The effectiveness of mother-led infant massage on symptoms of maternal postnatal depression: A systematic review.

INTRODUCTION: Postnatal depression is a significant public health issue which may escalate and lead to adverse outcomes for women, infants, their family and the wider society. The aim of this review was to examine the effectiveness and experiences of mother-led infant massage on symptoms of maternal postnatal depression and to synthesise these findings to inform policy, practice and further research. METHODS: A systematic search of five academic databases was conducted: CINAHL, MEDLINE, EMBASE, PsycINFO and Allied and Complementary Medicine Database in February 2023 with no date or geographic limiters set owing to the paucity of research on this subject area. Quality appraisal was undertaken using the Joanna Briggs Institute quality appraisal tools and all included RCT's were assessed separately using the Cochrane Risk of Bias Tool. Narrative synthesis was used to analyse the data. FINDINGS: A total of (n = 323) studies were returned of which (n = 8) met the inclusion criteria for the review. This review identified a total sampling of (n = 521) women with maternal postnatal depression. The results are presented under three themes: 1) the effectiveness of mother-led infant massage on symptoms of postnatal depression; 2) women's experiences of mother-led infant massage; and 3) the effects of mother-led infant massage on the mother-infant relationship. DISCUSSION: The review highlights women who used infant massage displayed a reduction in symptoms of postnatal depression, improved mother-infant interactions and improved self-efficacy in addition to benefits for infants. Public Health Nurse/Community Midwife-led infant massage may help to relieve such symptoms and empower women.

Effectiveness of infant massage on babies growth, mother-baby attachment and mothers' self-confidence: A randomized controlled trial.

Infant massage is a unique massage that can be application to babies in the postpartum period for centuries. While baby massage provides contact between the baby and the mother, it supports the growth processes of the baby. This study aimed to investigate the effects of online infant massage training on infant growth, mother-infant attachment, and mothers' self-confidence. This randomized controlled clinical trial included 60 healthy-term infants and mother. The Demographic Data Collection Form, Maternal Attachment Scale, and Pharis Self-Confidence Scale were completed by all the mothers participating in the study. At the end of the 4th week, infant massage training was given to the mothers of the babies in the massage group by the primary investigator. Body weight, height, and head circumference measurements were made at the end of the 4th, 8th, 12th, 16th, and 20th week of both group babies. At the end of the 20th week, the self-confidence of the mothers in both groups was assessed using the Maternal Attachment Scale and Pharis Self-Confidence Scale. Infants in the massage group had significantly higher mean body weight at the end of the 8th week (p = 0.006) and mean height at the end of 20th week (p = 0.05) than the infants in the control group. The Maternal Attachment Scale values were higher for the mothers in the massage group (p = 0.030). Infant massage is an effective method that strengthens maternal attachment and increases body weight and height in infants. The study is registered under the ClinicalTrials.gov identifier NCT05302427.

Inequalities in the prevalence of double burden of malnutrition among mother-child dyads in India.

In the midst of rapid urbanization and economic shifts, the global landscape witnesses a surge in overweight and obese individuals, even as child malnutrition persists as a formidable public health challenge in low- and middle-income countries (LMICs). This study seeks to unravel the prevalence of the double burden of malnutrition (DBM) within the context of India and delve into the associated disparities rooted in wealth. This study leverages data from the fifth wave of the National Family and Health Survey (NFHS-5), a nationally representative survey conducted in the year 2019-21 in India. This study focuses on mother-child dyads with children under the age of 3 years. Descriptive, bivariate and logistic regression analysis is used to decipher the intricate web of DBM's prevalence and risk factors, as underscored by socio-demographic attributes. Wagstaff decomposition analysis is applied to quantify the contribution of each inequality in the social determinants on the observed income-related inequality in the DBM. Result from bivariate and logistic regression indicated a heightened risk of DBM within households marked by C-section births, affluence, ongoing breastfeeding practices, advanced maternal age, and larger household sizes. Additionally, households harbouring women with abdominal obesity emerge as hotspots for elevated DBM risk. Notably, the interplay of abdominal obesity and geographical disparities looms large as drivers of substantial inequality in DBM prevalence, whereas other factors exert a comparably milder influence. As India grapples with the burgeoning burden of DBM, a conspicuous imbalance in its prevalence pervades, albeit inadequately addressed. This juncture warrants the formulation of dual-purpose strategies, and a slew of innovative actions to deftly navigate the complex challenges poised by the dual burden of malnutrition. Amidst these exigencies, the imperative to forge a holistic approach that encompasses both sides of the malnutrition spectrum remains a beacon guiding the quest for equitable health and nutrition outcomes.

A Relação Materno-Infantil e suas Implicações na Queixa Psicossomática / The Maternal-Infant Relationship and its Implications in Psychosomatic Complaint / La Relación Materno-Infantil y sus Implicaciones en la Queja Psicosomática

A somatização é uma manifestação corporal carente de simbolização. Relaciona-se com aspectos psicológicos tendendo a surgir no bebê, que se vê como uma extensão da mãe. O objetivo foi analisar aspectos psicológicos da relação materno-filial e suas implicações nas manifestações psicossomáticas. Trata-se de uma pesquisa documental, considerando os prontuários de crianças entre fevereiro/2015 e dezembro/2019, de uma clínica-escola do Grande ABC-SP. A busca realizada a partir de um software específico para arquivamento dos prontuários, utilizou como filtros os termos: infantil, queixas somatoformes, distúrbios alimentares e distúrbios do sono. Os dados foram categorizados em: a) identificação; b) evolução clínica; e c) aspectos da personalidade e o relacionamento materno. A análise qualitativa, de base psicanalítica, apontou que a dificuldade das mães em lidar com seus próprios conflitos influenciou no surgimento dos sintomas nos filhos. Observou-se relação entre os conflitos maternos e o tipo de queixa apresentada. Os resultados sustentam a importância da relação entre mães e filhos na queixa psicossomática. Fatores orgânicos no desenvolvimento infantil precisam ser considerados para além da natureza biológica, mas da dinâmica psíquica, ampliando a compreensão diagnóstica.

Somatization is a bodily manifestation lacking symbolization. It relates to psychological aspects tending to appear in the baby, who sees himself as an extension of the mother. The objective was to analyze the psychological aspects of the mother-child relationship and its implications for psychosomatic manifestations. This is documentary research, considering the clinical reports of children between February/2015 and December/2019, from a clinical school in Grande ABC-SP. The search performed using clinical reports record file software, used terms as filters: infant, somatoform complaints, eating disorders and sleep disorders. Data were categorized into a) identification; b) clinical evolution; and c) aspects of personality and maternal relationship. The qualitative analysis, based on psychoanalysis, showed that mothers' difficulty dealing with their own conflicts influenced the appearance of symptoms in their children. There was a relationship between maternal conflicts and the type of complaint presented. The results support the importance of the relationship between mothers and children in psychosomatic complaints. Organic factors in child development need to be considered beyond the biological nature, but the psychic dynamics, expanding the diagnostic understanding.

La somatización es una manifestación en el cuerpo del no simbolizado. Se relaciona con aspectos psicológicos que tienden a aparecer en el bebé, quien se ven a sí mismos como una extensión de la madre. El objetivo fue analizar aspectos psicológicos de la relación madre-hijo y sus implicaciones en las manifestaciones psicosomáticas. Es una investigación documental, que toma en cuenta las historias clínicas de niños en los períodos de febrero/2015 y diciembre/2019, de una clínica escuela del Grande ABC-SP. La búsqueda fue hecha con auxilio de un software específico de archivo de las historias clínicas, se utilizó como filtros los términos: infantil, quejas somatomorfas, desórdenes alimentarios y desórdenes del sueño. Los datos se clasificaron en: a) identificación; b) evolución clínica; y c) aspectos de personalidad y relación materna. El análisis cualitativo de base psicoanalítica señalo que la dificultad de las madres para lidiar con sus propios conflictos influyó en la aparición de los síntomas en sus hijos. Hubo relación entre los conflictos maternos y el tipo de queja presentada. Los resultados respaldan la importancia de la relación entre madres y hijos en quejas psicosomáticas. Factores orgánicos del desarrollo infantil necesitan ser considerados más allá de la naturaleza biológica, más de la dinámica psíquica, para ampliar la comprensión del diagnóstico.

An Integrated Mother-Child Intervention on Child Development and Maternal Mental Health.

OBJECTIVES: To evaluate an integrated, low-cost, facility-based group intervention designed to promote child care, boost maternal mental-wellbeing, reduce harsh discipline, and improve children's health, nutrition, and early development. METHODS: In Dhaka, 30 neighborhood clusters of a low-income urban community were randomized to intervention or control groups. Mothers with children between 6 and 24 months (n = 300) who self-reported negative discipline were identified and enrolled. A 1-year group intervention included integration of responsive caregiving, nutritional supplementation, caregivers' mental health, child protection, and health advice. Child outcomes were cognition (primary) and language, motor and behavioral development, growth, and hemoglobin and iron status (secondary). Maternal outcomes were depressive symptoms, self-esteem, negative discipline, and child care knowledge and practices. RESULTS: Overall, 222 (74%) mother-child dyads participated in the 1-year follow-up. Intervention and control groups differed on wealth, with no other significant differences. The intervention resulted in a 0.75 SD effect on cognition, 0.77 SD on language, 0.41 SD on motor, and 0.43 to 0.66 SDs on behavior during testing (emotion, cooperation, and vocalization) in the intervention arm. Mothers in the intervention group had fewer depressive symptoms (effect size: -0.72 SD), higher self-esteem (0.62 SD), better child care knowledge (2.02 SD), fewer harsh discipline practices (0.25 SD), and better home stimulation (0.73 SD). The intervention showed no effect on child growth or hemoglobin, but significantly improved serum iron status (-0.36 SD). CONCLUSIONS: A comprehensive intervention, delivered through group sessions in health facilities, was effective in promoting child development and reducing maternal depressive symptoms among mothers who reported using negative or harsh discipline.

Feasibility and Acceptability of a joint mother infant yoga intervention in mothers admitted to an inpatient mother baby unit.

Mothers with severe mental illness in the postpartum may have problems in bonding with their infants and there is a need to develop effective and acceptable interventions. Yoga has been shown to improve social cognition as well as increase oxytocin levels and maybe of value. This paper describes the feasibility and acceptability of a mother-infant yoga intervention in 14 mothers with severe mental illness admitted to a Mother Baby Unit in India. Mothers found the module acceptable and completion rates for mother-infant dyads were adequate.

Gestational and childhood urinary iodine concentrations and children's cognitive function in a longitudinal mother-child cohort in rural Bangladesh.

BACKGROUND: Severe iodine deficiency adversely affects neurodevelopment; however, evidence regarding the association of non-severe deficiency and child cognitive functioning is inconclusive. METHODS: This prospective mother-child cohort study was nested in a population-based nutritional supplementation trial in Bangladesh (Maternal and Infant Nutrition Interventions in Matlab [MINIMat]). Participants with data on cognitive abilities at 5 and 10 years of age (n = 1530) and at least one measurement of urinary iodine concentration (UIC) (gestational week 8, 5, and 10 years) were selected. Cognitive abilities were assessed using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III) and Wechsler Intelligence Scale for Children (WISC-IV). UICs were measured with inductively coupled plasma mass spectrometry and thereafter adjusted for specific gravity. RESULTS: Median UICs in our population: (282 µg/L [pregnancy]; 406 µg/L [5 years]; 294 µg/L [10 years]) indicated that iodine intake corresponded to above 'adequate' or even 'excessive', according to the WHO classification. Maternal 'UIC <150 µg/L' was associated with lower full-scale and verbal scores at 5 and 10 years, although the associations were weakened in the fully adjusted models. A tendency of decreased verbal scores was also observed for maternal 'UIC ≥500 µg/L' but not for the corresponding child iodine category (≥300 µg/L). Child 'UIC <100 µg/L' was associated with lower processing speed (B=-3.1, 95% CI [-6.2, -0.1]; P-value = 0.041) compared with the reference group (100 µg/L≤ UIC <300 µg/L). CONCLUSIONS: Current findings add to the growing evidence of a causal association of early-life iodine intake with cognitive development, indicating that low iodine intake during childhood is associated with reduced processing speed and non-optimal gestational iodine intake is weakly associated with slightly poorer verbal development outcomes.

O refluxo gastroesofágico e a relação mãe e bebê: estudo de caso / Gastroesophageal reflux and the mother-child relations: a case study / Le reflux gastro-œsophagien et les relations mère-enfant: une étude de cas / Reflujo gastroesofágico y la relación madre-hijo: un estudio de caso

O presente artigo problematiza aspectos afetivos inerentes à relação materno-filial que podem estar associados ao surgimento e estabelecimento de sintomas psicossomáticos de refluxo gastroesofágico no bebê de até 1 ano de idade. Para tanto, apresenta-se estudo de caso de uma díade mãe-bebê auxiliado por entrevista semiestruturada, aplicação das pranchas 1, 2 e 7MF do teste de apercepção temática e observação naturalista. Cada instrumento foi analisado qualitativamente e teve seus resultados integrados e articulados à teoria psicanalítica. Os principais resultados apontaram certa fragilidade egóica e necessidade de apoio social por parte da mãe, compatíveis com o período do puerpério. São discutidas possíveis maneiras de funcionamento do psiquismo materno, por exemplo, quando sobrecarregado com afetos ansiosos, há sobredeterminação de sintomas psicofuncionais no bebê, os quais, por sua vez, causam efeitos no modo como a mãe se posiciona no exercício da maternagem suficientemente boa, marcando um interjogo relacional

This article discusses affective aspects inherent to mother-child relations that may be associated with the onset and establishment of psychosomatic gastroesophageal reflux symptoms in infants up to 1 year old. A case study of a mother-child dyad was performed by conducting semi-structured interviews, applying the 1, 2 and 7MF cards of the Thematic Apperception Test and using naturalistic observation. Instruments were analyzed qualitatively and their results were integrated and linked to psychoanalytic theoretical framework. Results pointed to a certain egoic fragility and the need for social support for the mother compatible with the puerperium. It also discusses possible ways in which the maternal psyche functions. When overloaded with anxious affections, for example, it overdetermines psychofunctional symptoms in the baby which, in turn, affects how the mother positions herself in the exercise of good maternity, marking a relational interplay

Cet article traite des aspects affectifs inhérents aux relations mère-enfant qui peuvent être associés à l'émergence et à l'installation de symptômes psychosomatiques de reflux gastro-œsophagien chez les nourrissons jusqu'à l'âge d'un an. Une étude de cas d'une dyade mère-enfant a été réalisée en menant des entretiens semi-structurés, en appliquant les planches 1, 2 et 7MF du Test d'Aperception Thématique et en utilisant l'observation naturaliste. Les instruments ont été analysés qualitativement et leurs résultats ont été intégrés et reliés au cadre théorique psychanalytique. Les résultats ont mis en évidence une certaine fragilité égoïque et le besoin d'un soutien social pour la mère compatible avec la puerpéralité. L'étude aborde également les modes de fonctionnement possibles de la psyché maternelle. Lorsque celle-ci est surchargée d'affections anxieuses, elle surdétermine des symptômes psychofonctionnels chez le bébé qui, à leur tour, affectent la façon dont la mère se positionne dans l'exercice d'une maternité suffisamment bonne, marquant une interaction relationnelle

Este artículo discute aspectos afectivos inherentes a la relación madre-hijo que pueden estar asociados con la aparición y establecimiento de síntomas psicosomáticos del reflujo gastroesofágico en el bebé de hasta 1 año de edad. Para ello, se realiza un estudio de caso de una díada madre-hijo, con la aplicación de entrevistas semiestructuradas, con el uso de los tableros 1, 2 y 7MF del Test de Apercepción Temática y una observación naturalista. Los instrumentos se analizaron cualitativamente, y sus resultados se integraron y vincularon al marco teórico psicoanalítico. Los principales resultados apuntaban a una cierta fragilidad egoica y la necesidad de apoyo social de la madre, compatibles con el puerperio. Se discuten posibles formas de funcionamiento de la psique materna, por ejemplo, cuando se sobrecarga de afectos ansiosos, sobredeterminando síntomas psicofuncionales en el bebé que, a su vez, provocan efectos sobre cómo se siente la madre en el ejercicio de una maternaje suficiente buena, marcando una interacción relacional

Participants' Experience from a Clinical Trial on Fish Oil Supplementation during Pregnancy in a Mother-Child Cohort.

Fish Oil Supplementation during Pregnancy This Patient Platform describes the experiences of two families who participated in a study of fish oil supplementation during pregnancy to prevent asthma. Enrolled families were not only participants in observational epidemiologic research, but they also served as a resource for enrollment in controlled trial interventional research.

Avances de un estudio psicoanalítico acerca de la distancia afectiva en la relación madre-bebé / Advances of a psychoanalytic study about the affective distance in the mother-baby relationship

Medir el empuje que transmite la voz materna es casi inconcebible, (Didier-Weill,1998) ya que la estructura de su discurso primordial incluye una paradoja. ¿De qué manera entonces medir un espacio de encuentro que está en construcción? Este estudio explora la distancia afectiva en la díada madre-bebé desde una perspectiva intersubjetiva, durante la emisión del fenómeno sonoro denominado "tono maternés". Como parte de los avances de la investigación en curso, se destaca el valor de la interdisciplina para la obtención de los datos y el modo en que su procesamiento conduce a una posible categorización de su objeto de estudio. La consulta a expertos (del campo de la fonoaudiología y la psicomotricidad) permitió abordar un "único cuerpo suficientemente complejo"(Bernardi,2000)y de este modo cercar la realidad compartida. Se acuerda con Winnicott (1989) en la idea de que, si distintos observadores llegan a conclusiones semejantes, probablemente signifique que se ocupan de cosas reales(AU)

Measuring the drive transmitted by the maternal voice is almost inconceivable (Didier-Weill 1998). This statement is based on the idea that the primordial discourse structure is paradoxical. How then, to measure a meeting space that is under construction. One of the objectives of this psychoanalytic thesisis to explore the affective distance present in the dyad, while she emits the sound phenomenon 'babytalk'. As part of the progress, the author presents some moments of the investigation. This paper highlights the value of interdisciplinary approach to obtain the data and presents a possible categorization of the affective distance present in the early relationship.To study the real movements for the psychical constitution, it was required the dialogue with experts (from the areas of phonology and psychomotricity) to border a shared reality and address a "single sufficiently complex body (Bernardi, 2000). In agreement with Winnicott (1989), if different observers arrive at a similar conclusion, it possibly implies that they are dealing with real things(AU)

Selenium Status and Supplementation Effects in Pregnancy-A Study on Mother-Child Pairs from a Single-Center Cohort.

The demand for selenium (Se) increases during pregnancy since this element supports child growth, proper neuronal development and maternal thyroid function. The issue is particularly relevant for populations living in areas with a limited selenium supply, where many pregnant women opt for Se supplementation. The efficiency of this measure is unknown, although it seems vital in the prevention of severe Se deficiency. In order to evaluate this hypothesis, an observational study was conducted in Poland, where Se deficiency is prevalent. Pregnant women were invited to participate in the study and provided serum samples at the end of pregnancy (n = 115). Information on the supplemental intake of micronutrients was recorded in a face-to-face interview. In addition, serum samples were isolated from the cord blood of newborns at delivery (n = 112) and included in the analyses. Thyroid hormone status was evaluated by routine laboratory tests, and Se status was determined by total Se and selenoprotein P (SELENOP) concentrations and extracellular glutathione peroxidase (GPX3) activity. The three parameters of Se status correlated strongly within the group of mothers and within the group of newborns, with an additional significant correlation found among mother-child pairs. One-third of mothers reported additional Se intake, mainly as a component of multi-micronutrient supplements, at a mean (±SD) dosage of 42 ± 14 µg Se/day. Despite this regime, most of the women presented an insufficient Se status, with 79% of mothers displaying serum Se concentrations below 70 µg/L (indicating Se deficiency) and 22% showing levels below 45.9 µg/L (severe Se deficiency). The inadequate Se supply was also reflected in relatively low SELENOP concentrations and GPX3 activity. Neither total Se nor SELENOP or GPX3 levels were significantly higher in the group of mothers reporting the intake of supplements than in the non-supplementing group. Nevertheless, elevated SELENOP concentrations were observed in the subgroup receiving supplements with more than 55 µg/day. We conclude that the self-administered supplementation of small Se dosages was not sufficient to achieve replete Se status in the micronutrient scant area. However, the maternal Se deficit measured by either Se, SELENOP or GPX3 was transferred from mothers to the newborns, as the parameters correlated strongly in the mother-newborn pairs of samples. It is vital to re-evaluate the guidelines concerning pregnancy care and monitoring of micronutrient status during pregnancy, in particular in areas where deficiencies are present.

Rethinking Responsive Feeding: Insights from Bangladesh.

Young children's growth is influenced by food and feeding behavior. Responsive feeding has been shown to promote healthy growth and development, to prevent under- and overfeeding, and to encourage children's self-regulation. However, most measures of responsive feeding do not incorporate bidirectional mother-infant responsivity or early learning principles and have not been validated against observations. To overcome these gaps, we laid the groundwork for a responsive feeding measure based on a community sample of 67 mothers and their 6-18-month-old children in Bangladesh. Children were weighed and measured. Mothers reported on their child's dietary intake and responded to a 38-item responsive feeding questionnaire developed through a 2-phase Delphi procedure. Based on a video-recorded feeding observation, mother-child dyads were categorized into proximal (43%) and distal (57%) responsivity groups. Using stepwise logistic regression, a 9-item model from the responsive feeding questionnaire had excellent fit (AUC = 0.93), sensitivity (90%), specificity (89%), positive predictive value (87%), and negative predictive value (93%). Proximal responsivity was characterized by maternal concerns about children's dietary intake. Distal responsivity was characterized by maternal perception of children's happy mood during feeding. Findings support responsive feeding as modulating between proximal and distal responsivity, promoting autonomy, self-regulation, and enabling children to acquire and practice healthy eating behaviors.

Cohort profile: the Taicang and Wuqiang mother-child cohort study (TAWS) in China.

PURPOSE: The Taicang and Wuqiang cohort study (TAWS) was established to examine the association between early-life nutrition and children's health, and to explore the potential roles of maternal health, metabolites and microbiota in children's health in two different regions of China. PARTICIPANTS: A total of 7041 mother-child pairs were recruited during early pregnancy (n=4035, 57.3%) or delivery phase (n=3006, 42.7%) from health centres or hospitals in Taicang and Wuqiang. Mother-child pairs were followed up three times during pregnancy, once during delivery, and 7-10 times in the 3 years after delivery. Questionnaires were used to collect data on diet, supplementary intake, physical activity, depression scale, disease occurrence, feeding practice and development quotient of children. Anthropometric measurements of mothers and their children were assessed at each visit. Pregnancy outcomes were extracted from medical records. Biospecimens were collected and stored, including venous blood, cord blood, urine, stool, breast milk, cord and placenta. FINDINGS TO DATE: Data from the TAWS cohort showed different baseline characteristics of participants at the two sites of TAWS. Abnormal metabolism occurred among newborns whose mothers were diagnosed with gestational diabetes mellitus. Maternal serum folic acid above 14.5 ng/mL at early pregnancy was associated with a reduced risk of delivering small-for-gestational-age newborns. FUTURE PLANS: The association between maternal nutrition and the health of offspring will be examined at various follow-up visits. Biomarkers will be analysed to assess the associations between early-life nutrition and child development, immunity and health. Strategic recommendations for optimal infant feeding practices, obesity prevention and routine healthcare items will be developed and proposed based on the findings from the study. Children in this prospective cohort study will be followed up once a year until age 12 years to further examine the relationships between early-life nutrition and children's long-term development and health.

Mindful with your baby for mothers of infants with (parental) stress in a non-clinical setting: a wait-list controlled pilot trial.

BACKGROUND: Because of the far-reaching negative consequences of high levels of (parental) stress for the mother, infant, the mother-infant relationship, and family functioning, psychological support for young mothers is important. Mindful with Your Baby is a mindfulness-based intervention, originally developed and evaluated in a clinical population of mothers with mental health issues and/or babies with regulation problems. The current pilot examines whether Mindful with Your Baby for mothers with symptoms of (parental) stress offered in a non-clinical setting is also effective and acceptable. METHODS: In this pilot waitlist-controlled trial, 17 mothers with infants (2-15 months) admitted themselves for a Mindful with Your Baby training in a non-clinical setting because of (parental) stress. Mindful with Your Baby was offered in groups of three to six mother-infant dyads and consisted of eight weekly 2-h sessions. Participants completed questionnaires on symptoms of parental stress, general stress, depression, anxiety, mindfulness and self-compassion at 8-week waitlist, pretest, posttest and 8-week follow-up. RESULTS: There were no training drop-outs, attendance rate was 92.5%, and the training was evaluated positively: all mothers (100%) felt they got something of lasting importance as a result of taking the training, and reported becoming more conscious as a parent, and 93% reported changing their lifestyle or parenting as a result of the training. Multilevel analyses showed no significant changes between waitlist and pretest. At posttest, a significant improvement occurred in all outcome measures compared to pretest, of moderate to large effect sizes. At follow-up, a significant improvement was seen compared to pretest in all outcomes except anxiety compared to pretest, of small to moderate effect sizes. CONCLUSIONS: Mindful with Your Baby appears an acceptable and effective intervention for mothers with a baby who experience (parental) stress but who have not been referred to specialized mental health care. A low threshold access to Mindful with Your Baby in non-clinical settings could provide a timely and positive interference in (parental) stress.

Short-term Music Therapy for Families With Preterm Infants: A Randomized Trial.

OBJECTIVES: To evaluate short-term effects of music therapy (MT) for premature infants and their caregivers on mother-infant bonding, parental anxiety, and maternal depression. METHODS: Parallel, pragmatic, randomized controlled-trial conducted in 7 level III NICUs and 1 level IV NICU in 5 countries enrolling premature infants (<35 weeks gestational age at birth) and their parents. MT included 3 sessions per week with parent-led, infant-directed singing supported by a music therapist. Primary outcome was mother-infant bonding as measured by the Postpartum Bonding Questionnaire (PBQ) at discharge from NICU. Secondary outcomes were parents' symptoms of anxiety measured by General Anxiety Disorder-7 (GAD-7) and maternal depression measured by Edinburgh Postpartum Depression Scale (EPDS). Group differences at the assessment timepoint of discharge from hospital were tested by linear mixed effect models (ANCOVA). RESULTS: From August 2018 to April 2020, 213 families were enrolled in the study, of whom 108 were randomly assigned to standard care and 105 to MT. Of the participants, 208 of 213 (98%) completed treatment and assessments. Participants in the MT group received a mean (SD) of 10 sessions (5.95), and 87 of 105 participants (83%) received the minimum of 6 sessions. The estimated group effect (95% confidence interval) for PBQ was -0.61 (-1.82 to 0.59). No significant differences between groups were found (P = .32). No significant effects for secondary outcomes or subgroups were found. CONCLUSIONS: Parent-led, infant-directed singing supported by a music therapist resulted in no significant differences between groups in mother-infant bonding, parental anxiety, or maternal depression at discharge.

The Association Between Mindful Parenting and Adolescent Internalizing and Externalizing Problems: The Role of Mother-Child Communication.

This study aimed to explore the mediation process from maternal mindful parenting to adolescent internalizing and externalizing problems through mother-child communication and adolescent self-disclosure. A total of 496 mother-adolescent dyads participated in the current study. Mother-reported mindful parenting and mother-child communication and adolescent-reported self-disclosure and behavior problems were collected. Path analysis results showed that mothers' mindful parenting was indirectly associated with adolescent internalizing and externalizing behaviors through mother-child communication and adolescent self-disclosure. In addition, the specific components of mindful parenting were examined in detail. The component of interacting with full attention showed unique patterns, while components of compassion and acceptance and emotion awareness of children showed similar pattern with the total score. These findings contribute to the knowledge of the mechanism underlying how mindful parenting benefit adolescent internalizing and externalizing behaviors, and have implications for clinical interventions.

Análisis confirmatorio de un cuestionario de control y presión al comer en madres de preescolares costarricenses / Confirmatory analysis of a control and pressure when eating questionnaire among mothers of Costa Rican preschoolers

Resumen Objetivo: analizar la validez de la estructura factorial para un cuestionario adaptado a partir del Preschooler Feeding Questionnaire (PFQ) con subescalas asociadas al control y la presión parental al comer. Metodología: se elaboró un cuestionario de 11 reactivos expresados con escalas tipo Likert y agrupados en dos subescalas: Presión Maternal al Comer y Control Maternal al Comer. Se evaluaron 50 madres y posteriormente se realizó un análisis factorial para identificar la estructura factorial subyacente, mediante la evaluación de la confiabilidad con el α de Cronbach, la extracción de componentes principales con una rotación Varimax y la normalización de Kaiser. Luego, se efectuó un análisis confirmatorio de factores con 430 madres. Por medio de la estadística descriptiva se estudiaron las prácticas parentales de «control» y «presión», mientras un modelo SEM valoró la existencia de relaciones causales entre el IMC, el género infantil y dichas prácticas. Resultados: se validó una estructura factorial de dos escalas, Control y Presión, compuestas cada una de tres reactivos (x2 = 187,3, df. = 116, x2/df. = 1,62, CFI = 0,998, GFI = 0,991, AGFI = 0,983, NFI = 0,994, IFI = 0,998, and RMSEA = 0,018). No se estableció relación causal alguna entre estos factores con el IMC o el género de los infantes, siendo ambos factores mayores a la media. Conclusión: la adaptación del formulario constituye una herramienta válida y fiable de futura utilidad en el estudio de prácticas nutricionales parentales.

Abstract Objective: to analyze the validity of the factorial structure for a questionnaire adapted from the Preschooler Feeding Questionnaire (PFQ) with subscales associated with control and parental pressure when eating. Methodology: a questionnaire was prepared with 11 items expressed with "Likert" type scales and grouped into two subscales: "maternal pressure when eating" and "maternal control when eating". This was evaluated with 50 mothers, subsequently carrying out a factor analysis to identify the underlying factorial structure, evaluating the reliability with Cronbachs α and using a principal components extraction with a Varimax rotation and Kaiser normalization. A confirmatory factor analysis was subsequently performed with 430 mothers. Descriptive statistics studied both "control" and "pressure" parental practices, while an SEM model assessed the existence of causal relationships between BMI, child gender and these practices. Results: a factorial structure of two scales was validated, "Control" and "Pressure", each composed of three items (x2 = 187.3, df. = 116, x2 / df. = 1.62, CFI = 0.998, GFI = 0.991, AGFI = 0.983, NFI = 0.994, IFI = 0.998, and RMSEA = 0.018). No causal relationship was established between these factors with the BMI or the gender of the infants, both factors being greater than the average. Conclusion: The adaptation of the questionnaire is a valid and reliable tool of future utility in the study of parental nutritional practices.

Mothers' psychopathology symptoms and mindful parenting in the postpartum period: The role of parental reflective functioning.

Postpartum psychopathology has an adverse impact on parenting behaviors and, consequently, on the mother-infant relationship. This study aimed to explore whether the relationship between maternal anxiety and depression symptomatology in the postpartum period and the ability of mothers to adopt a mindful parenting approach is indirect and can be explained by parental reflective functioning. Two hundred ninety five Portuguese mothers of infants aged up to 12 months completed self-report measures assessing anxiety/depression symptoms, mindful parenting, and parental reflective functioning. Mothers who reported clinically significant anxious and/or depressive symptomatology levels (21%) showed lower levels of mindful parenting and of certainty about the mental states as well as higher levels of prementalizing modes of mental states than mothers with normal symptomatology levels. An indirect effect of depressive symptomatology on mindful parenting through the two dimensions of parental reflective functioning and a direct effect of anxious symptomatology on mindful parenting were found. The results suggest that parental reflective functioning is an important explanatory mechanism of the relationship between depressive symptomatology and mindful parenting, as well as that anxious symptomatology is directly associated with mindful parenting. This study suggests that reducing anxious and depressive symptoms in the postpartum period can promote reflective and mindful parenting skills.

La sicopatología posterior al parto tiene un impacto adverso sobre las conductas de crianza y, consecuentemente, sobre la relación madre-infante. Este estudio se propuso explorar si la sintomatología materna de ansiedad/depresión en el período posterior al parto se asocia con la más débil habilidad de la madre para adoptar un acercamiento consciente a la crianza y si esta relación es indirecta y la explica el funcionamiento reflexivo del progenitor. Doscientas noventa y cinco madres portuguesas de infantes de edad hasta los 12 meses completaron medidas de auto reporte para evaluar los síntomas de ansiedad/depresión, la crianza consciente, así como el funcionamiento reflexivo del progenitor. El 21% de las madres reportaron niveles de sintomatología de ansiedad y/o depresión clínicamente significativos. Estas madres mostraron niveles más débiles de una crianza consciente y de certeza acerca de los estados mentales y niveles más fuertes de modos mentales de mentalización previa que las madres con niveles normales de sintomatología. Encontramos un efecto indirecto de sintomatología depresiva sobre la crianza consciente a través de dos dimensiones del funcionamiento reflexivo del progenitor y un efecto directo de sintomatología de ansiedad sobre la crianza consciente. Los resultados sugieren que el funcionamiento reflexivo del progenitor es un mecanismo importante de explicación de la relación entre la sintomatología depresiva y la crianza consciente, como también la sintomatología de la ansiedad está directamente asociada con la crianza consciente. Este estudio sugiere que reducir los síntomas de ansiedad y depresión en el período posterior al parto puede promover las habilidades de una crianza reflexiva y consciente.

La psychopathologie postpartum a un impact négatif sur les comportements de parentage et par conséquent sur la relation mère-bébé. Cette étude s'est donnée pour but d'explorer si la symptomatologie anxiété/dépression maternelle durant la période postpartum est liée à une moindre capacité des mères à adopter une approche attentive au parentage et si cette relation est indirecte et expliquée par le fonctionnement parental de réflexion. 295 mères portugaises de bébés âgés de 0 à 12 mois ont rempli des mesures d'auto-évaluations évaluant les symptômes d'anxiété/dépression, le parentage attentif, et le fonctionnement parental de réflexion. 21% des mères ont fait état de niveaux cliniquement élevés de symptomatologie anxieuse et/ou dépressive. Ces mères ont fait preuve de niveaux moins élevés de parentage attentif et de certitude sur les états mentaux et de niveaux plus élevés de mode de pré-mentalisation que les mères avec des niveaux normaux de symptomatologie. Un effet indirect de symptomatologie dépressive sur le parentage attentif à travers deux dimensions de fonctionnement de réflexion maternelle et un effet direct de symptomatologie anxieuse sur le parentage attentif ont été trouvés. Les résultats suggèrent que le fonctionnement de réflexion parentage est un mécanisme important d'explication de la relation entre la symptomatologie dépressive et le parentage attentif. Ils suggèrent également que la symptomatologie anxieuse est directement liée au parentage attentif. Cette étude suggère que la réduction des symptômes anxieux et dépressifs durant la période post-partum peut promouvoir des capacités de parentage de réflexion et d'attention.

"Nobody Listened". Mothers' Experiences and Needs Regarding Professional Support Prior to Their Admission to an Infant Mental Health Day Clinic.

Challenges during the perinatal period can lead to maternal distress, negatively affecting mother-infant interaction. This study aims to retrospectively explore the experiences and needs regarding professional support of mothers with difficulties in mother-infant interaction prior to their admission to an infant mental health day clinic. In-depth semi-structured interviews were conducted with 13 mothers who had accessed an infant mental health day clinic because of persistent severe infant regulatory problems impairing the wellbeing of the infant and the family. Data were transcribed and analyzed using the Qualitative Analysis Guide of Leuven (QUAGOL). Three themes were identified: 'experience of pregnancy, birth, and parenthood'; 'difficult care paths'; and 'needs and their fulfillment'. The first theme consisted of three subthemes: (1) 'reality does not meet expectations', (2) 'resilience under pressure', and (3) 'despair'. Mothers experienced negative feelings that were in contradiction to the expected positive emotions associated with childbirth and motherhood. Resilience-related problems affected the mother-child relationship, and infants' regulatory capacities. Determined to find solutions, different healthcare providers were consulted. Mothers' search for help was complex and communication between healthcare providers was limited because of a fragmented care provision. This hindered the continuity of care and appropriate referrals. Another pitfall was the lack of a broader approach, with the emphasis on the medical aspects without attention to the mother-child dyad. An integrated care pathway focusing on the early detection of resilience-related problems and sufficient social support can be crucial in the prevention and early detection of perinatal and infant mental health problems.

Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: a meta-analysis.

BACKGROUND: Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. This meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae. METHODS: The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until June 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions conducted during 0 ~ 78 weeks postpartum for fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. Cohen's kappa coefficient was used to measure inter-rater agreement. The meta-analysis was conducted using Review Manager 5.3. RESULTS: Seventeen published clinical trials matched the eligibility criteria and ten studies involving 1194 participants were included in this meta-analysis. The intervention start time varied from immediately postpartum care to 1 year after delivery, and duration ranged from 1 day to 3 months. The results revealed that exercise (SMD = - 1.74, 95% CI = -2.61 to - 0.88) and drinking tea (MD = - 3.12, 95% CI = -5.44 to - 0.80) resulted in significant improvements in women's postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD = - 2.89, 95% CI = -4.30 to - 1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed. Physical therapies including mother-infant skin-to-skin contact, taking warm showers and breathing lavender oil aroma were used for reducing postpartum fatigue. No significant risk of publication bias was found. Small number of included studies and sample sizes, not time-matched conditions of control groups, high heterogeneity and the risk of bias within the included studies were the main limitations of our review. CONCLUSIONS: This review provides evidence that exercise and drinking tea may be effective nonpharmacological interventions for relieving postpartum fatigue. More effective and targeted exercise programs need to be further studied. Rigorous RCTs of drinking tea are needed. Caution is required when interpreting the findings due to the limitations of our study. Further studies are still needed to validate our findings and increase confidence in the results.