Quality Of Mother-infant Interaction Research Articles

Quality of mother-infant interaction, breastfeeding, and perinatal mental health

IntroductionThe quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile. Materials and methodEighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions. ResultsExclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants. ConclusionBreastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.

Associations among Maternal Trauma History, Postnatal Maternal Sensitivity, and Infant Temperament.

Women are at increased risk of trauma exposure and of experiencing prolonged posttraumatic stress. Maternal trauma exposure and associated impairment may adversely impact mother-infant interaction quality, which may in turn be associated with infant temperament difficulties. More research is needed to identify which maternal trauma predictors are most robustly related to infant temperament outcomes. The present study aimed to address this gap by examining maternal sensitivity as a mediator of relations between maternal trauma and infant temperament in a longitudinal study of a rural cohort of mother-infant dyads. Mediation via maternal sensitivity was not supported in any of the primary analyses. Greater maternal trauma exposure was found to predict greater infant regulation behavior, a finding that was in opposition to expected results and which may be explained by protective factors found within the sample. The present sample was skewed toward married, educated women who reported high social support satisfaction and low trauma-associated impairment. The findings elucidate protective factors that may mitigate adverse outcomes for both mothers and infants. Future research models should include additional maternal trauma variables (e.g., recency, type, revictimization/polyvictimization), in utero maternal cortisol exposure, maternal insensitivity/ambiguous response patterns during caregiver tasks, and analysis of the IBQ-R subscales.

The Self and Maternal Care: An Analysis of Rossella Schillachi's ‘Imprisoned Lullaby’

This paper discusses the importance of the nature of maternal care as it determines healthy or unhealthy psychological development. The purpose of this essay is to demonstrate that the ongoing quality of mother-infant interaction is more important than the issue of separation from the mother, as a close but unavailable mother or caregiver may cause extreme forms of trauma in the infant. Although attachment researchers have concentrated on the mother-child proximity and the disruptive effect of separation from the mother in the development of attachment theory, less attention has been directed towards the quality of caregiving processes that contribute to the formation and maintenance of secure attachment bonds across the lifespan. This study aims to fill this gap by showing the negative effects of suppressed and unresolved grief internalized by the mother on the mental and physical health of the child. To describe the importance of a good enough mother-child relationship, this study uses the method of textual analysis. Rossella Schillaci's documentary "Ninna Nanna Prigioniera (Imprisoned Lullaby)" provides a valuable framework to analyze how an insecure attachment between a mother and an infant can be disruptive for a child's self. The documentary follows the experience of a mother who chooses to keep her newborn and young child under three with her in prison. Roscella Schillachi illustrates the development of an insecure attachment between mother prisoner Yasmina and her daughter Lolita. The documentary film shows that unresolved traumas in a caregiver can lead to insecure or disorganized attachments in infants. Although several studies suggest that mother-child proximity during the first two years is crucial to develop a healthy sense of self, this analysis of documentary provides a different approach to the concept of separation and emphasizes that proximity to a mother with unresolved trauma disturb mother-infant attachment more than separation.

Skin-to-Skin Contact at Birth for Very Preterm Infants and Mother-Infant Interaction Quality at 4 Months

Good-quality parent-infant interactions have protective effects on infant socio-emotional and behavioral development. These interactions are especially critical for very preterm infants at risk of vulnerabilities related to immaturity. Skin-to-skin contact (SSC) has been found to improve mother-preterm infant interaction behaviors, but few studies exist regarding its benefits when initiated immediately after birth. To determine the effect of immediate SSC at birth for very preterm infants on mother-infant interaction quality at 4 months of corrected age. This secondary analysis used data from the Immediate Parent-Infant Skin-to-Skin Study (IPISTOSS), a randomized clinical trial conducted between April 1, 2018, and June 30, 2021, at 3 neonatal units in Sweden and Norway. Participants included very preterm infants (28-33 gestational weeks of age) and their parents. Four-month follow-up was concluded in December 2021. Data analyses were performed on March 16 and September 18, 2023. Infants were allocated to standard incubator care or SSC with either parent initiated at birth and continued throughout the first 6 hours after birth. The primary outcome was mother-infant interaction quality as measured with the Parent-Child Early Relational Assessment (PCERA), based on video recordings of a 5-minute free-play situation with mother-infant dyads at 4 months of corrected age. A multilevel regression analysis was performed. This analysis included 71 infants (31 twins [44%]) and 56 mothers. Infants had a mean (SD) gestational age of 31 weeks 3 (1.3) days, and more than half were male (42 [59%]); mothers had a mean (SD) age of 32 (4.9) years. There were 37 infants allocated to standard care and 34 to SSC with either parent after birth. During the first 6 hours after birth, fathers provided more SSC than mothers, with a median (IQR) of 3.25 (2.25-4.5) and 0.75 (0-2.5) hours, respectively. A statistically significant difference in 1 of 5 PCERA subscales (subscale 3: infant positive affect, communicative and social skills) was observed, with higher-quality mother-infant interaction in the SSC group at 4 months (Cohen d = 0.67 [95% CI, 0.17 to 1.17]; P = .01). This effect remained significant when adjusting for primiparity, child sex, and observation setting. In this study of the effect of immediate parent-infant SSC after very preterm birth, SSC was beneficial for the mother-infant relationship. These findings suggest that immediate SSC should be supported in the clinical setting. ClinicalTrials.gov Identifier: NCT03521310.

Father-infant synchrony and infant vagal tone as an index of emotion regulation: father-infant shared times in Switzerland as moderators

ABSTRACT Research has shown that the quality of mother-infant interactions, as measured by mother-infant synchrony, is associated with infants’ vagal tone, a physiological indicator of emotion regulation. However, little is known about the association between the infant’s vagal tone and the quality of father-infant interactions. Existing literature suggests that the greater quantity of time a father spends with the infant, either alone (dyadic time) or with others (social time) may strengthen this association. In this study we investigated the association between father-infant synchrony and infants’ vagal tone in 77 dyads made up of fathers and their 3-month-old infants, considering the moderating roles of dyadic time and social time. Results revealed no direct associations between father-infant synchrony and infants’ vagal tone. Moderation analyses revealed that more social time increases the association between synchrony and vagal tone. This result indicates a potential influence of family interactive processes. Key findings Father-infant synchrony is not associated with infants’ vagal tone in father-infant interactions. The time that fathers share with infants facilitates associations between father-infant synchrony and infants’ vagal tone during father-infant interactions. Further investigations should explore whether interactive processes during shared family time influence dyadic father-infant interactions and the infant’s physiological emotion regulation at 3 months.

Early intervention to prevent adverse child emotional and behavioural development following maternal depression in pregnancy: study protocol for a randomised controlled trial

BackgroundSubstantial evidence indicates that maternal depression during pregnancy (i.e., antenatal depression) is associated not only with maternal wellbeing but also with child emotional and behavioural development. Children of antenatally depressed women are at risk of emotional and behavioural problems, including internalising problems (e.g., anxiety and depression) and externalising problems (e.g., attention problems), that may last at least to adolescence. These enduring effects also constitute an enormous economic cost. Despite the seriousness of this problem, until recently there existed very few controlled studies evaluating whether active psychological treatment for antenatal depression can prevent adverse child outcomes. Our previous pilot randomised controlled trial (RCT) exploring the effect of cognitive behavioural therapy (CBT) for antenatal depression on child outcomes showed promising results. We aim to assess whether treating antenatal depression with an evidence-based 8-week structured CBT program can prevent or ameliorate adverse child developmental outcomes at 2 years of age.MethodsPregnant women ≤ 30 weeks gestation diagnosed with a depressive disorder are recruited and randomised to CBT or treatment as usual (TAU). The target sample size is 230 and the primary outcome measure is the infant Internalising scale of the Child Behaviour Checklist (CBCL) at 24 months of age. Secondary infant outcome measures at 24 months are the Externalising scale of the CBCL and the motor and cognitive development subscales of the Ages & Stages Questionnaire (ASQ-3). Additional secondary outcome measures are subscales of the Revised Infant Behaviour Questionnaire (IBQ-R), ASQ-3 and the ASQ-Socio-Emotional (ASQ-SE) at 3 and 12 months of age and the quality of mother-infant interaction at 3 and 24 months. Maternal measures, including demographic data, depression diagnosis, depressive and anxiety symptoms, perceived stress and parenting stress, are collected across all time points.DiscussionThe trial is ongoing and recruitment was slowed due to the COVID-19 pandemic. If results suggest a beneficial effect of antenatal depression treatment on infant outcomes, the project could have repercussions for standard antenatal care, for maternal and infant health services and for preventing the intergenerational transmission of mental health disorders.Trial registrationAustralia and New Zealand Clinical Trials Register: ACTRN12618001925235 Date Registered: 27 November 2018.

Mother–infant interaction and maternal postnatal psychological distress are associated with negative emotional reactivity among infants and toddlers— A FinnBrain Birth Cohort study

Studies have reported mixed findings regarding the effects of mother-infant interaction and maternal distress on children’s negative emotional reactivity. In the current study (N = 134 and 107), we examined the effects of maternal Emotional Availability (sensitivity, structuring, non-intrusiveness and non-hostility) and maternal psychological distress on negative reactivity among children in the FinnBrain birth cohort study. In addition, the possible moderating effect of mother-infant interaction on the associations between maternal psychological distress and children's negative reactivity was examined. We used questionnaires to asses maternal psychological distress, observations of mother-infant interaction and observations as well maternal reports of child temperament to overcome the key limitations of many studies relying on single-method assessments. Our results showed that higher maternal sensitivity and structuring at 8 months of child’s age were associated with lower mother-reported negative reactivity among children at 24 months. Higher maternal postnatal distress associated with higher parent-reported negative reactivity in children at 12 and 24 months of age when the effects of prenatal distress and the quality of mother-infant interaction were controlled for. Mother-infant interaction and maternal psychological distress did not associate with observations of child negative reactivity. We found no moderation effects of mother-infant interaction regarding the associations between maternal distress and children’s negative emotional reactivity. Our findings reflect the importance of developing interventions to reduce the maternal distress symptoms while enhancing maternal sensitivity and structuring to prevent the possible harmful effects of these on child negative reactivity.

Coding Interactive Behaviour Instrument: Mother-Infant Interaction Quality, Construct Validity, Measurement Invariance, and Postnatal Depression and Anxiety

The quality of parent-child interaction has consistently been associated with child psychosocial outcomes. Postnatal depression (PND) and anxiety (PNA) can have an adverse effect on the parent-child interaction. The Coding Interactive Behaviour (CIB) measure has frequently been used to assess parent-infant interaction quality; however, few have investigated the construct validity. The purpose of this study is to: (1) compare two theoretical models and one data-driven model for best fit and to test the best fitting one for measurement invariance among mothers with and without PND, and (2) compare effects of PND and PNA on the mother-infant interactions. The sample consisted of mothers with PND (n = 236) and a subclinical sample of mothers with elevated symptoms of PND but did not meet criteria for a diagnosis (n = 183) and their infants (aged ≤ 6 months). PND was assessed with a diagnostic interview and PNA using a self-report measure. Confirmatory factor analyses showed that the data-driven model, consisting of the composites ‘Maternal Sensitivity’, ‘Child Engagement’, ‘Maternal Social Withdrawal’, and ‘Maternal Controlling Behaviour’, reached the best fit and showed measurement invariance with regard to PND. Factorial ANOVAs showed no effects of PND and PNA on the composites. The study is the first to investigate and find measurement invariance in the CIB, providing evidence of construct validity. The importance of investigating the factor structure of an instrument liable to change due to contextual factors is discussed.

Expectant mothers' not fathers' mind-mindedness predicts infant, mother, and father conversational turns at 7months.

Parental mind-mindedness (MM), defined as the propensity to view one's child as an agent with thoughts, feelings, and desires, is associated with positive child outcomes (McMahon & Bernier, 2017) and can be assessed in expectant parents by using five-minute speech samples (Magaña etal., 1986). Individual differences in MM appear stable across the transition to parenthood (Foley etal., in press), offering an exciting intervention opportunity, as expectant mothers' thoughts and feelings about their unborn infants are associated with the quality of mother-infant interactions. To assess prenatal MM as a predictor of parent-infant conversation at 7months, we followed 93 low-risk British heterosexual couples across the transition to parenthood. Mothers' and fathers' MM was measured both in the third trimester of pregnancy and at 4months. Wearable LENA devices were used to gather detailed measures of mother-, father-, and infant-initiated conversations at 7months. Prenatal MM in both parents was associated with more frequent infant-initiated conversations at 7months, while prenatal maternal (not paternal) MM was also associated with more mother- and father-initiated conversations. While longitudinal research with more diverse samples is needed, these findings highlight the importance of parental mentalizing in the prenatal period for early family interactions.

Panda Unit, a Mother-Baby Unit Nested in a Neonatal Care Service

The PANDA unit is a full-time mother-baby hospitalization unit based on an original model of care for vulnerable dyads. It is located within a neonatal unit allowing tripartite care (perinatal psychiatry, neonatology and post-natal care). It thus differs from traditional mother-baby units in its close links with the other perinatal care actors, allowing comprehensive health and mental health care in the immediate post-partum period. Patients admitted to the Panda Unit may have been referred during the antenatal period or taken into care in an emergency if the mother's clinical condition requires it, in the aftermath of childbirth. During their stay, the dyads are evaluated daily by a perinatal psychiatrist. This includes assessment of maternal clinical state, the newborn's development and the quality of mother-infant interactions. During the first 6 months of use, 24 dyads have benefited from PANDA care. Three women among 5 were admitted during the antenatal period and almost one-third were aged under 21. The first primary diagnosis during the antepartum was major depressive disorder, two-fold that of personality disorder or bipolar disorder alone. At the end of PANDA stay, close to 3 women among 4 were back to their home with their child, and an out-of-home placement was mandated for 4 infants. PANDA unit is a step toward continuous and comprehensive integrative care. The mother and baby do not leave the maternity ward, and management of mother, baby, and their interactions can start immediately after birth. Considering the importance of the first months of life in the establishment of fundamental links and bonding, PANDA offers an innovative opportunity for what we hope will be both therapeutic and preventive for at-risk dyads. The detection, and ultimately prevention and management of risk of abuse and neglect is another major challenge that this unit hopes to address from the very beginning.

The impact of low birthweight in infant patterns of regulatory behavior, mother-infant quality of interaction, and attachment

It remains unclear whether infants born preterm are more likely to develop an insecure attachment with their mothers. In this study, instead of using gestational age criteria, we observe attachment in infants born with very low birthweight. Although the collinearity between gestational age and birthweight is high, infants born with very low birthweight for their gestational age tend to stay more days in NICU and to have more comorbidities than other infants with the same gestational age. Thus, we wonder about the impact of low gestational birth (per se) in infants' regulatory behavior, the quality of mother-infant interactions, and attachment security. The participants are 71 infants' weight lower than 1599 g of gestational weight (varying between 23 and 34 weeks of gestational) and their mothers. Dyads were observed in free play and during Face to Face Still-Face paradigm with infants at 3 months of corrected age. At 12 months of corrected age, mother-infant attachment was observed during Strange Situation. Results indicate that infants with low/very low gestational birthweight have high levels of insecure attachment (70 %) and non-positive patterns of regulatory behavior (64 %). Maternal and infant interactive behavior is highly associated with infant attachment. In turn, maternal interactive behavior is associated with gestational age, birthweight, and number of days in NICU.

Prenatal Reflective Functioning as a Predictor of Substance-Using Mothers' Treatment Outcome: Comparing Results From Two Different RF Measures.

Mothers with prenatal substance use disorder (SUD) often show broad deficits in their reflective functioning (RF), implying severe risk for the relationship with their baby. Two different types of prenatal maternal RF may be important for parenting: adult attachment-focused-RF (AAI-RF), regarding parent's own childhood experiences, and parenting-focused RF (PRF) regarding their own current process of becoming a parent. However, their inter-relations and potentially different roles for parenting intervention outcomes are not clear. This study examined the associations between mothers' prenatal AAI-RF and pre- and post-natal PRF, and their role in mother-infant interaction and substance use as treatment outcomes. The participants were 57 treatment-enrolled pregnant mothers with SUD and 50 low-risk comparison mothers. AAI-RF was measured with the Adult Attachment Interview. For a subsample of 30 mothers with SUD, PRF was measured with Pregnancy Interview (during pregnancy/pre-intervention), and with Parent Development Interview at 4 months (during intervention). Mother-infant interaction was measured with Emotional Availability Scales at 4 and 12 months (post-intervention), and maternal substance use by post-natal substance relapses. Prenatal AAI-RF and pre- and post-natal PRF were highly associated with each other. Only higher prenatal PRF predicted better mother-infant interaction quality at 4 months and less substance use during the child's first year. Interestingly, prenatal PRF and AAI-RF predicted opposite changes in mother-infant interaction: lower prenatal PRF, but higher AAI-RF predicting more positive change. AAI-RF was especially associated with a change in maternal intrusiveness and hostility, indicating that it represents a more general regulatory tendency. Further studies are needed in larger and lower-risk samples. Our results suggest, however, that AAI-RF and PRF are partially distinct and should be uniquely targeted in perinatal interventions.

Psychological Well-Being, Prenatal Attachment, and Quality of Early Mother-Infant Interaction: A Pilot Study With a Sample of Mothers With or Without Cancer History.

Given the positive impact of high-quality mother–infant interaction on child development, and that such relationship might be hindered by maternal stresses such past cancer, research is needed to understand protective and risk factors in this clinical population. As almost no data is available on the impact of history of cancer on the quality of mother–infant interaction, a multicentric and longitudinal pilot study was conducted. Differences in women’s prenatal psychological well-being and attachment (T1, third trimester), and postnatal quality of mother–infant interaction (T2, 2–5 months) were assessed in a sample of Italian mothers with (N = 11) or without cancer history (N = 13). Results showed that women did not differ significantly in their prenatal well-being (assessed with the Profile of Mood States questionnaire) and levels of attachment (assessed with the Prenatal Attachment Inventory). Looking at mother–infant interactions (assessed using the Global Rating Scale at T2), while maternal sensitivity, warmth and intrusiveness, and infant distress and attentiveness did not differ between the two groups, in the clinical group, mothers were more remote and less absorbed in the infant, and infants showed fewer positive communications. These findings might shed light on potential protective and risk factors for early parenting and later child outcomes in this clinical population.

Mother’s mental health and the interaction with her moderate preterm baby in the NICU

ABSTRACT Introduction: Moderate preterm infants, born between 320/7 and 336/7 weeks, represent a significant number of preterm-born infants; however, they remain a poorly studied group despite their vulnerability. The objective of this correlational study is to describe the impact of having a moderate preterm infant hospitalised in the NICU on the mothers’ mental health and how this relates to the interaction between the dyad. Method: During the hospitalisation period, 85 moderate preterm mother-infant dyads participated in this study. The participants provided self-reports of depression, parental stress, and skin to skin and breastfeeding practices. Also, mother-infant interaction was assessed in the NICU with an observational scale. Results: Mothers evidenced high levels of stress and depressive symptoms during the hospitalization. The stress experienced by these women was significant, although weakly, associated with the interaction with their babies; and mothers of small for gestational age babies showed difficulties in this area. Conclusions: The results of this study could represent a contribution to a better understanding of the relation between the characteristics of moderate preterm babies, maternal emotional wellbeing, and the quality of mother-infant interactions in NICU settings.

Maternal anxiety symptoms associated with increased behavioral synchrony in the early postnatal period.

The presence of perinatal mood and anxiety disorders has typically been associated with decreases in the quality of mother-infant interactions. However, maternal anxiety symptoms during the postpartum period have been less studied than other mental health disorders like depression. In the current study, we examined associations among symptoms of maternal anxiety, maternal perceived stress, and mother-infant behavioral synchrony in the early postnatal period. Eighty-one mother-infant dyads participated in this study when the infants were 3months old. Surveys were given to obtain demographic information and current maternal mental health symptoms, and dyads completed a 5-min free-play task to measure behavioral synchrony. Results indicated that maternal anxiety symptoms were positively associated with behavioral synchrony, but only for mothers reporting moderate levels of perceived stress. These findings highlight the differential impact of maternal postpartum mental health on behavioral synchrony and suggest that higher maternal anxiety symptoms during the postnatal period may play an adaptive role in fostering more dynamic mother-infant interactions.

Influence of Maternal Childhood Trauma on Perinatal Depression, Observed Mother-Infant Interactions, and Child Growth.

Mothers who have experienced childhood trauma may be at increased risk for disruptions in caregiving behavior, with potential consequences for early child development. However, assessments of caregiving behavior tend to be self-reported, which may bias results, and have been limited in lower-resource settings. In an overall sample of 256 South African mothers followed across the perinatal period, this longitudinal study used structural equation modeling to test pathways of association between maternal childhood trauma and depressive symptoms on observed mother-infant interactions at 3.5months and subsequent child growth outcomes at 1 year. On average, mothers with childhood trauma histories tended to show lower rated overall interactions with their infants (B = -0.16, p = .013), which in turn was associated with reduced child growth at 1 year (B = 0.17, p = .046). When this model was adjusted for maternal age and relative socioeconomic status (SES), maternal SES strongly explained child growth (B = 0.31, p < .001) such that the direct effect of mother-infant interactions was no longer significant. For child growth in a lower-resource setting, quality of mother-infant interactions could be a relevant predictor but more strongly explained by maternal SES factors, suggesting a need for broader approaches that not only improve dyadic relationships but also address maternal ecological resources.

Supporting early infant relationships and reducing maternal distress with the Newborn Behavioral Observations: A randomized controlled effectiveness trial.

Research points to the significant impact of maternal distress on the parent‐infant relationship and infant development. The Newborn Behavioral Observations (NBO) is a brief intervention supporting the infant, the parent and their relationship. This randomized controlled trial examined the effectiveness of the NBO in a population with antenatal distress and risk of postnatal depression (PND). Pregnant, first‐time mothers with current anxiety or depression symptoms or past mental illness were recruited from two Australian hospitals. Participants received three NBO sessions in the first month of life plus treatment as usual (TAU), or, TAU‐only. Outcomes assessed at infant age 4 months included mother‐infant interaction quality; maternal anxiety and depression symptoms; and depression diagnosis. Of 111 pregnant individuals randomized, 90 remained eligible and 74 completed the trial (82.2% retention). There were intervention effects on emotional availability F(6, 67) = 2.52, p = .049, Cohen's d = .90, with higher sensitivity and non‐intrusiveness in the intervention group (n = 40) than the comparison group (n = 34). There was an intervention effect approaching significance for anxiety symptoms at 4 months (p = .06), and a significant effect over time (p = .014), but not for depression symptoms. Anxiety and depression symptoms significantly reduced to sub‐clinical levels within the intervention group only. There were fewer depression diagnoses (n = 6) than expected across groups, with no observed intervention effect. No adverse intervention effects were seen. Exploratory analysis of sensory processing sensitivity suggested differential susceptibility to distress and intervention benefits. The NBO was accepted and exerted meaningful effects on relationship quality and distress; and may enhance the infant's interaction experience and maternal emotional adjustment in at‐risk populations.

Involvement of mothers in high-risk neonatal care: A capacity building program for neonatal nurses

The quality of mother-infant interaction directly impacts neonatal and maternal health and well-being. Nurses play a significant role in facilitating and supporting the mothers to participate in the care of their neonates admitted to Neonatal Intensive Care Unit (NICU). Capacity-Building Program (CBP) was conducted to empower the neonatal nurses to facilitate and support mothers in routine care of their neonates admitted to NICU. A total of 53 neonatal nurses participated in the program. This program focused on empowering the neonatal nurses on the responsibilities and strategies to involve mothers in routine care of neonates at NICU. The program was evaluated by testing nurses’ knowledge through pre-test and post-test score analysis. Neonatal nurses demonstrated a higher level of knowledge post-implementation of the program. It was found that the capacity-building program intervention was effective (p < 0.001) in improving the knowledge of neonatal nurses on the role of nurses in facilitating and supporting mothers in the care of their neonates admitted to NICU.

Smartphone use during breastfeeding and its impact on mother-infant interaction and maternal responsiveness: Within-subject design.

This study investigated the association between maternal smartphone use during breastfeeding and the quality of mother-infant interactions and maternal visual responsiveness to the infant's bids for attention. We observed 13 mother-infant dyads and video-recorded breastfeeding under the experimental (smartphone use) and control (no smartphone use) conditions on separate days. To evaluate the quality of mother-infant interactions between the two conditions, we used the Japanese revised version of the Assessment of Mother-Infant Sensitivity (AMIS) scale. The mothers' visual responses to their infants' bids for attention were categorized into two groups. In this study, although smartphone use clearly increased distracted feeding times, we found no significant associations between maternal smartphone use and the quality of mother-infant interactions or bonding during breastfeeding. However, smartphone use during breastfeeding was found to interfere with the mother's ability to respond visually to the infant's bid for her attention. The results of this study can be applied while developing resources regarding smartphone use for nursing mothers.

Maternal alexithymic traits are related to lower maternal sensitivity and higher hostility in mother-infant interaction

Background A child’s ability to regulate emotions, attention and arousal develops in the context of their primary caregiving from the very beginning of infancy and thus, is dependent on bidirectional signalling and understanding of emotions also within mother-infant interaction. Parental alexithymia could potentially complicate this emotional interaction. In this study, we aim to explore the association between maternal alexithymic traits and the quality of mother-infant interaction. Methods The study sample consisted of 158 mother-infant dyads within the FinnBrain Birth Cohort Study population who had filled in a questionnaire measuring alexithymic traits 6 months postpartum and participated in an observational study on mother-infant interaction 8 months postpartum. Alexithymia was measured with the 20-item Toronto Alexithymia Scale including all three alexithymia dimensions – Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF) and Externally Oriented Thinking (EOT). Mother-infant interaction was assessed with the Emotional Availability Scale and in this study all four adult dimensions (Sensitivity, Structuring, Non-intrusiveness and Non-hostility) were included. The associations were studied with correlation analyses and General Linear Model. Results Maternal alexithymic traits were associated with the quality of mother-infant interaction. Specifically, the association between DDF and Sensitivity (p = 0.044, η 2 p = 0.026) and EOT and Non-hostility (p = 0.030, η 2 p = 0.030) remained significant when controlled by associated background and confounding factors. Conclusions Support was found for the hypothesis that higher maternal alexithymic traits would associate with weaker maternal sensitivity and more hostile behavior in mother-infant interaction. Further studies are needed to gain support for these hypotheses and to investigate their possible implications for child development.