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Cooray N, Ho C, Bestman A, Adams S, Nassar N, Keay L, Brown J. Exploring the Potential of a Behavior Theory-Informed Digital Intervention for Infant Fall Prevention: Mixed Methods Longitudinal Study. JMIR Pediatr Parent 2024; 7:e47361. [PMID: 38170580 PMCID: PMC10794959 DOI: 10.2196/47361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Falls are the most common hospitalized injury mechanism in children aged ≤1 years, and currently, there are no targeted prevention interventions. The prevention of falls in children of this age requires changes in the behavior of their caregivers, and theoretically informed digital behavior change interventions (DBCIs) may provide a unique mechanism for achieving effective intervention. However, user acceptance and the ability of DBCIs to effect the required changes in behavior are critical to their likelihood of success. OBJECTIVE This study aims to evaluate a behavior theory-informed digital intervention developed following a user-centered approach for user experience, the potential for this intervention to prevent infant falls, and its impact on behavioral drivers underpinning fall risk in young children. METHODS Parents of infants aged <1 year were recruited and asked to use the intervention for 3 months. A pre-post longitudinal design was used to examine the change in the potential to reduce the risk of falls after a 3-month exposure to the intervention. Postintervention data on behavioral drivers for fall prevention, user acceptability, and engagement with the app were also collected. Interviews were conducted to explore user experiences and identify areas for further improvement of the intervention. RESULTS A total of 62 parents participated in the study. A statistically significant effect on the potential to reduce falls was observed after the intervention. This effect was higher for new parents. Parents agreed that the intervention targeted most of the target behavior drivers. The impact of behavior drivers and intervention on the potential for fall prevention had a positive correlation. The intervention demonstrated good levels of acceptability. Feedback from participants was mostly positive, and the primary area identified for further improvement was widening the scope of the intervention. CONCLUSIONS This study demonstrated the promise of a newly developed digital intervention to reduce the risk of infant falls, particularly among new parents. It also showed a positive influence of the DBCI on the drivers of parental behaviors that are important for fall reduction among infants. The acceptability of the app was high, and important insights were gained from users about how to further improve the app.
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Affiliation(s)
- Nipuna Cooray
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Catherine Ho
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Amy Bestman
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
| | - Susan Adams
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
- Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lisa Keay
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales Sydney, Sydney, Australia
| | - Julie Brown
- The George Institute for Global Health, Faculty of Medicine and Health, University of New South Wales Sydney, Barangaroo, Australia
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2
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Abargil M, Irani M, Klein Selle N, Atzil S. Breastfeeding at Any Cost? Adverse Effects of Breastfeeding Pain on Mother- Infant Behavior. Biology (Basel) 2023; 12:biology12050636. [PMID: 37237450 DOI: 10.3390/biology12050636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/11/2023] [Accepted: 04/19/2023] [Indexed: 05/28/2023]
Abstract
Breast milk is considered the ideal infant nutrition, and medical organizations encourage breastfeeding worldwide. Moreover, breastfeeding is often perceived as a natural and spontaneous socio-biological process and one of the fundamental roles of new mothers. While breastfeeding is beneficial, little scientific consideration has been given to its potential psychological challenges. Here, we investigate the phenomenon of breastfeeding pain in mothers and its association with maternal and infant behavioral regulation. During the postpartum weeks, the mother-infant dyad can be considered one allostatic unit directed at infant regulation and development. We hypothesize that pain comprises an allostatic challenge for mothers and will thus impair the capacity for dyadic regulation. To test this, we recruited 71 mothers with varying levels of breastfeeding pain and videotaped them with their infants (2-35 weeks old) during spontaneous face-to-face interactions. We quantified the individual differences in dyadic regulation by behaviorally coding the second-by-second affective expressions for each mother and infant throughout their interactions. We tested the extent to which breastfeeding pain alters affect regulation during mother-infant interactions. We discovered that mothers with severe breastfeeding pain express less affective expressions and less infant-directed gaze during interactive moments of engagement and play than mothers with no or moderate pain. Moreover, infants of mothers experiencing pain during breastfeeding express less affective expressions and more mother-directed gaze while interacting with their mothers than infants of mothers who are not in pain. This demonstrates that the allostatic challenge of maternal pain interferes with the behavioral regulation of both mothers and infants. Since the mother-infant dyad is a codependent allostatic unit, the allostatic challenges of one partner can impact the dyad and thus potentially impact child development, bonding, and mother and infant well-being. The challenges of breastfeeding should be considered in addition to the nutritional advances.
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Affiliation(s)
- Maayan Abargil
- The Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | - Merav Irani
- The Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
| | | | - Shir Atzil
- The Department of Psychology, The Hebrew University of Jerusalem, Jerusalem 9190501, Israel
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3
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Gwinner MG, Marchetti AL, Chollet-Hinton L, Fisher LR. Dietary Habits of Children 0 - 23 Months in Rural Kansas: Early Life Diets of Rural Children. Kans J Med 2023; 16:5-10. [PMID: 36703947 PMCID: PMC9872500 DOI: 10.17161/kjm.vol16.17945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction Children in rural areas face increased rates of obesity compared to their urban counterparts, and diet in early childhood may influence the development of diseases related to food intake. This study sought to determine current diet of children 0-23 months of age in rural Kansas. Methods Medical students participating in 6-week, summer, rural clinical experiences offered the survey to caregivers of children 0-23 months, born at term as singletons without a specialized diet. The survey asked respondents to answer with the child's diet over the last seven days. The survey was in the style of a validated Food Frequency Questionnaire for infants with an image for estimating portion sizes. Diets were compared to guidelines set by the Dietary Guidelines for Americans, 2020-2025. Results Of 44 responses, 21 children were aged 0-5 months, 7 aged 6-11 months, and 16 aged 12-23 months. Breastfeeding rates were nearly double reported national averages. All children aged 0-5 months met guidelines. None of the children 6-11 months or 12-23 months met guidelines. In the 6-11 month group, four consumed food in addition to breastmilk or formula (complementary foods). In the 12-23 month group, protein and dairy foods were lower than, and whole grains and vegetables were higher than, reported national averages, respectively. Conclusions Children may fall short of meeting dietary recommendations due to foods consumed in addition to breastmilk. There is a need for improved survey methods to capture the diets of young children in the rural United States.
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Affiliation(s)
- MacKenzie G. Gwinner
- Office of Rural Medical Education, University of Kansas School of Medicine-Wichita, Wichita, KS
| | - Arika L. Marchetti
- Office of Rural Medical Education, University of Kansas School of Medicine, Kansas City, KS
| | - Lynn Chollet-Hinton
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS
| | - Lynn R. Fisher
- Office of Rural Medical Education, University of Kansas School of Medicine-Wichita, Wichita, KS,Department of Family and Community Medicine, University of Kansas School of Medicine-Wichita, Wichita, KS
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Burtchen N, Alvarez-Segura M, Urben S, Giovanelli C, Mendelsohn AL, Guedeney A, Schechter DS. Effects of maternal trauma and associated psychopathology on atypical maternal behavior and infant social withdrawal six months postpartum. Attach Hum Dev 2022; 24:1-27. [PMID: 36371796 DOI: 10.1080/14616734.2022.2142894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/29/2022] [Indexed: 11/15/2022]
Abstract
Maternal psychopathology given a history of maltreatment and domestic violence exposure increases the risk for child psychopathology. Infant social withdrawal is one warning sign of adverse developmental outcomes including child anxiety and depression. It remains unclear how maternal trauma-related psychopathology might affect infant social withdrawal six-months postpartum. METHODS One-hundred ninety-five women and their six-month-old infants were studied in an at-risk community sample. Maternal trauma history, posttraumatic stress (PTSD) and major depressive (MDD) disorders were assessed. Maternal and infant behaviors were coded from videotaped interactions. RESULTS Maternal trauma was correlated with atypical maternal behavior (AMB) and infant social withdrawal (p ≤ .001). PTSD and MDD, and comorbid PTSD/MDD predicted increased AMB (p ≤ .001) but only maternal MDD was predictive of infant social withdrawal (p ≤ .001). Effects of maternal MDD on infant withdrawal were mediated by AMB. CONCLUSIONS At six-months postpartum, maternal MDD was associated with infant withdrawal. AMB is an important target for early intervention.
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Affiliation(s)
- Nina Burtchen
- Clinic for Psychosomatic Medicine and Psychotherapy, Freiburg University Medical Center, Freiburg, Germany
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Mar Alvarez-Segura
- Child and Adolescent Psychiatry Service, Department of Psychiatry, Abat Oliba CEU University, Barcelona, Spain
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
| | - Sébastien Urben
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | | | - Alan L Mendelsohn
- Department of Pediatrics, New York University, New York University Grossman School of Medicine, New York, NY, USA
| | - Antoine Guedeney
- Child & Adolescent Psychiatry Service, Hôpital Bichat-Claude
- Bernard Faculty of Medicine, University of Paris Diderot, Paris, France
| | - Daniel S Schechter
- Department of Child & Adolescent Psychiatry, New York University Grossman School of Medicine, New York, NY, USA
- Child & Adolescent Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and Faculty of Biology and Medicine, Lausanne, Switzerland
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Zeevi L, Irani M, Catana C, Feldman Barrett L, Atzil S. Maternal dopamine encodes affective signals of human infants. Soc Cogn Affect Neurosci 2022; 17:503-509. [PMID: 34750627 PMCID: PMC9071406 DOI: 10.1093/scan/nsab116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 09/24/2021] [Accepted: 11/08/2021] [Indexed: 11/14/2022] Open
Abstract
Mothers are highly responsive to their offspring. In non-human mammals, mothers secrete dopamine in the nucleus accumbens (NAcc) in response to their pups. Yet, it is still unknown which aspect of the offspring behavior elicits dopaminergic responses in mothers. Here, we tested whether infants' affective signals elicit dopaminergic responses in the NAcc of human mothers. First, we conducted a behavioral analysis on videos of infants' free play and quantified the affective signals infants spontaneously communicated. Then, we presented the same videos to mothers during a magnetic resonance-positron emission tomography scan. We traced the binding of [11C]raclopride to free D2/3-type receptors to assess maternal dopaminergic responses during the infant videos. When mothers observed videos with many infant signals during the scan, they had less [11C]raclopride binding in the right NAcc. Less [11C]raclopride binding indicates that less D2/3 receptors were free, possibly due to increased endogenous dopamine responses to infants' affective signals. We conclude that NAcc D2/3 receptors are involved in maternal responsiveness to affective signals of human infants. D2/3 receptors have been associated with maternal responsiveness in nonhuman animals. This evidence supports a similar mechanism in humans and specifies infant-behaviors that activate the maternal dopaminergic system, with implications for social neuroscience, development and psychopathology.
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Affiliation(s)
- Lior Zeevi
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem 91905, Israel
| | - Merav Irani
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem 91905, Israel
| | - Ciprian Catana
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Lisa Feldman Barrett
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
- Department of Psychology, Northeastern University, Boston, MA 02115, USA
| | - Shir Atzil
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem 91905, Israel
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Frankel LA, Umemura T, Pfeffer KA, Powell EM, Hughes KR. Maternal Perceptions of Infant Behavior as a Potential Indicator of Parents or Infants in Need of Additional Support and Intervention. Front Public Health 2021; 9:630201. [PMID: 34746069 PMCID: PMC8564034 DOI: 10.3389/fpubh.2021.630201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 09/13/2021] [Indexed: 11/13/2022] Open
Abstract
The goal of the present study is to examine the relationship between early infant behaviors, which can be easily reported by parents, with parent-infant bonding and maternal mental health. It has long been established that child characteristics and behaviors have a significant impact on parent well-being and how parents respond to their infants. Examining parent perceptions of challenging infant behaviors may help health professionals identify high risk infants in need of intervention and mothers in need of additional support. Mothers of 73 infants between the ages of 3.5 weeks and 6 months filled out questionnaires. Infant stomach issues were positively correlated with bonding issues, maternal anxiety and maternal depression. Infant crying issues were also positively correlated with bonding issues, maternal anxiety and maternal depression. Potential clinical and research applications of the instrument include early identification of caregivers in need of support and screening for further clinical assessment and care.
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Affiliation(s)
- Leslie A. Frankel
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX, United States
| | - Tomotaka Umemura
- Department of Psychology, Hiroshima University, Hiroshima, Japan
| | - Kendall A. Pfeffer
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX, United States
- Department of Psychology, New School for Social Research, New York, NY, United States
| | - Elisabeth M. Powell
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX, United States
- Western Psychological and Counseling Services, Vancouver, WA, United States
| | - K. R. Hughes
- Department of Psychological, Health and Learning Sciences, University of Houston, Houston, TX, United States
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7
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Affiliation(s)
| | - Chao-Huei Chen
- 40293 Taiwan Academy of Breastfeeding , The Republic of China
| | - Louise Dumas
- 59310 Nursing Sciences, Université du Québec en Outaouais, Canada
| | | | - Linda J Smith
- Bright Future Lactation Resource Centre Ltd, OH, USA
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8
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Ceniceros LC, Capitanio JP, Kinnally EL. Prenatal Relocation Stress Enhances Resilience Under Challenge in Infant Rhesus Macaques. Front Behav Neurosci 2021; 15:641795. [PMID: 33854420 PMCID: PMC8039121 DOI: 10.3389/fnbeh.2021.641795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/04/2021] [Indexed: 11/13/2022] Open
Abstract
The prenatal period is a developmental stage of peak sensitivity, during which environmental exposures can program post-natal developmental outcomes. Prenatal stress, in particular, has often been associated with detrimental neurobehavioral outcomes like mood and anxiety disorders. In the present study, we examined the effects of a stressful prenatal maternal experience (maternal relocation during pregnancy) on the post-partum development of offspring in rhesus macaques. To help isolate the effects of prenatal stress from genetic predispositions and post-natal experience, we compared biologically reared infants (infants raised with their biological mothers) with cross-fostered infants (those raised by non-related females in new social groups). We examined the effects of prenatal relocation stress on measures collected at 3-4 months of age during a standardized biobehavioral assessment. Unexpectedly, we found that prenatal stress resulted in a behavioral pattern consistent with resilience rather than anxiety: prenatal stress was linked with greater activity, lower anxiety, and more interaction with novel objects, as well as higher ratings of temperamental confidence during assessment. These effects were observed in infants reared by biological mothers as well as cross-fostered infants, suggesting that the effects of prenatal stress were not attributable to maternal genetics or post-natal factors. Our surprising results suggest that prenatal relocation stress may confer resilience in infant rhesus monkeys.
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Affiliation(s)
- Lesly C Ceniceros
- California National Primate Research Center, University of California, Davis, Davis, CA, United States
| | - John P Capitanio
- California National Primate Research Center, University of California, Davis, Davis, CA, United States.,Department of Psychology, University of California, Davis, Davis, CA, United States
| | - Erin L Kinnally
- California National Primate Research Center, University of California, Davis, Davis, CA, United States.,Department of Psychology, University of California, Davis, Davis, CA, United States
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9
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Zivan M, Morag I, Yarmolovsky J, Geva R. Hyper-Reactivity to Salience Limits Social Interaction Among Infants Born Pre-term and Infant Siblings of Children With ASD. Front Psychiatry 2021; 12:646838. [PMID: 34054606 PMCID: PMC8160104 DOI: 10.3389/fpsyt.2021.646838] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/12/2021] [Indexed: 12/13/2022] Open
Abstract
The ability to engage attention with selected stimuli is essential for infants to explore the world and process information relating to their surroundings. There are two main populations with a higher risk to develop attentional and social deficits whose deficits may arise from difficulties in regulating attention to salient cues: (1) siblings of children diagnosed with Autism; and (2) infants who were born pre-term. This study investigated infants' (N = 97) attention-engagement and pupil-dilation (PD) at 9 months of age, using a gaze-contingent paradigm and a structured social interaction. Specifically, we explored attention to stimuli with simple salient features (e.g., clear defined shapes, colors, and motions) vs. more complex non-social cues (amorphous shapes, colors, and motions) and social interaction in typically developing infants (TD, N = 25) and among two groups of infants at-risk to develop social difficulties (pre-terms, N = 56; siblings of children with Autism, N = 16). Findings show that the two risk groups preferred stimuli with simple features (F = 11.306, p < 0.001), accompanied by increased PD (F = 6.6, p < 0.001). Specifically, pre-term infants showed increased PD toward simple vs. complex stimuli (p < 0.001), while siblings showed a pervasive hyper-arousal to both simple and complex stimuli. Infants in the TD group preferred complex stimuli with no change in PD. Finally, the preference for the simple stimulus mediated the relationship between increased risk for social difficulties and decreased engagement duration in face-to-face interaction with the experimenter. Results suggest that activation of the attention-salience network shapes social abilities at infancy. Further, hyper-reactivity to salient stimuli limits social interaction among infants born pre-term and siblings of children with ASD.
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Affiliation(s)
- Michal Zivan
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Iris Morag
- Assaf Harofeh Medical Center, Zerifin, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jessica Yarmolovsky
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.,The Department of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Ronny Geva
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat Gan, Israel.,The Department of Psychology, Bar Ilan University, Ramat Gan, Israel
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10
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Huang P, Zhou F, Guo Y, Yuan S, Lin S, Lu J, Tu S, Lu M, Shen S, Guedeney A, Xia H, Qiu X. Association Between the COVID-19 Pandemic and Infant Neurodevelopment: A Comparison Before and During COVID-19. Front Pediatr 2021; 9:662165. [PMID: 34692602 PMCID: PMC8527007 DOI: 10.3389/fped.2021.662165] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 09/10/2021] [Indexed: 12/19/2022] Open
Abstract
Aim: To investigate the association between the experience of the coronavirus disease 2019 (COVID-19) pandemic and neurodevelopment of 6-month-old and 1-year-old children and explore the differences in the association by birth order. Methods: This comparison study was embedded in the Born in Guangzhou Cohort Study in China. The exposed group included 546 6-month-old and 285 1-year-old children who attended neurodevelopment assessments between March 1 and May 15, 2020, and the non-exposed group included 3,009 6-month-old and 2,214 1-year-old children during the same months from 2015 to 2019. Neurodevelopment at age 6 months and 1 year was assessed by trained clinical staff using the Ages and Stages Questionnaires, third edition (ASQ-3) and the Gesell Developmental Schedules (GDS). Results: The experience of the pandemic in 2020 was associated with a higher risk of delay in the fine motor (adjusted OR: 2.50, 95% CI: 1.25, 4.99; estimated by logistic regression) and communication (adjusted RR [aRR]: 1.13, 95% CI: 1.02, 1.25; estimated by log-binomial regression) domains at age 1 year. The association between the experience of the pandemic and communication delay at age 1 year only existed in first-born children (aRR: 1.15, 95% CI: 1.03, 1.30) but not in later-born children (aRR: 1.02, 95% CI: 0.84, 1.25). No associations were observed in any domain among 6-month-olds. Conclusion: Experiencing the COVID-19 pandemic and related public health strategies might be associated with a higher risk of delay in the development of fine motor and communication in 1-year-old children; the association observed in the communication domain only existed in first-born children.
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Affiliation(s)
- Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Fengjuan Zhou
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Yixin Guo
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Shanshan Yuan
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Shanshan Lin
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Jinhua Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Si Tu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Minshan Lu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Songying Shen
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China
| | - Antoine Guedeney
- Department of Child and Adolescent Psychiatry, Bichat Claude Bernard Hospital, Paris University, Paris, France
| | - Huimin Xia
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China.,Provincial Clinical Research Center for Child Health, Guangdong, China
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.,Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China.,Provincial Clinical Research Center for Child Health, Guangdong, China
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Mendres-Smith AE, Borrero JC, Castillo MI, Davis BJ, Becraft JL, Hussey-Gardner B. Tummy time without the tears: The impact of parent positioning and play. J Appl Behav Anal 2020; 53:2090-2107. [PMID: 32436294 DOI: 10.1002/jaba.715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 03/09/2020] [Accepted: 03/09/2020] [Indexed: 11/08/2022]
Abstract
The American Academy of Pediatrics (AAP) recommends that infants spend supervised time in the prone (tummy) position to foster motor development and prevent cranial deformities. However, infants may not tolerate the position, and consequently, caregivers may avoid placing their infants in the prone position. The AAP recommends that caregivers provide toys or interaction during tummy time. We evaluated the individual and combined effects of a play mat and experimenter interaction on negative vocalizations and head elevation during tummy time-positive effects were limited. Next, we evaluated a parent-led intervention wherein mothers interacted with their infants, using a toy, while lying chest-to-chest. This intervention was associated with a reduction in negative vocalizations and an increase in head elevation for the majority of infants. Additionally, mothers rated the effectiveness of the parent-led intervention more favorably than the experimenter-led intervention, suggesting the effects of the parent-led intervention were also socially valid.
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Affiliation(s)
| | | | | | | | - Jessica L Becraft
- The Kennedy Krieger Institute and Johns Hopkins University School of Medicine
| | - Brenda Hussey-Gardner
- University of Maryland, School of Medicine and University of Maryland, Baltimore County
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12
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Most CA, Strum SC. Bringing up baby: Maternal responsiveness, secondary attachments, and the development of infant social competence in wild olive baboons (Papio anubis). Dev Psychobiol 2020; 62:963-978. [PMID: 32374036 DOI: 10.1002/dev.21973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 02/22/2020] [Accepted: 03/02/2020] [Indexed: 11/12/2022]
Abstract
Caregiver responsiveness and presence of secondary attachments play a crucial role in children's socio-cognitive and emotional development, but little is known of their effect on the development of non-human primates. Here we present the results of a 16-month behavioral study conducted on 22 wild infant olive baboons (Papio anubis) at the Uaso Ngiro Baboon Project, Kenya. This is the first study to examine the effects of maternal responsiveness and secondary attachments on the development of infant social behavior in a wild primate species that does not breed cooperatively. The data track maternal responsiveness and the rates of two behavioral indicators of infant social competence-orienting toward interactions and social play-over the course of the first year of life. Maternal responsiveness decreased as infants grew older, while infant orientation toward interactions and play behavior increased. Infants with poorly responsive mothers were more likely to have secondary attachments, and infants with secondary attachments to siblings oriented more frequently to social interactions than those with secondary attachments to adult/subadult males or with no secondary attachments. These findings indicate that variation in maternal responsiveness and presence of secondary attachments can influence the development of social competence in olive baboon infants.
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Affiliation(s)
- Corinna A Most
- Department of Ecology, Evolution, and Organismal Biology, Iowa State University, Ames, IA, USA
| | - Shirley C Strum
- Department of Anthropology, University of California, San Diego, CA, USA.,Uaso Ngiro Baboon Project, Nairobi, Kenya.,Kenya Wildlife Service (KWS), Nairobi, Kenya
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13
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Marinelli KA, Ball HL, McKenna JJ, Blair PS. An Integrated Analysis of Maternal-Infant Sleep, Breastfeeding, and Sudden Infant Death Syndrome Research Supporting a Balanced Discourse. J Hum Lact 2019; 35:510-520. [PMID: 31184521 DOI: 10.1177/0890334419851797] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Breastfeeding and the place of sleep for the mother and the infant have been controversial internationally due to reported concerns regarding infant deaths despite the known benefits of exclusive and prolonged breastfeeding, which are increased by breastfeeding at night. The aims of this integrated analysis were to (a) review breastfeeding and maternal and infant sleep research literature via historical, epidemiological, anthropological, and methodological lenses; (b) use this information to determine where we are currently in safeguarding both infant lives and breastfeeding; and (c) postulate the direction that research might take from this point forward to improve our knowledge and inform our policy and practice. Despite well-meaning but unsuccessful campaigns in some countries to dissuade parents from sleeping with their babies, many breastfeeding mothers and caregivers do sleep with their infants whether intentionally or unintentionally. Taking cultural contexts and socio-ecological circumstances into consideration, data supports policies to counsel parents and caregivers on safe sleep practices, including bed-sharing in non-hazardous circumstances, particularly in the absence of parental smoking, recent parental alcohol consumption, or sleeping next to an adult on a sofa. Further research with appropriate methodology is needed to drill down on actual rates of infant deaths, paying close attention to the definitions of deaths, the circumstances of the deaths, and confounding factors, in order to ensure we have the best information with which to derive public health policy. Introduction and use of the concept of "breastsleeping" is a plausible way to remove the negative connotations of "co-sleeping" and redirect ongoing data-driven discussions and education of best practices of breastfeeding and sleep.
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Affiliation(s)
| | - Helen L Ball
- 2 Infancy & Sleep Centre, Department of Anthropology, Durham University, Durham, UK
| | - James J McKenna
- 3 Mother-Baby Behavioral Sleep Laboratory, Department of Anthropology, University of Notre Dame, Notre Dame, Indiana, USA
| | - Peter S Blair
- 4 Centre of Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
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14
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Abstract
BACKGROUND Human milk is considered the gold standard for infant nutrition, but more data are needed that examine the constellation of weight-related concerns as barriers to exclusive breastfeeding. RESEARCH AIMS The aim of this study was to examine how mothers' concerns regarding their own and their infants' weight, as well as disordered eating behaviors, were associated with breastfeeding self-efficacy and exclusive breastfeeding at 6 months. METHODS A prospective, quantitative, and self-report online survey design was used. Participants included 206 women (88.30% White, 59.20% with graduate degrees), with a mean age of 33.04 years ( SD = 4.31 years) and a mean prepregnancy body mass index (BMI) of 24.80 kg/m2 ( SD = 5.50 kg/m2), who had given birth within the past 6 months. RESULTS Participants who reported not exclusively breastfeeding at 6 months had significantly higher prepregnancy BMI ( p < .001), higher body dissatisfaction ( p = .003), more disordered eating ( p = .036), higher child weight concerns ( p < .001), and lower breastfeeding self-efficacy ( p < .001). Mediation modeling revealed a direct negative relationship between prepregnancy BMI and exclusive breastfeeding at 6 months ( p < .001). Indirect negative relationships between prepregnancy BMI and exclusive breastfeeding at six months via (a) body dissatisfaction, (b) disordered eating, and (c) child weight concern, as well as breastfeeding self-efficacy (entered as concurrent mediators), were all significant. CONCLUSIONS Mothers' weight, body image and eating concerns, concern regarding their children's weight, and breastfeeding self-efficacy may constitute critical barriers to exclusive breastfeeding at 6 months. Interventions to improve breastfeeding duration and confidence should target maternal body image and eating concerns.
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Affiliation(s)
| | - Rachel F Rodgers
- 1 Northeastern University, Boston, MA, USA.,2 Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHRU Montpellier, Montpellier, France
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Chen L, Lucas RF, Feng B. A Novel System to Measure Infants' Nutritive Sucking During Breastfeeding: the Breastfeeding Diagnostic Device (BDD). IEEE J Transl Eng Health Med 2018; 6:2700208. [PMID: 29888144 PMCID: PMC5991864 DOI: 10.1109/jtehm.2018.2838139] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/17/2018] [Accepted: 05/14/2018] [Indexed: 01/19/2023]
Abstract
Breastfeeding is optimal for infant health, but more than 66% of mothers cease exclusive breastfeeding within three months after giving birth. Evaluating infants’ sucking effort provides valuable diagnosis to mothers encountering barriers with breastfeeding. Sucking microstructure is defined as an array of metrics that comprehensively capture infants’ ability to create a sealed latch onto mother’s nipple and regulate feeding, including number of sucks, sucks per burst, number of bursts, intra suck interval, and maximal sucking pressure. In this paper, we proposed a breastfeeding diagnostic device (BDD) which allows convenient and objective measurement of infants’ sucking microstructure in both home and clinical settings. BDD utilizes an air-based pressure transducer to measure infants’ sucking behavior. We conducted pilot clinical studies on six dyads of mother and infant to test the feasibility of the BDD system. To facilitate comparison, both breastfeeding and bottle-feeding were conducted on the six dyads using the BDD in home settings, and the outcomes are comparable with prior recordings in research or clinical settings. By offering a convenient and objective measurement of the sucking microstructure, the BDD will provide clinically meaningful guidance and diagnosis to mothers struggling with breastfeeding. BDD will also serve as an objective metric useful in research areas relevant to infant behaviors, assessment of neurodevelopment, and potentially a screening tool for developmental disabilities.
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Affiliation(s)
- Longtu Chen
- Biomedical Engineering DepartmentUniversity of ConnecticutStorrsCT06269USA
| | - Ruth F Lucas
- School of NursingUniversity of ConnecticutStorrsCT06269USA
| | - Bin Feng
- Biomedical Engineering DepartmentUniversity of ConnecticutStorrsCT06269USA
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DiCorcia JA, Snidman NC, Tronick E. Here Today, Gone Tomorrow? Changes in 4-Month-Olds' Physiologic and Behavioral Responses Do Not Indicate Memory for a Social Stressor. Front Psychol 2018. [PMID: 29515477 PMCID: PMC5826301 DOI: 10.3389/fpsyg.2018.00128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although much is known about early memory development, only a few studies have explored infants' memory of social stress. While these few studies suggest that infants can remember stressful interactions, limitations seen in both methodology and statistical analyses give pause. In the current study, 4-month-olds and their mothers participated in both stressful and non-stressful interactions over 2 days. On Day 1, memory group infants participated in the double Face-to-Face Still-Face (FFSF) paradigm and control group infants participated in typical play. Both groups experienced the double FFSF paradigm on Day 2. Memory group infants exhibited the standard SF response but no differences in infant cortisol on Day 1. Both infant groups exhibited the standard SF response on Day 2. However, infants in the memory group, who saw the FFSF paradigm for the second time, did not demonstrate changes in cortisol or behavior indicative of memory across the 2 days. There was also no relationship between changes in cortisol and behavior for both days. The findings question the use of salivary cortisol as a measure of social stress and suggest that, although 4-month-olds reacted to the Still-Face social stressor immediately, they did not remember the following day.
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Affiliation(s)
- Jennifer A DiCorcia
- Department of Psychology, University of Massachusetts, Boston, MA, United States
| | - Nancy C Snidman
- Department of Psychology, University of Massachusetts, Boston, MA, United States
| | - Ed Tronick
- Department of Psychology, University of Massachusetts, Boston, MA, United States
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17
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Sancho-Rossignol A, Schilliger Z, Cordero MI, Rusconi Serpa S, Epiney M, Hüppi P, Ansermet F, Schechter DS. The Association of Maternal Exposure to Domestic Violence During Childhood With Prenatal Attachment, Maternal-Fetal Heart Rate, and Infant Behavioral Regulation. Front Psychiatry 2018; 9:358. [PMID: 30131731 PMCID: PMC6090178 DOI: 10.3389/fpsyt.2018.00358] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/19/2018] [Indexed: 11/24/2022] Open
Abstract
Human and animal models suggest that maternal hormonal and physiological adaptations during pregnancy shape maternal brain functioning and behavior crucial for offspring care and survival. Less sensitive maternal behavior, often associated with psychobiological dysregulation and the offspring's behavioral and emotional disorders, has been observed in mothers who have experienced adverse childhood experiences. Strong evidence shows that children who are exposed to domestic violence (DV) are at risk of being abused or becoming abusive in adulthood. Yet little is known about the effect of childhood exposure to DV on the expecting mother, her subsequent caregiving behavior and related effects on her infant. Thus, the present study examined the association of maternal exposure to DV during childhood on prenatal maternal attachment, maternal heart rate reactivity to an infant-crying stimulus and post-natal infant emotional regulation. Thirty-three women with and without exposure to DV during childhood were recruited during the first trimester of pregnancy and followed until 6-month after birth. The Maternal Antenatal Attachment Scale (MAAS) was used to measure prenatal attachment of the mother to her fetus during the second trimester of pregnancy, maternal and fetal heart rate reactivity to an infant-crying stimulus was assessed at the third trimester of pregnancy, and the Infant Behavior Questionnaire-Revised (IBQ-R) was used to assess infant emotional regulation at 6-months. Results showed that pregnant women that were exposed to DV during childhood had a poorer quality of prenatal attachment of mother to fetus, regardless of whether they also experienced DV during adulthood. In addition, maternal exposure to DV during childhood was associated with increased maternal heart rate to infant-crying stimulus and worse infant emotional regulation. These findings highlight the importance of prenatal screening for maternal exposure to DV during childhood as a risk factor for disturbances in the development of maternal attachment, dysfunctional maternal behavior and emotion dysregulation.
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Affiliation(s)
- Ana Sancho-Rossignol
- Child & Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Zoe Schilliger
- Child & Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - María I Cordero
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Sandra Rusconi Serpa
- Child & Adolescent Psychiatry Service, University of Geneva Hospitals, Geneva, Switzerland
| | - Manuella Epiney
- Department of Obstetrics & Gynecology, University of Geneva Hospitals, Geneva, Switzerland
| | - Petra Hüppi
- Developmental Pediatrics Service, University of Geneva Hospitals, Geneva, Switzerland
| | - François Ansermet
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel S Schechter
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Department of Child & Adolescent Psychiatry, New York University Langone Medical Center and School of Medicine, New York, NY, United States
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18
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Douglas P, Keogh R. Gestalt Breastfeeding: Helping Mothers and Infants Optimize Positional Stability and Intraoral Breast Tissue Volume for Effective, Pain-Free Milk Transfer. J Hum Lact 2017; 33:509-518. [PMID: 28614671 DOI: 10.1177/0890334417707958] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In the past decade, biological nurturing and activation of maternal and infant instincts after birth have constituted a major advance in clinical breastfeeding support. Yet, physiologic breastfeeding initiation is not enough to ensure ongoing pain-free and effective breastfeeding for many pairs. Current interventions, including "hands-off" mammalian approaches, do not improve breastfeeding outcomes, including in randomized controlled trials. Back-arching, difficulty latching or staying on the breast, and fussing at the breast are common signs of infant positional instability during breastfeeding. These cues are, however, often misdiagnosed as signs of medical conditions or oral connective tissue abnormalities, and underlying positional instability is not addressed. New clinical approaches are urgently required. This article offers a clinical approach to fit and hold (or latch and positioning)- gestalt breastfeeding, which aims to optimize positional stability and intraoral breast tissue volumes for pain-free effective breastfeeding. The word gestalt (pronounced "ger-shtolt") means a whole that is more than the sum of its parts. Gestalt breastfeeding builds on the theoretical foundations of complexity science, physiologic breastfeeding initiation, and new understandings of the biomechanics of infant suck elucidated in ultrasound studies. It also integrates simple psychological strategies from applied functional contextualism, popularly known as Acceptance and Commitment Therapy, empowering women to attend mindfully to breast sensations and their infant's cues. Gestalt breastfeeding can be reproduced for research purposes, including in comparison studies with oral surgery, and has the potential to improve breastfeeding outcomes.
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Affiliation(s)
- Pamela Douglas
- 1 The Possums Clinic, Brisbane, QLD, Australia.,2 Maternity, Newborn and Families Research Collaborative, MHIQ, Griffith University, Brisbane, Australia.,3 Discipline of General Practice, The University of Queensland, Brisbane, Australia
| | - Renee Keogh
- 1 The Possums Clinic, Brisbane, QLD, Australia
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19
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Baudesson de Chanville A, Brevaut-Malaty V, Garbi A, Tosello B, Baumstarck K, Gire C. Analgesic Effect of Maternal Human Milk Odor on Premature Neonates: A Randomized Controlled Trial. J Hum Lact 2017; 33:300-308. [PMID: 28346843 DOI: 10.1177/0890334417693225] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Two studies have demonstrated an analgesic effect of maternal milk odor in preterm neonates, without specifying the method of olfactory stimulation. Research aim: This study aimed to assess the analgesic effect of maternal milk odor in preterm neonates by using a standardized method of olfactory stimulation. METHODS This trial was prospective, randomized, controlled, double blinded, and centrally administered. The inclusion criteria for breastfed infants included being born between 30 and 36 weeks + 6 days gestational age and being less than 10 days postnatal age. There were two groups: (a) A maternal milk odor group underwent a venipuncture with a diffuser emitting their own mother's milk odor and (2) a control group underwent a venipuncture with an odorless diffuser. The primary outcome was the Premature Infant Pain Profile (PIPP) score, with secondary outcomes being the French scale of neonatal pain-Douleur Aiguë du Nouveau-né (DAN) scale-and crying duration. All neonates were given a dummy. RESULTS Our study included 16 neonates in the maternal milk odor group and 17 in the control group. Neonates exposed to their own mother's milk odor had a significantly lower median PIPP score during venipuncture compared with the control group (6.3 [interquartile range (IQR) = 5-10] versus 12.0 [IQR = 7-13], p = .03). There was no significant difference between the DAN scores in the two groups ( p = .06). Maternal milk odor significantly reduced crying duration after venipuncture (0 [IQR = 0-0] versus 0 [IQR = 0-18], p = .04). CONCLUSION Maternal milk odor has an analgesic effect on preterm neonates.
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Affiliation(s)
| | | | - Aurélie Garbi
- 1 Department of Neonatology, North Hospital, Marseille, France
| | | | - Karine Baumstarck
- 2 Clinical Research Methodology Support Service, Faculty of Medicine, Marseille, France
| | - Catherine Gire
- 1 Department of Neonatology, North Hospital, Marseille, France
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20
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Shabani F, Nayeri ND, Karimi R, Zarei K, Chehrazi M. Effects of music therapy on pain responses induced by blood sampling in premature infants: A randomized cross-over trial. Iran J Nurs Midwifery Res 2016; 21:391-6. [PMID: 27563323 PMCID: PMC4979263 DOI: 10.4103/1735-9066.185581] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background: Premature infants are subjected to many painful procedures during care and treatment. The aim of this study was to assess the effect of music therapy on physiological and behavioral pain responses of premature infants during and after blood sampling. Materials and Methods: This study was a cross-over clinical trial conducted on 20 infants in a hospital affiliated to Tehran University of Medical Sciences for a 5-month period in 2011. In the experimental group, Transitions music was played from 5 min before until 10 min after blood sampling. The infants’ facial expressions and physiological measures were recorded from 10 min before until 10 min after sampling. All steps and measurements, except music therapy, were the same for the control group. Data were analyzed using SAS and SPSS software through analysis of variance (ANOVA) and Chi-square tests. Results: There were significant differences between the experimental and control groups (P = 0.022) in terms of heart rate during needle extraction and at the first 5 min after sampling (P = 0.005). Considering the infant's sleep–wake state in the second 5 min before sampling, the statistical difference was significant (P = 0.044). Difference was significant (P = 0.045) during injection of the needle, in the first 5 min after sampling (P = 0.002), and in the second 5 min after sampling (P = 0.005). There were significant difference in infants’ facial expressions of pain in the first 5 min after sampling (P = 0.001). Conclusions: Music therapy reduces the physiological and behavioral responses of pain during and after blood sampling.
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Affiliation(s)
- Fidan Shabani
- Ph.D Candidate in Nursing, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Department of Nursing Management, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Roghiyeh Karimi
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Khadijeh Zarei
- Department of Pediatric Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Chehrazi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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21
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Herrington JA, Del Rosso LA, Capitanio JP. Biobehavioral consequences of prenatal exposure to a matrilineal overthrow and relocation in captive infant rhesus (Macaca mulatta) monkeys. Am J Primatol 2016; 78:895-903. [PMID: 27150125 DOI: 10.1002/ajp.22557] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 03/14/2016] [Accepted: 04/15/2016] [Indexed: 11/06/2022]
Abstract
There is a general consensus that perinatal experiences help to shape infant behavior; however, relatively little is known about the effects of prenatal experience on postnatal phenotype in non-human primates. The current study sought to take advantage of a naturally occurring incident in a captive population of rhesus monkeys. Following a matrilineal overthrow in an outdoor field cage, pregnant female rhesus macaques were relocated from outdoor to indoor housing. Using data collected from the California National Primate Research Center's Biobehavioral Assessment Program, we assessed infants born to mothers that were in their first or second trimester of pregnancy during the overthrow and relocation, and compared their data with that of animals from two control groups born in the same year: indoor mother raised infants and field cage reared infants. Our results suggest that the experience of an overthrow and relocation during the first trimester elevated postnatal emotional responsiveness, while the same experience in the second trimester resulted in modified HPA axis regulation, elevated glucocorticoid output following maternal separation, and lower hematocrit levels compared to control groups. These data add to a growing body of literature that prenatal experiences represent a significant contribution to postnatal phenotypic variability. Findings such as ours have implications for studies in captive management and the management of captive rhesus monkey populations. Am. J. Primatol. 78:895-903, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Joshua A Herrington
- California National Primate Research Center, University of California Davis, Davis, California
| | - Laura A Del Rosso
- California National Primate Research Center, University of California Davis, Davis, California
| | - John P Capitanio
- California National Primate Research Center, University of California Davis, Davis, California
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22
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Lucas R, Judge M, Sajdlowska J, Cong X, McGrath JM, Brandon D. Effect of Maternal Body Mass Index on Infant Breastfeeding Behaviors and Exclusive Direct Breastfeeding. J Obstet Gynecol Neonatal Nurs 2015; 44:772-83. [PMID: 26402851 DOI: 10.1111/1552-6909.12755] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To describe the effect of maternal body mass index (BMI) on infant breastfeeding behaviors (poor, steady, vigorous) and the transition of the mother-infant dyad to exclusive, direct breastfeeding during the first month of life. DESIGN Longitudinal descriptive investigation. SETTING Tertiary-level southeastern medical center and follow-up telephone calls. PARTICIPANTS One hundred sixteen healthy, racially diverse, breastfeeding mother-infant dyads (77 full-term and 39 late-preterm infants). MAIN OUTCOME MEASURE(S) Breastfeeding outcomes were classified as exclusive direct or partially breastfed. The effect of maternal BMI was compared to results from weekly mother's reports of infant breastfeeding behaviors. RESULTS Significant breastfeeding differences were observed based on maternal BMI and infant gestational age. Mothers with BMIs greater than 25 who described their infants as a vigorous breastfeeders were less likely to exclusively direct breastfeed (p < .002). Only 40% of mother-infant dyads had exclusive direct breastfeeding at any time point or gestational age with no significant increase at any time point after discharge. The BMIs of the woman made no difference in exclusive direct breastfeeding full-term infants compared to late-preterm infants. CONCLUSION Maternal BMI had limited negative influence on exclusive direct breastfeeding during the first 4 weeks after discharge. Mothers should be educated that many infants need 3 to 4 weeks after discharge to learn how to breastfeed, infant feeding demands change during this time, and this time is important to the infant's neurologic and overall development.
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Longobardi C, Quaglia R, Iotti NO. Reconsidering the scribbling stage of drawing: a new perspective on toddlers' representational processes. Front Psychol 2015; 6:1227. [PMID: 26347690 PMCID: PMC4543818 DOI: 10.3389/fpsyg.2015.01227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 08/03/2015] [Indexed: 11/19/2022] Open
Abstract
Although the scribbling stage of drawing has been historically regarded as meaningless and transitional, a sort of prelude to the “actual” drawing phase of childhood, recent studies have begun to re-evaluate this important moment of a child's development and find meaning in what was once considered mere motor activity and nothing more. The present study analyzes scribbling in all its subphases and discovers a clear intention behind young children's gestures. From expressing the dynamic qualities of an object and the child's relationship with it, to gradually reducing itself to a simple contour of a content no more “alive” on the paper, but only in the child's own imagination, we trace the evolution of the line as a tool that toddlers use to communicate feelings and intentions to the world that surrounds them. We will provide a selected number of graphical examples that are representative of our theory. These drawings (13 in total) were extracted from a much wider sample derived from our studies on children's graphical-pictorial abilities, conducted on children aged 0–3 years in various Italian nurseries. Our results appear to indicate that scribbling evolves through a series of stages, and that early graphical activity in children is sparked and maintained by their relationship with their caregivers and the desire to communicate with them.
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Affiliation(s)
| | - Rocco Quaglia
- Department of Psychology, University of Turin Turin, Italy
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Muscat T, Obst P, Cockshaw W, Thorpe K. Beliefs about infant regulation, early infant behaviors and maternal postnatal depressive symptoms. Birth 2014; 41:206-13. [PMID: 24684274 DOI: 10.1111/birt.12107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Young infants may have irregular sleeping and feeding patterns. Such regulation difficulties are known correlates of maternal depressive symptoms. Parental beliefs about their role in regulating infant behaviors also may play a role. We investigated the association of depressive symptoms with infant feeding/sleeping behaviors, parent regulation beliefs, and the interaction of the two. METHOD In 2006, 272 mothers of infants aged up to 24 weeks completed a questionnaire about infant behavior and regulation beliefs. Participants were recruited from general medical practices and child health clinics in Brisbane, Australia. Depressive symptomology was measured using the Edinburgh Postnatal Depression Scale. Other measures were adapted from the ALSPAC study. RESULTS Regression analyses were run controlling for partner support, other support, life events, and a range of demographic variables. Maternal depressive symptoms were associated with infant sleeping and feeding problems but not regulation beliefs. The most important infant predictor was sleep behaviors with feeding behaviors accounting for little additional variance. An interaction between regulation beliefs and sleep behaviors was found. Mothers with high regulation beliefs were more susceptible to postnatal depressive symptoms when infant sleep behaviors were problematic. CONCLUSION Mothers of young infants who expect greater control are more susceptible to depressive symptoms when their infant presents challenging sleep behavior.
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Affiliation(s)
- Tracey Muscat
- School of Psychology and Counseling and Institute for Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Abstract
TOPIC Dr. T. Berry Brazelton's contributions span over 60 years and have shaped the interdisciplinary field of infant-parent work. PURPOSE It is easy to lose sight of the foundational contributions to understandings and perspectives that currently seem universal or inherent. Brazelton's work began in the 1950s when prevailing belief suggested newborns could not see or hear, much less contribute to interactional processes, speak through their behavior, and be equal partners in the development of the parent-child relationship. CONCLUSIONS Brazelton's immense contributions are intrinsic to infant, child, and family work, particularly infant mental health, and continue to shape the nature of this interdisciplinary field.
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Kadey HJ, Roane HS. Effects of access to a stimulating object on infant behavior during tummy time. J Appl Behav Anal 2013; 45:395-9. [PMID: 22844145 DOI: 10.1901/jaba.2012.45-395] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 12/06/2011] [Indexed: 11/22/2022]
Abstract
Placing infants in a prone position for "tummy time" often is recommended to ensure appropriate infant development and to combat the effects associated with infants spending extended periods of time in a supine position. However, tummy time may be associated with inappropriate infant behavior such as crying and noncompliance. We provided continuous access to a preferred stimulus to decrease negative vocalizations and to increase the duration of an infant's head being elevated during tummy time.
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Affiliation(s)
- Heather J Kadey
- SUNY Upstate Medical University, Syracuse, New York 13210, USA.
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Vandeleest JJ, Capitanio JP. Birth timing and behavioral responsiveness predict individual differences in the mother-infant relationship and infant behavior during weaning and maternal breeding. Am J Primatol 2012; 74:734-46. [PMID: 24436198 PMCID: PMC3896920 DOI: 10.1002/ajp.22024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2011] [Revised: 12/17/2011] [Accepted: 02/06/2012] [Indexed: 11/12/2022]
Abstract
There is a great deal of variability in mother-infant interactions and infant behavior across the first year of life in rhesus monkeys. The current article has two specific aims: (1) to determine if birth timing predicts variability in the mother-infant relationship and infant behavior during weaning and maternal breeding, and (2) to identify predictors of infant behavior during a period of acute challenge, maternal breeding. Forty-one mother-infant pairs were observed during weaning when infants were 4.5 months old, and 33 were followed through maternal breeding. Subjective ratings of 16 adjectives reflecting qualities of maternal attitude, mother-infant interactions, and infant attitude were factor analyzed to construct factors relating to the mother-infant relationship (Relaxed and Aggressive) and infant behavior (Positive Engagement and Distress). During weaning, late born infants were more Positively Engaged than peak born infants (ANOVA, P < 0.05); however, birth timing did not affect the mother-infant relationship factors Relaxed and Aggressive or the infant attitude factor Distress. During maternal breeding, early born infants had less Relaxed relationships with their mothers than peak or late born infants, higher Positive Engagement scores than peak or late born infants, and tended to have higher Distress scores than peak born infants (repeated-measures ANOVA, P < 0.05). In addition, Distress scores were higher during maternal breeding than during the pre- and postbreeding phases. Finally, multiple regression (P < 0.05) indicated that while infant behavioral responsiveness predicted infant Positive Engagement during the acute challenge of maternal breeding, qualities of the mother-infant relationship predicted infant Distress. These data suggest that birth timing influences the patterns of mother-infant interactions during weaning and maternal breeding. Additionally, infant behavioral responsiveness and mother-infant relationship quality impact infant social engagement and affect expression, respectively.
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Affiliation(s)
- Jessica J. Vandeleest
- California National Primate Research Center, Davis, CA
- Department of Psychology, University of California-Davis, Davis, CA
| | - John P. Capitanio
- California National Primate Research Center, Davis, CA
- Department of Psychology, University of California-Davis, Davis, CA
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Slining M, Adair LS, Goldman BD, Borja JB, Bentley M. Infant overweight is associated with delayed motor development. J Pediatr 2010; 157:20-25.e1. [PMID: 20227724 DOI: 10.1016/j.jpeds.2009.12.054] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 11/17/2009] [Accepted: 12/30/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To examine how infant overweight and high subcutaneous fat relate to infant motor development. STUDY DESIGN Participants were from the Infant Care, Feeding, and Risk of Obesity Project, a prospective, longitudinal study of low-income African-American mother-infant dyads assessed from 3 to 18 months of age (836 observations on 217 infants). Exposures were overweight (weight-for-length z-score>or=90th percentile of 2000 Centers for Disease Control/National Center for Health Statistics growth reference) and high subcutaneous fat (sum of 3 skinfold measurements>90th percentile of our sample). Motor development was assessed by using the Bayley Scales of Infant Development-II. Developmental delay was characterized as a standardized Psychomotor Development Index score<85. Longitudinal models estimated developmental outcomes as functions of time-varying overweight and subcutaneous fat, controlling for age and sex. Alternate models tested concurrent and lagged relationships (earlier weight or subcutaneous fat predicting current motor development). RESULTS Motor delay was 1.80 times as likely in overweight infants compared with non-overweight infants (95% CI,1.09-2.97) and 2.32 times as likely in infants with high subcutaneous fat compared with infants with lower subcutaneous fat (95% CI, 1.26-4.29). High subcutaneous fat was also associated with delay in subsequent motor development (odds ratio, 2.27; 95% CI, 1.08-4.76). CONCLUSIONS Pediatric overweight and high subcutaneous fat are associated with delayed infant motor development.
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Maestripieri D, Hoffman CL, Anderson GM, Carter CS, Higley JD. Mother-infant interactions in free-ranging rhesus macaques: relationships between physiological and behavioral variables. Physiol Behav 2009; 96:613-9. [PMID: 19150451 PMCID: PMC3955190 DOI: 10.1016/j.physbeh.2008.12.016] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2008] [Revised: 12/11/2008] [Accepted: 12/18/2008] [Indexed: 11/29/2022]
Abstract
Studies of mother-infant relationships in nonhuman primates have increasingly attempted to understand the neuroendocrine bases of interindividual variation in mothering styles and the mechanisms through which early exposure to variable mothering styles affects infant behavioral development. In this study of free-ranging rhesus macaques on Cayo Santiago, Puerto Rico, we aimed to: 1) compare lactating and nonlactating females to investigate whether lactation is associated with changes in plasma cortisol, prolactin and oxytocin, as well as changes in CSF levels of serotonin and dopamine metabolites (5-HIAA and HVA); 2) examine the extent to which interindividual variation in maternal physiology is associated with variation in maternal behavior; 3) examine the extent to which interindividual variation in infant physiology and behavior is accounted for by variation in maternal physiology and behavior. Lactating females had higher plasma concentrations of cortisol, prolactin, and oxytocin but lower CSF concentrations of HVA than nonlactating females. Variation in maternal rejection behavior was positively correlated with variation in maternal plasma cortisol levels and in CSF 5-HIAA levels while variation in the time spent nursing and grooming was associated with maternal plasma oxytocin levels. Infants who were protected more by their mothers had higher cortisol levels than those who were protected less, while infants who were rejected more had lower CSF 5-HIAA than infants who were rejected less. Since exposure to high levels of maternal protectiveness and rejection is known to affect the offspring's behavior and responsiveness to the environment later in life, our results are consistent with the hypothesis that these effects are mediated by long-term changes in the activity of the offspring's HPA axis and brain serotonergic system.
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Affiliation(s)
- Dario Maestripieri
- Department of Comparative Human Development, University of Chicago, 5730 S.Woodlawn Avenue, Chicago, IL 60637 USA.
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Plusquellec P, Muckle G, Dewailly E, Ayotte P, Jacobson SW, Jacobson JL. The relation of low-level prenatal lead exposure to behavioral indicators of attention in Inuit infants in Arctic Quebec. Neurotoxicol Teratol 2007; 29:527-37. [PMID: 17706923 PMCID: PMC3417247 DOI: 10.1016/j.ntt.2007.07.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2006] [Revised: 06/20/2007] [Accepted: 07/03/2007] [Indexed: 10/23/2022]
Abstract
The aim of this study was to investigate the association between prenatal exposure to lead (Pb) and several aspects of behavioral function during infancy through examiner ratings and behavioral coding of video recordings. The sample consisted of 169 11-month-old Inuit infants from Arctic Quebec. Umbilical cord and maternal blood samples were used to document prenatal exposure to Pb. Average blood Pb levels were 4.6 mug/dL and 5.9 mug/dL in cord and maternal samples respectively. The Behavior Rating Scales (BRS) from the Bayley Scales of Infant Development (BSID-II) were used to assess behavior. Attention was assessed through the BRS and behavioral coding of video recordings taken during the administration of the BSID-II. Whereas the examiner ratings of behaviors detected very few associations with prenatal Pb exposure, cord blood Pb concentrations were significantly related to the direct observational measures of infant attention, after adjustment for confounding variables. These data provide evidence that increasing the specificity and the precision of the behavioral assessment has considerable potential for improving our ability to detect low-to-moderate associations between neurotoxicants, such Pb and infant behavior.
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Affiliation(s)
- P Plusquellec
- Public Health Research Unit, CHUQ Research Center (CHUL), Sainte-Foy, Québec, Canada G1V 2M2
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Abstract
The results of previous research in our laboratory revealed that breast-fed infants experience significantly less active sleep after exposure to alcohol in their mothers' milk than do breast-fed infants not exposed to alcohol. The present study tested the hypothesis that infants would compensate for such reductions if their mothers then refrained from drinking alcohol. To this end, 23 breast-fed infants from 3 to 5 months of age and their mothers were tested on 2 days separated by 1 week. A small, computerized movement detector, an actigraph, was placed on the infants' left ankles to monitor sleep and activity patterning after which they were bottle fed mother's milk alone (control condition) on 1 test day and mother's milk containing 32 mg of ethanol per 100 ml--the average concentration detected in human milk after lactating women drank an acute dose (0.3 g/kg) of alcohol--on the other. The infants' behaviors were monitored for the next 24 h; the first 3.5 h of monitoring on each test day took place at the Monell Center. Consistent with previous findings, infants exhibited significantly less active sleep during the 3.5 h immediately after exposure to alcohol in mothers' milk compared with the control condition; the decrease in active sleep was observed in all but 4 of the infants tested. Compensatory increases in active sleep were then observed in the next 20.5 h, when mothers refrained from drinking alcohol. Although the mechanisms underlying the reduction in sleep remain to be elucidated, these findings demonstrate that short-term exposure to small amounts of alcohol in mothers' milk produces distinctive changes in the infants' sleep-wake patterning.
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Affiliation(s)
- J A Mennella
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, PA 19104-3308, USA.
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