional scale of perceived social support (perceived social support scale, MSPSS) and perceived stress scale (PSS). Demographic and labor characteristics were recorded. At 6 weeks and 3 months postpartum, self-reported assessments included EPDS, STAI, BPI, maternal parent infant attachment scale (MPAS), and perceived maternal parenting self-efficacy (PMP-SE). Child development outcomes were assessed at 6 weeks and 3 months using the Ages and Stages Questionnaire (ASQ). Univariable linear regression assessed the relationships between pain and parenting outcomes (MPAS and PMP-SE), including potential interactions between pain and mood for parenting outcomes. Generalized linear modeling was used to explore the relationships between postpartum pain, parenting outcomes, and child development outcomes. Of 187 subjects, 87 had complete data on parent–infant attachment and parenting self-efficacy data at 3 months. Lower "pain right now" scores (BPI) on postpartum day 1 was associated with higher maternal–infant attachment (MPAS) at 6 weeks postpartum (Estimate − 1.8, 95% CI − 3.4 to − 0.2, P < 0.03) but not at 3 months (Estimate 0.23 95% CI − 1.1 to 1.6, P = 0.7). Higher depression (EPDS) scores at 6 weeks were also associated with lower MPAS scores at 6 weeks (Estimate − 1.24, 95% CI − 2.07 to − 0.40, P = 0.004). However, there was no evidence that the relationship between pain and MPAS varied by depression score at 6 weeks (P = 0.42). Pain scores at baseline, six weeks, or three months did not correlate with parenting outcomes (MPAS, PMP-SE) at six weeks or three months. Results of the generalized linear modeling revealed relationships between pain, age, anxiety (STAI), and depression (EPDS) predictors, and the outcomes of parenting (MPAS, PMP-SE) and gross motor and personal–social (ASQ) aspects of infant development. There is a pattern of association between worse postpartum pain, anxiety, and depression with worse parenting outcomes. Depression and pain may also affect infant development, but future work is required to replicate and characterize these potential relationships.

Concept analysis of maternal-infant attachment during the weaning process.

At the time that the mother and baby transit from breastfeeding to weaning, maternal-fetal attachment becomes a crucial basis for maintaining their emotional relationship. Conceptualization is needed to better understand the phenomenon of maternal-infant attachment during the weaning process. The purpose of this paper is to explore and identify the essence of the term maternal-infant attachment during weaning and to arrive at an operational definition of the concept. Concept analysis following Walker and Avant. The attributes of maternal-infant attachment during the weaning process include (1) consistent and properly timed, (2) dynamic transactional interaction, and (3) secured adjustment. Maternal-infant attachment during the weaning process is brought by maternal sensitivity, closeness and proximity seeking, gentle and positive weaning, and breastfeeding experiences, which later turn into favorable emotion regulation, maturity, self-efficacy, secured bond, less intrusive interaction, resilience, and child's behavioral and development. This concept analysis provides new insight into maternal-infant attachment during the weaning process that guides the nursing practice. Also, the findings can help develop or improve the models, theories, and instruments collected for maintaining maternal-fetal attachment during the weaning process.