The untenable omission of touch in maternal sensitivity and attachment research

Soothing touch matters: Patterns of everyday mother-infant physical contact and their real-time physiological implications

Physical contact between infants and caregivers is crucial for attachment development. Previous research shows that skin-to-skin contact after birth and frequent baby wearing in the first year predict secure attachment at 12-months. This relationship is thought to be mediated by the activation of infants' parasympathetic nervous system through caregiver touch. However, little is known about everyday touch behaviors and their impact on infants' real-time parasympathetic activity. Laboratory observations may not accurately represent real-world interactions, highlighting the need for ecologically valid studies. To address this, we examined everyday dyadic touch behaviors and their real-time effects on infant parasympathetic activation. We video recorded N = 28 infants (1-10 months old) and their mothers at home for behavioral analyses. All infants wore wireless ECG sensors (1024 Hz) during video recordings, and n = 21 infants had high-quality ECG data that could be used for Respiratory Sinus Arrhythmia analyses. We used a dynamic measure of RSA (updated every 200 ms) as an index for real-time parasympathetic activation. We found that dyads touch interactions at home involve short, though highly variable bouts of physical contact, that change with infant age. Younger infants spent more time remaining stationary during contact and receiving more soothing touch compared to older infants. Only soothing touch - i.e., rocking, patting, bouncing, or stroking- led to immediate, significant increases in parasympathetic activity (RSA), and this effect was driven by younger infants. This study provides new insights into the ecological patterns of touch in early development and the biobehavioral mechanisms promoting secure attachment.

Effects of infant massage on infant attachment security in a randomized controlled trial

Benefits of attachment security have been demonstrated in multiple realms of development, and an extensive body of research has identified some of the antecedents associated with the development of secure attachments. While previous research has indicated that infant massage may support the development of mothers' attachment to their babies, no published research exists that investigated infants' attachment security after mothers learn infant massage strokes. This study tested the impact of an infant massage intervention on mothers' massage frequency and attachment security in infants. Fifty-eight mother-infant dyads were randomly assigned to a treatment (massage, n = 28) or control (education, n = 30) group. Most mothers had preschool aged children participating in Head Start as well as an infant under 8 months of age; the remaining mothers were from the community. Mothers in the treatment group completed 4 weeks of infant massage training using standard strokes from Infant Massage USA, a chapter of the International Association of Infant Massage, headquartered in Sweden. At 12 months, mothers were guided through the standard sorting procedure of the Attachment Q-set (Waters, 1987). The treatment was effective, as 86 % of mothers in the massage group were still massaging their babies at the follow-up, an average of 10 months later, and infants whose mothers massaged them had higher attachment security scores. Surprisingly, 29 % of the mothers in the comparison group reported that they massaged their babies. A treatment X massage frequency ANOVA indicated that 12-month-old infants whose mothers in the treatment group had massaged them more than once per week were more securely attached than infants of mothers who massaged their infants less than once per week and also were more securely attached than infants in the comparison group. However mothers in the control group defined massage, it was not associated with infant attachment security at the follow-up. These results indicate that this inexpensive, easy to implement intervention effectively increased mothers' ongoing use of infant massage, which in turn predicted more attachment security in their infants.

Exploring maternal touch in the infant’s first 18 months of Life: A study on an Italian sample

Affective touch is a crucial component of caregiving in early life and constitutes a key factor with a significant impact on infant later-life outcomes. The Parent-Infant Caregiving Touch Scale (PICTS) allows to quantify and qualify the caregiver's self-perception of touch in the first months of an infant's life. In the current study, we contributed to validation of the PICTS in the Italian language in order to explore whether early maternal touch would be associated with maternal emotional state, maternal history of affective touch experiences throughout the lifespan, and infants' sex and age. Data analyses were run on a sample of 377 Italian mothers (mean age = 33.29; SD = 4.79) participating in an online survey. Confirmatory factor analysis was applied. A three-dimensional structure of PICTS (i.e., stroking, affective communication, and holding) after removing one item out resulted in the best model in our sample. Maternal emotional state did not affect PICTS factor scores while maternal comfort and amount of affective touch experienced during adulthood was significantly associated with the stroking, affective communication, and holding factors. Regarding infants' dimensions, infants' sex and age were not associated with PICTS factor scores. Findings suggest that the PICTS Italian version is a good measurement of caregiver's self-perception of touch in early infancy and that maternal history of touch is associated with a mother's current use of touch.

Maternal and infant touching behaviours during perturbed interactions: Associations with maternal depressive symptomatology and infant crying

Touch is an important means through which mothers and infants co-regulate during periods of stress or perturbation. The present study examined the synchrony of maternal and infant touching behaviours among 41 mother-infant dyads, some of whom were deemed at-risk due to maternal depressive symptomatology. Mothers and their 4-month-old infants participated in the Still-Face (maternal emotional unavailability; SF) and Separation (maternal physical unavailability; SP) procedures. Infant crying was examined across procedures and investigated as a brief period of perturbation. Results revealed that mothers and infants displayed a positive pattern of tactile synchrony (coordinated, analogous changes in touch) during infant crying episodes. However, dyads in the high depression group displayed significantly less affectionate touch during instances of infant crying. Furthermore, more depressive symptoms were associated with less maternal and infant touch and lower rates of infant crying. This group of dyads may be less expressive via touch, be less affected by disruptions in their interactions, have impaired regulatory abilities, or simply require minimal amounts of touch to mutually regulate following social stressors and during brief perturbation periods. These findings enrich our limited knowledge about the dynamic interplay of maternal and infant touch and inform preventative intervention programs for at-risk groups.

Affective Touch and Regulation of Stress Responses

Much has been documented on the association between stress and health. Both direct and indirect pathways have been identified and explored extensively, helping us understand trajectories from healthy individuals to reductions in well-being, and development of preclinical and disease states. Some of these pathways are well established within the field; physiology, affect regulation, and social relationships. The purpose of this review is to push beyond what is known separately about these pathways and provide a means to integrate them using one common mechanism. We propose that social touch, specifically affective touch, may be the missing active ingredient fundamental to our understanding of how close relationships contribute to stress and health. We provide empirical evidence detailing how affective touch is fundamental to the development of our stress systems, critical to the development of attachment bonds and subsequent social relationships across the life course. We will also explore how we can use this in applied contexts and incorporate it into existing interventions.

Studying caregiver-infant co-regulation in dynamic, diverse cultural contexts: A call to action

Caregivers and infants co-regulate their physiology, emotions, and behavior in a way that is dynamically responsive to each other and the contexts in which they live. This paper is an introduction and call to action for researchers interested in understanding how to study caregiver-infant interactions in the home and diverse cultural contexts, including marginalized communities. We argue that research will be more valid, culturally relevant, and tapped-in to the daily lives of caregivers and infants if there is partnership and collaboration with the caregivers in the design of the questions, data collection and analysis, and distribution of the findings. We recommend dynamically assessing emotions, behaviors, and physiology using repeated sampling methods including ecological momentary assessments (EMA), salivary bioscience, and actigraphy. We aim to extend current practices of studying caregiver-infant co-regulation by measuring fluctuations of daily life and considering sociocultural factors that shape naturalistic caregiver-infant interactions. Using methodological advancements and community-based participatory research approaches can enable developmental scientists to measure life as it is actually lived.

The Role of Affectionate Caregiver Touch in Early Neurodevelopment and Parent-Infant Interactional Synchrony

Though rarely included in studies of parent–infant interactions, affectionate touch plays a unique and vital role in infant development. Previous studies in human and rodent models have established that early and consistent affectionate touch from a caregiver confers wide-ranging and holistic benefits for infant psychosocial and neurophysiological development. We begin with an introduction to the neurophysiological pathways for the positive effects of touch. Then, we provide a brief review of how affectionate touch tunes the development of infant somatosensory, autonomic (stress regulation), and immune systems. Affective touch also plays a foundational role in the establishment of social affiliative bonds and early psychosocial behavior. These touch-related bonding effects are known to be mediated primarily by the oxytocin system, but touch also activates mesocorticolimbic dopamine and endogenous opioid systems which aid the development of social cognitive processes such as social learning and reward processing. We conclude by proposing a unique role for affectionate touch as an essential pathway to establishing and maintaining parent-infant interactional synchrony at behavioral and neural levels. The limitations of the current understanding of affectionate touch in infant development point to fruitful avenues for future research.

Social and affective touch in primates and its role in the evolution of social cohesion

Primates are long-lived, highly social mammals who maintain long-term social bonds and cohesive social groups through many affiliative mechanisms, foremost among them social touch. From birth through adulthood, social touch - primarily mutual grooming - creates and maintains relationships of trust and reliance, which are the basis for individual physical and emotional well-being and reproductive success. Because social touch helps to establish, maintain, and repair social alliances in primates, it contributes to the emotional stability of individuals and the cohesion of social groups. In these fundamental ways, thus, social touch supports the slow life histories of primates. The reinforcing neurochemistry of social touch insures that it is a pleasurable activity and this, in turn, makes it a behavioral commodity that can be traded between primates for desirable rewards such as protection against future aggression or opportunities to handle infants. Social touch is essential to normal primate development, and individuals deprived of social touch exhibit high levels of anxiety and lower fertility compared to those receiving regular social touch. Understanding the centrality of social touch to primate health and well-being throughout the lifespan provides the foundation for appreciating the importance of social touch in human life.