Parent-infant Relationship Research Articles

Preterm Parents' Stress and Coping Strategies in a Neonatal Intensive Care Unit in a University Hospital of Central Greece.

Background:The early birth of a newborn and the hospital care in the intensive care causes stress to parents.Objective:The main objective of this study was to investigate preterm parents’ level of stress and which coping strategies do they use in a Neonatal Intensive care Unit in a University Hospital of Central Greece.Methods:This cross-sectional study used a group of 82 preterm parents in the Neonatal Intensive care unit in a University Hospital of Central Greece. They were asked to answer a questionnaire with the Parental Stressor Scale: Neonatal Intensive Care Unit (PSS: NICU), Coping Orientation to Problems Experienced (BRIEF/COPE), Daily Spiritual Experience Scale (DSES). The McNemar test was used to compare fathers ‘and mothers’ views on psychological support. The paired t-test or the Wilcoxon-signed rank test was used to compare scores between fathers and mothers. The levels of importance are bilateral and the statistical importance was defined as 0.5. For the analysis SPSS 22.0 was used.Results:The most common cause of admission to NICU was low birth weight. The severity of the preterm’s condition was found to be independently correlated with PSS-NICU score due to “sights and sounds” and due to “Infant Appearance and behaviour” in the NICU. The severity of the child’s condition and the parents’ DSES score were found to be independently correlated to the stress score due to their “parent-infant relationship”. Mothers ‘and fathers’ scores on the dimensions of the Brief-COPE Questionnaire were similar, suggesting a similar way of managing stress. Substance use, religion, humor were found to correlate with total score of PSS-NICU. More specifically PSS-NICU correlated negatively with substance use (r=-0.30 p=0.009) and humor (r=-0.28 p=0.016) while it correlated positively with religion (r=0.29 p=0.011).Conclusion:Mothers and fathers of preterm need support. Spirituality and religion, helps then face the challenges of having their baby hospitalized in a NICU.

Infant-Family Mental Health in the NICU: A Mixed-Methods Study Exploring Referral Pathways and Family Engagement.

Parents and infants in the neonatal intensive care unit (NICU) are exposed to considerable stress, and infant-family mental health (IFMH) services foster emotional well-being in the context of the parent-infant relationship. This mixed-methods study examined the role of an IFMH program introduced in a level 4 NICU. The study included (1) retrospective medical record review of NICU patients who were referred to the IFMH program and (2) qualitative interviews with NICU nurse managers, neonatologists, and medical social workers to explore their understanding of the IFMH program, explore the referral pathways and factors that supported family engagement, and identify specific recommendations for program improvement. Of the 311 infant-parent dyads referred to the IFMH program, 62% had at least one session and Spanish-speaking families were more likely to engage. Of those families receiving services, about one-third had brief intervention, one-third had 4 to 10 sessions, and one-third had long-term services, including in-home after-discharge services. Qualitative interviews with health providers identified unique qualities of the IFMH program and why families were and were not referred to the program. Recommendations centered on adding a full-time IFMH mental health provider to the NICU and increasing communication and integration between the IFMH program and the medical team.

Creative Music Therapy with Premature Infants and Their Parents: A Mixed-Method Pilot Study on Parents' Anxiety, Stress and Depressive Symptoms and Parent-Infant Attachment.

Premature birth is stressful for infants and parents and can adversely affect the parent–infant dyad. This mixed-methods pilot study evaluates whether creative music therapy (CMT) can alleviate anxiety, stress, and depressive symptoms in parents and support the bonding process with their infant. Sixteen parent couples were included. Ten couples were randomly allocated to the music therapy group (MTG) and six to the control group (CG). All couples completed psychological questionnaires measuring anxiety and depressive symptoms as well as an implicit measure of parent–infant attachment at two weeks postpartum (T1), at approximate neonatal intensive care unit (NICU) hospitalization halftime (T2), and two weeks after the infant had been discharged (T3). At T1 and T2, the parents additionally completed a questionnaire assessing the degree of stress they experienced at the NICU. Qualitative data were collected through a semi-structured, problem-centered interview with MTG parents at T3. The results of the quantitative analyses revealed reductions in anxiety levels from T1 to T2 (p = 0.002) as well as decreases in depressive symptoms from T2 to T3 (p = 0.022). No such changes were apparent in the CG. In fact, parental stress increased from T1 to T2 (p = 0.016). Significant increases in attachment across time were also observed within the MTG, but not in the CG. The qualitative inquiry confirmed that CMT can support the parent–infant relationship. Being in musical interaction evoked feelings of joy and relaxation in the parents and encouraged them to interact more profoundly with their infant. The results call for a more extensive powered follow-up study to further investigate CMT’s potential for parental well-being and parent–infant bonding.

Mind-mindedness versus mentalistic interpretations of behavior: Is mind-mindedness a relational construct?

Mind-mindedness is a measure of the tendency to represent significant others in internal state terms and is central to supportive parent-infant relationships. The two studies reported here explored whether mind-mindedness generalizes to representations of unknown individuals, using a novel task that assessed individual differences in adults' tendency to interpret others' behavior with reference to their internal states: the Unknown Mother-Infant Interaction Task (UMIIT). We compared UMIIT performance with measures of mind-mindedness from (a) adults' descriptions of close friends and partners (Study 1, N=96) and (b) mothers' appropriate versus nonattuned comments on their infants' internal states (Study 2, N=56). In line with the proposal that mind-mindedness is a relational construct, UMIIT performance was unrelated to mind-mindedness in both studies.

Interventions to support parents of infants at risk or with a diagnosis of neurodevelopmental disability.

Parents of children with a diagnosis or at risk of neurodevelopmental disabilities experience varied challenges of psychological adjustment. Many studies report psychological distress, including guilt, helplessness, anxiety and depression while in the Neonatal Intensive Care Unit (NICU)1 and often experience this time as traumatic and stressful.2 Interventions to improve the pyschological adjustment and well-being of parents of these vulnerable infants are varied in framework, dosage and timing.3 In their recent systematic review, Dickinson and colleagues examine the effect of interventions on psychological adjustment of parents of infants with a diagnosis or risk of neurodevelopmental disability compared with usual care.4 This study is different to other reviews that have included only preterm infants, rather than broader neurodevelopmental impairments, or focused primarily on infant development,5 mother-infant attachment6 or NICU-based3 interventions. Based on these papers, Dickinson and colleagues reported that a small number of high-quality studies demonstrated moderate strength of effectiveness in reducing parental psychological symptoms of trauma and stress, which was maintained at follow-up post-intervention (6 months to 8 years). Of the high-quality studies measuring depression and anxiety symptoms, there were no significant effects of interventions immediately post-intervention; however, significant improvements in these symptoms were seen at longer-term follow-up, suggesting a delayed effect of interventions on parental psychological adjustment. This highlights the importance of having psychological and emotional support for parents of high-risk infants both during an admission to the NICU and on discharge home, along with longer-term follow-up. High-quality studies were restricted to studies of preterm or low birth weight infants, highlighting a need for further studies in diverse high-risk infant populations. As a parent's ability to cope and support their infants’ needs is highly influenced by their psychological and emotional state, most interventions commence in the NICU to help parental psychological adjustment from the beginning of their child's journey.4 Similar to therapeutic interventions for infants with neurodevelopmental disabilities such as cerebral palsy,7 many intervention frameworks were explored in this review and no single approach appeared superior over another. This draws attention to the heterogeneity of therapy approaches in this area and the potential for future research to validate one approach over the others. Few included studies focused on both infant and parent outcomes, with only 33% also measuring infant or parent-infant relationship outcomes.4 Future studies may investigate both infant and parent outcomes to more holistically capture the entire family unit. Major strengths of this study were the systematic search strategy and clinically relevant interventions and outcomes. While some included studies had poor methodological quality, these were removed from meta-analyses to establish pooled effect of high-quality studies only. This review, while comprehensive, is limited by the research to date which is primarily focused on infants born preterm or low birth weight. Therefore, further research should explore parental psychological adjustment and well-being in wider neurodevelopmental disabilities. This knowledge is important to health professionals as parental mental health in adjusting to their infant's medical needs is crucial in the care provided to these infants. None. https://ebneo.org/2020/12/support-to-parents-neurodevelopmental-disability

What are the effects of supporting early parenting by newborn behavioral observations (NBO)? A cluster randomised trial

BackgroundProfessional support to enhance the early parent-infant relationship in the first months after birth is recommended, but little is known about the effect of universal interventions. The objective was to investigate the effect of health visitors’ use of the Newborn Behavioral Observations system in new families.MethodsA cluster-randomised study was conducted in four Danish municipalities. Health visitors’ geographical districts constituted the units for randomisation (n = 17). In the intervention group, 1332 families received NBO from 3 weeks after birth; in the comparison group, 1234 received usual care. Self-administered questionnaires were collected at baseline one to two weeks after birth, and at follow-up three and nine months postpartum. The outcomes were change over time measured by The Karitane Parenting Confidence Scale (KPCS), The Major Depression Inventory (MDI), The Ages and Stages Questionnaire: social-emotional (ASQ:SE) and The Mother and Baby Interaction Scale (MABIC). Data were analysed with mixed-effects linear regression using the intention-to-treat approach.ResultsAt baseline, no significant differences between the two groups were seen regarding maternal and infant factors. At follow-up three and nine months after birth, the change in maternal confidence and mood, infant’s socio-emotional behaviour, and early parent-infant relationship moved in a slightly more positive direction in the intervention group than in the comparison group, though not statistically significant. The only significant effect was that the intervention mothers reported higher level of knowledge about infant’s communication skills, response to cues, and how to sooth and establish a relation with the infant, compared to the comparison group.ConclusionsWe found no effect of the NBO system delivered in a universal context to all families in a community setting. The only significant difference between groups was a higher maternal degree of knowledge regarding early parenting in the intervention group.Trial registrationClinicalTrials.gov ID: NCT03070652. Registrated February 22, 2017.

How does adolescent motherhood affect mother–infant/toddler relationship and emotional availability

Background The present study examined the different aspects of infant–mother relationships in adolescent mothers and compared them in adult mothers. Methods Children aged 18–40 months who were referred to our outpatient Infant Mental Health Department were analysed retrospectively. Sociodemographic data, Parent–Infant Relationship Global Assessment Scale (PIR-GAS) scores, and Emotional Availability (EA) Scales scores were analysed. Twenty-nine adolescent mothers being younger than 20 years at the beginning of pregnancy and thirty mothers who were aged at least 25 years were enrolled the same data as adult mother group. Results In the adolescent mothers group, the education years of the mothers, the ratio of mothers having professions were significantly lower (p < 0.001); the spousal age gap was significantly higher than among the adult mothers (p < 0.001). It was also found that an underinvolved relationship pattern was seen more frequently among the mother–infant dyads in the adolescent mothers’ group than in the adult mothers group (p = 0.002). Conclusions Although there were not found many problems in terms of the relationship of adolescent mothers with their infants/toddlers in the current study this may have been due to a small sample, we would like to emphasise that the problems should be detected and appropriate interventions should be made for adolescent mothers. Key points Our main aim for this study was assesment of the effect of adolescent motherhood in terms of infant\ oddler–mother relationship Our findings showed that lower education level and being unemployed were higher in adolescent mothers group. Higher age gap between spouses was found to be associated with adolescent motherhood. Underinvolved relationship was highly prevalent among adolescent mothers Our findings suggest that early motherhood is a risk factor for mother–infant\ oddler–relationship and parenthood. Intervention and education programs during and after pregnancy for adolescent girls may help them to prepare for motherhood more consciously and form established relationships with their infants.

Early Parenting Acceptance and Commitment Therapy ‘Early PACT’ for parents of infants with cerebral palsy: a study protocol of a randomised controlled trial

IntroductionNew international clinical practice guidelines exist for identifying infants at high risk of cerebral palsy (CP) earlier: between 12 to 24 weeks corrected age, significantly earlier than previous diagnosis windows...

The Efficacy of Brief Parent−Infant Psychotherapy for Treating Early Regulatory Disorders: A Randomized Controlled Trial

Early regulatory disorders (ERD) place considerable strain on the parent-infant relationship and are associated with high parental distress. Brief (4-session) psychodynamic-based focused parent-infant psychotherapy (fPIP) treats ERD by strengthening the quality of the parent-infant relationship. This randomized controlled trial investigates the efficacy of fPIP for treating ERD compared to standard pediatric care (treatment as usual [TAU]). Participants were 154 mothers and infants from 4 to 15 months who met criteria for persistent excessive crying, sleeping disorders, feeding disorders, or regulation disorders of sensory processing and were randomly assigned to fPIP (n= 81) or TAU (n= 73). Assessments took place at baseline and at the end of treatment after 12 weeks. Primary outcomes were the infants' regulatory symptoms and remission rate. Secondary outcomes were parents' psychological distress, depression, parenting stress, maternal self-efficacy, parental reflective functioning, and observer-rated emotional availability. fPIP was superior to TAU in reducing infants' overall symptoms (p= .004, η2= 0.05, CI= 0.01-0.12), night-waking disorders (p= .030, odds ratio= 3.12, CI= 1.21-9.22), and mothers' psychological distress (p= .000, η2= 0.08, CI= 0.03-0.16) and depression (p= .002, η2= 0.06, CI= 0.02-0.13). There was a trend suggesting that fPIP led to increased maternal self-efficacy and parental reflective functioning. Results underscore the efficacy of brief fPIP in significantly reducing symptoms in infants with ERD and their mothers. Generalizability is restricted to low psychosocial risk samples with highly distressed mothers and comorbid ERD with a predominance of night-waking disorders. The Efficacy of a Brief Parent-Infant Psychotherapy for the Treatment of Early Regulatory Disorders: A Randomized Controlled Trial; https://www.drks.de/drks_web/; DRKS00005739.

First-Time Mothers' and Fathers' Developmental Changes in the Perception of Their Daughters' and Sons' Temperament: Its Association With Parents' Mental Health.

ObjectiveMost studies investigating the role of parenting behaviors on a child’s development are directed to mothers. However, recent analyses show that mothers and fathers have a different influence on a child’s functioning, specifically her/his temperament. The present study explored the developmental change of parents’ perception of their daughters’ and sons’ temperament and its association with parental mental health problems.MethodsThe sample included 188 parents (94 couples) and their at-term 94 babies (55.3% boys, 44.7% girls). Assessments by self-reports were conducted at 3 (Time 1) and 12 (Time 2) months after the children’s birth; at Time 1, mothers and fathers independently answered: the State–Trait Anxiety Inventory (STAI), the Edinburgh Postnatal Depression Scale (EPDS), and the Infant Behavior Questionnaire (IBQ-R). At Time 2, EPDS, STAI, and IBQ-R were again administered to mothers and fathers.ResultsIn general, mothers and fathers would give similar descriptions of their child’s temperament throughout the first year of life; however, infant temperament showed developmental changes as well as gender differences. Mother and father anxiety and depression symptoms are associated with the infants’ negative affectivity. Also, mothers with high anxiety and depression levels perceive their infants with a minor tendency to approach novelty, to seek environmental stimulation, and to express/experience positive emotions.ConclusionThe results highlight the need to screen for infants’ temperament vulnerabilities in the context of maternal and paternal depression in order to protect the child from behavioral, cognitive, and emotional difficulties and to create specific programs aimed at preventing dysfunctional parent–infant relationships.

The downstream effects of COVID-19: a call for supporting family wellbeing in the NICU.

Parents of NICU infants are a vulnerable population from a psychological perspective, and often experience high levels of acute stress, depression, anxiety, and post-traumatic stress. The added burden of the current SARS CoV-2 disease (COVID-19) pandemic is likely to exacerbate these issues, with potential implications for the wellbeing of infants and families in the short- and long-term. In this paper, we propose utilizing the stress contagion framework and consider how psychosocial stress can “spill over” into the parent-infant relationship domain, which can impact child development and family wellbeing longer term. As the effects of the pandemic will likely persist well beyond the acute stage, we offer advocacy points and general guidelines for healthcare professionals to consider in their quest to mitigate stress and build resilience in NICU families.

The Crying Clinic: Increasing accessibility to Infant Mental Health services for immigrant parents at risk for peripartum depression.

Peripartum depression (PPD) is considered a major public health concern due to its profound impact on families, including infants. In this paper, we report on a pilot initiative designed to reduce barriers and stigma related to the use of traditional infant mental health services for immigrant parents deemed at high risk of PPD. The Crying Clinic (CC) is an innovative walk-in service offered in a culturally diverse Canadian community to support maternal well-being and healthy parent-infant relationships. The CC was designed to be a gateway to existing infant mental health services, through its emphasis on accessibility and cultural sensitivity. Support for concrete concerns, such as anxiety about normative infant behaviors like crying, is underscored in this approach to attract vulnerable families who would otherwise not access mental health support. A review of 44 users, utilization, plans for the use of additional services, and client evaluations suggests that the CC accomplished most of its goals. We conclude that gateway service models such as the CC have the potential to enhance traditional infant mental health programs by creatively addressing the challenge of engaging highly vulnerable parents from culturally diverse backgrounds.

Small for gestational age-cognitive performance from infancy to adulthood: an observational study.

To determine whether cognitive performance from infancy to adulthood is affected by being born small for gestational age (SGA), and if this depends on the SGA reference used. Furthermore, to determine SGA's effect while considering the effects of very preterm/very low birthweight (VP/VLBW), socio-economic status (SES) and parent-infant relationship. A total of 414 participants (197 term-born, 217 VP/VLBW) of the Bavarian Longitudinal Study. Small for gestational age was classified using neonatal or fetal growth references. SES and the parent-infant relationship were assessed before the infant was 5months old. Developmental (DQ) and intelligence (IQ) tests assessed cognitive performance on six occasions, from 5months to 26years of age. The fetal reference classified more infants as SGA (<10th centile) than the neonatal reference (n=138, 33% versus n=75, 18%). Using linear mixed models, SGA was associated with IQ -8 points lower than appropriate for gestational age, regardless of reference used (95% CI -13.66 to -0.64 and 95% CI -13.75 to -1.98). This difference narrowed minimally into adulthood. Being VP/VLBW was associated with IQ -16 (95% CI -21.01 to -10.04) points lower than term-born participants. Low SES was associated with IQ -14 (95% CI -18.55 to -9.06) points lower than high SES. A poor parent-infant relationship was associated with IQ -10 points lower than those with a good relationship (95% CI -13.91 to -6.47). Small for gestational age is associated with lower IQ throughout development, independent of VP/VLBW birth, low SES or poor parent-child relationship. Social factors effects on IQ comparable to those of SGA and should be considered for interventions. Small for gestational age is associated with lower cognitive performance from infancy to adulthood.

Understanding the effects of being small for gestational age at birth.

Longitudinal neonatal outcome studies are becoming more exciting as we start to evaluate the trajectory of the well described sequelae of prematurity into the young adult effects of being born very preterm. In this issue of BJOG, Eves and colleagues use the Bavarian Longitudinal Study to evaluate the relative effects of being born small for gestational age (SGA) alongside important measures of social advantage and of parent infant relationship measures (BJOG 2020 xxxx). This is as it says - the effect of being small for dates at birth and not the effect of fetal growth restriction (FGR), an important distinction.

Efficacy of interventions to improve psychological adjustment for parents of infants with or at risk of neurodevelopmental disability: A systematic review.

Supportive and targeted interventions for families are required to optimize parental adjustment and the parent-infant relationship in line with earlier diagnosis of neurodevelopmental risk for infants. The purpose of this systematic review was to determine the efficacy of interventions in improving psychological adjustment and well-being for parents who have an infant diagnosed with or at risk of neurodevelopmental disability. The Cochrane Review Group search strategy was followed with search of The Cochrane Central Register of Controlled Trials, PubMed, CINAHL, PsycINFO, and Embase between July and December 2017. Methodological quality of included articles was assessed using the Physiotherapy Evidence Database (PEDro) Scale by two independent reviewers. Twelve studies met the inclusion criteria. A small number of high-quality trials demonstrated moderate to large effectiveness of reducing adverse parent psychological symptoms of trauma and stress. Significant improvements in depression and anxiety symptoms emerged at longer-term (6 months to 8 years) follow-up postinterventions. There is promising support for the effectiveness of some interventions to reduce maladaptive psychological symptoms in parents with infants diagnosed at risk of neurodevelopmental disability. Further quality RCTs of psychological interventions addressing broader neurodevelopmental risk conditions for infants are required.

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: results from the Northern Babies Longitudinal Study (NorBaby)

BackgroundFamilies can experience the postpartum period as overwhelming and many report a special need for support. The Newborn Behavioral Observation (NBO) aims to promote a positive parent-infant relationship by sensitising parents to the infant’s signals. This article evaluates the NBO as a universal preventive intervention within the regular well-baby clinic service on measures of maternal depressive symptoms, parental stress, the mother-infant relationship and satisfaction/benefit of the postpartum follow-up.MethodsThis investigation is part of a larger longitudinal study comprising 220 women and 130 of their partners recruited between 2015 and 2017. The study had a non-randomised cluster-controlled design with 6 measurement points. This article is based on a sample of 196 women using data from T1 (gestational weeks 13–39), T4 (5–15 weeks postpartum) and T5 (3–9 months postpartum). Participants were allocated to a group receiving the NBO (n = 82) and a care as usual comparison group (n = 114). We measured maternal depressive symptoms and parental stress using the Edinburgh Postnatal Depression Scale (EPDS) and the Parenting Stress Index (PSI). The mother-infant relationship was assessed with the Parental Reflective Functioning Questionnaire (PRFQ), the Maternal Postnatal Attachment Scale (MPAS) and the Maternal Confidence Questionnaire (MCQ). Participants also answered questions about satisfaction/benefit of the postpartum follow-up.ResultsA Mann-Whitney U test indicated that participants in the NBO-group learned significantly more than the comparison group from the follow-up about the baby’s signals in relation to sleep/sleep patterns, social interaction and crying/fuzziness. Multivariate analyses of covariance (MANCOVA) and repeated measures ANCOVA found no significant differences between the groups for the mother-infant relationship domain and few differences in depressive symptoms and parental stress. The repeated measures ANCOVA found that participants in the NBO-group scored slightly higher on parental stress, although the difference was small.ConclusionsThe results indicate that the NBO-group learned more than the comparison group about reading their child’s signals in important everyday situations. However, the benefits of the NBO were limited for depressive symptoms, parental stress and self-reported mother-infant relationship. The study sample was generally well-functioning, and the results indicate that the benefits of the NBO may be limited within a well-functioning sample.Trial registrationClinicalTrials, NCT02538497, Registered 2 September 2015.

The impact of having a baby with cleft lip and palate on parents and on parent-baby relationship: the first French prospective multicentre study

BackgroundThe objective of this prospective, multidisciplinary and multicenter study was to explore the effect of a cleft lip, associated or not with a cleft palate, on parents, on parent-infant relationship, and on the baby’s relational development. It also highlighted how the type of cleft and the timing of the surgery could impact this effect.Method158 infants, with Cleft lip with or without Palate, and their parents participated in this multicenter prospective cohort. Clinical evaluations were performed at 4 and 12 months postpartum. The impact on the parents and on the parent-infant relationship was evaluated by the Parenting Stress Index (PSI), the Edinburgh Post-partum Depression Scale (EPDS) and the Impact-on-Family Scale (IOFS). The relational development of the infant was assessed using the Alarm Distress Baby Scale (ADBB). The main criteria used to compare the infants were the severity of cleft and the time of surgery.ResultsThe timing of surgery, the type of malformation or the care structure had no effect on social withdrawal behaviors of the child at 4 and 12 months postpartum (ADBB). Furthermore, early intervention significantly decreased maternal stress assessed with the PSI at 4 months. Parents for whom it had been possible to give a prenatal diagnosis were much better prepared to accept the waiting time between birth and the first surgical intervention (IOFS). Higher postpartum depression scores (EPDS) were found for both parents compared to the general population.ConclusionA joint assessment of the mental health of both infants and parents is required in the follow-up of cleft lip and palate. Even if most families are remarkably resilient faced with this major cause of stress, a significant proportion of them could require help to deal with the situation, especially during this first year of follow-up. An assessment of the child’s social withdrawal behaviour and of the parental stress and depression appears useful, in order to adapt care to infant and parent’s needs.Trial registrationClinicalTrials.gov Identifier: NCT00993993. Registered 10/14/2009 <.

The Primary Care-Video Intervention Therapy for Growth-Vulnerable Infants. A Case Study

Perinatal growth vulnerability (e.g., Small for Gestational Age, SGA) poses the goal to not overlook subtle developmental susceptibilities and their impact on the parent–infant relationship. In this case study, we examined the application of a video-feedback intervention program to support parenting, the Primary Care-Video Intervention Therapy (PC-VIT), specifically developed to fit pediatric care characteristics. The case presentation details the principal steps of the intervention with the family of an SGA infant from birth up to toddlerhood. Findings for this family highlighted initial worries about the infant’s growth. Along sessions, PC-VIT held maternal anxiety and sustained parents’ abilities to recognize and talk about the infant’s developmental skills and regulatory abilities. The PC-VIT shows the powerful opportunity to limit the impact of infant growth vulnerability on the parent–child relationship and socio-emotional development. Pediatricians can prevent vulnerable developmental milestones from clinical outcomes by implementing timely and effective strategies embracing mental health and parenting-related issues.

Maternal intrusiveness predicts infants' event-related potential responses to angry and happy prosody independent of infant frontal asymmetry.

Infants’ social‐cognitive skills first develop within the parent–infant relationship, but large differences between parents exist in the way they approach and interact with their infant. These may have important consequences for infants’ social‐cognitive development. The current study investigated effects of maternal sensitive and intrusive behavior on 6‐ to 7‐month‐old infants’ ERP responses to a socio‐emotional cue that infants are often confronted with from an early age: emotional prosody in infant‐directed speech. Infants may differ in their sensitivity to environmental (including parenting) influences on development, and the current study also explored whether infants’ resting frontal asymmetry conveys differential susceptibility to effects of maternal sensitivity and intrusiveness. Results revealed that maternal intrusiveness was related to the difference in infants’ ERP responses to happy and angry utterances. Specifically, P2 amplitudes in response to angry sounds were less positive than those in response to happy sounds for infants with less intrusive mothers. Whether this difference reflects an enhanced sensitivity to emotional prosody or a (processing) preference remains to be investigated. No evidence for differential susceptibility was found, as infant frontal asymmetry did not moderate effects of sensitivity or intrusiveness.

Substance use and mothers' neural responses to infant cues.

Substance use may influence mothers' responsiveness to their infants and negatively impact the parent-infant relationship. Maternal substance use may co-opt neural circuitry involved in caregiving, thus reducing the salience of infant cues and diminishing the sense of reward experienced by caring for infants. Gaps in understanding exist with regard to the mechanisms by which substance use operates to influence mothers' processing of infant cues and how this translates to caregiving. Therefore, we examined how substance use might relate to maternal neural responses to infant cues using event-related potentials (ERPs). Substance-using (n=29) and nonsubstance-using (n=29) mothers viewed photographs of infant faces and heard recordings of infant vocalizations while electroencephalography was recorded simultaneously. Three specific ERP components were used to examine initial processing of infant faces (N170) and cries (N100), and attentional allocation to infant faces and cries (P300). Substance-using mothers did not discriminate facial affect at early encoding stages (N170), were generally slower to orient to infant cries (N100), showed heightened responses to neutral faces (P300), and failed to adaptively differentiate between high-distress versus low-distress cries (P300). These differences may be important to caregiving behaviors associated with the formation of mother-child attachment. Implications are discussed, as are limitations and future directions.