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Family nurture intervention for preterm infants facilitates positive mother-infant face-to-face engagement at 4 months.

ABSTRACT: Although preterm infants are at risk for social deficits, interventions to improve mother-infant interaction in the neonatal intensive care unit (NICU) are not part of standard care (SC). Study participants were a subset from a randomized controlled trial of a new intervention for premature infants, the Family Nurture Intervention (FNI), designed to help mothers and infants establish an emotional connection. At infants' 4 months corrected age, mother-infant face-to-face interaction was filmed and coded on a 1-s time base for mother touch, infant vocal affect, mother gaze, and infant gaze. Time-series models assessed self- and interactive contingency. Comparing FNI to SC dyads, FNI mothers showed more touch and calmer touch patterns, and FNI infants showed more angry-protest but less cry. In maternal touch self-contingency, FNI mothers were more likely to sustain positive touch and to repair moments of negative touch by transitioning to positive touch. In maternal touch interactive contingency, when infants looked at mothers, FNI mothers were likely to respond with more positive touch. In infant vocal affect self-contingency, FNI infants were more likely to sustain positive vocal affect and to transition from negative to positive vocal affect. In maternal gaze interactive contingency, following infants' looking at mother, FNI mothers of male infants were more likely to look at their sons. In maternal gaze self-contingency, following mothers' looking away, FNI mothers of male infants were more likely to look at their sons. Documentation of positive effects of the FNI for 4-month mother-infant face-to-face communication is useful clinically and has important implications for an improved developmental trajectory of these infants. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

SUBMITTER: Beebe B

PROVIDER: S-EPMC6202224 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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Family nurture intervention for preterm infants facilitates positive mother-infant face-to-face engagement at 4 months.

Beebe Beatrice B Myers Michael M MM Lee Sang Han SH Lange Adrianne A Ewing Julie J Rubinchik Nataliya N Andrews Howard H Austin Judy J Hane Amie A Margolis Amy E AE Hofer Myron M Ludwig Robert J RJ Welch Martha G MG

Developmental psychology 20181004 11

Although preterm infants are at risk for social deficits, interventions to improve mother-infant interaction in the neonatal intensive care unit (NICU) are not part of standard care (SC). Study participants were a subset from a randomized controlled trial of a new intervention for premature infants, the Family Nurture Intervention (FNI), designed to help mothers and infants establish an emotional connection. At infants' 4 months corrected age, mother-infant face-to-face interaction was filmed an ...[more]

PMID: 30284883

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Project description:BackgroundPreterm infants have difficulty maintaining engagement throughout early oral feedings, which can lead to less efficient feeding and prolonged feeding skill development.ObjectiveTo examine contributions of the infant, mother, and feeding context to infant engagement during bottle-feeding.MethodsBottle-feedings of very-low-birthweight infants (n = 22) by their mothers were observed. Infant and maternal behaviors were coded and synchronized with physiologic measures. At completion of the feeding, the mothers were interviewed, and their working model of feeding coregulation was scored. Feedings were subdivided into feeding episodes (n = 114). Using multilevel linear regression analyses, four dyadic characteristics (working model of the caregiver's role as coregulator, birthweight, postconceptional age, baseline oxygen saturation) and five episode characteristics (readiness at episode onset, episode baseline oxygen saturation, mean oxygen saturation during the episode, maternal feeding behavior, and phase of feeding) were examined as potential predictors of feeding episode engagement.ResultsConditions observed during the feeding observation explained most of the variation in engagement. Engagement was more likely to occur during the early phase of feeding (p <.05), during feeding episodes that began with infant readiness (p <.05), and during feeding episodes with higher mean oxygen saturation during the episode (p <.05). Feeding episodes with less jiggling of the nipple had a significantly greater amount of engagement (p <.05).ConclusionsThe ability of the preterm infant to maintain engagement during bottle-feeding cannot be explained by characteristics of the infant or by the prefeeding condition of the infant alone. Rather, engagement is coregulated by the caregiver and the infant throughout the feeding. Strategies to assist infants in maintaining physiologic stability during bottle-feeding and further study of effective and contingent caregiver feeding behaviors are needed.

Project description:The last decades have seen an increasing interest in the phenomenon of yawning and the dynamics of its modulation, yet no widespread consensus exists on its origins and potential functions. Although most scholars have focused on its potential physiological functions, e.g., related to thermoregulation, arousal modulation or cortisol levels and distress, an emerging line of research has been also investigating the social implications of yawning, including its hypothesized relationship with empathy. In order to explore the dynamics of yawning modulation in infants, we investigated whether a social perturbation-like the one induced by the Face to Face Still Face paradigm, a procedure designed to assess socio-emotional regulation in infants-affects yawning and self-touch hand movements behavior in three-months old infants. As the Still Face episode represents a source of mild distress, we hypothesized that during this phase yawns would be more frequent. Moreover, through the use of path analysis, we investigated potential dynamics of facilitation, inhibition or covariance between the frequencies of these behavioral patterns. Our results showed a sharp increase in self-touch hand movements as well as in the likelihood of yawning during the stressful phase of the procedure (still-face) compared with the two minutes of face-to-face interaction and the reunion episode. Regressions also showed a higher incidence of yawns among girls, consistently with the hypothesis that the analysis of yawning behavior might capture subtle differences in regulatory strategies of infants, possibly related to the transient sex-specific activation of the hypothalamic-pituitary-gonadal axis known as mini-puberty. The path analysis showed a greater consistency between the frequencies of self-touch hand movements during the three episodes of the procedure, compared with yawning. This finding could be a result of distinct yawning-regulating mechanisms being at play in different conditions, e.g., a modulation related to stress and one to social interaction. Taken together, these results suggest that human yawning regulation is an irreducibly complex and multifaceted phenomenon since early age. Moreover, the gender differences highlighted might suggest an early diversification in yawning modulation.

Dataset Information

Family nurture intervention for preterm infants facilitates positive mother-infant face-to-face engagement at 4 months.

Publications

Family nurture intervention for preterm infants facilitates positive mother-infant face-to-face engagement at 4 months.

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