Postpartum Bonding Questionnaire Research Articles

Association of a Zero-Separation Neonatal Care Model With Stress in Mothers of Preterm Infants

Active participation in care by parents and zero separation between parents and their newborns is highly recommended during infant hospitalization in the neonatal intensive care unit (NICU). To study the association of a family integrated care (FICare) model with maternal mental health at hospital discharge of their preterm newborn compared with standard neonatal care (SNC). This prospective, multicenter cohort study included mothers with infants born preterm treated in level-2 neonatal units in the Netherlands (1 unit with single family rooms [the FICare model] and 2 control sites with standard care in open bay units) between May 2017 and January 2020 as part of the AMICA study (fAMily Integrated CAre in the neonatal ward). Participants included mothers of preterm newborns admitted to participating units. Data analysis was performed from January to April 2021. FICare model in single family rooms with complete couplet-care for the mother-newborn dyad during maternity and/or neonatal care. Maternal mental health, measured using the Parental Stress Scale: NICU (PSS-NICU). Secondary outcomes included survey scores on the Hospital Anxiety and Depression Scale, Postpartum Bonding Questionnaire, Perceived Maternal Parenting Self-efficacy Scale, and satisfaction with care (using EMPATHIC-N). Parent participation (using the CO-PARTNER tool) was assessed as a potential mediator of the association of the FICare model on outcomes with mediation analyses. A total of 296 mothers were included; 124 of 141 mothers (87.9%) in the FICare model and 115 of 155 (74.2%) mothers in SNC responded to questionnaires (mean [SD] age: FICare, 33.3 [4.0] years; SNC, 33.3 [4.1] years). Mothers in the FICare model had lower total PSS-NICU stress scores at discharge (adjusted mean difference, -12.24; 95% CI, -18.44 to -6.04) than mothers in SNC, and specifically had lower scores for mother-newborn separation (adjusted mean difference, -1.273; 95% CI, -1.835 to -0.712). Mothers in the FICare model were present more (>8 hours per day: 105 of 125 [84.0%] mothers vs 42 of 115 [36.5%]; adjusted odds ratio, 19.35; 95% CI, 8.13 to 46.08) and participated more in neonatal care (mean [SD] score: 46.7 [6.9] vs 40.8 [6.7]; adjusted mean difference, 5.618; 95% CI, 3.705 to 7.532). Active parent participation was a significant mediator of the association between the FICare model and less maternal depression and anxiety (adjusted indirect effect, -0.133; 95% CI, -0.226 to -0.055), higher maternal self-efficacy (adjusted indirect effect, 1.855; 95% CI, 0.693 to 3.348), and better mother-newborn bonding (adjusted indirect effect, -0.169; 95% CI, -0.292 to -0.068). The FICare model in our study was associated with less maternal stress at discharge; mothers were more present and participated more in the care for their newborn than in SNC, which was associated with improved maternal mental health outcomes. Future intervention strategies should aim at reducing mother-newborn separation and intensifying active parent participation in neonatal care. Netherlands Trial Register identifier NL6175.

The prediction of perceived parenting style on mother-infant bonding

BackgroundThere are limited studies on the associations among parenting style, postpartum depression, and mother-infant bonding. ObjectiveThe aims of this study are investigating how the parenting style of maternal grandparents predicted the mothers' bonding with their infants. The mediating roles of postpartum depression were also explored. Participants and settingA community sample of 227 postpartum women participated in this study. The participants primarily consisted of women who gave birth within six months (89.9%). MethodsA cross-sectional and convenient sampling strategy was applied. Instruments were Parental Bonding Instrument, Edinburgh Postnatal Depression Scale, Postpartum Bonding Questionnaire, and Background Form. ResultsIn the young infant group (i.e. mothers with infants not older than three months), the results indicated that maternal protection could predict “impaired bonding” (β = 0.20, p < .05). This prediction was mediated by postpartum depression (β = 0.32, p < .001). In the older infant group, paternal and maternal care could directly predict “rejection and anger” (β = −0.20, −0.22 respectively, p < .05). Maternal protection could predict three bonding factors (β = 0.25–0.29, p < .05, 0.01). Postpartum depression acted as total mediator for “impaired bonding”(β = 0.45, p <. 001), and acted as partial mediators in “rejection and anger” and “anxiety about care” (β = 0.45, 0.28, ps < .001, .01). ConclusionsPerceived parenting style (especially maternal protection) has impacts on adverse mother-infant bonding. Furthermore, the impact is more prominent on mothers of older infants. “Rejection and anger” could be the most vulnerable bonding factor affected by parenting style. Since postpartum depression mediates the predictions, interventions could concurrently address maternal parenting style and postpartum depression.

Depressive symptoms as a transdiagnostic mediator of mother-to-infant bonding: Results from a psychiatric mother-baby unit

Maternal symptoms of depression can interfere with the establishment of healthy mother-infant-bonding, which negatively affects developmental trajectories of the child and maternal wellbeing. However, current evidence about the effects of treatment in severely affected women is still lacking and the transdiagnostic prognostic value of depressive symptoms is not fully clear. Therefore, a naturalistic clinical sample of 140 mother-infant-dyads in inpatient treatment at a mother-baby-unit was analyzed with instruments being administered at admission and before dismissal. Linear mixed effects models were calculated in order to assess the longitudinal influence of scores on the Edingburgh Postpartum Depression Scale (EPDS) on post-partum-bonding measured with the postpartum bonding questionnaire (PBQ). Furthermore, interaction-effects with psychiatric diagnosis of the mothers (depression vs. psychosis) and their partners were assessed. Successful treatment of depressive symptoms was paralleled by a significant decrease of impaired bonding, with only 6.4% of the women having PBQ total scores above cut-off at discharge. Overall, higher scores on the EPDS were associated with a significantly poorer outcome on the PBQ (p = < 0.001), irrespective of diagnosis (p = 0.93). Importantly, there was an interaction effect of EPDS and a psychiatric diagnosis of the partner on the PBQ (p = 0.017). Thus, our results further emphasize the significance of postpartum symptoms of depression for mother-child bonding, which can be effectively improved by comprehensive treatment even in severely affected women. Optimizing treatment and diagnostics as early as possible and enabling access for all women must become a priority.

Validation of the postpartum bonding questionnaire: A cross-sectional study among Flemish mothers

ObjectiveBecoming a mother is a process of transition that is subject to constant change and may last for over one year postpartum. Bonding is an important component of this transition to motherhood and can be measured with the Postpartum Bonding Questionnaire (PBQ). Most often, the PBQ is used among mothers up to 12 weeks postpartum. However, the transition to motherhood – and thus bonding – takes much longer and usually continues until 12 months postpartum. DesignValidation study to test the PBQ for validity and reliability for use among mothers up to one year postpartum. Internal consistency and construct validity were established using Cronbach's Alpha, exploratory factor analysis (EFA) and subsequent confirmatory factor analysis (CFA). Settingmothers living in Flanders, Belgium ParticipantsThe sample was composed of 254 Flemish mothers who had given birth to healthy neonates up to one year earlier. FindingsThe EFA (principal component analysis) resulted in a uni-dimensional factor, “Impaired Bonding”, consisting of 21 items. Four items were excluded because of a low factor load. This uni-dimensional version of the PBQ was checked with CFA, resulting in an acceptable model-of-fit: significant X2 (p < 0.001), CMIN/df = 2.61, CFI = 0.85, RMSEA = 0.08. The internal consistency of the 21-item version showed a Cronbach's alpha of 0.89. Key conclusionThe 21-item version of the PBQ is a valid and reliable tool to identify bonding in a general population of Flemish mothers up to one year postpartum. Further research is of merit.

Postpartum bonding and association with depressive symptoms and prenatal attachment in women with fear of birth

BackgroundCo-morbidity is prevalent in women with fear of birth. Depressive symptoms and lack of prenatal attachment might influence the postpartum bonding between the mother and the new-born.AimTo examine the underlying dimensions of the Postpartum Bonding Questionnaire and to investigate associations between depressive symptoms, prenatal attachment and postpartum bonding in women with fear of birth.MethodsA longitudinal study comprising 172 women with fear of birth. Data were collected by questionnaires in mid- and late pregnancy and two months after birth. The Edinburgh Postnatal Depressive Scale, Prenatal Attachment Inventory and Postpartum Bonding Questionnaire were investigated.ResultsTwo factors of the Postpartum Bonding Questionnaire were identified: Factor 1 mirrored caring activities and the women’s perceptions of motherhood, whereas Factor 2 reflected negative feelings towards the baby. The Postpartum Bonding Questionnaire was negatively correlated with the Prenatal Attachment Inventory and positively with The Edinburgh Postnatal Depressive Scale.Women with fear of birth and depressive symptoms both during pregnancy and postpartum showed the highest risk of impaired bonding after birth. Primiparity and being single were also associated with impaired bonding.ConclusionA focus on women’s mental health during pregnancy is necessary in order to avoid the negative effects of impaired bonding on the infant. Depressive symptoms could be concurrent with fear of birth and, therefore, it is important to determine both fear of birth and depressive symptoms in screening procedures during pregnancy. Caregivers who meet women during pregnancy need to acknowledge prenatal attachment and thereby influence adaptation to motherhood.

Alexithymic traits and parental postpartum bonding: Findings from the FinnBrain Birth Cohort Study.

In the postpartum period, some parents experience problems in bonding with the infant, which can lead to difficulties in adjusting to the parental caregiving role. Alexithymia, through deficits in emotional processing, could potentially be associated with problems in parental postpartum bonding. In the current study, this association has been explored in a large population-based sample of mothers and fathers, and to our knowledge, this is the first study to investigate this association. The study population (n = 2,671) was part of the FinnBrain Birth Cohort study and included 1,766 mothers and 905 fathers who returned The Postpartum Bonding Questionnaire (PBQ) at three months postpartum and the 20-item Toronto Alexithymia Scale (TAS-20) at six months postpartum. Correlation analyses and hierarchical regression modeling, adjusted for selected background factors, were performed separately for mothers and fathers. The alexithymia dimension "Difficulty Identifying Feelings" (DIF) in mothers and fathers, and additionally dimensions of "Difficulty Describing Feelings" (DDF) and "Externally Oriented Thinking" (EOT) in fathers were associated with weaker postpartum bonding, when related background factors were controlled for. To our knowledge this was the first study to investigate the relationship between parents' alexithymic traits and postpartum bonding within a large birth cohort study population. The main finding was that especially higher levels of maternal DIF and paternal EOT were associated with weaker postpartum bonding. Longitudinal studies are needed to establish the potential causality of this relationship.

Short-term Music Therapy for Families With Preterm Infants: A Randomized Trial

To evaluate short-term effects of music therapy (MT) for premature infants and their caregivers on mother-infant bonding, parental anxiety, and maternal depression. Parallel, pragmatic, randomized controlled-trial conducted in 7 level III NICUs and 1 level IV NICU in 5 countries enrolling premature infants (<35 weeks gestational age at birth) and their parents. MT included 3 sessions per week with parent-led, infant-directed singing supported by a music therapist. Primary outcome was mother-infant bonding as measured by the Postpartum Bonding Questionnaire (PBQ) at discharge from NICU. Secondary outcomes were parents' symptoms of anxiety measured by General Anxiety Disorder-7 (GAD-7) and maternal depression measured by Edinburgh Postpartum Depression Scale (EPDS). Group differences at the assessment timepoint of discharge from hospital were tested by linear mixed effect models (ANCOVA). From August 2018 to April 2020, 213 families were enrolled in the study, of whom 108 were randomly assigned to standard care and 105 to MT. Of the participants, 208 of 213 (98%) completed treatment and assessments. Participants in the MT group received a mean (SD) of 10 sessions (5.95), and 87 of 105 participants (83%) received the minimum of 6 sessions. The estimated group effect (95% confidence interval) for PBQ was -0.61 (-1.82 to 0.59). No significant differences between groups were found (P = .32). No significant effects for secondary outcomes or subgroups were found. Parent-led, infant-directed singing supported by a music therapist resulted in no significant differences between groups in mother-infant bonding, parental anxiety, or maternal depression at discharge.

Impact of the nursing mother project on the mother-baby bond and breastfeeding in a neonatal intensive care unit

OBJECTIVE: To evaluate whether the stay of mothers of premature newborns (PN) in the hospital through the nursing mother project (NMP) favors the mother-baby bond and leads to greater adherence to breastfeeding. METHODS: Prospective cross-sectional study, carried out in a Neonatal Intensive Care Unit, which included mothers of newborns with gestational age (GA) <36 weeks and who participated or not in the NMP. Socio-demographic and delivery conditions and adherence to breastfeeding were evaluated. The mother-baby bond was quantified with the Postpartum Bonding Questionnaire (PBQ). Statistical analysis was performed using the Chi-square test, the T test and the Bartlett test and a p value <0.05 was considered significant. RESULTS: Forty-two mothers were included. The period of absence from the hospital was short: median: 1 day and mean: 1.96 (± 2.8) days. There was no difference in PBQ between the group that remained and the group that left the hospital (7.56 and 6.2) p = 0.49. Babies of mothers who stayed in the nursing mother accommodation needed less infant formula (p: 0.058). Most mothers in both groups considered themselves to be well-informed about breastfeeding and felt safe to maintain breastfeeding after hospital discharge. CONCLUSION: The PBQ score was low in both groups, demonstrating a good bond between mothers and babies. As the period of absence was short, most mothers received support from the breastfeeding support team, which may have favored adherence to breastfeeding.

Mother-Infant Bonding in Patients with Bipolar Disorder.

The quality of mother-infant bonding might play a role in future psychopathologies of the infant. The present study aims to compare the mother-infant bonding in mothers with remitted bipolar disorder (BD) and healthy mothers. We included 51 mothers who have bipolar disorder in remission and 53 healthy mothers during postpartum one-year period. All participants were interviewed with Structured Clinical Interview for DSM-IV (SCID-IV). Young Mania Rating Scale and the Hamilton Depression Rating Scale were given to the patient group to evaluate depressive and manic symptoms. Mother-infant bonding in both groups were evaluated with the Postpartum Bonding Questionnaire (PBQ). There was no significant difference in PBQ scores between the bipolar group and the control group. Age was negatively correlated with PBQ scores in the patient group. Women with bipolar disorder can develop healthy bonding patterns with their babies, during remission.

Management of Psychiatric Disorders during the Perinatal Period.

Management of Psychiatric Disorders during the Perinatal Period.

Home phototherapy of term neonates improves parental bonding and stress: Findings from a randomised controlled trial.

We aimed to evaluate whether in-home phototherapy for hyperbilirubinaemia could reduce the poorer parent-infant bonding and increased parental stress associated with neonatal hospital treatment. In this multicentre randomised controlled trial, we allocated families to either home phototherapy or standard hospital care. The primary outcome was parent-infant bonding measured on the Postpartum Bonding Questionnaire directly after therapy and 4months later. Secondary outcomes were results on four other instruments measuring parental bonding, quality of life and mental health. We randomised 78 of 147 newborn infants to intervention and 69 to the control group. No significant differences were detected in length of stay, mean bilirubin, or weight gain. Parents in the intervention group had better scores on bonding both at discharge (p=0.034) and at 4months (p=0.008; effect size r=0.2) and lower levels of stress at 4months (p=0.024) than controls. No statistically significant outcomes were found for the secondary outcomes. In-home phototherapy improved bonding and reduced parental stress in comparison with usual in-hospital treatment. Caregivers should consider offering home phototherapy to families of non-immunised term infants with hyperbilirubinaemia.

Postnatal depression – the role of attachment and mentalization

Aim of the studyThe aim of this paper was to find differences in the quality of relationships with a partner, mother's attachment to the child, mentalization and the style of the mother's attachment between groups of women with and without postnatal depression (also referred to as postpartum depression) as measured by the EPDS questionnaire.Subject or material and methodsThe research group comprised 68 women in total. They were divided into two groups. Thirty-three women who scored more than or equal to 12 points in the EPDS questionnaire were included in the group with postnatal depression. The control group consisted of 35 women who scored below 12 points on the same scale. The following tools were used in the study: Experiences in Close Relationships (ECR), Mental Scale Task (MST), Quality of Relationships Inventory (QRI), and Postpartum Bonding Questionnaire (PBQ).ResultsThe results obtained point out to specific differences between the two groups. The women whose EPDS score indicates postnatal depression are characterized by a weaker bond with their child, weakened mentalization capacity, their attachment patterns are more often insecure and relationship-related problems tend to occur.Discussion-ConclusionsThe conducted research shows a relationship between mentalization, attachment style and postpartum depression. Reflectiveness, a secure attachment style and a good relationship with partner can prevent postnatal depression.

The Relationship Between Bonding Impairment and Maternal Postpartum Smoking.

Maternal postpartum smoking is associated with several negative outcomes for mother and child. The relationship between bonding impairment (BI) and maternal postpartum smoking is less known. The aim of the present study was to assess the relationship between BI and maternal postpartum smoking at 6 to 8 months after childbirth in a primary care sample of low-income mothers who had depression during the previous pregnancy. We performed a cross-sectional, secondary analysis from a community trial with 356 postpartum women from public primary care clinics in São Paulo, Brazil. The main outcome measure was maternal postpartum smoking. The main exposure variable was BI assessed with the Postpartum Bonding Questionnaire. A socio-demographic questionnaire evaluated maternal and obstetric characteristics. Postpartum depression was assessed with the Patient Health Questionnaire. Crude and adjusted prevalence ratios (PR) of the association between BI and maternal postpartum smoking, with 95% confidence intervals (CI), were calculated using Poisson regression. Multivariate analysis was performed using three models (Model 1 adjusted for randomization during pregnancy, Model 2 adjusted for Model 1 plus mother's socioeconomic and obstetric characteristics, and Model 3 adjusted for Model 2 plus postpartum depression). Maternal postpartum smoking occurred in 16.7% of our sample. In the multivariable analysis, BI was associated with maternal postpartum smoking (PR:2.04; CI 95% 1.08:3.84). Women presenting bonding problems are at higher risk of smoking after childbirth. Intervention to enhance mother-child bonding may have the potential to decrease maternal postpartum smoking.

Asociación entre el vínculo madre-hijo y los síntomas depresivos en madres de la Unidad de Cuidados Intensivos Neonatales: estudio caso-control

ObjectivesMaternal perinatal depression has been associated with impaired mother-infant bonding. The adverse effect of this impaired bonding has been reported. This study aimed to investigate and compare the posnatal depressive symptoms and the mother-infant bonding in a Neonatal Intensive Care Unit (NICU) and of mothers with healthy newborns respectively. Secondly, was to explore the association between depressive symptomatology and bonding in both groups. MethodsIn this case study, mothers in the early pospartum period who gave birth in the same perinatal center of Greece were recruited to participate. The cases consisted of 88 mothers of neonates who were hospitalized in the NICU and controls were 100 mothers of full-term healthy neonates. For the collection of the data questionnaires including demographics and perinatal variables were used. For the bonding and posnatal assessment, the Mother to Infant Bonding Scale, the Postpartum Bonding Questionnaire, and the Hospital Anxiety and Depression Scale were used. ResultsThere was a significant difference between the mean of bonding scores of NICU mothers and the control group (t=-2.696, P=.008). NICU mothers presented lower scores in bonding with the newborn compared to the control group and presented higher depression scores compared to those of controls (χ2=28.588, P=.000). The depression scores were correlated with bonding scores in both groups. DiscussionA NICU admission has an impact on bonding and in some way interacts with maternal pospartum mental health, therefore more research is needed. ConclusionsNICU mothers have been presented as more vulnerable than mothers of healthy infants since they expressed a lower mother-infant bonding and higher depression scores. The support of these vulnerable mothers and the facilitation of mother-infant bonding by the NICU staff is of utmost importance.

The relationship between dietary elimination and maternal psychopathology in breastfeeding mothers of infants with food allergy.

There has been no study evaluating the psychopathology in breastfeeding mothers of infants with food allergy (FA). The aim of the study was to investigate the relationship between dietary elimination and maternal psychopathology, specifically anxiety, depression, and mother-to-infant bonding, in breastfeeding mothers of infants with food allergy. Breastfeeding mothers following an elimination diet due to FA in their children aged 1-to-12months were compared with the healthy controls. The physician-diagnosed FA group was divided into IgE-, non-IgE-mediated, and infants with some minor symptoms which were not enough to make the diagnosis of FA were classified as Indecisive symptoms for FA group. Mothers completed standardized questionnaires including Symptom Checklist 90R, Beck Depression/Anxiety Inventories (BDI/BAI), Postpartum Bonding Questionnaire (Bonding). Of 179mother and infants, 64 were healthy, 89 were FA, 16 were indecisive symptoms for FA. The mean age of the mothers and infants were 31.1±4.7years and 6.3±3.6months, respectively. The physician-diagnosed FA groups had higher scores for anxiety (p=.008), anger (p=.042), depression (p<.001), obsession (p=.002), phobia (p=.008), somatization (p=.002), general symptom index (GSI) (p=.001), BDI (p<.001), BAI (p=.008), and Bonding (attachment [p=.001], anger [p=.019], and total [p=.036]) than the healthy ones. The indecisive symptoms for FA group had a similar score pattern to physician-diagnosed FA, except interpersonal sensitivity, BDI, and attachment. Breastfeeding mothers of infants with FA were more anxious, with higher depression scores than controls, and had many psychopathologies which affected bonding. Interventions targeting negativity in caregivers' social relationships are urgently needed.

Effect of Online 1-Day Cognitive Behavioral Therapy–Based Workshops Plus Usual Care vs Usual Care Alone for Postpartum Depression

Postpartum depression (PPD) affects as many as 20% of mothers, yet just 1 in 10 of these women receives evidence-based treatment. The COVID-19 pandemic has increased PPD risk, reduced treatment access, and shifted preferences toward virtual care. To determine whether an online 1-day cognitive behavioral therapy (CBT)-based workshop added to treatment as usual improves PPD, anxiety, social support, mother-infant relationship quality, and infant temperament more than treatment as usual alone. This randomized clinical trial included 403 women with PPD who were recruited across Ontario, Canada, during the COVID-19 pandemic (April 20 to October 4, 2020). Women with Edinburgh Postnatal Depression Scale (EPDS) scores of at least 10 who were 18 years or older and had an infant younger than 12 months were eligible. Women were randomly assigned to receive a live, interactive online 1-day CBT-based workshop delivered by a registered psychotherapist, psychiatrist, or clinical psychology graduate student in addition to treatment as usual (n = 202) or to receive treatment as usual and wait-listed to receive the workshop 12 weeks later (n = 201). The primary outcome was change in PPD (EPDS scores) in experimental and wait list control groups 12 weeks after baseline. Secondary outcomes included maternal anxiety (7-item Generalized Anxiety Disorder Questionnaire [GAD-7]), social support (Social Provisions Scale), quality of the mother-infant relationship (Postpartum Bonding Questionnaire), and infant temperament (Infant Behavior Questionnaire-Revised Very Short Form). Participants all identified as women with a mean (SD) age of 31.8 (4.4) years. The workshop led to significant mean (SD) reductions in EPDS scores (from 16.47 [4.41] to 11.65 [4.83]; B = -4.82; P < .001) and was associated with a higher odds of exhibiting a clinically significant decrease in EPDS scores (odds ratio, 4.15; 95% CI, 2.66-6.46). The mean (SD) GAD-7 scores decreased from 12.41 (5.12) to 7.97 (5.54) after the workshop (B = -4.44; 95% CI, -5.47 to -3.38; P < .001) and participants were more likely to experience a clinically significant change (odds ratio, 3.09; 95% CI, 1.99-4.81). Mothers also reported improvements in bonding (B = -3.22; 95% CI, -4.72 to -1.71; P < .001), infant-focused anxiety (B = -1.64; 95% CI, -2.25 to 1.00; P < .001), social support (B = 3.31; 95% CI, 1.04 to 5.57; P < .001), and positive affectivity/surgency in infants (B = 0.31; 95% CI, 0.05 to 0.56; P < .001). In this randomized clinical trial, an online 1-day CBT-based workshop for PPD provides an effective, brief option for mothers, reducing PPD and anxiety as well as improving social support, the mother-infant relationship, and positive affectivity/surgency in offspring. ClinicalTrials.gov Identifier: NCT04485000.

Parental Sensitivity and Responsiveness as Mediators Between Postpartum Mental Health and Bonding in Mothers and Fathers.

Background: There is a lack of studies that examine the complex relationship between parental mental health, parental sensitivity and responsiveness, and parent-infant bonding. This study aimed to test whether parental sensitivity and responsiveness were mediators between postpartum mental health (depression, anxiety, and stress) and parent-infant bonding in mothers and fathers.Method: Mothers (n = 427) and fathers (n = 170) of infants aged up to 1-year-old participated in an online study. The parents completed questionnaires on depression (Edinburgh Postnatal Depression Scale, EPDS), anxiety and stress (Depression, Anxiety, and Stress Scale, DASS-21). Parent-infant bonding was measured by Postpartum Bonding Questionnaire (PBQ) that has three components: Impaired bonding (PBQ1), Anxiety about care and parental distress (PBQ2), and Lack of enjoyment and affection with infant (PB3Q). Parental sensitivity was measured as the number of correct recognitions of infant facial expressions (City Infant Faces Database, CIFD). Responsiveness was measured as a self-report with two subscales of responsiveness and non-responsiveness (Maternal Infant Responsiveness Instrument, MIRI).Results: The path analysis showed that the model had a good fit to the data. Parental sex was a significant moderator, indicating different paths in mothers and fathers. In mothers, responsiveness and non-responsiveness were significant mediators between depression symptoms and three dimensions of bonding. In fathers, only non-responsiveness was a significant mediator between anxiety and PBQ3. Although recognizing infant facial expressions directly affected PBQ3 in mothers (but not in fathers), it was not a significant mediator between mental health and bonding.Conclusion: Higher levels of parental mental health problems (depression and anxiety) were associated with lower levels of parental responsiveness, which is, in turn, related to poor parent-infant bonding. Prevention and intervention programs should be offered for both mothers and fathers, focusing on postpartum mental health promotion and enhancing responsiveness in infant care.

Prenatal expectations and other psycho-social factors as risk factors of postnatal bonding disturbance.

The mother's bond to her baby starts to develop during pregnancy, and it is related to the baby's attachment. We study how the mother's prenatal expectations of her unborn baby, the mother's adult relationships, and postnatal psycho-social factors (stress, depression, and anxiety) are related to the risk of bonding disturbance. The study comprised 1398 mothers and their unborn babies assessed both during pregnancy and when the babies were 3 months old (47.7% girls). The mother's risk of bonding disturbance was investigated using Brockington's Postpartum Bonding Questionnaire. According to the results, 71 (5.1%) of all the mothers in the study had a risk of a bonding disturbance. In a final adjusted logistic regression model, the most important risk factors were the mother's inability to form positive expectations about relationships with the baby during the third trimester of pregnancy (AOR=7.78, p ≤ .001), maternal postnatal stress (AOR=4.95, p ≤ .001) and maternal postnatal depression (AOR=3.46, p ≤ .01). The results challenge healthcare professionals to screen pregnant mothers to identify at-risk groups for post-partum bonding disturbances. Intervention programs to prevent the development of bonding disturbances, and thus their possible serious consequences for children's development, should be considered.

Relationship Between Infant Tongue-Tie and Maternal Wellbeing.

Tongue-tie is a mild oral anomaly that can cause feeding challenges, especially for breastfeeding mothers and infants. Delayed diagnosis may place mothers at increased risk of stress and impaired mother-infant bonding when feeding does not go as planned. The purpose of this study was to explore the risk for altered maternal wellbeing (e.g., stress and maternal-infant bonding) in mothers of infants with tongue-tie-using-a mixed-methods, cross-sectional study. We recruited mothers from two sites to participate in a survey about their experiences with tongue-tie: Facebook™ tongue-tie support group and a local pediatric dental office where frenotomy is commonly performed. Inclusion criteria were mothers 18 or older; able to read, write, and understand English. Infants were under the age of 1 year when diagnosed with tongue-tie. The survey contained both selection and open-text entry questions. Maternal-infant bonding was assessed using the Postpartum Bonding Questionnaire and maternal stress was measured using the Parental Stress Scale. N = 113 mothers participated. Findings suggest that mothers of infants with tongue-tie report increased stress, especially when a diagnosis of tongue-tie is delayed. After correction, maternal wellbeing, the breastfeeding relationship, and maternal report of infant temperament improved. Early assessment, diagnosis, and management of tongue-tie are important. Partner support is helpful in fostering the mother-infant relationship. Future research is needed to understand barriers to appropriate referrals and delay in treatment of tongue-tie.

Maternal Bonding in Early Infancy Predicts Childrens' Social Competences in Preschool Age.

Background: There are many studies on mother-child-bonding with little theoretical doubt that better bonding may have a positive effect on further social development. However, there is hardly any empirical evidence. In particular, there is a lack prospective longitudinal studies.Methods: As part of a longitudinal study, bonding was assessed in a community sample of 97 healthy mothers using the Postpartum Bonding Questionnaire (PBQ) 6 weeks after birth of their child. Social competencies in the offspring were assessed using the Self- and Other-oriented Social Competencies (SOCOMP) at 5.5 years of age. A potential correlation between bonding and social competencies was tested using Spearman Rank Correlation.Results: Retention rate over 5.5 years was 77.23%. Lower Maternal Bonding Impairment Scores 6 weeks postnatally were positively related to childrens' social competences at 5.5 years of age.Conclusion: The present data confirm a positive and long-term influence of bonding on social skills and provide further evidence of the importance of parent child bonding for child development in general. This result should give reason to further investigate this relationship in depth, causally and at later points in time.