Development and validation of the Maternal Distraction Questionnaire

Development of the Baby Behaviors when Satiated (BABES) behavioral coding scheme

Current infant feeding recommendations promote responsive feeding, wherein caregivers respond to infants' cues to determine feeding pace and duration, to support infant self-regulation and healthy weight outcomes. A central tenet of responsive feeding is that infants will effectively signal hunger, receptiveness to feeding, needs to disengage from feeding, and satiation, yet there is a lack of research available to support this assumption. Rather, previous research illustrates substantial variability exists for the extent to which infants exhibit behavioral cues during feeding and that many mothers feel their infants do not clearly communicate satiation, suggesting certain caregivers need tailored support to understand their infants' needs during feeding interactions. As a first step toward addressing this research gap, we developed the Baby Behaviors when Satiated (BABES) coding scheme, a comprehensive tool that assesses infants' disengagement/satiation behaviors and mothers' responses to infant behaviors and feeding practices during mother-infant feeding interactions. The BABES was applied to 876 videos of bottle-feeding interactions from a prospective, longitudinal study of dyads observed when infants were 1, 2, 4, 6, 9, and 12 months old. Coders achieved moderate to strong inter-rater reliability. Descriptive analyses illustrated that the percentages of infants and mothers exhibiting different behaviors at each age were consistent with developmental trends noted in previous research. Application of this tool within future research holds the potential to create rich datasets allowing for description of intra- and inter-individual variability in infant and mother behaviors and how infants' and mothers' behaviors co-develop across the first year.

Daily smartphone use predicts parent depressive symptoms, but parents' perceptions of responsiveness to their child moderate this effect

Introduction

Smartphone use during caregiving has become increasingly common, especially around infants and very young children, and this use around young children has been linked with lower quality and quantity of parent-child interaction, with potential implications for child behavior, and parent-child attachment. To understand drivers and consequences of parent phone use, we were interested in the daily associations between parent phone use and depressed mood, as well as the potential for parent perceptions of their responsiveness toward their infant to alter the association between parent phone use and mood.

Methods

In the present study, we explored associations between day-to-day changes in parent smartphone use (objectively-measured via passive sensing) around their infant, depressed mood, and parent perceptions of their responsiveness to their infants among a sample of 264 parents across eight days. We utilized multilevel modeling to examine these within-person daily associations.

Results

Objectively-measured parent smartphone use during time around their infant was significantly associated with depressed mood on a daily basis. Interestingly, this was not true on days when parents perceived themselves to be more responsive to their infant.

Discussion

These results suggest that parent judgements and perceptions of their parenting behavior may impact the potential link between parent phone use and parent mood. This is the first study utilizing intensive daily data to examine how parent perceptions may alter the felt effects of phone use on their parenting. Future work examining potential impacts of smartphone use on parenting should consider the effects of both actual use and perceptions about that use.

Developing the mother-child interaction inventory and uncovering mother-child interaction profiles in Türkiye

BACKGROUND

In this study, we aimed to design a mother-report inventory to comprehensively assess mother-child interaction in the 0-3 age range, focusing on maternal and child interaction behavior and mutual attunement.

METHODS

Our research involved three stages, with 1061 mothers and their 0-3-year-old children: 45 in the pilot study, 498 in exploratory factor analysis and latent profile analysis, and 518 in confirmatory factor analysis.

FINDINGS

The Mother-Child Interaction Inventory emerged as a valid and reliable measurement tool, comprising three distinct scales: 1) Maternal Interaction Behavior Questionnaire with sensitive structuring, hostility, and intrusiveness subscales; 2) Child Interaction Behavior Questionnaire with emotional-behavioral involvement and child characteristics; and 3) Mutual Attunement Questionnaire with reciprocity and problem-solving subscales. Latent profile analysis revealed four mother-child interaction profiles, indicating different characteristics in maternal and child interaction behavior and mutual attunement, categorized as "Excellent interaction quality," "Average interaction quality 1", "Average interaction quality 2," and "Poor interaction quality."

DISCUSSION

The study underscores the significance of maternal and child interaction behavior and mutual attunement in determining the quality of mother-child interaction. The mother-report The Mother-Child Interaction Inventory is a functional measurement tool to evaluate interaction separately and holistically, unveiling mother-child interaction profiles in the Turkish context.

PRACTICE IMPLICATIONS

The practical implications of this research are significant for health professionals, educators, and stakeholders working with children and families. The Mother-Child Interaction Inventory provides a valuable tool for assessing interaction dynamics, offering insights that can be directly applied to improve mother-child interaction.

Investigating the influence of family-oriented counselling on breastfeeding continuity in mothers experiencing distractions: A randomized controlled trial

The prevalence of distraction among breastfeeding mothers is on the rise, primarily attributed to the escalating use of media technologies. This study aimed to assess the influence of family-oriented counselling on the continuity of breastfeeding in mothers experiencing distractions. This randomized controlled trial included 120 eligible lactating mothers who accessed postpartum services at comprehensive health centers in Zanjan, a city in northwest Iran from August 21, 2022 to May 10, 2023. Participants were assigned to two groups through block randomization with a block size of four. The intervention group received Family-Oriented Counselling in three sessions at weekly intervals, and the control group received standard postpartum care. The study measured outcomes using the Maternal Distraction Questionnaire and breastfeeding patterns before, monthly, and up to 4 months after counselling. Data analysis employed statistical methods, including the Chi-square test, independent t-test, repeated measures ANOVA, and the Kaplan-Meier method, with a significance level set at P < 0.05. The results showed that the continuation of exclusive breastfeeding was 33 (55 %) in the intervention group and 21 (35 %) in the control group. This difference was statistically significant (p = 0.001). The reduction in distraction scores over time was more pronounced in the intervention group compared to the control group. The between-group effect was found to be statistically significant with an eta effect size of 0.73 (p = 0.001). In conclusion, the study suggests that the implementation of a family-centered intervention was effective in promoting the continuation of breastfeeding and reducing maternal distractions both during breastfeeding and non-breastfeeding activities. This approach proves to be a valuable step in enhancing the health of both mother and child. The findings underscore the importance of considering such interventions in health policymaking.

Heavy users, mobile gamers, and social networkers: Patterns of objective smartphone use in parents of infants and associations with parent depression, sleep, parenting, and problematic phone use

Smartphone use during parenting is common, which may lead to distraction (also known as technoference). However, it is likely that some phone activities are less disruptive to parents and children. In this study, we explored smartphone use (via passive sensing across 8 days) within 264 parents of infants, measuring parents' application use on their phone (e.g., messaging, social media, mobile gaming, video chat) and phone use across contexts (e.g., during feeding and at bedtime). We utilized latent profile analysis to identify profiles of users, revealing five user types: Moderate User Social Networkers (37%), followed by Moderate User Gamers (20%), Moderate User Video Chatters (17%), Low Users (15%), and Heavy Users (11%). Parents varied in their use, from Low Users, who used their phone approximately 2.4 hours each day, spent only 13% of their child time on their phone, and used their phone for about 18 minutes at bedtime, to Heavy Users, who spent approximately 8 hours a day, about 50% of their child time on their phone, and about 1 hour at bedtime. Heavy Users showed higher depressive symptoms and poorer sleep (although not poorer sleep than Moderate User Gamers). Surprisingly, we found no differences between groups in perceptions of parenting stress, responsiveness to their infant, or problematic phone use and distraction. We also explored demographic differences across groups. We call for future work to examine parent phone use more comprehensively and holistically and to view specific phone use activities as simultaneously interconnected with other types of use activities.

Parents' Desire to Change Phone Use: Associations with Objective Smartphone Use and Feelings About Problematic Use and Distraction

We examined objective smartphone use (via a mobile sensing application) and self-reported desire to change phone use among a sample of 268 U.S. parents of infants. Using the Transtheoretical Stages of Change model as a conceptual foundation, we contextualized their attitudes and behaviors and explored how phone use and desire to change relate to perceptions of distraction and problematic phone use around their child. Latent profile analysis of parents' precontemplation, contemplation, and action scores revealed two classes-precontemplators (15%) and contemplators (85%). Contemplators-those considering or desiring change-showed more bedtime phone use and general social networking than precontemplors; however, there were no significant differences between groups on other objective use measures (e.g., total daily duration of phone use, phone use around child, etc.). Contemplators also showed greater perceptions of problematic use around their child and parenting distraction. Moreover, parents' problematic use and distraction were predictive of higher contemplation scores, even after controlling for demographic and objective phone use variables. Taken together, these results suggest that perceptions of phone use as problematic may be more important than actual phone habits, especially total phone use duration, for desire to change. Suggestions for future research and intervention are provided.

Development and validation of the Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa

BACKGROUND

In Sub-Saharan Africa, the nutritional status of children born to teenage mothers deserves critical attention. Maternal knowledge and attitudes concerning infant and young child feeding (IYCF) may predict actual practices and child nutritional status. This study created and validated the Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa.

METHODS

A literature search on IYCF knowledge and attitude gaps in teenage mothers generated scale items. Ten nutrition experts and six teenage mothers assessed content validity and comprehensibility, respectively. Construct validation was conducted by item response theory (IRT) and confirmatory factor analysis (CFA), in 150 teenage mothers in rural communities of Abuja, Nigeria. Model fit parameters were estimated by standardized chi-square tests. Internal consistency reliability was determined by marginal reliability and Cronbach's alpha. In a sub-sample of 40 women who completed the questionnaire two weeks later, test-retest reliability was assessed via intraclass correlations.

RESULTS

The IRT analysis retained 23 knowledge items on infant food type, breastfeeding and complementary feeding, with acceptable discrimination and difficulty. CFA produced a six-factor solution (exclusive breastfeeding, breast milk expression, meal frequency, responsive feeding, dietary diversity, and barriers) with 17 attitude items. Confirmatory fit and Tucker Lewis indices > 0.9; Root Mean Square Errors of Approximation and Standardized Root Mean Square Residuals < 0.08, showed good model fit. Overall Cronbach's alpha of the attitude scale (0.843), subscales (≥ 0.6) and high intraclass correlation coefficients (> 0.75) indicated reliability.

CONCLUSION

The Teen Moms Child Feeding Questionnaire for Sub-Saharan Africa is a valid assessment tool for IYCF knowledge and attitudes of teenage mothers.

Impacts of Parental Technoference on Parent-Child Relationships and Child Health and Developmental Outcomes: A Scoping Review

Parental technological immersion during parenting activities has been shown to alter parent-child interactions. This concept, referred to as parental technoference, has the potential to affect parent-child relationships and children's health and development. This scoping review utilized the Joanna Briggs Institute (JBI) methodology to identify, describe, and summarize: (a) evidence of parental technoference on parent-child relationships, and children's health and development; (b) definitions and measurements of parental technoference; (c) research designs and methodologies used to investigate parental technoference; and (d) literature gaps. We searched MEDLINE, APA PsycInfo, Cochrane Central Register of Controlled Trials, Cochrane Database for Systematic Reviews, JBI EBP Database, Embase, CINAHL, and Scopus, as well as the reference lists of included studies for literature on parental technology use during parenting and parent-child interactions and its effects on parent-child relationships, and children's health and development. Sixty-four studies, found in 61 publications, met the review criteria. The effect of parental technoference on parent-child relationships was most studied, and findings demonstrated that parents recognized, and researchers observed, changes in parents' and children's behaviors. Adolescent self-reported mental health concerns and maladaptive technological behaviors (e.g., cyberbullying) were associated with more parental technoference, and findings highlighted safety concerns for children. Other aspects of children's development, although less studied, were also negatively impacted by parental technoference. No significant associations were found between parental technoference and children's medical and physiological health, yet these associations were the least studied. Additional research is needed to understand these associations and evaluate interventions designed to mitigate technoference harms.

Infant Age Moderates Associations between Infant Temperament and Maternal Technology Use during Infant Feeding and Care

Previous research illustrated that infants' temperamental traits shape parents' behaviors, but parents' behaviors can also elicit or intensify infants' behaviors in ways that shape temperament. One understudied aspect of parenting that may exhibit bidirectional influences with temperament is parent technology use (e.g., use of mobile devices) within family contexts. To date, few studies have examined whether maternal technology use is associated with infant temperament and whether age-related differences in these associations exist. The present study was a secondary analysis of pooled data from three infant feeding studies. Mothers (n = 374) of young infants (age 16.2 ± 6.2 weeks) completed measures of maternal technology use during infant feeding and care interactions, infant temperament, and family demographics. Maternal technology use was positively associated with negative affectivity and negatively associated with orienting/regulatory capacity but was not associated with positive affectivity/surgency. The association between maternal technology use and negative affectivity was stronger for younger infants than older infants, while the association between maternal technology use and orienting/regulatory capacity was not significant for younger infants but was for older infants. Findings suggest maternal technology use is associated with infant negative affectivity and orienting/regulatory capacity, but the strength of these associations may change with infant age. Further longitudinal research is needed to verify this interpretation and understand mechanisms underlying these associations.

Associations between maternal technology use, perceptions of infant temperament, and indicators of mother-to-infant attachment quality

BACKGROUND

Previous research suggests parents' use of technological devices, such as TV and mobile devices, within family contexts may decrease the quality of parent-child interactions. During early infancy, mothers report engaging with technological devices during infant feeding and care interactions, however, few studies have explored potential associations between maternal technology use and the quality of mother-to-infant attachment.

AIM

To examine associations between maternal technology use during mother-infant interactions and indicators of mother-to-infant attachment during early infancy.

STUDY DESIGN

Cross-sectional survey.

METHODS

Mothers (n = 332) of infants aged 2 to 6 months were recruited via MTurk, a crowdsourcing platform, to participate in an online survey. Participants responded to a series of validated questionnaires that assessed maternal technology use during mother-infant interactions (Maternal Distraction Questionnaire), infant temperament (Infant Behavior Questionnaire-Revised Very Short Form), and indicators of mother-to-infant attachment, including quality of attachment, absence of hostility toward motherhood, and pleasure in mother-infant interactions (Maternal Postnatal Attachment Questionnaire).

RESULTS

Greater technology use during mother-infant interactions was significantly associated with greater infant negative affectivity (β = 0.26, p < .0001). Greater technology use was also significantly associated with lower mother-to-infant attachment quality (β = -0.21, p = .0001), and greater hostility toward motherhood (β = -0.39, p < .0001). Associations between technology use and indicators of mother-to-infant attachment were not mediated by infant negative affectivity.

CONCLUSIONS

Maternal technology use was associated with greater perceptions of infant negative affectivity and poorer mother-to-infant attachment quality; further research is needed to understand mechanisms underlying these associations.