Social support buffers the impact of pregnancy stress on perceptions of parent-infant closeness during the COVID-19 pandemic.

Pregnant individuals and parents have experienced elevated mental health problems and stress during COVID-19. Stress during pregnancy can be harmful to the fetus and detrimental to the parent-child relationship. However, social support is known to act as a protective factor, buffering against the adverse effects of stress. The present study examined whether (1) prenatal stress during COVID-19 was associated with parent-infant closeness at 6 months postpartum, and (2) social support moderated the effect of prenatal stress on the parent-infant relationship. In total, 181 participants completed questionnaires during pregnancy and at 6 months postpartum. A hierarchical linear regression analysis was conducted to assess whether social support moderated the effect of stress during pregnancy on parent-infant closeness at 6 months postpartum. Results indicated a significant interaction between prenatal stress and social support on parents' perceptions of closeness with their infants at 6 months postpartum (ß = .805, p = .029); parents who experienced high prenatal stress with high social support reported greater parent-infant closeness, compared to those who reported high levels of stress and low social support. Findings underscore the importance of social support in protecting the parent-infant relationship, particularly in times of high stress, such as during the COVID-19 pandemic.

Individuos y progenitores en estado de embarazo experimentan elevados problemas de salud mental y estrés durante el COVID-19. El estrés durante el embarazo puede ser dañino para el feto y perjudicial para la relación progenitor-niño. Sin embargo, es sabido que el apoyo social actúa como un factor de protección, sirviendo como agente amortiguador contra los adversos efectos del estrés. El presente estudio longitudinal examinó si 1) el estrés prenatal durante el COVID-19 se asociaba con la cercanía madre-infante a los seis meses después del parto, y 2) el apoyo social moderaba el efecto del estrés prenatal en la relación madre-infante. Un total de 181 participantes completaron cuestionarios durante el embarazo y a los seis meses después del parto. Un análisis de regresión lineal jerárquico se llevó a cabo para evaluar si el apoyo social moderaba el efecto del estrés durante el embarazo en cuanto a la cercanía progenitor-infante a los seis meses después del parto. Los resultados indicaron una interacción significativa entre el estrés prenatal y el apoyo social sobre las percepciones que los progenitores tenían de la cercanía con sus infantes a los seis meses después del parto (ß = .805, p = .029); los progenitores que experimentaron un alto estrés prenatal con un alto apoyo social reportaron una mayor cercanía progenitor-infante, comparados con aquellos que reportaron altos niveles de estrés y bajo apoyo social. Los resultados subrayan la importancia del apoyo social para proteger la relación progenitor-infante, particularmente en épocas de alto estés, tal como durante la pandemia del COVID-19.

Les personnes enceintes et les parents font l'expérience de plus grands problèmes de santé mentale et de plus de stress durant la crise du COVID-19. Le stress durant la grossesse peut être néfaste pour le foetus et vient au détriment de la relation parent-enfant. Cependant l'on sait que le soutien social est un facteur de protection, faisant tampon face aux effets adverses du stress. Cette étude longitudinale a examiné si 1) le stress prénatal durant le COVID-19 était lié à la proximité mère-nourrisson à six mois postpartum, et 2) le soutien social a modéré l'effet du stress prénatale sur la relation mère-nourrisson. En tout 181 participants ont rempli des questionnaires durant la grossesse et à sic mois postpartum. Une analyse de régression linéaire hiérarchique a été faite pour évaluer si le soutien social a modéré l'effet du stress durant la grossesse sur la proximité parent-nourrisson à six mois postpartum. Les résultats ont indiqué une interaction importante entre le stress prénatal et le soutien social sur les perceptions des parents de la proximité avec leurs nourrissons à six mois postpartum (ß = ,805, p = ,029); les parents qui ont fait l'expérience d'un stress prénatal élevé avec un soutien social élevé ont signalé une plus grande proximité parent-nourrisson, comparé à ceux ayant signalé des niveaux de stress élevés et un faible soutien social. Les résultats soulignent l'importance du soutien social dans la protection de la relation parent-nourrisson, particulièrement en temps de stress élevé, comme durant la pandémie de COVID-19.

Within-individual relationships between mother-to-infant bonding and postpartum depressive symptoms: a longitudinal study.

BACKGROUND: Although the importance of the dynamic intra-individual relationship between mother-to-infant bonding and postpartum depressive symptoms has been widely recognized, the complex interplay between them is not well understood. Furthermore, the potential role of prenatal depressive symptoms and infant temperament in this relationship remains unclear. This study aims to examine the bidirectional influence of mother-to-infant bonding on postpartum depressive symptoms within individuals and to elucidate whether prenatal depressive symptoms and infant temperament would influence deviations from stable individual states. METHODS: Longitudinal data were collected from 433 women in early pregnancy. Of these, 360 participants completed the main questionnaires measuring impaired mother-to-infant bonding and postpartum depressive symptoms at least once during the postpartum period. Data were collected at early and late pregnancy and several postpartum time points: shortly after birth and at one, four, ten, and 18 months postpartum. We also assessed prenatal depressive symptoms and infant temperament. A random-intercept cross-lagged panel model was used. RESULTS: Within-individual variability in mother-to-infant bonding, especially anger and rejection, significantly predicted subsequent postpartum depressive symptoms. However, the inverse relationship was not significant. Additionally, prenatal depressive symptoms and difficult infant temperament were associated with greater within-individual variability in impaired mother-to-infant bonding and postpartum depressive symptoms. CONCLUSIONS: The present study demonstrated that the within-individual relationship between mother-to-infant bonding and postpartum depressive symptoms is likely non-bidirectional. The significance of the findings is underscored by the potential for interventions aimed at improving mother-to-infant bonding to alleviate postpartum depressive symptoms, suggesting avenues for future research and practice.

Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study.

BACKGROUND: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents' cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. METHODS: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children's Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. RESULTS: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents' and mothers' perspectives as associated with adolescents' MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. CONCLUSIONS: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence.

Effect modifications of BMI transition and trajectory in the associations of adverse childhood experiences with new-onset dementia and its subtypes in older US adults.

Background: Adverse childhood experiences (ACEs) and dementia are associated and comorbid with obesity. However, according to emerging research, the role of obesity in the association between ACEs and dementia seems controversial. Aims: This analysis aimed to explore the associations between ACEs and different dementia subtypes and the effect modification of long-term body mass index (BMI). Methods: Data were obtained from the US Health and Retirement Study. Six ACEs were categorised as 0, 1 and 2 or more. All-cause dementia, Alzheimer's disease (AD) and other dementias were defined by self-reported or proxy-reported physician diagnosis. Cox proportional hazards regression was used to explore the associations of ACEs with new-onset all-cause dementia, AD and other dementias from 2010 to 2020. Effect modification of BMI in 2010 and BMI transition and trajectory (fitted by group-based trajectory modelling) from 2004 to 2010 were assessed. Results: 15 282 participants with a mean age of 67.0 years (58.0-75.0) were included in the 2010 data analysis. Significant interactions of ACEs with baseline BMI, BMI transition and BMI trajectory in their associations with new-onset all-cause dementia and AD were observed (all p<0.05). For instance, positive associations of two or more ACEs (vs none) with all-cause dementia and AD were found in those with a BMI trajectory of maintaining ≥30 kg/m2 (maintain obesity) rather than a decline to or maintaining <25 kg/m2 (decline to or maintain normal weight), with hazard ratios (HRs) of 1.87 (95% confidence interval (CI): 1.45 to 2.42) and 1.85 (95% CI: 1.22 to 2.80), respectively. Conclusions: ACEs were associated with dementia and AD in US adults with long-term abnormally elevated BMI but not with long-term normal or decreasing BMI. Integrated weight management throughout life could prevent dementia among those with childhood adversity.

Relationship among Maternal Perception of Childbirth Experience, Spiritual Health and Maternal-Infant Relationship in the Postpartum Women: A Cross-Sectional Study.

Background: Birth represents an influential moment in women's lives that can be a powerful or traumatic experience. Therefore, the aim of this study was to assess the relationship among maternal perception of childbirth experience, spiritual health, and maternal-infant relationship in the postpartum women. Materials and Methods: This descriptive-analytical study was conducted on 305 postpartum women referred to Health Centers in Karaj. The data were collected using the Perception of Birth Scale (POBS), maternal postnatal relationship scale, and spiritual health questionnaire. Results: In this study, the mean (standard deviation (SD) age of the participants was 27.50 (5.56) years. The Spearman's correlation test results showed that there was a significant positive relationship among the maternal perception of childbirth experience, the general maternal-infant relationship (r = 0.34, p < 0.001), quality of relationship (r = 0.17, p = 0.002), pleasure with interaction (r = 0.32, p < 0.001), and absence of hostility (r = 0.28, p < 0.001). In addition, a positive relationship was observed among spiritual health and general maternal-infant relationship (r = 0.21, p < 0.001), pleasure in interaction (r = 0.08, p = 0.164), absence of hostility (r = 0.15, p = 0.008), and the maternal perception of childbirth experience (r = 0.11, p = 0.039). Conclusions: It seems that to promote maternal-infant relationship, health care providers should not only try to promote physical intimacy between mother and infant but also create a positive emotional state for the mother during birth.

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.

Idealização da maternidade e herança psíquica: reflexões no contemporáneo / Idealization of motherhood and psychic heritage: reflections in the contemporary / Idealización de la maternidad y herencia psíquica: reflexiones en lo contemporáneo

Considerando as transformações na maternidade ao longo da história e a atual crise identitária na relação da mulher com a maternidade, ou seja, o conflito entre os ideais de maternidade relacionados à figura da mulher/mãe e as demandas contemporâneas de realização individual no trabalho, realizou-se este estudo transversal, exploratório-descritivo de abordagem qualitativa, cujo objetivo consistia em descrever e analisar, a partir da psicanálise de casal e família, a experiência de mães que abandonaram da carreira profissional para a dedicação exclusiva à maternidade. Foram entrevistadas oito mulheres de classe média, entre 30 e 50 anos, que eram mães e abandonaram suas carreiras profissionais para se dedicarem à maternidade. As entrevistas que compuseram os resultados foram transcritas e as análises de conteúdo temática apontaram as múltiplas exigências, tanto sociais, quanto relacionadas à herança psíquica, que trazem implicações para a construção identitária dessas mulheres. Concluímos que um processo de elaboração dessa herança exige uma rede vincular de apoio e pressupõe a desidealização da maternidade, entendendo-a como plural, tanto no sentido de ser múltipla e diversa, quanto no sentido de ser uma construção vincular.

Noticing the history transformations in motherhood, and the current identity crisis in the woman's relationship between femininity and maternity, that is, the conflict between the ideas of motherhood related to the figure of the woman/mother and the contemporary demands of individual realization at work, this exploratory-descriptive, cross-sectional, study of a qualitative approach was carried out, whose objective was to describe and analyze, from the perspective of psychoanalysis of the linking configurations, the experience of mothers who abandoned the professional career for the exclusive dedication to motherhood. Eight middle-class women, aged between 30 and 50, who were mothers and abandoned their professional careers to dedicate themselves to motherhood-retirar, were interviewed. The interviews that composed the results were transcribed, and thematic content analyses pointed out the multiple demands, both social and related to psychic heritage, which have implications for the identity construction of these women. We conclude that an elaboration of this heritage requires a link network of support and presupposes the non-idealization of motherhood, understanding it as plural, both in the sense of being multiple and diverse, and in the sense of being a bonding construction.

Considerando los cambios en la maternidad a lo largo de la historia y la actual crisis de identidad en la relación de la mujer con la maternidad, es decir, el conflicto entre los ideales de maternidad relacionados con la figura de la mujer/madre y las demandas contemporáneas de realización individual en el trabajo, se realizó este estudio transversal, exploratorio-descriptivo de abordaje cualitativo, cuyo objetivo consistía en describir y analizar, a partir del psicoanálisis de las configuraciones vincular, la experiencia de madres que abandonaron de la carrera profesional para la dedicación exclusiva a la maternidad. Fueron entrevistadas ocho mujeres de clase media, entre 30 y 50 años. que eran madres y abandonaron sus carreras profesionales para dedicarse a la maternidad-retirar. Las entrevistas que compusieron los resultados fueron transcritas y los análisis de contenido temático señalaron las múltiples exigencias, tanto sociales, como relacionadas a la herencia psíquica, que traen implicaciones para la construcción identitaria de esas mujeres. Concluimos que un proceso de elaboración de esa herencia exige una red vincular de apoyo y presupone la desidealización de la maternidad, entendiéndola como plural, tanto en el sentido de ser múltiple y diversa, como en el sentido de ser una construcción vincular.

Maternal Knowledge of Oral Health During Pregnancy and Childbirth.

OBJECTIVE: This cohort study was to investigate maternal knowledge of the oral health of woman and children during pregnancy and after childbirth, and the associated factors. METHODS: Groups of women participating in a public prenatal dental care programme in Brazil were assessed, in two different stages. In the first stage, pregnant women were assessed for their own oral health. In the second stage, after childbirth, women were assessed for the oral health of their child. The examiner assigned a maternal knowledge score to the questionnaires, considering the ideal alternatives within the context of oral health promotion as correct answers. Statistical analysis included the Kruskal-Wallis and multiple linear regression tests, considering a level of significance of P < 0.05. RESULTS: Ninety-eight women were included in the study, with a mean age 26.27 years (SD 6.51). In the regression analysis, the maternal knowledge score was associated with the presence of myths about oral health (P < 0.01), the children first dental appointment in the first year of life (P = 0.07), the presence of a non-nutritious sucking habit (P < 0.01), considering dental treatment to be important during pregnancy (P < 0.01), and having been instructed on oral health during pregnancy (P < 0.01) and after the children birth (P = 0.02). CONCLUSION: This study suggests that the women showed a regular score of knowledge about their oral health and that of their children, as they still believed in some myths about oral health and the risks of dental treatment during pregnancy. Women who received guidance on oral health in pregnancy and after birth showed higher knowledge of their oral health and that of their children, demonstrating the importance of carrying out health promotion actions during pregnancy and the first years of the child's life.

Síntesis de teoría de la percepción materna del peso corporal del hijo / Síntese da teoria da percepção materna do peso corporal do filho / Theory synthesis of maternal perception of her child’s body weight

To build a middle range theory of maternal perception of her child´s body weight. Thismiddle range theory was built deductively from the concept of social perception and from researchliterature published following the steps of theory synthesis. This theory has inputs, and the maternal perception of her child´s body weight is the outcome, that influence on maternal attitudes, andbehaviors related to the child’s body weight. This theory offers an explanation how mothers builda judgement about their child’s body weight. The professionals could work with the factors thatinfluence the maternal perception of her child´s body weight.(AU)

Desarrollar una teoría de rango medio de la percepción materna del peso corporal delhijo. Esta teoría fue desarrollada de forma deductiva a partir del concepto de percepción social y dehallazgos científicos publicados, siguiendo los pasos de síntesis de teoría. Esta teoría tiene elementos de entrada y la percepción maternal del peso del hijo es el resultado, que influye en las actitudesy conductas maternas relacionadas al peso corporal del hijo. Esta teoría ofrece una explicación decómo las madres construyen el juicio respecto al peso corporal de su hijo. Los profesionales podríantrabajar con los factores que influyen en la percepción materna del peso corporal del hijo.(AU)

Desenvolver uma teoria de classe média da percepção materna do peso corporal do filho.Essa teoria foi desenvolvida dedutivamente a partir do conceito de percepção social e descobertascientíficas publicadas, seguindo as etapas de síntese da teoria. Essa teoria tem elementos de entradae o resultado é a percepção materna do peso corporal do filho, que influencia as atitudes e comportamentos maternos relacionados ao peso corporal do filho. Essa teoria oferece uma explicação decomo as mães constroem seu julgamento sobre o peso corporal do seu filho. Os profissionais poderiam trabalhar com os fatores que influenciam a percepção materna sobre o peso corporal do filho.(AU)

Maternal perinatal depression and child neurocognitive development: A relationship still to be clarified.

Pregnancy frequently is associated with emotional conditions such as anxiety and depression. Perinatal depression has an incidence of around 12%. Only recently researcher put the attention on the effects of pre- and postpartum psychopathology on infant neurocognitive development. Neurobiology studies indicate that perinatal maternal depression can significantly affect the structure and function of children's prefrontal cortex and modulate the development of cognitive abilities from intrauterine life. On the topic, the scientific literature appears ambiguous, reporting mixed results. Some studies have found no significant differences in developmental outcomes between prenatal and postpartum exposure to maternal depression, others have suggested a greater burden of depression in pregnancy than in postpartum, and still others have emphasized the role of chronicity of symptoms rather than the period of onset. Few studies have examined the effects of different developmental trajectories of maternal depression on children's neurocognitive outcomes. The assessment of maternal health has for years been limited to postpartum depression often neglecting the timing of onset, the intensity of symptoms and their chronicity. These aspects have received less attention than they deserve, especially in relation to the effects on children's neurocognitive development. The aim of this Perspective was to highlight inconsistencies and gaps that need to be filled in the approach to the study of this problem. Given the wide heterogeneity of data in the current literature, further studies are needed to clarify these interactions. This Perspective provides an overview of current progress, future directions, and a presentation of the authors' views on the topic.

The effect of instructing mothers in attachment behaviors on short-term health outcomes of premature infants in NICU.

BACKGROUND: The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs). MATERIAL AND METHODS: In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother-infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant's Maternal Attachment Assessment Strategy. Moreover, infants' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis. RESULTS: On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4-42/11) and 37 (31/85-42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05). CONCLUSION: Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants.

Breastfeeding Aversion Response (BAR): A Descriptive Study.

INTRODUCTION: For many women, breastfeeding their infant is an enjoyable experience. Some, however, have reported negative sensations such as an overwhelming need to unlatch while breastfeeding. This phenomenon is known as breastfeeding aversion response (BAR). The incidence of BAR is unknown and literature on this experience is limited. This study therefore aimed to expand the understanding of BAR using an online survey targeting those who have experienced feelings of aversion while breastfeeding. METHODS: An online survey was distributed within Australia using purposive sampling to those who self-identified as experiencing BAR. This survey contained 5 sections: (1) demographics and health-related characteristics, (2) breastfeeding difficulties and onset of BAR, (3) the experience of BAR, (4) birth and breastfeeding experience, and (5) coping with BAR and support. Questions were included to test the generalizability of previous qualitative findings on BAR. RESULTS: Participants (N = 210) predominantly were aged between 25 and 35 years (69.2%), were in a relationship (96.2%), and had one child (80%). BAR was more commonly experienced when feeding the first-born child (44.8%), breastfeeding while pregnant (31%), or tandem feeding (10%). The feelings of aversion were experienced by most respondents throughout the feed while the child was latched (76.7%). More than half (52.4%) of participants reported that BAR had caused them to end breastfeeding sessions before their child was ready to stop feeding. Almost half of the participants (48.6%) reported receiving no support from a health care provider for BAR. DISCUSSION: This study contributes new information about the experience of BAR, including when it commonly happens and who may be at greater risk. More support is needed for women who want to breastfeed while experiencing BAR. New public health policies which promote breastfeeding are needed to help women achieve satisfying breastfeeding experiences and meet their own breastfeeding goals.

Maternal educational practices and mental health disorders of school-age children

Abstract Objective: To investigate the association between emotional and behavioral difficulties in schoolchildren and maternal educational practices. Methods: Participants and Setting: 631 mother-child pairs were evaluated in a poor urban district in Recife, northeastern Brazil. Cross-sectional study carried out between 2013 and 2014. It integrates a prospective cohort study designed to investigate the consequences of intimate partner violence that occurred during pregnancy, postpartum, and seven years after birth for the physical and mental health of women and their children. Maternal educational practices were assessed using the Parent-Child Conflict Tactics Scale (CTSPC - mother-child version) and the child's behavioral and emotional disorders through the Strengths and Difficulties Questionnaire (SDQ) mother-version. The association was estimated through crude and adjusted prevalence ratios, using Poisson regression considering the 95% confidence interval. Results: The prevalence of violent maternal educational practices was 91.8% (572/631) being 89.7% (566/631) of psychological aggression and 75.6% of physical aggression, subdivided into corporal punishment (73.5%), physical maltreatment (35.8%) and severe physical maltreatment (1.7%). Corporal punishment (Adjusted PR 1.5; CI 95%: 1.1-2.1; p = 0.010) and severe physical maltreatment (Adjusted PR 1.9; CI 95%: 1.3-2.8; p = 0.002) were associated with emotional and behavioral difficulties in schoolchildren. Conclusion: The high prevalence of violent maternal educational practices, especially corporal punishment and severe physical maltreatment is associated with emotional and behavioral disorders in children. Therefore, it is necessary to interventions that promote parental support and effective use of non-violent discipline in conducting the educational process to establish healthier family relationships and to prevent/mitigate the impact of emotional and behavioral problems in children. © 2022 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

The role of midwives in supporting the development of the mother-infant relationship: a scoping review.

BACKGROUND: The mother-infant relationship is complex and dynamic, informing the psychological development of the infant through bonding and attachment. Positive early interactions influence the quality of this relationship. Midwives are well placed to support the developing relationship between the mother and baby, yet there has been limited research exploring the role of the midwife in this context. AIM: To explore interventions that have been provided by the midwife which support the development of the maternal-fetal or mother-infant relationship amongst a low-risk population from pregnancy, and up to six weeks postnatal. The review also sought to understand the types of interventions developed, format and delivery, outcomes measured and if cultural considerations had been incorporated. METHODS: A scoping review of the research literature was undertaken using the Joanna Briggs Institute framework. Five online databases were searched for relevant articles published in English from 2000 to 2021. FINDINGS: Sixteen articles met the inclusion criteria. Three themes emerged: (1) viewing the fetus as separate from the mother, (2) focused activities on the maternal-infant relationship and (3) targeted educational interventions. DISCUSSION: Providing focused activities and targeted education during the pre and postnatal periods support the development of the mother-infant relationship. Significantly, there was insufficient research that considered the influence of culture in supporting the mother-infant relationship. CONCLUSION: Further research is required to develop interventions that include a diverse sample to ensure culturally appropriate activities can be integrated into care during pregnancy and/or the postnatal period provided by midwives.

Instruments to measure interaction of mothers and newborns: A systematic review.

Interactions between newborns and their parents/primary caregivers are characterized by asymmetric and dependent relationships. This systematic review mapped, identified, and described the psychometric parameters, categories, and items of instruments used to assess mother-newborn interaction. Seven electronic databases were accessed in this study. Furthermore, this research included neonatal interaction studies describing instruments' items, domains, and psychometric properties while excluding studies that focused on maternal interactions and lacked items for assessing newborns. Additionally, studies validated with older infants that did not have a newborn in the sample were used for test validation, which is a criterion used to decrease the risk of bias. Fourteen observational instruments from 1047 identified citations were included that addressed interactions using varying techniques, constructs, and settings. Particularly, we focused on observational settings that assessed interactions with communication-based constructs in the context of proximity or distance as influenced by physical, behavioral, or procedural barriers. These tools are also used to predict risk behaviors in a psychological context, mitigate feeding difficulties, and conduct neurobehavioral assessments of mother-newborn interactions. The elicited imitation was also an observational setting. This study found that the most described properties in the included citations were inter-rater reliability followed by criterion validity. However, only two instruments reported content, construct, and criterion validity, as well as a description of an internal consistency assessment and inter-rater reliability. Finally, the synthesis of the instruments reported in this study can guide clinicians and researchers in selecting the most appropriate one for their own application.

Associations between maternal postpartum depression and infant temperament in treatment-seeking mothers prior to and during the COVID-19 pandemic.

It remains unclear how the COVID-19 pandemic has affected the mother-infant relationship and associations between maternal postpartum depression (PPD) and offspring temperament. This study examined the impact of the pandemic on these links and how maternal ratings of the mother-infant relationship mediated associations between PPD and infant temperament in a sample of treatment-seeking mothers in Ontario, Canada before and during the COVID-19 pandemic. Mothers with infants <12 months of age and Edinburgh Postnatal Depression Scale scores ≥10 enrolled in two separate randomized controlled trials of 1-day cognitive behavioral therapy-based workshops for PPD conducted before COVID-19 (n = 392) and during the pandemic (n = 403). Mothers reported on depressive symptomatology, infant temperament, and the mother-infant relationship. Maternal PPD was associated with more infant negative affectivity and mother-infant relationship difficulties. While associations between PPD and infant-focused anxiety were stronger during COVID-19, the pandemic did not otherwise affect associations between PPD and infant temperament. Mediation analyses suggested that aspects of the mother-infant relationship mediated associations between PPD and infant negative affectivity. Findings highlight the importance of detecting PPD and intervening to potentially improve outcomes for mothers and their children.

Maternal predictors of children's mental health in low-income families: A structural equation model.

Low-income populations are particularly susceptible to mental health problems, and the susceptibilities of family members may be interconnected. In particular, maternal factors are known to be linked to their children's outcomes. This study aims to investigate how maternal cognition, depression, and the mother-child relationship, as well as children's cognition, predict the mental health of children in low-income families. Pairs of mothers and children from families receiving governmental assistance were surveyed between January 2018 and March 2019. Korean versions of the following instruments were used: Strengths and Difficulties Questionnaire (children's mental health problems), Cognitive Triad Inventory for Children (children's cognition), Kerns' Security Scale (mother-child relationship), Center for Epidemiologic Studies Depression Scale (maternal depression), and Automatic Thoughts Questionnaire-Negative (maternal cognition). A structural equation model was used to examine how maternal cognition, depression, the mother-child relationship, and children's cognition predict children's mental health. Maternal negative cognition and depression mediated by the children's relationships with their mothers negatively predicted their cognition and mental health problems. Enhancing maternal mental health and a mother-child relationship can help improve positive cognition and mental health of children from low-income families.

Mothers' and Children's Mental Health During the COVID-19 Pandemic Lockdown: The Mediating Role of Parenting Stress.

The present study, carried out during the first peak of the COVID-19 outbreak in Italy, aimed at investigating the mental health of mothers and children during the nationwide lockdown. More specifically, the study investigated children's depression and mothers' individual distress and parenting stress, in comparison with normative samples. The mediating effect of mothers' parenting stress on the relationship between mothers' individual distress and children's depression was also explored. Finally, the study analyzed whether children's biological sex and age moderated the structural paths of the proposed model. A sample of 206 Italian mothers and their children completed an online survey. Mothers were administered self-report questionnaires investigating individual distress and parenting stress; children completed a standardized measure of depression. Mothers' individual distress and parenting stress and children's depression were higher than those recorded for the normative samples. Mothers' parenting stress was found to mediate the association between mothers' individual distress and children's depression. With respect to children, neither biological sex nor age emerged as significant moderators of this association, highlighting that the proposed model was robust and invariant. During the current and future pandemics, public health services should support parents-and particularly mothers-in reducing individual distress and parenting stress, as these are associated with children's depression.