What factors influence dyadic synchrony? A systematic review of the literature on predictors of mother-infant dyadic processes of shared behavior and affect

Dyadic behavioral synchrony is a complex interactional process that takes place between the mother and her infant. In the first year of life, when the infant is prelinguistic, processes such as synchrony enable the dyad to communicate through shared behavior and affect. To date, no systematic review has been carried out to understand the risk and protective factors that influence behavioral synchrony in the mother-infant dyad. The aim of this review was to identify and evaluate the factors that influence behavioral synchrony in the mother-infant dyad, when the infant is between 3 and 9 months old. Key electronic databases were searched between 1970 and April 2021, and 28 eligible studies were identified for review. As the results were largely heterogeneous, four subgroups of factors were identified: (i) infant demographics, (ii) physiological factors, (iii) maternal mental health, and (iv) miscellaneous factors. Identified risk factors and covariates suggest that social determinants of health, underpinned by biological factors, play a large role in influencing behavioral synchrony within the dyad. Implications for the need to identify additional risk and protective factors, as well as design support for at-risk families are discussed.

Improving mother-infant interaction during infant feeding: A randomised controlled trial in a low-income community in South Africa

BACKGROUND

Maternal-infant feeding interactions are a primary context for engagement between mothers and their infants, and constitute a unique space in which reciprocity, attunement and maternal sensitivity can be expressed. Increasingly, research demonstrates the importance of the psychological and social nature of the feeding context, and how it may be affected by maternal mental state, feeding skills and sensitivity. As such, feeding interactions may provide useful contexts for observations of maternal sensitivity, reflecting well on day-to-day maternal sensitivity.

AIMS AND OBJECTIVES

This paper is a post hoc examination of the impact of an intervention on maternal sensitivity during a feeding interaction when the infants were 6 months old.

PARTICIPANTS

A total of 449 women consented to participate in the original intervention and were randomly assigned to the intervention or control groups. Mothers and infants were assessed during pregnancy, and then at 2, 6, 12 and 18 months of infant age. At the 6 month follow-up visit, 79% (354 out of 449) of the participants were retained. Post hoc analyses were conducted on the original sample to determine breastfeeding status. Sixty-nine percent of the women completed the feeding observation at the 6 months follow-up visit, of which 47% reported exclusively breastfeeding and 22% reported bottle-feeding.

RESULTS

Results demonstrated that during a feeding interaction, maternal sensitivity was significantly improved among non-breastfeeding mothers who received the intervention. Particularly, maternal responsiveness to infant cues and synchronous interactions was higher among non-breastfeeding intervention mothers compared to control group mothers. The results also show that non-breastfeeding mothers who received the intervention were significantly less intrusive in their interactions with their infants.

CONCLUSION

The intervention had particular beneficial effects for mothers who were not breastfeeding and suggest that the intervention offered a protective effect for non-breastfeeding mothers.

Maternal postpartum depression is a risk factor for infant emotional variability at 4 months

Maternal postpartum depression (PPD) is a risk for disruption of mother-infant interaction. Infants of depressed mothers have been found to display less positive, more negative, and neutral affect. Other studies have found that infants of mothers with PPD inhibit both positive and negative affect. In a sample of 28 infants of mothers with PPD and 52 infants of nonclinical mothers, we examined the role of PPD diagnosis and symptoms for infants' emotional variability, measured as facial expressions, vocal protest, and gaze using microanalysis, during a mother-infant face-to-face interaction. PPD symptoms and diagnosis were associated with (a) infants displaying fewer high negative, but more neutral/interest facial affect events, and (b) fewer gaze off events.  PPD diagnosis, but not symptoms, was associated with less infant vocal protest. Total duration of seconds of infant facial affective displays and gaze off was not related to PPD diagnosis or symptoms, suggesting that when infants of depressed mothers display high negative facial affect or gaze off, these expressions are more sustained, indicating lower infant ability to calm down and re-engage, interpreted as a disturbance in self-regulation. The findings highlight the importance of not only examining durations, but also frequencies, as the latter may inform infant emotional variability.

[Cultural countertransference faced with mother-baby interactions during play sessions]

The role of the cultural countertransference of researchers with regard to the subject of their study must be taken into consideration. The analysis of one's own emotions and reactions, loaded with cultural representations, thereby enables the research subject's singularity and cultural specificity to be respected. The results are therefore more objective and not so readily influenced by a particular culture.

Maternal experience of their infants' crying in the context of war trauma: Determinants and consequences

We examined, first, how prenatal maternal mental health and war trauma predicted mothers' experience of their infant crying, indicated by emotions, cognitions, and behavior; and second, how these experiences influenced the mother-infant interaction and infant development. Participants were 511 Palestinian mothers from the Gaza Strip, reporting their war trauma, symptoms of posttraumatic stress disorder (PTSD), depression, and perceived stress during pregnancy (Time 1). They reported experiences of infant crying at 4 months (Time 2), and the mother-infant interaction and infant sensorimotor and language development at 12 months of infants' age (Time 3). Results revealed that maternal mental health problems, but not war trauma, were important to experiences of infant crying. A high level of PTSD symptoms predicted negative emotions evoked by infant crying, and high depressive symptoms predicted low active and positive responses to crying. Unexpectedly, high prenatal perceived stress predicted high active and positive responsiveness. Concerning the consequences, mothers' sensitive interpretation of infant crying predicted optimal infant sensorimotor development, and mothers' active and positive responses predicted high emotional availability in mother-infant interaction. Crying is the first communication tool for infants, and mothers' sensitive responses to crying contribute to infant well-being. Therefore, reinforcing mother's optimal responses is important when helping war-affected dyads.

[Countertransference with mother-baby dyads in a context of multiple traumas]

The encounter of mother-baby dyads in a context of a traumatic narrative renders the areas of transference and countertransference more complex, with multiple identification processes. What are the implications regarding the transmission of trauma to the child and how does it occur? The clinical case of a mother, with a past fraught with challenges and traumas, illustrates a way of accessing a child's experience of trauma via the clinician's countertransference.

[Creation of an observation scale for newborns in the maternity setting]

In clinical practice in the maternity setting, professionals are regularly confronted with situations for which a clinical observation of the newborn's condition is necessary. The Assessment for Newborn Development and Abilities (Panda) scale is a tool for evaluating the sensory-motor skills of newborns and their relationship with others, as well as raising professionals' awareness of their fine observation.

PATTERNS OF EMOTIONAL AVAILABILITY IN MOTHER-INFANT DYADS: ASSOCIATIONS WITH MULTIPLE LEVELS OF CONTEXT

This study explored emotional availability (EA)- an individual's emotional responsiveness and attunement to another's needs and goals (R.N. Emde, 1980)- among a high social risk group of 226 adolescent mothers and their infants (average = 12 months old). The aim was to identify dyadic patterns of EA and to examine their association with multiple indicators of the ecological context. Maternal sensitivity, maternal nonhostility, and child responsiveness were assessed with the Emotional Availability Scales, Third Edition (Z. Biringen, J. Robinson, & R.N. Emde, 1998) during free play and teaching observations at home. Four EA patterns were identified using k-means cluster analysis: (a) "low functioning," (b) "high functioning," (c) "low functioning dyads with nonhostile mothers," and (d) "inconsistently sensitive mother and responsive child." These patterns had distinct associations with (a) mothers' parenting attitudes regarding children's power and independence and parent-child role reversal, (b) mothers' strategies in conflict resolution with their partners and their children, and (c) the dyads' living arrangements. This study makes a contribution to the understanding of the mother-child relationship from a systemic and relational perspective and explores the association of EA patterns with the dyads' relational context. Implications for programs and treatment approaches aimed at supporting dyads at social risk are discussed.