Care with child development and André Bullinger's special look at prematurity.

OBJECTIVE: To assess different ways of caring for preterm infants' development and for their families in neonatal units, with emphasis on the studies by André Bullinger. DATA SOURCE: A review of the literature in the databases PubMed, SciELO, and the Cairn.info portal, which publishes reviews in human sciences in French. Also, the books and articles of André Bullinger, available only in French, were reviewed. DATA SYNTHESIS: This review includes the Kangaroo Method, which is based on skin to skin contact and the encouragement of breastfeeding; the Newborn Individualized Developmental Care and Assessment Program (NIDCAP), based on the Synaptic Developmental Theory and aiming to positively change the neonatal environment, having the preterm newborn as the actor of their own development and the mother as a regulator; and the Bullinger Approach, which uses a sensory-motor perspective to approach child development, including preterm infants' development. CONCLUSIONS: The Kangaroo Method has changed child developmental care in countries with limited financial resources. NIDCAP was shown to be efficient, although only a few long-term studies have been conducted on the subject. The Bullinger Approach is well diffused in European neonatal units, with promising results for the prevention of neurodevelopmental disabilities, especially those related to orality.

The Effects of Prenatal Diagnosis on the Interaction of the Mother-Infant Dyad: A Longitudinal Study of Prenatal Care in the First Year of Life.

Introduction: Mother-child interactions during the first years of life have a significant impact on the emotional and cognitive development of the child. In this work, we study how a prenatal diagnosis of malformation may affect maternal representations and the quality of these early interactions. To this end, we conducted a longitudinal observational study of mother-child interactions from the gestational stage until the baby completed 12 months of age. Participants and Methods: We recruited 250 pregnant women from a local university hospital. Among them, 50 mother-infant dyads participated in all stages of the study. The study group consisted of 25 pregnant women with fetuses with some structural alteration and the control group consisted of 25 pregnant women with fetuses without structural anomalies. We collected obstetric and socio demographic data and pregnancy outcomes. Anxiety and depressive state data were collected using the COVI and Raskin Scales. We video-recorded the mother-infant interactions during several stages, including when the child was a newborn and when the child was 2, 4, 6, 9, and 12 months of age. The quality of the mother infant interactions were measured using the Coding Interactive Behavior (CIB). The interactive moments recorded on video was composed of three different activities, each one lasting appoximately 3 min, which included (1) Free Interaction, where the mother was instructed to interact "as usual" without any toy, (2) Toy Interaction, where the mother and baby played with a puppv, and (3) Song Interaction, where the mother and baby interacted while the mother sang the "Happy Birthday" song. Results: In the gestational phase, there was a significant difference between the groups with respect to anxiety and depression scores, which were significantly higher for the study group. In the postnatal phase, we found significant differences between the groups with respect to CIB scales after the child completed 6 months of age: the study group presented significantly higher values of Maternal Sensitivity at 6 months of age, of Baby Involvement at 9 and 12 months of age, and of Dyadic Reciprocity at 6, 9, and 12 months of age, while the control group presented significantly higher values of Withdrawal of the Baby at 6 months of age, and of Dyadic Negative States at 6 and 9 months of age. Conclusion: The support offered by the study favored the mother-infant bond and had a positive effect on the quality of interaction during the first year of life, despite the presence of prenatal diagnosis.

Preventive parent-young child interaction interventions to promote optimal attachment.

PURPOSE OF REVIEW: Quality of attachment relationships is believed to be an important early indicator of infant mental health as it is considered a vital component of social and emotional development in the early years. As a result, there has been a growing call for the development of early intervention attachment research programs. In this brief overview, we summarize what we consider to be the state-of-the-art of intervention programs targeted to increase the prevalence of secure attachment and to reduce the level of disorganized attachment among infants with a wide range of psychological risks. RECENT FINDINGS: The themes in the literature covered by the article are as follows: recent results of the main preventive parent-young child interaction interventions to promote optimal attachment; recent metaanalysis on efficiency of these early attachment-based programs; intermediate variables on intervention effects; and benefits of specific therapeutic approaches focused on maternal psychopathology. Globally, early attachment-informed interventions show positive effects, both for mothers and infants. SUMMARY: Our revision stresses the importance of formally assessing the underlying mechanisms of change within interventions in research programs to open the path to improve and target these preventive approaches and consequently promote optimal attachment.