Parents Of Infants Research Articles

Identifying Profiles of Parental Reflective Functioning in First-Time Parents and Associations with Parental Attachment and Infant Socioemotional Adjustment

SYNOPSIS Objective. Parental reflective functioning (PRF) consists of three dimensions using the Parental Reflective Functioning Questionnaire (PRFQ): Pre-Mentalizing Modes, Certainty about Mental States, and Interest and Curiosity. Different types of mentalization, such as genuine mentalization, hypomentalization, and hypermentalization, have been hypothesized yet rarely empirically examined. This study aims to identify PRF profiles using latent profile analysis based on the infant version of the PRFQ completed 4 months postpartum. How profile membership was predicted by parental attachment and predictive of infant socioemotional adjustment was also examined. Design. The community sample consisted of 1,168 first-time mothers and 490 fathers responding to surveys 2, 4, and 11 months postpartum. Results. Three qualitatively different and meaningful PRF profiles for mothers/fathers were found: Moderately Low Certainty (51.1%/46.2%), Moderately High Certainty (46.5%/39.0%), and High Pre-Mentalizing (2.4%/2.8%). An additional profile was identified for fathers only: Moderate Interest (12.1%). Parental attachment predicted profile membership differently for mothers and fathers. Membership in High Moderately Certainty predicted better infant socioemotional adjustment compared to membership in any other profile, although for fathers this profile was not different from the High Pre-Mentalizing profile. Conclusions. Identifying PRF profiles enables the identification of subgroups of parents with specific deficits and strengths in PRF. Future research is needed to examine the replicability of the identified profiles and relevant connections to parent and child outcomes to identify at-risk and protective profiles.

An Integrated Review of Transitional Care for Families of Pre-Term Infants

This study was conducted to identify the key elements of transitional care for families with pre-term infants in South Korea. We used an integrative review methodology proposed by Whittemore and Knafle. During the problem identification step, the review question was constructed via the population, intervention, outcome, and timeframe (PIOT) format. During the literature search step, integrative reviews of the published literature from nine electronic databases were undertaken and a total of 14 studies were reviewed that met our inclusion criteria. During the data evaluation step, the quality of the literature was assessed using the Mixed Methods Appraisal Tool (MMAT) developed by Hong et al. We identified three domains and 10 key attributes of transitional care for families of pre-term infants. The parenting empowerment domain included growth and development, developmental promotion, nutrition, safe environment, general parenting, and parent–infant interaction. The emotional support domain included counseling, advocacy, and community network. The social support domain included professional collaboration. Efforts should continue to further develop programs and policies to enhance transitional care for families of pre-term infants that reflect South Korean nursing practices.

Factors contributing to parental stress in newborns requiring surgical care: a cross-sectional study.

To assess parental stress in newborns undergoing surgical care. A cross-sectional study was conducted in the Department of Pediatric Surgery at a tertiary center. The study included all parents of newborns requiring surgery, admitted between July 2023 and June 2024. The overall stress score among the study population was 3.3 ± 1. Approximately 90% of parents reported experiencing at least some level of stress (stress score ≥ 2), with the "parental role alteration" domain scoring the highest (3.9 ± 1.1). In the "surgical aspects" domain, 27% reported extreme stress and 22% reported high stress. Higher stress scores were found among parents of preterm infants (3.6 ± 0.9 vs. 3.1 ± 1.1, p = 0.04), infants with a birth order ≥ 2 (3.4 ± 1.1 vs. 3.1 ± 1, p = 0.04), and those from the Muslim community. Graduate parents (2.8 ± 0.9, p = 0.01) and parents of upper socioeconomic status (2.3 ± 0.7, p < 0.0001) were found to have lower stress scores. Parental stress is significant among surgical newborns, especially in parents of preterm babies, babies with severe medical conditions, and those with lower education and socioeconomic status. "Parental role alteration" was the most stressful aspect, highlighting the need for targeted support.

Paternal and Maternal Speech at 3 Months Postpartum: An Exploratory Study on the Effect of Parental Role and Birth Weight

Recent research highlights a growing interest in early interactions between fathers and their infants, acknowledging the significant influence these interactions have on developmental outcomes. However, there is a limited understanding of the specific characteristics of paternal infant-directed speech (IDS), especially in the context of premature birth. This study aimed to analyze the functional and morpho-syntactic features of paternal IDS to full-term (FT) and preterm (PT) infants at 3 months, comparing it with maternal communicative style. Additionally, the study explored the influence of the severity of preterm birth according to birth weight, further distinguishing between extremely low-birth-weight (ELBW) and very low-birth-weight (VLBW) infants. Seventy-one father–infant and mother–infant dyads (24 FT, 22 ELBW, 25 VLBW) were recruited at 3 months (corrected age for PTs). Parent–infant interactions were video recorded to assess lexical, syntactic, and functional aspects of paternal and maternal speech. Results revealed lower verbosity and lexical variability in paternal IDS compared to the maternal one. No differences were found between parents of the PT and FT groups. Overall, these findings could contribute to better understanding the patterns of parent–infant communications in both FT and PT dyads, confirming the importance of involving both mothers and fathers from the early stages of development.

Preterm infant attachment is independent of breast milk intake during neonatal care

Background Following preterm birth, breast milk feeding is recommended because it confers broad health benefits to preterm infants. Breast milk has been suggested to promote secure attachment in infancy, but this is uncertain. Elucidating the relationship between breast milk intake and infant attachment is crucial for supporting parents of preterm infants to make feeding choices and providing accurate counselling when breast milk is not available. We aimed to investigate if breast milk exposure during neonatal care associates with attachment outcomes derived from infants’ responses to the Still-Face Paradigm (SFP) at nine months of age. Methods We studied 77 preterm (&lt; 33 weeks’ gestation) and 71 term infants. Preterm infant feeding data were collected from birth until hospital discharge. Infant responses to the SFP were videocoded at nine months corrected age. Infants’ distress, fretfulness, attentiveness to caregivers and attachment classification were compared between preterm infants who received exclusive breast milk for ≥ 75% of inpatient days, those who received exclusive breast milk for &lt; 75% of inpatient days, and term infants. Milk intake thresholds were chosen based on our previous work demonstrating positive associations between breast milk intake and MRI markers of brain maturation. Results There were no significant differences in infant distress, fretfulness, attentiveness to caregivers (p-values &gt; 0.19), or in the odds of secure versus insecure attachment classification (relative risk ratio = 0.57–0.89, p-values = 1.00) between preterm infants with high or low breast milk exposure, or term comparators. Conclusions Attachment outcomes at nine months were similar between term and preterm infants, and breast milk exposure did not associate with attachment in the preterm group. Although breast milk feeding has clear benefits, these findings may alleviate some of the pressures experienced by parents who are unable to provide breast milk for infants cared for in the neonatal unit.

Parents' experiences of psychotherapeutic support on the neonatal unit: A mixed methods systematic review to inform intervention development for a multicultural population.

Parents of infants admitted to neonatal intensive care require support to minimize the impact on their mental health and to encourage engagement with their infants to support infant neurodevelopment. Many interventions aim to address this need, but there is a lack of research considering the accessibility of these for a multicultural population. To systematically identify sources of psychotherapeutic support available for parents with infants admitted to neonatal care (NNU, neonatal intensive care unit [NICU] and special care units), assess their accessibility and acceptability and identify challenges and facilitators. Six electronic databases with no restrictions on language or date were used to identify relevant studies following Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Publications were included in the review if they reviewed parent experience of an intervention actively in place to support parent experience during the neonatal unit stay. Any studies where the intervention's primary aim was infant focused, such as developmental care, were excluded. All publications were quality-assessed using quality appraisal tools appropriate for their design type. Data were extracted line by line using Sekhon et al.'s theoretical acceptability framework and questionnaire. A total of 3309 studies were found, of which 36 studies met the inclusion criteria. Included studies were published worldwide between 2000 and 2023 and explored 15 different interventions. Challenges for parental engagement were due to preconceived ideas about intervention requirements and parents' ability to participate in them. Timely information and providers' experience in delivering the intervention were reported to support engagement and as being valuable for enhancing participant knowledge. The emotional content of interventions was found to be challenging by parents across most studies. This was prominent in interventions designed to be carried out in a group format and where keepsakes were created. However, the value of these interventions was in reducing parents' feelings of isolation through increased social support and providing a starting point for conversations with wider family and friends about the family's neonatal experience. Participant demographics were poorly reported, with only two studies taking into consideration the ethicality of the intervention. Poor reporting of participant demographics, and a focus on mothers as participants, means findings are not transferrable to the wider population of parents in neonatal units. Future studies should consider how to ensure that research and interventions are accessible to multicultural populations to improve the understanding of the acceptability of interventions. Better knowledge of neonates and the NNU setting amongst intervention providers could increase the accessibility of psychotherapeutic support for parents. Training for providers on how to manage sensitive conversations may also be beneficial to support parents during interventions. The impact of neonatal admission on parental mental health is increasingly recognized and reported. Interventions have been developed to reduce the negative impact on the mental health of parents. There continue to be significant health inequalities as a result of many services not taking into account the acceptability and accessibility of interventions in this setting for their multicultural populations. This review highlights the need for better reporting of participant demographics in research and the inclusion of those seldom heard to ensure interventions are culturally, religiously and linguistically appropriate for multicultural populations.

The Reliability of YouTube as an Information Resource for Parents About Retinopathy of Prematurity.

To investigate the quality and reliability of YouTube videos about retinopathy of prematurity (ROP) to direct parents of infants with the disease to access more accurate content. The term "retinopathy of prematurity" has been searched on YouTube containing all of the videos between January 2 and February 2, 2024. The first 200 videos were evaluated by two ophthalmologists. Duplicated-split videos, videos shorter than 60 seconds, videos presented in languages other than English or with an incomprehensible accent, and videos unrelated to ROP were excluded. Video uploaders, types, continental origins, durations, and viewer interactions were noted. DISCERN, The Journal of the American Medical Association (JAMA), and the Global Quality Score (GQS) scoring systems were used to evaluate the quality of the videos. The mean quality of all videos was poor in all scoring systems. Academic societies and medical institutes scored highest in video uploaders, followed by physicians; patient experience videos had the lowest quality. Of the video types, the medical education seminars were of the highest quality. Although a strong positive correlation was detected between video duration and video quality, this same strong correlation was not observed between viewer interactions and video quality. There was no significant difference between video origins in terms of video quality. It would be wiser to direct the parents of patients with ROP to watch longer videos uploaded by the academic community, medical institute, or physicians, and to watch the medical training seminars. Also, it might be important to warn them not to take user interactions too seriously. [J Pediatr Ophthalmol Strabismus. 20XX;XX(X):XXX-XXX.].

Sensory-processing sensitivity, parenting styles, and adult attachment patterns in parents of young children

ABSTRACT Background Increased sensitivity to internal and external stimuli, known as sensory-processing sensitivity (SPS), has been linked to attachment insecurity and less optimal parenting styles in parents of children aged 4–13 years. Associations between these parenting factors in parents of children aged 3 years and younger have not yet been investigated. Understanding the relationships between these factors will facilitate the development of strategies to better support highly sensitive parents. Methods A sample of 153 parents of children aged 3 years and younger completed an online survey comprising standardised measures of SPS, attachment, and infant parenting styles. The underlying factor structure of the Infancy Parenting Styles Questionnaire was investigated. Results Factor analysis identified 33 items loading onto five factors: Discipline, Routine, Anxiety, Nurturance, and Involvement, with moderate to high reliability. SPS was positively correlated with parenting anxiety, attachment anxiety, and attachment avoidance, but did not predict parenting style. Younger parent age was associate with more insecure attachment styles. Multivariate regression analyses revealed that variability in parenting anxiety was predicted only by attachment anxiety and having fewer children. Conclusion While SPS was not seen to predict parenting anxiety, relationships between SPS, parenting anxiety, and insecure attachment suggest that strategies tailored to SPS would support highly sensitive parents to care for their children and promote improved parent–child relationships. These strategies may therefore be a beneficial addition to attachment-based parenting programs. Further studies using the Toddler Parenting Styles Questionnaire (TPSQ) are needed to identify optimal parenting styles for parents of infants and toddlers.

71 Development and validation of the COCINL scale assessing family resilience in the NICU among parents of preterm infants

Abstract Background Given the negative impact of parental distress on preterm infants and their families, examining the role of family resilience in the neonatal intensive care unit (NICU) is a promising avenue for promoting parental mental health while remaining consistent with family-centered care. A tool to assess NICU family resilience is essential to guide care and research, yet none specifically adapted for the neonatal context exists to date according to a recent systematic review. Objectives Therefore, the aim of this study was to develop and validate a new scale, the COCINL scale, designed to measure family resilience in the context of neonatal care among French-speaking parents of preterm infants. Design/Methods This methodological design study was carried out in four successive phases: (I) compilation of an item pool (II) mixed-method evaluation of content validity (clarity, relevance, representativeness) involving 12 experts, (III) pre-testing and electronic administration of the COCINL scale, along with a measure of psychological distress (Kessler-6) and an open-ended self-report question on family resilience to parents of preterm infants (n=88) and (IV) psychometric testing of the COCINL scale (internal consistency, construct validity, exploratory sensitivity and specificity). Parents of preterm infants and experts were recruited by convenience sampling from two urban, level III NICUs. Results From a pool of 112 items, 55 items were favorably evaluated after content validation (S-CVI&amp;gt;0.95). Based on preliminary interitem correlations and internal consistency results, the COCINL scale was shortened to 42 items and divided in four subscales. High internal consistency is also shown in subscales (0.796 to 0.908) and total scale (0.937) Cronbach’s alphas. The COCINL scale displays adequate construct validity, as determined by the Pearson correlation obtained between scores of family resilience and psychological distress (r=-0.236, p=0.027). Strong in between correlations of the four subscales and with the COCINL total score (0.732 to 0.851), further indicated good construct validity. Exploratory sensitivity and specificity analysis revealed the COCINL scale compares to participants' self-reported perception of family resilience (AUC 0.754). Conclusion The COCINL scale has shown strong evidence of validity and internal consistency. Thus, the scale can be recommended for research use as a measure of family resilience in the neonatal context. Still, additional evidence of its validity and reliability should be compiled before clinical use is considered. The COCINL scale could potentially support the development, evaluation and implementation of nursing interventions consistent with the family-centered care approach being promoted in NICUs across Canada and worldwide.

A Seat at the Table: Family Conferences for Infants with Neurological Conditions.

Objective: We aimed to characterize parents' perspectives on the value of and opportunities to improve conferences between parents of critically ill infants and the health care team. Background: The parent perspective on the value of family conferences in the intensive care unit is not well characterized. Methods: In this descriptive qualitative study, parents of infants with neurological conditions in the intensive care unit at a U.S. academic medical center completed longitudinal semi-structured interviews about their experiences making decisions and communicating with clinicians. Parents were included if they had an upcoming family conference to discuss goals of care or neurological prognosis. This secondary data analysis targets interview content about family conferences. Parent responses were characterized using a conventional content analysis approach. Results: Fifty-two parents of 37 infants completed 123 interviews. Parents described valuing when clinicians (1) provided space to process emotions, (2) prioritized "big picture" discussions about serious decisions, (3) dedicated time to parent questions, and (4) responded to parent concerns and made an effort to foster consensus. Parent-identified opportunities for improvement included: (1) having the team assume responsibility for calling regular meetings, (2) prioritizing attendance of consistent and supportive team members, and (3) summarizing meeting content for parents and documenting discussions for clinicians. Conclusions: These findings demonstrate that parents of infants with neurological conditions value family conferences as an important venue for communicating with the health care team. Future studies should explore the feasibility and impact of regularly scheduled family conferences, attendees dedicated to parent support, and accessible meeting summaries on therapeutic alliance, parent well-being, and communication quality.

Evaluation of a Model of Transitional Care After Preterm Birth on Parents' Mental Health and Self-Efficacy: A Randomized Controlled Pilot Trial.

Parents of premature infants experience depression, anxiety, post-traumatic stress disorder, and increased stress, which can negatively impact parent-infant relationships and infant development. To reduce negative consequences and optimally support families, we developed the Transition to Home model (TtH). In this randomized controlled pilot trial (RCT), the feasibility of performing an experimental study to analyse the effects of TtH on parental mental health over time was evaluated. The following domains were assessed: recruitment, follow-up and study burden, outcome measures used and parental mental health outcomes. We included n = 22 parent couples with their preterm infants in the control group and n = 23 in the intervention group. Depression, anxiety and post-traumatic stress disorders, parenting stress, and parental self-efficacy were assessed at five timepoints. The study burden was evaluated once at the end of the study. The control and intervention groups had similar socio-demographic characteristics. The groups showed no differences in the mental health outcomes except for depression in mothers at T2 (p = 0.042) and T5 (p = 0.027) and state anxiety in fathers at T2 (p = 0.016). This pilot RCT established a framework for the evaluation of the TtH model of care and demonstrated the viability of the evaluation scheme. The results confirm the suitability of the RCT's structure and the feasibility of the methods and instruments used. Minor adjustments are recommended to include a more diverse sample in future studies.

Impact of visitation restrictions in neonatal intensive care units during the COVID-19 pandemic on parents in northern Hokkaido, Japan.

Medical institutions restricted visitation to neonatal intensive care units (NICUs) during the coronavirus disease (COVID-19) pandemic. Therefore, this study aimed to investigate the impact of COVID-19 NICU visitor restrictions on parents. We conducted a questionnaire of 378 parents of infants who were hospitalised for more than 1 week at two NICUs in our area and discharged between 1 April 2020 and 31 March 2022. While the visiting rules for NICUs during this period varied depending on the phase of the COVID-19 epidemic, generally, only parents were allowed to visit the NICUs for a few hours daily. A total of 157 parents (A University Hospital (AMUH), n = 79; AK General Hospital (AKGH), n = 78) responded to the survey (41.3% response rate), with 40% stating that their emotions towards their infants were affected by restrictions due to the COVID-19 pandemic. Parents' feelings towards their infants were influenced by mode of delivery, parity, duration of hospitalisation and opportunities to visit the NICU. More than 70% of respondents felt stressed due to COVID-19 restrictions, and anxiety and emotional stress related to visitor restrictions were significantly affected by the number and duration of visits and allowability of family member visits. Parents felt that the restrictions had a negative impact on breastfeeding, overall infant care and infant-family bonding. As parents felt an impact on the bond with their infant during visitation restrictions, it is essential for facilities to implement measures to protect infant-family bonding during potential future pandemics.

Enhanced Infant Movement Analysis Using Transformer-Based Fusion of Diverse Video Features for Neurodevelopmental Monitoring

Neurodevelopment is a highly intricate process, and early detection of abnormalities is critical for optimizing outcomes through timely intervention. Accurate and cost-effective diagnostic methods for neurological disorders, particularly in infants, remain a significant challenge due to the heterogeneity of data and the variability in neurodevelopmental conditions. This study recruited twelve parent–infant pairs, with infants aged 3 to 12 months. Approximately 25 min of 2D video footage was captured, documenting natural play interactions between the infants and toys. We developed a novel, open-source method to classify and analyse infant movement patterns using deep learning techniques, specifically employing a transformer-based fusion model that integrates multiple video features within a unified deep neural network. This approach significantly outperforms traditional methods reliant on individual video features, achieving an accuracy of over 90%. Furthermore, a sensitivity analysis revealed that the pose estimation contributed far less to the model’s output than the pre-trained transformer and convolutional neural network (CNN) components, providing key insights into the relative importance of different feature sets. By providing a more robust, accurate and low-cost analysis of movement patterns, our work aims to enhance the early detection and potential prediction of neurodevelopmental delays, whilst providing insight into the functioning of the transformer-based fusion models of diverse video features.

Mobile health monitoring of children with CHDs.

Mobile health has been shown to improve quality, access, and efficiency of health care in select populations. We sought to evaluate the benefits of mobile health monitoring using the KidsHeart app in an infant CHD population. We reviewed data submitted to KidsHeart from parents of infants discharged following intervention for high-risk CHD lesions including subjects status post stage 1 single ventricle palliation, ductal stent or surgical shunt, pulmonary artery band, or right ventricular outflow tract stent. We report on the benefits of a novel mobile health red flag scoring system, mobile health growth/feed tracking, and longitudinal neurodevelopmental outcomes tracking. A total of 69 CHD subjects (63% male, 41% non-white, median age 28 days [interquartile range 20, 75 days]) were included with median mobile health follow-up of 137 days (56, 190). During the analytic window, subjects submitted 5700 mobile health red flag notifications including 245 violations (mean [standard deviation] 3 ± 3.96 per participant) with 80% (55/69) of subjects submitting at least one violation. Violations precipitated 116 interventions including hospital admission in 34 (29%) with trans-catheter evaluation in 15 (13%) of those. Growth data (n = 2543 daily weights) were submitted by 63/69 (91%) subjects and precipitated 31 feed changes in 23 participants. Sixty-eight percent of subjects with age >2 months submitted at least one complete neurodevelopment questionnaire. In our initial experience, mobile health monitoring using the KidsHeart app enhanced interstage monitoring permitting earlier intervention, allowed for remote tracking of growth feeding, and provided a means for tracking longitudinal neurodevelopmental outcomes.

The Mediating Effect of Perceived Social Support and Health Literacy on the Relationship Between Decisional Dilemma and Participation in Shared Decision-Making Among Chinese Parents of Premature Infants.

This research was conducted to explore the mediating effect of perceived social support and health literacy on the relationship between decisional dilemmas and participation in shared decision-making among Chinese parents of premature infants. This cross-sectional study recruited 225 Chinese parents of premature infants in a neonatal ward of a Chinese hospital through convenience sampling. Data were collected from August 2022 to February 2023 using 5 self-administered instruments. Structural equation modeling and multiple mediation tests were applied to explore the interplay among perceived social support, health literacy, decisional dilemmas, and participation in shared decision-making. The study is reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Decisional dilemmas were found to negatively impact participation in shared decision-making. Perceived social support and health literacy were identified as partial mediators in this relationship, collectively accounting for a mediation effect of -0.413, which represents 50.0% of the total effect. The findings elucidate a multifaceted model of factors influencing participation in shared decision-making among Chinese parents of premature infants. Prompt recognition of these variables can enable nursing professionals to incorporate tailored management strategies within patient-centered care frameworks, thereby enhancing decisional outcomes.

Facilitators and barriers of adherence to rectal interventions by parents of young children with functional constipation: a qualitative study.

Functional constipation in children is a worldwide problem that impacts both children's gastrointestinal function and the quality of family life. The treatment of this condition often depends on parental involvement to administer rectal interventions to their children to stimulate defecation. However, adherence to rectal interventions is currently suboptimal. We sought to explore the factors that facilitate and hinder parents from adherence to rectal interventions. A descriptive qualitative study was conducted involving semi-structured interviews with parents of infants and young children with functional constipation requiring rectal interventions from March to May 2023. The data were analyzed using content analysis. Fourteen parents participated in the study. Parents reported the main facilitators of adherence to prescribed rectal interventions as recognition of illness severity, support from family and friends, and medical resource support and e-health literacy. Parents reported the primary barriers as information barriers, family conflict, cognitive misalignment, and difficulties in accessing healthcare services. Rectal interventions are often essential in managing constipation in young children, with parental compliance being crucial for effective treatment. Healthcare providers must consider the psychosocial aspects of parents' perceptions, adhere to guidelines to standardize communication, and ensure comprehensive education to improve medication literacy.

Infant Motor Milestones: Analysis of Content and Variability Among Popular Sources for Parents.

Evaluate the content and variability of infant motor milestone education provided to parents in popular sources. Sources were screened for inclusion, and their motor milestone content was coded. Descriptive and inferential analyses were performed. Content from 241 websites, applications, and books was evaluated; 6984 motor milestones were extracted, representing 146 unique milestone codes across 14 categories. Books and applications had more milestone content than websites. There was variability in the milestones mentioned and their associated ages across the sources and relative to the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) content. Several frequently mentioned milestones were behaviors that facilitate early learning. There is variability among sources in the motor milestones they provide to parents of infants. The AAP and CDC content likely has some influence on the broader content available, but there is substantial deviation from the information they provide.

The effect of live-performed music therapy with physical contact in preterm infants on parental perceived stress and salivary cortisol levels.

Parents of preterm infants face a stressful life event which might have long term impact on the parent-child relation as well as on the infant's cognitive and socio-emotional development. Both music therapy (MT) and physical contact (PC) are stress-reducing interventions for parents and preterm infants on the neonatal intensive care unit (NICU). Meanwhile, especially close PC is considered as standard care (SC) in most NICUs. However, the effect of live performed MT with PC on parental perceived stress and cortisol levels has barely been investigated. We hypothesized that MT with PC leads to reduced stress levels and lower salivary cortisol concentrations compared to SC in parents of preterm infants during the first 4 weeks after birth. Randomized-controlled trial enrolling the parents of 99 preterm infants (MT n = 50, SC n = 49 infants). The infants received either MT with PC or SC only. Perceived stress was measured with the perceived stress questionnaire 20 (PSQ-20) after birth and 4 weeks later. Salivary cortisol levels were obtained and measured weekly after birth for 4 weeks. Forty-two mothers and eight fathers of the intervention group (MT with PC) as well as n = 43 mothers and n = 6 fathers of the control group (SC) were enrolled. For the intervention group, salivary cortisol was reduced 4 weeks after birth [mothers 5.5 nmol/l (confidence interval (CI) 3.6-7.5); fathers 8.3 (CI 7.2-9.4)] compared to the control group [mothers 10.3 nmol/l (CI 5.4-15.3); fathers 14.8 (CI 8.9-20.7)]. Overall perceived stress scores decreased in the intervention group (mothers -17.6; fathers -12.6) and increased in the control group (mothers +6.1; fathers +21.4) over 4 weeks. Live-performed MT with PC in preterm infants might be an effective, non-invasive intervention to reduce parental stress and cortisol levels. Future studies should investigate the long-term effects of this intervention on the parent-infant relation as well as on the infants' cognitive and socio-emotional development. https://drks.de/search/en/trial/DRKS00025755 identifier [DRKS00025755].

Infant and parent heart rates during a babywearing procedure: Evidence for autonomic coregulation

Babywearing is the practice of carrying an infant in a baby carrier, which may provide an inexpensive, nonpharmacological intervention for the parent-infant dyads to handle mental stressors, such as pain and anxiety, especially among vulnerable infants. This study investigated the influence of babywearing on parent-infant autonomic coregulation based on the changes in the HR of mother-infant and father-infant dyads for infants with neonatal abstinence syndrome (NAS). Guided by the Calming Cycle Theory as the framework, the correlation between parent HR and infant HR and the difference in the mother-infant dyad (n = 17) compared to the father-infant dyad (n = 8) were examined. Although only the mother-infant HRs reached statistical significance during babywearing (r̅ =.52, p = .03), both parent-infant dyads had strong correlations during babywearing (compared to pre- and post-babywearing conditions), indicating that babywearing, for parents and their infants with NAS, may influence autonomic coregulation.

Practical resources for effective postpartum parenting (PREPP): a randomized controlled trial of a novel parent-infant dyadic intervention to reduce symptoms of postpartum depression

BackgroundThere is little known about the effectiveness of psychological interventions to prevent postpartum depression that focus on the birthing parent and infant dyad. Risk factors for PPD include depression during pregnancy, low parenting self-efficacy, and disrupted parental nocturnal sleep. The brief Practical Resources for Effective Postpartum Parenting (PREPP) intervention is designed for pregnant individuals at-risk for postpartum depression, providing them with 1) caregiving strategies aimed at reducing infant fuss and cry behavior and increasing infant sleep, 2) self-reflection and mindfulness skills and 3) psychoeducation about the postpartum period and infant behavior. The aims are to set more realistic postpartum expectations, enhance parenting confidence and sleep via supporting infant regulatory behavior, improve parental affect regulation and ultimately reduce the risk of postpartum depression. ObjectiveAssess the effectiveness of PREPP compared to enhanced treatment as usual in reducing symptoms of depression and anxiety and episodes of infant fuss and cry behavior and improving parental and infant sleep in the early postpartum. Study designA randomized controlled trial was conducted of 175 pregnant individuals. Inclusion criteria were standard prenatal care for a singleton pregnancy, aged 18 to 45 and at increased risk of PPD as determined by a score of ≥19 on the Predictive Index of Postnatal Depression or ≥7 on the Edinburgh Postnatal Depression Scale. Participants assigned to the PREPP group (n=88) received 3 coaching sessions and 2 phone check-ins. Participants assigned to the enhanced treatment as usual group (n=87) received 3 sessions which included psychoeducation, mood assessments, and clinical referral and follow-up as indicated. Assessments were conducted at 28 to 32 weeks and 34 to 39 weeks gestation, and at 6, 12 and 16 weeks postpartum and included measures of parental depression, anxiety and sleep (Edinburgh Postnatal Depression Scale, Patient Health Questionnaire (PHQ-9), Hamilton Rating Scales of Depression and Anxiety and Pittsburgh Sleep Quality Index) and infant sleep and fuss and cry behavior (Baby Day Diary). ResultsCompared to enhanced treatment as usual, PREPP significantly reduced depressive symptoms at 6, 12 and 16 weeks postpartum with medium to large effect sizes (d=0.7-0.98). Compared to enhanced treatment as usual, participants receiving PREPP reported less of a decline in sleep quality at 6 weeks postpartum (p=0.035) and the effect size was large (d=0.83). Moreover, parents receiving the PREPP intervention reported less infant fussing and crying, with the largest effect for morning crying (p<.001; d=-1.48). ConclusionThe results provide evidence that PREPP, initiated during pregnancy, reduced symptoms of parental depression and infant fuss and cry behavior in the early postpartum, compared to enhanced treatment as usual, in a sample at-risk for postpartum depression.