Karitane Parenting Confidence Scale: measuring parenting self-efficacy in Portuguese mothers during the first year postpartum.

BACKGROUND: The Karitane Parenting Confidence Scale (KPCS) was designed to assess parenting self-efficacy in parents of infants during the first year. OBJECTIVE: The aim of this study was to analyse the psychometric characteristics of the KPCS in Portuguese mothers during the first-year postpartum. METHODS: A sample of 383 mothers were recruited at two public outpatient units in Northern Portugal. Mothers completed the KPCS, a sociodemographic questionnaire, and measures of depressive and anxiety symptoms at least one time between two weeks, three, six and 12 months postpartum. RESULTS: Good fit was found for a factor model with three subscales: parenting, support and child development. The KPCS presented good internal consistency. Regarding the criterion validity of the KPCS, significant effects of mother's age were found on the development subscale and significant associations were found between mother's depressive and anxiety symptoms and the KPCS total scale and subscales. Optimal clinical cut-offs were suggested. CONCLUSION: Findings provided evidence on the psychometric characteristics of the KPCS which can be used to assess parenting self-efficacy in Portuguese mothers during the first-year postpartum, possibly identifying mothers with low parenting self-efficacy.

Maternal Prenatal Depressive Symptoms and Infant Sleep Problems: The Role of Infant Temperament and Sex.

OBJECTIVES: We aimed to analyze whether (1) infant temperament mediates the impact of maternal prenatal depressive symptoms on infant sleep problems and (2) the mediation role of infant temperament was moderated by the infant's sex. METHODS: The sample was comprised of 172 mother-infant dyads. Mothers completed self-reported measures of prenatal and postnatal depressive symptoms, infant temperament (negative affectivity, surgency/extraversion, and orienting regulation), and sleep problems. RESULTS: While controlling for maternal postnatal depressive symptoms, our results revealed that (1) infant negative affectivity at two weeks partially mediated the impact of maternal prenatal depressive symptoms on sleep anxiety at six months, and (2) this mediation is independent of the infant's sex. CONCLUSIONS: Our findings provided evidence that negative affectivity can be an early specific marker of sleep anxiety and can partially explain the negative impact of maternal prenatal depressive symptoms on further sleep problems in the infant.

Unidirectional and bidirectional links between maternal depression symptoms and infant sleep problems.

The present study explored (a) the unidirectional and bidirectional links between maternal depression symptoms and infant sleep problems and (b) the moderating role of the infant's sex on these unidirectional and bidirectional links. Mothers (N = 312) completed measures of depression symptoms at the third pregnancy trimester, and measures of depression symptoms and infant sleep problems at 2 weeks, and at 3 and 6 months postpartum. The findings revealed: (a) a main unidirectional link between maternal depression symptoms during the third trimester and infant sleep problems, particularly on infant unsettled sleep and daytime sleepiness at 3 and 6 months; (b) bidirectional links between maternal postpartum depression symptoms and infant unsettled sleep at 2 weeks, 3 and 6 months of life; and (c) the reported links between maternal depression symptoms and infant sleep problems occur specifically in boys and their mothers. Maternal prenatal depression symptoms are linked to infant sleep problems and infant sleep problems are linked to maternal postnatal depression symptoms. Boys are more susceptible to the effects of maternal prenatal and postnatal depression symptoms, and mothers of boys are more susceptible to the effects of boys' sleep problems.

The Infant Behavior Questionnaire - Revised: psychometric properties at 2 weeks, 3, 6 and 12 months of life.

BACKGROUND: Temperament characteristics are key elements for infants' development. The Infant Behavior Questionnaire - Revised (IBQ-R) is one of the most used measures to assess temperament in infants aged between 3 and 12 months. Its reliability and factor structure have not yet been examined in infants younger than 3 months. AIMS: To analyze the reliability of the IBQ-R at 2 weeks and the IBQ-R factor structure from 2 weeks to 12 months of life. METHOD: A longitudinal repeated measures design was used. Three hundred mothers completed the IBQ-R when their infants were 2 weeks, and 3, 6 and 12 months. RESULTS: At 2 weeks the proportion of "non-applicable" responses was higher in duration of orienting, high intensity pleasure, approach and smiling and laughter scales. The Cronbach's alpha for the IBQ-R dimensions ranged between 0.62 and 0.63 and the McDonald's omega ranged between 0.67 and 0.80, all dimensions exhibited a mean-scale correlation above 0.15, and more than half of the scales revealed a scale-dimension correlation higher than 0.30. The same factor structure was found at 2 weeks, and at 3, 6, and 12 months: surgency/extraversion, p < 0.001, negative affectivity, p < 0.001, and orienting regulation, p = 0.007. CONCLUSIONS: The IBQ-R may be applied in the first weeks of life and its factor structure remains stable when applied across different ages throughout infancy.

Mother's prenatal and postpartum depression symptoms and infant's sleep problems at 6 months.

Mother's prenatal and postpartum depression have been associated with infant's sleep problems. This study aimed to analyze (a) the effects of mother's prenatal and postpartum depression symptoms, including the effects of prenatal and postpartum anxiety and depression scores of the Edinburgh Postnatal Depression Scale (EPDS), on infant's sleep problems at 6 months, and (b) the interaction effect between mother's prenatal and postpartum depression symptoms and infant's sex on infant's sleep problems at 6 months. The sample was comprised of 164 mother-infant dyads whose mothers completed measures of depression at the third trimester of pregnancy, 2 weeks, 3 and 6 months postpartum and a measure of infant's sleep problems at 6 months (CSHQ-I). Mother's prenatal depression symptoms, specifically depression scores of the EPDS, predicted more infant's sleep anxiety and daytime sleepiness, while mother's depression symptoms at 2 weeks postpartum, specifically anxiety scores of the EPDS, predicted more bedtime resistance and CSHQ-I total scores at 6 months. Boys of mothers with more prenatal depression symptoms presented more sleep anxiety at 6 months. Both mother's prenatal and early postpartum depression symptoms have a negative effect on the emergence of infant's sleep problems. Additionally, boys seem more vulnerable to mother's prenatal depression symptoms.

La depresión prenatal y posterior al parto de la madre ha sido asociada con problemas de dormir del infante. Este estudio se propuso analizar (1) los efectos de los síntomas de la depresión prenatal y posterior al parto de la madre, incluyendo los efectos que los puntajes de ansiedad y depresión prenatal y posterior al parto en la Escala de Depresión Postnatal de Edinburgo (EPDS) tienen en los problemas de dormir del infante a los seis meses, y (2) el efecto de la interacción entre los síntomas de depresión prenatal y posterior al parto de la madre y el sexo del infante sobre los problemas de dormir del infante a los seis meses. El grupo muestra estuvo compuesto de 164 díadas madre-infante cuyas madres completaron medidas de depresión al tercer trimestre del embarazo, a las dos semanas, tres y seis meses posteriores al parto y una medida de los problemas de dormir del infante a los seis meses (CSHQ-I). Los síntomas prenatales de depresión de la madre, específicamente los puntajes de depresión en EPDS, predijeron más ansiedad de dormir en el infante y el tener sueño durante el día, mientras que los síntomas de depresión de la madre a las dos semanas posteriores al parto, específicamente los puntajes de ansiedad en EPDS, predijeron más resistencia al tiempo de estar en cama y los puntajes totales de CSHQ-I a los seis meses. Los varoncitos de madres con más síntomas de depresión prenatal presentaron más ansiedad de dormir a los seis meses. Tanto los síntomas de depresión prenatales como los de la temprana etapa del postparto tienen un efecto negativo en cuanto al surgimiento de problemas de dormir en el infante. Adicionalmente, los varoncitos parecen más vulnerables a los síntomas de depresión prenatal de la madre. Palabras claves: depresión prenatal, depresión posterior al parto, problemas de dormir, desarrollo, diferencia de sexo.

La dépression prénatale et postpartum de la mère a été liée aux problèmes de sommeil du nourrisson. Cette étude s'est donnée pour but d'analyser (1) les effets des symptômes de dépression prénatale et postpartum de la mère, y compris les effets de l'anxiété prénatale et postpartum et les scores de dépression de l'Echelle de Dépression Post-Partum d'Edimbourg (abrégée en anglais EPDS) sur les problèmes de sommeil du nourrisson à six mois, et (2) l'effet d'interaction entre les symptômes de dépression prénatale et postpartum de la mère et le sexe du nourrisson sur les problèmes de sommeil du nourrisson à six mois. L'échantillon a compris 164 dyades mère-nourrisson dont les mères avaient rempli des mesures de dépression au troisième trimestre de la grossesse, à deux semaines, trois mois et six mois postpartum et une mesure des problèmes de sommeil du nourrisson à six mois (CSHQ-I). Les symptômes de dépression prénatale de la mère, plus spécifiquement les scores de dépression de l'EPDS, ont prédit plus d'anxiété du sommeil du nourrisson et d'endormissement durant la journée, alors que les symptômes de dépression de la mère à deux semaines postpartum, plus spécifiquement les scores d'anxiété de l'EPDS, a prédit plus de résistance au coucher et des scores totaux CSHQ-I à six mois. Les garçons de mères avec plus de symptômes de dépression postnatale ont présenté plus d'anxiété du sommeil à six mois. Les symptômes de dépression prénatale et de dépression précoce postpartum ont tous deux un effet négatif sur l'émergence de problèmes de sommeil du nourrisson. De plus les garçons semblent plus vulnérables aux symptômes de dépression prénatale de la mère. Mots clés: dépression prénatale, dépression postpartum, problèmes de sommeil, développement, différences entre les sexes.

The breastfeeding self-efficacy scale-short form: Psychometric characteristics in Portuguese pregnant women.

BACKGROUND: The Breastfeeding Self-Efficacy Scale-Short Form is a reliable instrument to measure mother's confidence in her ability to breastfeed. The Breastfeeding Self-Efficacy Scale-Short Form has traditionally been used postnatally, but evidence suggests that it can be used antenatally to identify mothers at-risk of requiring additional support to improve breastfeeding outcomes. OBJECTIVE: The aim of this study was to examine the psychometric characteristics of an antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form, among pregnant Portuguese women. DESIGN: Methodological prospective study to examine the psychometric characteristics of the antenatal Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form. SETTINGS: Two public hospital units in the Northern Portugal. PARTICIPANTS: The sample was comprised of 373 pregnant women recruited at 30-34 gestational weeks. METHODS: The original English version of the antenatal Breastfeeding Self-Efficacy Scale-Short Form was translated into Portuguese and the Portuguese antenatal version of the scale was tested in a sample of 373 pregnant women. To examine the psychometric characteristics of the Portuguese antenatal version of the scale, the maternal demographic variables and the depressive and anxiety symptomatology of the participants were examined. The predictive validity of the Portuguese antenatal version of the scale was studied according to infant feeding method at one, three, and six months postpartum. RESULTS: The Cronbach's alpha coefficient was 0.92. The antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form scores were found to be associated with women's parity, educational level, occupational status, time they intend to breastfeed, and previous breastfeeding experience. Also, the antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form scores significantly predicted exclusive breastfeeding at 1 month postpartum. CONCLUSIONS: Results provided evidence that the antenatal Portuguese version of the Breastfeeding Self-Efficacy Scale-Short Form is a valid and reliable measure to assess breastfeeding self-efficacy in pregnant women. The antenatal version of the Breastfeeding Self-Efficacy Scale-Short Form could be a useful tool to assist Portuguese health professionals during routine prenatal care appointments to screen women with lower antenatal breastfeeding self-efficacy and, consequently, those that could be at risk for not initiating or early breastfeeding cessation.

Children's Sleep Habits Questionnaire - Infant Version / Questionário de Hábitos de Sono das Crianças - Versão de Neonatos

Abstract Objectives This study proposed a version of the Children's Sleep Habits Questionnaire for infants under 12 months (CSHQ-I). Methods The sample was comprised of 299 infants, aged between 2 weeks and 12 months. Results Exploratory factor analysis revealed four subscales: Bedtime Resistance, Sleep Anxiety, Positive Sleep Habits, and Daytime Sleepiness. The CSHQ-I total scale presented good test-retest reliability and internal consistency. The CSHQ-I also showed good concurrent validity, with significant associations found between the CSHQ-I total scale and subscales and a measure of infant sleep-wake behaviors. Conclusions The present study suggested the CSHQ-I as a reliable instrument to assess sleep problems in infants during the first year of life.

Resumo Objetivos Este estudo propôs uma versão do Questionário de Hábitos de Sono das Crianças para bebés com menos de 12 meses (CSHQ-I). Métodos Amostra composta de 299 bebés, entre duas semanas e 12 meses. Resultados A análise fatorial exploratória revelou quatros subescalas: resistência a ir para a cama, ansiedade do sono, hábitos de sono positivos e sonolência diurna. A escala completa do CSHQ-I apresentou boa confiabilidade teste-reteste e consistência interna. O CSHQ-I também mostrou boa validade concorrente, com associações significativas encontradas entre a escala completa e subescalas do CSHQ-I e uma medida de comportamentos de sono-vigília dos bebés. Conclusões O presente estudo sugeriu o CSHQ-I como um instrumento confiável para avaliar os problemas de sono em bebés durante o primeiro ano de vida.

Children's Sleep Habits Questionnaire - Infant Version.

OBJECTIVES: This study proposed a version of the Children's Sleep Habits Questionnaire for infants under 12 months (CSHQ-I). METHODS: The sample was comprised of 299 infants, aged between 2 weeks and 12 months. RESULTS: Exploratory factor analysis revealed four subscales: Bedtime Resistance, Sleep Anxiety, Positive Sleep Habits, and Daytime Sleepiness. The CSHQ-I total scale presented good test-retest reliability and internal consistency. The CSHQ-I also showed good concurrent validity, with significant associations found between the CSHQ-I total scale and subscales and a measure of infant sleep-wake behaviors. CONCLUSIONS: The present study suggested the CSHQ-I as a reliable instrument to assess sleep problems in infants during the first year of life.

Exclusive breastfeeding at three months and infant sleep-wake behaviors at two weeks, three and six months.

This study assessed infant sleep-wake behavior at two weeks, three and six months as function of feeding method at three months (exclusively breastfed, partially breastfed, and exclusively formula fed infants). Mothers of 163 first-born, full-term, normal birth weight, healthy infants completed socio-demographic, depression, anxiety, and infant sleep-wake behavior measures. No effects were found for sleep arrangements, depression or anxiety, on feeding methods and sleep-wake behavior at three months. At two weeks exclusively breastfed infants at three months spent more hours sleeping and less hours awake during the 24-h period than partially breastfed infants. At three months, exclusively breastfed infants had a shorter of the longest sleep period at night than exclusively formula fed infants. At six months, exclusively breastfed infants at three months spent more hours awake at night than partially breastfed infants, awake more at night than exclusively formula fed infants, and had a shorter sleep period at night than partially breastfed and exclusively formula fed infants. This study showed differences in sleep-wake behaviors at two weeks, three and six months, when exclusively breastfed infants are compared with partially breastfed and exclusively formula fed infants at three months, while no effects were found for sleep arrangements, depression or anxiety.

Infant sleep-wake behaviors at two weeks, three and six months.

Although infant sleep-wake behavior presents several developmental changes during the first six months, literature lacks on reference values and few studies have explored the role of individual change and stability on infant sleep-wake behavior during the first six months. This study aimed (1) to describe infant sleep-wake behaviors during the 24-h period, day and night, at two weeks, three, and six months, (2) and to explore developmental changes and the role of individual change and stability on infant sleep-wake behaviors from two weeks to six months. Ninety-four primiparous mothers completed measures on infant sleep-wake behaviors at two weeks, three and six months. Significant developmental changes were found on infant sleep-wake behaviors from two weeks to six months. Two-week-old infants sleep 13.3h, spend 8.7h awake, awake 6.1 times, have 0.4h of latency to sleep, and 3.2h of longest sleep period. Three-month-old infants sleep 13.0h, spend 9.2h awake, awake 5.5 times, have 0.4h of latency to sleep, and 5.2h of longest sleep period. Six-month-old infants sleep 12.2h, spend 10.0h awake, awake 5.2 times, have 0.4h of latency to sleep, and 5.6h of longest sleep period. Significant individual change and stability were also found on infant sleep-wake behaviors from two weeks to six months. Despite significant developmental and individual changes, individual stability explains a significant amount of the variance on infant sleep-wake behaviors over the first six months of life.

Breastfeeding and depression: a systematic review of the literature.

BACKGROUND: Research has separately indicated associations between pregnancy depression and breastfeeding, breastfeeding and postpartum depression, and pregnancy and postpartum depression. This paper aimed to provide a systematic literature review on breastfeeding and depression, considering both pregnancy and postpartum depression. METHODS: An electronic search in three databases was performed using the keywords: "breast feeding", "bottle feeding", "depression", "pregnancy", and "postpartum". Two investigators independently evaluated the titles and abstracts in a first stage and the full-text in a second stage review. Papers not addressing the association among breastfeeding and pregnancy or postpartum depression, non-original research and research focused on the effect of anti-depressants were excluded. 48 studies were selected and included. Data were independently extracted. RESULTS: Pregnancy depression predicts a shorter breastfeeding duration, but not breastfeeding intention or initiation. Breastfeeding duration is associated with postpartum depression in almost all studies. Postpartum depression predicts and is predicted by breastfeeding cessation in several studies. Pregnancy and postpartum depression are associated with shorter breastfeeding duration. Breastfeeding may mediate the association between pregnancy and postpartum depression. Pregnancy depression predicts shorter breastfeeding duration and that may increase depressive symptoms during postpartum. LIMITATIONS: The selected keywords may have led to the exclusion of relevant references. CONCLUSIONS: Although strong empirical evidence regarding the associations among breastfeeding and pregnancy or postpartum depression was separately provided, further research, such as prospective studies, is needed to clarify the association among these three variables. Help for depressed pregnant women should be delivered to enhance both breastfeeding and postpartum psychological adjustment.