Mother-baby Relationship Research Articles

Postpartum Depression and Its Impact of the Mother Child Relationship

Introduction: Depression is one of the main complications of the postpartum period [1]. Yet it is often insufficiently prevented, diagnosed and treated. Objectives: To determine the prevalence of postpartum depression and its impact on the mother-baby relationship, and to identify associated risk factors. Materials and Methods: Descriptive and analytical cross-sectional study, over a three-month period from January 1 to March 31, 2022, of postpartum women using a hetero-questionnaire (socio-demographic data); Edinburgh Postpartum Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ). Results: We enrolled 227 patients. The mean age of our patients was 28.8 ± 5.76 years.53.7% of our patients were primiparous, and 83.3% wanted their current pregnancy. 13.7% had given birth prematurely. The prevalence of postpartum depression was 21.1% and correlated with celibacy, low educational level, lack of desire for pregnancy and poor marital relationship. Post-partum depression is said to have an impact on family dynamics, mainly on the mother-baby relationship, and later on the child's psychological balance and development, as assessed by the PBQ. The PBQ came back disturbed in our study. Conclusion: Therapeutic, preventive and even curative measures should be proposed for postpartum women, from educational measures for women and their close circle, psychotherapeutic means to well timed and appropriate drug prescription before complications set in.

A Qualitative Investigation of a Prenatal Mindfulness Relationship-Based (PMRB) Program to Support Maternal Mental Health and Mother–Baby Relationship During Pregnancy and Post-Partum

BackgroundPregnancy and the postpartum period are times of significant transition for women, with changes in maternal physical and mental health. The formation of a relationship between a mother and her baby is vital and has been recognised as laying the foundation for later child development. There is considerable evidence that this early relationship is influenced by a woman’s well-being during pregnancy and in the early post-partum period. Mindfulness-based programs have previously revealed positive outcomes, primarily in reducing maternal stress, anxiety, and depression. However, there remains a need for considering the influence of mindfulness on the mother-baby relationship and embodiment during pregnancy and the first trimester post-partum. This study aimed to conduct an in-depth exploration of pregnant women’s experiences of a nine-session prenatal mindfulness relationship-based (PMRB) program to support its feasibility.MethodsInformation about pregnant women’s (n = 13) experiences of the PMRB program was collected through online interviews during the sessions, including their birth stories. Responses to an open-ended question about how the program had supported them during pregnancy, labour/birth, and the first post-partum trimester were summarised using thematic analysis.ResultsSixteen themes were identified and organised in four categories: (1) expectations and motivations (healthy pregnancy and mental health, non-medicalised birth, contribution to the field); (2) experiences of the PMRB program (positive experiences, shared experience, engagement with mindfulness practices, pain, stress, and anxiety relief); (3) changes attributed to the PMRB program (a new way of responding to stressors, trusting the process, connecting to body, breath, and unborn baby, awareness of the unborn baby as a sentient being); (4) changes attributed to the mindfulness practice (increased mindfulness/self-awareness, stop look listen, embracing the moment, acceptance).ConclusionsThe evaluation suggested the PMRB program may help women cope with pain and emotional challenges and be more connected to their bodies and infant. The program may also help women become more aware of their unborn baby as a sentient being and the influence of their health and mental well-being on the baby development and health. Furthermore, the program may facilitate the mother-baby relationship during pregnancy, post-partum, and breastfeeding.PreregistrationThe trial has been successfully registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) following ethical approval from Bond University Human Research Ethics Committee (BUHREC—Application AS03534, approved 20 December 2022) and allocated the Australian clinical trials registration number (ACTRN): ACTRN12623000679684.

Intergenerational Impact of Maternal Early Life Stress on Infant Development: Risk and Protective Factors From the BABIP Birth Cohort

BackgroundMaternal early life stress may exert an intergenerational impact, leading to adverse infant outcomes. Recent studies suggest moderation of this impact by characteristics of the perinatal environment and physiology. In the Bogazici Mother Baby Relationship Project (BABIP) birth cohort from Istanbul, Turkey, we investigated the role of pregnancy-related worries, fetal bonding and cortisol awakening response as potential risk and protective factors on infant development. MethodsParticipants were pregnant women (N = 187) and their babies from BABIP birth cohort. Maternal early life stress, pregnancy-related worries and fetal bonding was measured by Childhood Trauma Questionnaire, Cambridge Worry Scale, and Fetal Attachment Scale, respectively. Cortisol awakening response was measured from saliva samples collected during pregnancy as the difference between awakening and peak cortisol after awakening. Infant development was measured at 4 months after birth using the Ages & Stages Questionnaire. ResultsMaternal early life stress was associated with worse infant development at 4 months. This effect was exacerbated in mothers with high pregnancy-related worries (p <.05) and low fetal bonding (p <.01) during pregnancy. There was a trend for more pronounced effects for both factors in women with higher cortisol awakening response. There were no differences by infant sex. ConclusionThe results suggest that the intergenerational impact of maternal early life stress on infant development may be moderated by prenatal risk and resilience factors, suggesting that infant development is influenced by interactions between maternal early and prenatal environment and physiology. FundingBogazici University BAP #11662&18983&19357, TUBITAK #221K039 (EAD).

Un autre regard sur l’énigme du sexe : l’excès et l’affect à la lumière de la complémentarité des sexes

ContextThis article traces the history of my efforts to understand how binary gender signifiers organise the otherness of sexuality; to analyse the tension of bearing the tension of sexuality with regard to the regulation of affect and the theory of recognition. ObjectivesThe core of this work has been an effort to establish a place in intersubjective and relational thought for sexuality. MethodTo do this, I locate the origins of our stance toward sexual arousal in experiences of the early mother-child dyad and following the traces of this model into gender complementarity. ResultsThe clinical sequelae of early dysregulation should be noted: the effects of unacknowledged distress, abandonment and overstimulation on adult sexuality. We have explored how the inability to tolerate sexual arousal and the affect of arousal, the “overflow”, reflects the failures of the mother-baby relationship. The marks of these failures are apparent when they emerge in the clinical staging of transference-countertransference. InterpretationsThe constant tension between intrapsychic fantasy and intersubjective procedural work in the transferential matrix should be emphasised. The interweaving of these two layers is visible in the fantasies that – at once – mask and reveal the intersubjective failures of regulation and recognition. These fantasies are shaped by the gender metaphors used to deal with the enigmatic message.

The effect of spiritual self-care training on the attachment of the mothers of premature babies hospitalized in the neonatal intensive care unit (NICU) of Taleghani Hospital, Ilam

Background. The birth of a premature baby needing to be hospitalized in the neonatal intensive care unit (NICU) endangers the initial mother-baby relationship, affecting mother-baby attachment. Therefore, it seems necessary to provide mothers of premature babies with appropriate nursing support. In the present study, we aimed to investigate the effects of spiritual self-care training on the mother-baby attachment of mothers giving birth to premature babies hospitalized in the NICU. Methods. This was a semi-experimental study with pre-test/post-test design conducted on 60 mothers with babies admitted to the NICU of Taleghani Hospital of Ilam (30 participants in each of the intervention and control groups).Two questionnaires were used for data collection, including a demographic information questionnaire and the Maternal Postnatal Attachment Scale (MPAS). Five self-care training sessions (45 minutes each) were held for mothers of the intervention group according to a self-care booklet prepared by the researcher. The attachment questionnaire was again completed after one week of the last training sessions by all participants, and the data were analyzed using SPSS version 22 software. Descriptive statistics were used to present quantitative (mean ±SD) and qualitative (frequency, %) variables. The normality of the data was checked using the Kolmogorov Smirnov test, and the MANOVA and univariate analysis of covariance (ANCOVA) tests were used to investigate the effects of the training on mother-baby attachment. The statistical significance level was considered P&lt;0.05. Results. The means of the total attachment score in the intervention and control groups were obtained as 51.73 and 56.43 at the pretest and 53.36 and 49.77 at the post-test, respectively, indicating that spiritual self-care training was effective in improving mother-baby attachment (P&lt;0.05). Conclusion. Our results showed that spiritual self-care training augmented mothers’ attachment to their babies hospitalized at the NICU. According to the results of the present study, it is suggested to pave the ground in clinical environments by educating nurses and caregivers and supporting the mother and the baby through spiritual self-care interventions to promote maternal attachment and improve their conditions. Practical Implications. According to the results of the present study, it is suggested to pave the ground in clinical environments by educating nurses and caregivers and supporting the mother and the baby through spiritual self-care interventions to promote maternal attachment and improve their conditions.

Living with a birthmark: Phenomenology of prematurity for mothers in Turkey

BackgroundMothers of premature infants are in the risk group for having psychological symptoms and attachment-interaction difficulties. Preventing these maternal risks is essential for providing optimal care and health opportunities for infants, consequently improving developmental outcomes. MethodsIn this study, we aimed to understand how mothers experienced prematurity within four processes retrospectively: (a) the mother's hospitalization after birth, (b) the infant's hospitalization in the Neonatal Intensive Care Unit (NICU), (c) after discharge, and (d) in early childhood. We adopted Max van Manen's phenomenology of practice and interviewed nine mothers whose children were born premature and reached early childhood. FindingsThe themes were as follows: (a) incomplete mother; (b) facing prematurity, uncertainty, natural touch barrier, facing reductive social response, and NICU friendship; (c) being on the alert, a period of complete closure, and fighting with the reductive social response; (d) association to prematurity and (cannot) overcome the difficulties. We expressed the mothers' overall experiences through the metaphor “living with a birthmark.” This metaphor represents the longitudinal effects of prematurity. As much as it is apparent and painful at first, it fades over time, and the pain lessens, but the effects of the birthmark remain in early childhood. The birthmark becomes a part of the mother-baby relationship. Conclusions and practice implicationsOur study contributes to premature infant care and health literature by highlighting the longitudinal experiences of mothers on prematurity.

Childbirth, trauma and family relationships

ABSTRACT Background: Childbirth is a major life event with expected positive outcomes, yet for some women postnatal psychopathological symptoms may harm women’s interpersonal relationships. We hypothesized that higher levels of postnatal depression, post-traumatic stress (PTSD) symptoms, and fear of childbirth would be associated with mother-baby bond disorders and relationship dissatisfaction in couples. Method: A cross-sectional self-report online questionnaire was used to survey partnered women who had delivered in the year prior to the study. We used a convenience sample of 228 women recruited through purposive and snowball sampling. Childbirth experience, PTSD symptoms, attachment style, depression, mother-baby bond disorders, and couple relationship dissatisfaction were measured. Results: Women with higher PTSD and postnatal depression scores reported higher levels of mother-baby bond disorders—a relationship fully mediated by postnatal depression symptoms. Women who perceived childbirth as fearful or anxiety provoking had higher levels of PTSD and postnatal depression symptoms. Fearful and anxious birth perception was positively associated with mother-baby bond disorders—an association partly mediated by PTSD symptoms. Insecure attachment style was not found to be significantly associated with fearful or anxious perceptions of childbirth. Limitations: Women who have postnatal PTSD/depression are less inclined to participate in a study of this nature. Also, online surveys prevented the use of clinical diagnoses of PTSD and depression. Discussion and conclusions: Our results suggest that PTSD and postnatal depression affect women’s mental health and family bonding. Women should be assessed for negative traumatic birth experiences, PTSD, and depression, to allow targeted observation for psychopathologies and therapeutic interventions.

Fragile Infant Forums for Implementation of IFCDC Standards, “The Mother-Baby Relationship: The Key Cornerstone of the IFCDC Standards”

Fragile Infant Forums for Implementation of IFCDC Standards, “The Mother-Baby Relationship: The Key Cornerstone of the IFCDC Standards”

Possible Stress-Neuroendocrine System-Psychological Symptoms Relationship in Pregnant Women during the COVID-19 Pandemic.

The COVID-19 pandemic induced long-term damages that weigh on the national health systems of various countries in terms of support and care. This review aimed to highlight the mental health impact of the COVID-19 pandemic in pregnant women. We first report data on the immune system physiopathology and the main viral infections in pregnancy, including COVID-19. Then, the attention is focused on the main factors that affect the mental health of pregnant women during the COVID-19 pandemic, such as (1) the fear of being infected and transmitting the infection to the fetus, (2) the cancellation of checkups and pre-child courses, and (3) confinement and the inability to have close friends or a partner at the time of delivery or in the first days after delivery, as well as family tensions. Because of all this, pregnant women find themselves in a stressful condition independent of the pregnancy, and thus experience anxiety, depression, insomnia, hostility, delirium, and an alteration of the mother–baby relationship. Several studies have shown an involvement of the hypothalamic–pituitary–adrenal axis and the hypothalamic–pituitary–thyroid axis in response to the pandemic. We propose a possible involvement of the neuroendocrine system as a mediator of the psychological symptoms of pregnant women induced by COVID-19-related stress.

Uncovering the Model and Philosophy of Care of a Psychiatric Inpatient Mother-Baby Unit in a Qualitative Study with Staff.

The postnatal period is high-risk time for the first onset and recurrence of maternal mental health disorders. Untreated maternal mental illness can have significant adverse impacts on a woman, her baby, and the wider family unit. For women with mental illnesses that cannot be managed in the community, psychiatric inpatient mother-baby units are the gold standard treatment whereby mothers are co-admitted with their infant for specialist perinatal and infant mental health assessment and treatment. The study explores the model of care and examines the philosophies of care that are used within a psychiatric mother-baby unit. Purposive sampling was used to conduct semi-structured focus group and individual interviews with multidisciplinary staff members at a single mother-baby unit. Themes derived from these interviews were coded into two primary themes and a range of sub-themes. The first primary theme focused on the Model of Care consisting of the following sub-themes: mental health care, physical health care, babies’ care, building mother-baby relationship, fostering relationships with supports, and facilitating community support. The second primary theme centered around the Philosophy of Care comprising of: person-centered care, trauma-informed care, compassion-centered care, recovery-oriented care, attachment-informed care, non-judgmental care, strengths-based care and interdisciplinary care. The model can be used to provide consistency across mother-baby units and to support core capabilities of staff in providing an optimal level of care.

New units for perinatal mental health disorders: Description of the first 150 dyads attended at Mother Baby Day Hospital CLINIC-BCN

IntroductionPerinatal Mental Disorders are considered a public health problem due to the impact on both, the maternal health and the children, in the short and long term. During 2018, at the Hospital Clínic of Barcelona, the first Mother Baby Day Hospital (MBDH) in Spain was developed and implemented. MethodThe first 150 dyads (mother and baby) attended from January 2018 to October 2021 were selected. The sociodemographic and clinical characteristics were described. The clinical variables studied were anxious and depressive symptoms, mother–baby relationship and maternal functionality. ResultsThe mean age of mothers was 34 years and of babies 3.7 months. 80% had a psychiatric background and 30.7% had required some psychiatric inpatient admission. 48.7% of the patients were diagnosed with a major depressive episode and a half had some psychiatric comorbidity (54.7%). One in 3 patients admitted had a moderate–high suicidal risk and 10.7% had attempted suicide in the current episode. At discharge, significant improvements were observed in the scales of depression (EPDS), anxiety (STAI-E), mother–baby relationship (PBQ) and functionality (HoNOS). ConclusionsThe MBDH allows us a comprehensive, intensive and multidisciplinary care for postpartum mothers with a mental disorder with good results and containment of risk behaviours. Likewise, MBDH allows us to detect and to intervene in bonding difficulties and maternal care giving.

Understanding the impact of newborn touch upon mothers of hospitalized preterm neonates.

Introduction: Many interventions have been designed to support the development of the preterm baby and minimise the complications of prematurity. However, there is limited evidence of the possible psychological benefits of touch to the mother when she is the one performing the support programme during the hospitalisation of her newborn. Objective: This study explored whether the type of touch provided to preterm neonates had an impact on maternal self-efficacy, self-esteem and maternal-to-infant attachment, as-well-as newborn weight gain. Methods: Using a randomised cluster trial, forty babies and their mothers were allocated to one of two groups receiving either a touch-based intervention (TAC-TIC; Touching And Caressing; Tender In Caring) or spontaneous touch. Results: Mothers who provided the touch-based intervention demonstrated greater increases in self-efficacy, self-esteem and attachment, and babies gained more weight than those using spontaneous touch. Conclusion: The results indicate that systematic touch interventions may be used to facilitate the mother-baby relationship as well as to promote newborn weight gain.

Postpartum psychosis treatment: review of mother-baby units

IntroductionPostpartum Psychosis is an underdiagnosticated psychiatric condition that may be suffered by mothers within a year since delivery. It is a severe syndrome in which symptoms such as delusions, hallucinations and disorganized thinking may appear. The traditional approach of admitting the mothers separated from their children has shown harmful consequences. This has led to the creation of Mother-Baby Units (MBU), psychiatric admission units dedicated to full-time housing mothers and their babies.Objectives To evaluate the evidence available regarding the potential benefits of MBU not only for the mothers, the babies, but for the mother-baby bond. To analyse postpartum psychosis risk factors and prognosis.MethodsA thorough review of scientific literature and databases regarding postpartum psychosis and MBU has been carried out. Additionally, international mental health care guidelines for perinatal mental disorders were analysed.ResultsA wide range of related aspects were studied for the present work, including characteristics of the patients, differences in the self- assessment scales of depression, anxiety, postpartum attachment of the mother to the baby at admission and at discharge and the work and social adaptation. Other studies analysed the percentage of mother-baby separation at discharge, as well as the most frequent delusions, and the potential effect of childhood trauma on these patients.ConclusionsThe available evidence suggest that MBU may be helpful for the improvement of the mental health in women suffering perinatal mental disorders and for the building of a secure attachment style in the baby. The results of the interventions included in MBU programs also show promotion of a positive mother-baby relationship.DisclosureNo significant relationships.

Ser gestante en tiempos de pandemia: Una mirada de la salud mental antes y durante la pandemia

Introduction: Pregnancy is a time of physiological, psychological, personal and social changes for women. The role of the emotional and psychological aspect encompasses the entire period because as fetal development advances, the mother-baby relationship strengthens, making the mother vulnerable. Objectives: To collect, describe and analyze relevant information on mental health in pregnant women, both at different stages of gestation and before and during the COVID-19 pandemic. Methods: A literature search was conducted through PubMed, Google Scholar and Scielo using terminology compiled from MeSH and DeCs. Results: Pregnancy due to hormonal changes causes the presence of anxiety and depression that worsen as the stages of fetal development progress. These psychological disorders have greatly increased during the COVID-19 pandemic due to several reasons such as the relationship with the couple, uncertainty, fear, anguish and increasing phobia about contagion. Final considerations: Pregnant women are a vulnerable population, whose mental health has always been affected and nowadays it has been much more affected due to the pandemic, therefore they need better attention in the health sector such as providing them with reliable information on measures to alleviate the burden of stressors, since they not only carry the anguish of their health but also that of the fetus.

The OneFlorida Data Trust: a centralized, translational research data infrastructure of statewide scope.

The OneFlorida Data Trust is a centralized research patient data repository created and managed by the OneFlorida Clinical Research Consortium (“OneFlorida”). It comprises structured electronic health record (EHR), administrative claims, tumor registry, death, and other data on 17.2 million individuals who received healthcare in Florida between January 2012 and the present. Ten healthcare systems in Miami, Orlando, Tampa, Jacksonville, Tallahassee, Gainesville, and rural areas of Florida contribute EHR data, covering the major metropolitan regions in Florida. Deduplication of patients is accomplished via privacy-preserving entity resolution (precision 0.97–0.99, recall 0.75), thereby linking patients’ EHR, claims, and death data. Another unique feature is the establishment of mother-baby relationships via Florida vital statistics data. Research usage has been significant, including major studies launched in the National Patient-Centered Clinical Research Network (“PCORnet”), where OneFlorida is 1 of 9 clinical research networks. The Data Trust’s robust, centralized, statewide data are a valuable and relatively unique research resource.

Breastfeeding in Mothers with COVID-19: Insights from Laboratory Tests and Follow-Up from Early Outbreak of the Pandemic in China.

Objective: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) threatens a surging number of community groups within society, including women actively breastfeeding. Breastfeeding involves intimate behaviors, a major transmission route of SARS-CoV-2, and is integral to the close mother-baby relationship highly correlated with maternal psychological status. Materials and Methods: Twenty-three pregnant women and puerperae with either confirmed or suspected diagnoses of COVID-19 were enrolled in the study. The clinical characteristics and outcomes of the mothers and neonates were recorded. The presence of SARS-CoV-2, IgG, and IgM in breast milk, maternal blood, and infant blood, together with feeding patterns, was assessed within 1 month after delivery. Feeding patterns and maternal psychological status were also recorded in the second follow-up. Results: No positive detection of SARS-CoV-2 was found in neonates. All breast milk samples were negative for the detection of SARS-CoV-2. The presence of IgM for SARS-CoV-2 in breast milk was correlated with IgM presence in the maternal blood. The results of IgG detection for SARS-CoV-2 were negative in all breast milk samples. All infants were in a healthy condition in two follow-ups, and antibody tests for SARS-CoV-2 were negative. The rate of breast milk feeding increased during two follow-ups. All mothers receiving a second follow-up experienced negative psychological factors and status. Conclusions: Our findings support the feasibility of breastfeeding in women infected with SARS-CoV-2. The additional negative psychological status of mothers due to COVID-19 should also be considered during the puerperium period.

Suicidalité en période périnatale : quels sont les facteurs associés ?

ObjectivesSuicide is the leading cause of maternal mortality in high-resource countries. The onset of suicidal ideation is a major risk factor for suicide attempts. Suicidality has a major impact on the mother-baby relationship and on child development. The main objective of the study was to identify factors associated with the occurrence of perinatal suicidal ideation in women requiring hospitalization. The secondary objectives of the study were to describe the socio-demographic and clinical characteristics of this specific population, to specify the follow-up procedures at hospital discharge and to develop a semi-directed interview framework for psychiatric evaluation of perinatal patients admitted to a psychiatric hospital in order to better identify those at risk of suicide and improve overall management, particularly in terms of referral to existing perinatal care services. MethodsDescriptive and retrospective study carried out at the Specialized Hospital Center of women hospitalized in the perinatal period between 2014 and 2019. The inclusion criteria were: inpatient pregnant or postpartum within one year of delivery, 16 to 43 years. A keyword search was performed to retrieve the computerized records. All records matching the inclusion criteria were included. We studied the occurrence of suicidal ideation according to the main known clinical and socio-demographic risk factors. ResultsThe sample included 25 pregnant patients and 57 post-partum patients. The presence of a psychiatric history increased the risk of suicidal ideation by 4.38 (P<0.03). The association between the occurrence of a stressful life event and the risk of suicidal ideation onset was close to significant (P<0.10). One third of the patients had been admitted for a reason related to suicidality. Less than one-third of the patients had been referred to existing perinatal services. ConclusionsSuicidality in the perinatal period has a major impact on the dyad as well as on the whole family. The search for suicidal ideas must be systematic during psychiatric interviews, a fortiori when a psychiatric history has been authenticated. Every patient hospitalized in adult psychiatry should be referred to specialized outpatient perinatal psychiatry services. Prevention involves raising awareness and training of all health professionals, networking, but also informing the general public.

Infant massage programs for newborn babies: systematic review

Introduction Parenthood is a period of stress and great demand for parents. Taking care of a baby requires parental adjustment and behavioural development in order to satisfy child’s needs. Infant massage is an important parental support strategy which enhances parent-child relationship and promotes baby’s development [1]. This is a widely and effective technique used in preterm and term infants. In recent years, many studies showed several benefits, such as improved weight gain; pain reduction; relaxation; increased alertness and learning; decreased stress, depression and anxiety levels; promoted deep sleep and improved immune system [2–4]. However, when evaluating term massage programs, it is noticed that there are no similar methodologies between studies. The purpose of this study is to review massage programs for newborn babies. Materials and methods This is a systematic review study. A literature search was conducted via three databases: PubMed, PEDro and Scielo using the search terms “Massage therapy”; “Infant massage”; “Baby massage”; “Full term”; “term babies”; “neonates”, “newborn” and “Maternal support” or “Mother support”. The inclusion criteria were: Studies published in English, Spanish or Portuguese; RCT studies; Quasi-experimental studies; Studies with massage program; Studies with term babies’ samples; Studies published between 2009 and 2019. The exclusion criteria were studies with term “babies with congenital disease”. A total of 62 papers were found and analysed by both authors. Fourteen met the criteria, 5 RCT’s and 9 quasi experimental studies. Results Studies described 6 programs of infant massage to newborn babies. Ten studies described mothers applying term massage program, 3 applied by health professionals and 1 divided between health professionals when in hospital and by their mothers when babies were discharged. The most representative direction of massage was from head to feet. Majority of the studies used group strategy for teaching infant massage to mothers. Programs varied from 1–3 days twice a day for 15 mn to once a week between 30–60 mn during 4–8 weeks. Studies were scored by PEDro’s scale and ranged from 2 to 7. Half of the studies obtained score 5. Discussion and conclusion We can conclude that 6 massage programs are described in literature; the majority is performed by babies’ mothers and there is a wide variety concerning program duration and frequency. Studies outcomes showed effects both on newborn babies and mother–baby relationship. Infant massage programs seem to be an important group teaching strategy for new parents. However, more studies should be done in order to understand if newborn massage works, regardless of the program type.

Suicide attempts in women with severe mental illness in the perinatal period

Suicide is one of the leading causes of perinatal maternal mortality (1). Maternal suicidality has a negative impact on the mother-baby relationship and child development. However, little is known about specific risk factors for perinatal suicide attempts in women with severe mental illness. In a sample of 1439 women with severe mental illness in the perinatal period and jointly admitted with their baby in a mother and baby unit, 154 (11.7%) attempted suicide, 49 in pregnancy (3.7%) and 105 (8.0%) in the post-partum period (2). Suicide attempt in pregnancy was related to alcohol use, smoking during pregnancy and a history of miscarriage, and in the post-partum period to major depressive episode or recurrent depression and younger age. Women who attempt suicide either in pregnancy or in the postnatal period could have different psychopathological and environmental profiles. Past obstetric history and addictive behaviours during pregnancy are essential elements to explore. In addition, depressive symptoms should be assessed in all women to treat major depression, as a means of preventing suicide attempt. Special attention to risk of suicide is needed during the perinatal period for women with severe mental illness. For women suffering from an acute psychiatric disorder, or a history of mental illness, multi-disciplinary management should be implemented. 1. Oates M. Suicide: the leading cause of maternal death. Br J Psychiatry. 2003;183:279-81. 2. Gressier F et al. Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. J Psychiatr Res. 2017;84:284-291.DisclosureNo significant relationships.

Postpartum Maternal Tethering: A Bioethics of Early Motherhood.

This article proposes a new way of conceptualizing the ethical relationship between postpartum mothers and their newborn babies. I suggest that the intertwinement of mother and baby - and the tensions that this intertwinement produces - do not disappear with birth, but rather persist throughout the postpartum period in the form of postpartum maternal tethering. I draw upon three years of ethnographic fieldwork and training in the US and China to argue that the dependency associated with postpartum maternal tethering makes it extremely difficult for postpartum mothers to act autonomously, even in the relational sense. I then examine how breaches in the postpartum maternal tether can open up new possibilities for thinking about the bioethics of vulnerability, dependency and care, by denaturalizing and de-sanctifying the mother-baby relationship and diversifying newborn care.