The Mother–Infant Feeding Relationship Across the First Year and the Development of Feeding Difficulties in Low‐Risk Premature Infants

Although feeding problems are common during infancy and are typically accompanied by relational difficulties, little research observed the mother–infant feeding relationship across the first year as an antecedent to the development of feeding difficulties. We followed 76 low‐risk premature infants and their mothers from the transition to oral feeding in the neonatal period to the end of the first year. Prior to hospital discharge, microlevel patterns of maternal touch and gaze were coded during feeding and nonfeeding interactions, global patterns of maternal adaptation were assessed, and infants' neurobehavioral status was tested. Psychomotor development was evaluated at 4 months. At 1 year, feeding difficulties were determined on the basis of maternal interview and direct observations of feeding interactions. Mothers of infants who exhibited feeding difficulties at 1 year showed less affectionate touch and gaze during nonfeeding interactions and more gaze aversion and lower adaptability during feeding interactions already in the neonatal period. Infants with feeding difficulties demonstrated poorer psychomotor performance at 4 months. Feeding interactions of infants with feeding difficulties at 1 year were characterized by higher maternal intrusiveness, lower infant involvement, and greater infant withdrawal. Less maternal affectionate touch and lower maternal adaptation in the neonatal period, poor infant psychomotor skills, and higher maternal intrusiveness and lower infant involvement at 1 year predicted feeding difficulties. The findings underscore the role of the relational components across the first year in the development of feeding difficulties.     

Gaze Behaviors of Preterm and Full‐Term Infants in Nonsocial and Social Contexts of Increasing Dynamics: Visual Recognition,Attention Regulation,and Gaze Synchrony

Although research has demonstrated poor visual skills in premature infants, few studies assessed infants’ gaze behaviors across several domains of functioning in a single study. Thirty premature and 30 full‐term 3‐month‐old infants were tested in three social and nonsocial tasks of increasing complexity and their gaze behavior was micro‐coded. In a one‐trial version of the visual recognition paradigm, where novel stimuli were paired with familiar stimuli, preterm infants showed longer first looks to novel stimuli. In the behavior response paradigm, which presented infants with 17 stimuli of increasing complexity in a predetermined “on‐off” sequence, premature infants tended to look away from toys more during presentation. Finally, during mother–infant face‐to‐face interaction, the most dynamic interpersonal context, preterm infants and their mothers displayed short, frequent episodes of gaze synchrony, and lag‐sequential analysis indicated that both mother and infant broke moments of mutual gaze within 2 sec of its initiation. The propotion of look away during the behavior response paradigm was related to lower gaze synchrony and more gaze breaks during mother–infant interactions. Results are discussed in terms of the unique and adaptive gaze patterns typical of low‐risk premature infants.     

Does social modeling increase infants’ willingness to accept unfamiliar foods?

Despite a rich knowledge base about infants’ social learning and studies observing social referencing in other species in food contexts, we know surprisingly little about social learning about food among human infants. This gap in the literature is particularly surprising considering that feeding unfamiliar foods to infants is a very common experience as infants begin to eat solid foods. The present study examines whether parental social modeling influences infants’ willingness to accept unfamiliar foods. In two Zoom sessions, parents will be asked to feed unfamiliar foods to their 6- to 24-month-old infants (different unfamiliar foods in each session). In both sessions, infants’ food acceptance and rejection will be measured. In the first session, parents will be asked to do what they would typically do; spontaneous social modeling will be recorded. In the second session, parents will be instructed to model eating the unfamiliar food. We will examine associations between infants’ willingness to eat unfamiliar foods, parent social modeling, and extant parent and infant characteristics.     

The Effects of Alcohol in Breast Milk on Infant Behavioral State and Mother‐Infant Feeding Interactions

The short‐term impact of infant exposure to alcohol in breast milk on mother‐infant interactions and infant arousal was examined. Fourteen mother‐infant dyads were tested on 2 occasions that consisted of an alcohol administration and a nonalcohol condition. Mother‐infant interactions during feeding were videotaped and coded for dyadic reciprocity, maternal noncontingency, and dyadic conflict. Infants were observed for 1 hr after receiving either plain breast milk or breast milk containing alcohol. Behavioral state, startles, and tremors were recorded every 30 sec. Mother‐infant interactions were characterized by higher noncontingency and dyadic conflict in the alcohol condition. After drinking breast milk containing alcohol, infants changed behavioral state more often, startled more, and spent less time in quiet sleep and more time in quiet alert and crying states. These findings suggest that exposure to breast milk containing alcohol may not have a sedating effect, as commonly believed.     

Maternal Into‐The‐Face Behavior,Shared Attention,and Infant Distress During Face‐to‐Face Play at 12 Months: Bi‐directional Contingencies

We describe a new maternal intrusion behavior, moving a toy or hand “into‐the‐face” of the infant, and we investigate its bi‐directional associations with infant‐initiated shared attention, infant distress, and infant gaze, during mother–infant face‐to‐face play at 12 months. The play was videotaped split‐screen, with infants seated in a high chair. Videotapes were coded on a 1‐sec time base for mother and infant gaze (at partner, toy, both, or gaze away); infant distress; and maternal intrusion behavior, “into‐the‐face.” We defined “infant‐initiated shared attention” as mother and infant looking in the same second at a toy that the infant‐initiated interest in. We documented that maternal into‐the‐face behavior decreased the likelihood of infant‐initiated shared attention, increased the likelihood of infant distress, and decreased the likelihood of infant gazing away. Reciprocally, infant distress and gazing away increased the likelihood of mother into‐the‐face. In moments when the dyad was engaged in infant‐initiated shared attention, mother into‐the‐face was less likely. This work documents bi‐directional contingencies in the regulation of maternal intrusion and infant behavior during face‐to‐face play at 12 months. We suggest that mother into‐the‐face behavior disturbs an aspect of the infant's experience of recognition.     

Patterns of positivity: Positive affect trajectories among infants of mothers with a history of depression

This study examined positive affect (PA) trajectories over the first year of life among infants of mothers with a history of depression (N = 191) as well as predictors (i.e., maternal prenatal and postpartum depression symptoms, maternal parenting behaviors) of those trajectories. Infant PA was observed in play and feeding tasks during laboratory visits at 3, 6, and 12 months of age; parenting behaviors were observed at 3 months. Mothers completed questionnaires regarding their symptoms of depression throughout the prenatal period and during the first 3 months postpartum. Growth curve analyses indicated that infant PA increased across time, and this finding replicated across both the play and feeding tasks, though increases slowed over time. Neither maternal prenatal nor postpartum depression symptoms predicted infants' PA trajectories, but mothers' PA, positive parenting, and disengaged parenting were associated with infant PA during the play task. Our finding that infant PA increased over the first year postpartum suggests PA trajectories among infants of mothers with a history of depression may be indices of resilience, despite risks associated with their mothers' history of depression. Furthermore, this study highlights parenting behaviors that may be important targets of prevention and early intervention efforts to bolster infant PA.     

Attention to Maternal Multimodal Naming by 6‐ to 8‐Month‐Old Infants and Learning of Word–Object Relations

We examined whether mothers' use of temporal synchrony between spoken words and moving objects, and infants' attention to object naming, predict infants' learning of word–object relations. Following 5 min of free play, 24 mothers taught their 6‐ to 8‐month‐olds the names of 2 toy objects, Gow and Chi, during a 3‐min play episode. Infants were then tested for their word mapping. The videotaped episodes were coded for mothers' object naming and infants' attention to different naming types. Results indicated that mothers' use of temporal synchrony and infants' attention during play covaried with infants' word‐mapping ability. Specifically, infants who switched eye gaze from mother to object most frequently during naming learned the word–object relations. The findings suggest that maternal naming and infants' word‐mapping abilities are bidirectionally related. Variability in infants' attention to maternal multimodal naming explains the variability in early lexical‐mapping development.     

Individual Differences in the Contribution of Maternal Soothing to Infant Distress Reduction

This study investigates individual differences in the contribution of specific maternal regulatory behaviors to the mother‐infant dyad's regulation of infant distress response. Additionally, we examined the stability of infants' stress responses and the stability of specific maternal soothing behaviors. The sample included 128 mother‐infant dyads that were observed during an inoculation at 2 and 6 months. The average intensity of infant cry response showed modest stability across age only before controlling for the infant's general state of irritability, and the duration of crying was not stable. Of the 8 specific maternal regulatory behaviors studied, affection, touching, and vocalizing showed the strongest stability across infant age. Finally, an index of the contingency between maternal soothing and infant cry reduction at 2 months predicted shorter cry duration but not cry intensity at 6 months. The results of this study indicate that infants whose mothers showed a greater contribution to reducing their distress at 2 months showed a shorter duration of crying 4 months later. This suggests a possible longitudinal influence of maternal regulation on infants' distress responses.     

Maternal Sensitivity and the Learning‐Promoting Effects of Depressed and Nondepressed Mothers' Infant‐Directed Speech

The hypothesis that aspects of current mother‐infant interactions predict an infant's response to maternal infant‐directed speech (IDS) was tested. Relative to infants of nondepressed mothers, those of depressed mothers acquired weaker voice‐face associations in response to their own mothers' IDS in a conditioned‐attention paradigm, although this was partially attributable to demographic differences between the 2 groups. The extent of fundamental frequency modulation (ΔF₀) in maternal IDS was smaller for infants of depressed than nondepressed mothers, but did not predict infant learning. However, Emotional Availability Scale ratings of maternal sensitivity, coded from videotapes of mothers and infants engaged in a brief play interaction, were significant predictors of infant learning, even after maternal depression, its demographic correlates, and antidepressant medication use had been taken into account. These findings are consistent with a role for experience‐dependent processes in determining the effects of IDS on infant learning.     

Infants’ response to a mobile phone modified still‐face paradigm: Links to maternal behaviors and beliefs regarding technoference

Interruptions to parent–child interactions due to technology, or “technoference,” have been correlated with a host of negative child developmental outcomes. Yet, the influence of technoference on parent–infant interactions and infant behaviors has received less attention and more experimental work is warranted. For this study, parent–infant dyads (n = 227) completed a modified still‐face paradigm (SFP) using a mobile phone during the still‐face phase. Infant responses were coded for positive and negative affect, object and parent orientation, self‐comforting, and escape behaviors during the task. Results showed a robust still‐face effect, with infants displaying increased negative affect, decreased positive affect, increased self‐comforting, object orientation, and escape behaviors during the “still‐face” or phone distracted phase of the paradigm and frequently failing to return to baseline during the reunion phase. Older infants (older than 9 months) likewise demonstrated higher levels of negative affect across all three phases of the paradigm relative to younger infants (less than 9 months). Parent reports of technoference behavior were related to increased object orientation for younger infants. Parental technoference behaviors were also linked to more escape behaviors for younger infants and decreased object orientation in older infants during the still‐face portion of the SFP. Higher levels of technoference also appear to attenuate the negative emotional response of infants during still face. Results are discussed in relation to infants’ increasing exposure to digital technology in the context of early relationships.     

The Relation between Mothers' Mirroring of Infants' Behavior and Maternal Mind‐Mindedness

Maternal mind‐mindedness, which is a measure of maternal mentalization involving mothers' speech, was examined as a predictor of mothers' mirroring of infant behavior during interaction. Five‐month‐old infants and their mothers engaged in a Still‐Face Task in which the mother's mirroring of the infant's behavior was assessed. After the task, the mother was shown a video of her infant in the task and asked to comment on what was happening for her infant; her comments were assessed for mind‐mindedness. Maternal mind‐mindedness when mothers were asked to reflect upon what was happening for their infants during the task predicted mothers' mirroring behaviors while engaged with their infants in the task. Maternal mirroring behavior may be a manifestation of maternal mentalization that is salient to infants.     

Mothers' Verbal and Nonverbal Strategies in Relation to Infants' Object‐Directed Actions in Real Time and Across the First Three Years in Ethnically Diverse Families

We examined maternal behavioral strategies in relation to infants' object‐directed actions in real time and over developmental time in 206 mother–infant dyads from African American, Dominican immigrant, and Mexican immigrant backgrounds. Mothers were asked to share a set of beads and strings with their infants when children were 14, 24, and 36 months. We coded three types of maternal strategies—eliciting attention, instructive assistance, and encouragement—which could be expressed verbally (e.g., “look”, “turn it”, “good job!”) or physically (i.e., through gestures, hands‐on guidance, or transfer of objects). We also coded infants' unassisted bead‐stringing. Across ethnic groups and ages, mothers' hands‐on guidance and object transfer increased the likelihood that infants would follow with unassisted bead‐stringing during real‐time interaction. Over developmental time, mothers modified their strategies: They displayed fewer attention‐getting strategies and more encouragement across infant ages, and peaked in their provision of instructive assistance when infants were 24 months. Additionally, Mexican mothers displayed more nonverbal strategies (e.g., gestures, hands‐on guidance) than did African American and/or Dominican mothers, who displayed more verbal strategies (e.g., attention‐getting and encouraging language). Developmental and real‐time patterns in mother–infant object‐related interactions generalize across ethnicities, although mothers' emphases on specific strategies are culture specific.     

Maternal Disrupted Communication During Face‐to‐Face Interaction at 4 months: Relation to Maternal and Infant Cortisol Among at‐Risk Families

The study evaluated the association between maternal disrupted communication and the reactivity and regulation of the psychobiology of the stress response in infancy. Mothers and infants were recruited via the National Health Service from the 20% most economically impoverished data zones in a suburban region of Scotland. Mothers (N = 63; M age = 25.9) and their 4‐month‐old infants (35 boys, 28 girls) were videotaped interacting for 8 min, including a still‐face procedure as a stress inducer and a 5‐min coded recovery period. Saliva samples were collected from the dyads prior to, during, and after the still‐face procedure and later assayed for cortisol. Level of disruption in maternal communication with the infant was coded from the 5‐min videotaped interaction during the recovery period which followed the still‐face procedure. Severely disrupted maternal communication was associated with lower levels of maternal cortisol and a greater divergence between mothers' and infants' cortisol levels. Results point to low maternal cortisol as a possible mechanism contributing to the mother's difficulty in sensitively attuning to her infant's cues, which in turn has implications for the infant's reactivity to and recovery from a mild stressor in early infancy.     

The Interplay Between Tonal Synchrony and Social Engagement in Mother–Infant Interaction

This study explores the relationship between tonal synchrony and maternal‐infant social engagement based on free‐play recordings of 15 mothers and their 3‐month‐old infants in a laboratory setting. Moment‐by‐moment analyses on a microlevel were used to study social engagement and vocal interaction. We analysed and categorized 854 vocalization periods (mother‐only vocalizations, tonal interaction periods, nontonal interaction periods, and mutual silence). Tonal synchrony was analysed in terms of harmonic and pentatonic series based on pitch frequency analyses. Social engagement was microanalyzed in terms of matched and mismatched engagement states. ANOVA‐repeated measures revealed, most importantly, a significant relationship between TIPs and social interaction repair, which indicates the importance of tonal synchrony in the flow of social engagement in mother–infant dyads. Other significant relationships were found between (a) nTIPs/mismatch–mismatch, and, (b) MOV/affect loss. As mentioned in the discussion, the findings are suggestive for clinical applications (e.g., music therapy) and warrant further research.     

Very Preterm and Full‐Term Infants’ Response to Socio‐Emotional Stress: The Role of Postnatal Maternal Bonding

Very preterm (VPT) infants are at risk for altered socio‐emotional stress regulation, even in the absence of perinatal complications. Moreover, becoming a mother of a VPT infant is a traumatic event, which might affect the establishment of a bonding relationship toward the infant during the postnatal period. The main aim of the present study was to assess the association between maternal postnatal bonding and socio‐emotional stress response in 3‐month‐old VPT infants, compared to full‐term (FT) controls. Thirty‐three VPT and 28 FT infant‐mother dyads underwent the maternal Face‐to‐Face Still‐Face (FFSF) procedure to assess socio‐emotional stress regulation. Maternal postnatal bonding was measured through the Maternal Post‐Natal Attachment Scale (MPAS), which includes three scales: Quality of attachment, Absence of hostility, and Pleasure in interaction. The VPT infants exhibited less self‐directed and other‐directed regulatory behaviors during the Still‐Face episode. Mothers of VPT infants reported lower Quality of attachment compared to FT counterparts. Importantly, higher levels of Quality of attachment were associated with more other‐directed behaviors during the Still‐Face episode in FT dyads, whereas this was not observed in VPT dyads. In conclusion, VPT infants might be exposed to a double‐risk condition for socio‐emotional development, encompassing both difficulties in stress response and the exposure to a less‐than‐optimal maternal bonding.     

Does Child Sex Moderate Vulnerability to Postpartum Risk among Infants of Mothers at Risk for Psychopathology?

Early childhood behavior problems may indicate risk for subsequent psychopathology (Shaw, Gilliom, Ingoldsby, & Nagin, Developmental Psychology, 39, 2003, 189). There is some evidence to suggest that boys and girls may be differentially susceptible to postpartum risk factors that predict problem behaviors in early childhood (Kochanska, Coy, & Murray, Child Development, 72, 2001, 1091; Martel, Klump, Nigg, Breedlove, & Sisk, Hormones and Behavior , 55, 2009, 465). The main aim of this study is to examine whether child sex moderates the effect of infant and maternal predictors of toddler problem behaviors in a unique sample of high‐risk mother–child dyads. Analyses were based on data collected for 198 mother–child dyads (52% male offspring) followed longitudinally from birth to 18 months. Maternal and infant variables, including maternal PTSD and depression symptoms, maternal maltreatment history, observed maternal parenting quality, demographic risk, and infant negative emotionality and night waking, were used to predict toddler behavior problems. Although boys and girls displayed similar levels of total problem behaviors at 18 months overall, the specific set of infant and maternal variables that predicted toddler problems varied by child sex. The significant predictor for boys was maternal PTSD symptoms, whereas significant predictors for girls were infant negative emotionality and sleep problems. Results suggest that sex‐differentiated transmission of risk can be identified as early as 18 months postpartum. These differences suggest a gender‐specific biological sensitivity to maternal psychopathology, or alternatively, a gender‐specific reporting bias among mothers with childhood maltreatment histories.     

The practical utility of the Welch Emotional Connection Screen for rating parent–infant relational health

Emotional Connection (EC) measured by the Welch Emotional Connection Screen (WECS) was related to the Parent–Infant Interaction Rating System (PIIRS), a 5‐point adaptation of the rating system developed for the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (e.g., NICHD Early Child Care Research Network, 1999, Developmental Psychology, 35, 1399). Parent–infant dyads (n = 49 mothers; 43 fathers) were videotaped during face‐to‐face interaction at infant age 6 months; interactions were coded with both the WECS and PIIRS. At age 3, mothers completed the Child Behavior Checklist. WECS ratings of EC were associated with PIIRS rating items for both mother–infant and father–infant dyads. Mother–infant EC related positively to maternal sensitivity and positive regard for child, child positive mood and sustained attention, and dyadic mutuality, and negatively with maternal intrusiveness. Father–infant EC related positively to fathers' positive regard for child, child positive mood and sustained attention, and dyadic mutuality. Mother–infant EC predicted child behavior problems at age 3 better than mother–infant PIIRS ratings of dyadic mutuality. With fathers, neither EC nor dyadic mutuality ratings predicted mother‐reported child behavior problems. Findings highlight the practical utility of the WECS for identifying potentially at‐risk dyads and supporting early relational health.     

Stabilities of infant behaviors and maternal responses to them

Consistency in the order of individuals in a group across substantial lengths of time—stability—is a central concept in developmental science for several reasons. Stability underscores the meaningfulness of individual differences in psychological phenomena; stability informs about the origins, nature, and overall developmental course of psychological phenomena; stability signals individual status and so affects the environment, experience, and development; stability has both theoretical and clinical implications for individual functioning; and stability helps to establish that a measure constitutes a consequential individual‐differences metric. In this three‐wave prospective longitudinal study (Ns = 40 infants and mothers), we examined stabilities of individual variation in multiple infant behaviors and maternal responses to them across infant ages 10, 14, and 21 months. Medium to large effect size stabilities in infant behaviors and maternal responses emerged, but both betray substantial amounts of unshared variance. Documenting the ontogenetic trajectories of infant behaviors and maternal responses helps to elucidate the nature and structure of early human development.     

A Comparative Study of Arm‐Restraint Methodology: Differential Effects of Mother and Stranger Restrainers on Infants' Distress Reactivity at 6 and 9 Months of Age

This study examined both differential patterns and the stability of infants' (N = 70) distress reactivity across mother and stranger arm‐restraint conditions when infants were 6 and 9 months of age. Reactivity measures included observational variables for the rise, intensity, and duration of infant distress as well as motor activities associated with escape behaviors. Correlation analyses revealed that infant behaviors during arm restraint were modestly stable across conditions and over time; however, mean comparisons also showed that infants' distress responses appear to be sensitive to protocol parameters (whether restrainer is mother or stranger). At 6 months of age, infants cried more during maternal restraint than with strangers and exhibited escape behaviors more frequently with mothers. Findings further indicate that infants' distress reactivity undergoes developmental alterations from 6 to 9 months of age, with infants crying more quickly, reaching peak intensity of distress faster, and displaying more distress at 9 months compared to 6 months. These changes in infants' reactivity were particularly accentuated during maternal compared to stranger restraint conditions at 9 months of age.     

Trajectories of Regulatory Behaviors in Early Infancy: Determinants of Infant Self‐Distraction and Self‐Comforting

The ability to effectively regulate emotions is an important marker for early socio‐emotional development. The uses of self‐comforting behaviors and self‐distraction have been empirically supported as effective regulatory strategies for infants, although research on determinants of such behaviors is scarce. Thus, a more thorough examination of the development of regulatory behaviors is needed. For the current study, 135 mothers, fathers, and their infants participated in laboratory visits at 3, 5, and 7 months of age where parent sensitivity and infant regulatory strategies were coded from the Still‐Face Paradigm. Parents also filled out questionnaires about infant temperament and parental involvement. Using multilevel modeling to examine levels and trajectories of self‐comforting and self‐distraction, the current study found: (1) infants higher in temperamental surgency used more self‐distraction and self‐comforting, (2) infants lower in surgency with highly involved parents increased in self‐distraction at a faster rate, particularly with highly involved fathers, and (3) infants used self‐comforting more than average with fathers when the infant was also lower in temperamental regulation. In addition, we examined trajectories of parent involvement and temperament in relation to infant regulatory strategy.