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PubMed2000

Are infant crying and maternal responsiveness during the first year related to infant-mother attachment at 15 months?

In this longitudinal investigation, Bell and Ainsworth's (1972) Baltimore study on maternal responsiveness, infant crying and infant attachment security was replicated and extended. Each of the 50 families was observed at home during more than 20 hours, and infant crying behavior as well as maternal responses were recorded. Mothers and their infants were observed in the Strange Situation procedure at 15 months of age. Descriptive results showed that infants produced about the same number of crying bouts across the first 40 weeks after birth, but the duration of the bouts decreased by half during this period. The duration of crying peaked in the first nine weeks. The descriptive data are remarkably similar to the findings of Bell and Ainsworth (1972). Maternal responsiveness influenced crying behavior. Contrary to our expectations, the more frequently mothers ignored their infants' crying bout in the first nine-week period, the less frequently their infants cried in the following nine-week period, even if intervening variables like earlier crying and synchronous responsiveness were controlled for. 'Benign neglect' of fussing may stimulate the emergent abilities in infants to cope with mild distress. Extending an earlier report on this investigation (Hubbard & van IJzendoorn, 1991), we found that crying at home did not differentiate between secure and insecure attachment classifications, and it was not related to Strange Situation crying. Mothers of avoidant infants responded most promptly to their infants' crying. The failure to replicate the Baltimore findings was interpreted in terms of 'differential responsiveness'.

Crying↗

PubMed2002

Infant polysomnography: reliability and validity of infant arousal assessment.

Infant arousal scoring based on the Atlas Task Force definition of transient EEG arousal was evaluated to determine (1). whether transient arousals can be identified and assessed reliably in infants and (2). whether arousal and no-arousal epochs scored previously by trained raters can be validated reliably by independent sleep experts. Phase I for inter- and intrarater reliability scoring was based on two datasets of sleep epochs selected randomly from nocturnal polysomnograms of healthy full-term, preterm, idiopathic apparent life-threatening event cases, and siblings of Sudden Infant Death Syndrome infants of 35 to 64 weeks postconceptional age. After training, test set 1 reliability was assessed and discrepancies identified. After retraining, test set 2 was scored by the same raters to determine interrater reliability. Later, three raters from the trained group rescored test set 2 to assess inter- and intrarater reliabilities. Interrater and intrarater reliability kappa's, with 95% confidence intervals, ranged from substantial to almost perfect levels of agreement. Interrater reliabilities for spontaneous arousals were initially moderate and then substantial. During the validation phase, 315 previously scored epochs were presented to four sleep experts to rate as containing arousal or no-arousal events. Interrater expert agreements were diverse and considered as noninterpretable. Concordance in sleep experts' agreements, based on identification of the previously sampled arousal and no-arousal epochs, was used as a secondary evaluative technique. Results showed agreement by two or more experts on 86% of the Collaborative Home Infant Monitoring Evaluation Study arousal scored events. Conversely, only 1% of the Collaborative Home Infant Monitoring Evaluation Study-scored no-arousal epochs were rated as an arousal. In summary, this study presents an empirically tested model with procedures and criteria for attaining improved reliability in transient EEG arousal assessments in infants using the modified Atlas Task Force standards. With training based on specific criteria, substantial inter- and intrarater agreement in identifying infant arousals was demonstrated. Corroborative validation results were too disparate for meaningful interpretation. Alternate evaluation based on concordance agreements supports reliance on infant EEG criteria for assessment. Results mandate additional confirmatory validation studies with specific training on infant EEG arousal assessment criteria.

Arousal↗

PubMed2005

Does a triplet birth pose a special risk for infant development? Assessing cognitive development in relation to intrauterine growth and mother-infant interaction across the first 2 years.

OBJECTIVE: To examine whether a triplet birth per se poses a risk to the development of infants' cognitive competencies and to the mother-infant relationship. METHODS: Twenty-three sets of triplets were matched with 23 sets of twins and 23 singleton infants (n = 138) with respect to gestational age, birth weight, and medical and demographic features. Infants with perinatal asphyxia, intraventricular hemorrhage of grade 3 or 4, periventricular leukomalacia, or central nervous system infection were excluded from the study. At 6, 12, and 24 months of age, mother-infant interaction was observed and infants' cognitive development was tested with the Bayley II test. RESULTS: Mothers of triplets displayed lower levels of sensitivity at 6, 12, and 24 months and infants were less socially involved at 6 and 24 months, compared with singletons and twins. Triplets scored lower than singletons and twins on the Bayley Mental Developmental Index at 6, 12, and 24 months. A weight discordance of >15% was found for 15 triplet sets (65.2%). The discordant triplets showed decreased cognitive skills at 12 and 24 months, compared with their siblings, and received the lowest scores for maternal sensitivity. Hierarchical multivariate regression analysis revealed that greater medical risk at birth, multiple-birth status, lower maternal sensitivity, and reduced infant social involvement in the first 2 years were each predictive of lower cognitive outcomes at 2 years (R2 = 0.33). CONCLUSIONS: Triplets appear to be at higher risk for cognitive delays in the first 2 years of life, and discordant infants are at especially high risk. This delay is related in part to the difficulty of providing sensitive mothering to 3 infants at the same time. The findings may assist practitioners in guiding prenatal and postpartum parental care and management.

Analysis of Variance↗

PubMed2003

Maternal accommodation in infant-directed speech during mother's and twin-infants' vocal interactions.

In this study a mother's instinctive accommodations of vocal fundamental frequency (f0) of infant-directed speech to two different infants was explored. Maternal speech directed to individual 3-mo.-old fraternal twin-infants was subjected to acoustic analysis. Natural samples of infant-directed speech were recorded at home. There were differences in the rate of infants' vocal responses. The mother changed her f0 and patterns of intonation contour when she spoke to each infant. When she spoke to the infant whose vocal response was less frequent than the other infant, she used a higher mean f0 and a rising intonation contour more than when she spoke to the other infant. The result suggested that the mother's speech characteristic is not inflexible and that the mother may use a higher f0 and rising contour as a strategy to elicit an infant's less frequent vocal response.

Adult↗

PubMed1992

Down's syndrome and infant gaze. Gaze behavior of Down's syndrome and nondelayed infants in interactions with their mothers.

The study reported here compared the gaze behavior of infants with Down syndrome (DS) and nondelayed infants during interactions with their mothers. The subjects were 10 DS infants and 11 nondelayed infants. Five of the DS infants and 6 of the nondelayed infants were 4 months old; the rest were 9 months old. The results support the expectation that infants with DS gazed at their mothers longer than did nondelayed infants during face-to-face play, and also indicate that all the infants visually attended to their mothers less at 9 months than at 4 months of age. It is conjectured that the increased gaze of the infants with DS may well facilitate attachment in the 1st year of life.

Attention↗

PubMed1990

The role of dyadic affect in play and infant sex in predicting infant response to the still-face situation.

This study was designed to examine mothers' and 3-month-old infants' affect in play and infant sex as predictors of infants' response to the still-face situation. Infants who evidenced negative affect in play were likely to respond with negative displays during a subsequent still-face situation. Maternal positivity in play was positively correlated with infants' social gaze in the still-face situation. In addition, maternal positivity and infant sex significantly interacted in predicting infant affective response in the still-face situation. For girls, maternal positivity was associated with decreased expressivity. For boys, maternal positivity was associated with early positive bids, which were followed by negative bids and moderately negative affect. Finally, maternal positivity and its interaction with infant sex provide unique information beyond the carry-over effect from infant affect in play to infant response to the still-face. Results are discussed in terms of patterns of individual and joint regulation.

Affect↗

PubMed2002

Infant and caregiving factors affecting weight-for-age and motor development of full-term and premature infants at 1 year post-term.

Guided by a theoretical process model, we examined direct and indirect effects of infants' biologic condition and experience, the caregiving environment, and caloric intake variables on two outcomes, weight-for-age and motor development, for 52 full-term and 47 premature infants at 12 months post-term age. For full-term infants, birth weight and infant expression of positive affect and behavior during feeding had predicted positive direct effects on weight-for-age. Infant regulation of negative affect and behavior had an unexpected negative effect on this outcome. For premature infants, severity of acute illness, mother's regulation of negative affect and feeding behavior, and caloric intake affected weight-for-age in unpredicted directions. Caregiving variables had indirect effects, through caloric intake, on both outcomes only for premature infants. The findings suggest the theoretical process model differs for premature infants and full-term infants, both in the contributing variables and in the processes of effects.

Adult↗

PubMed2004

Patterns of brain electrical activity in infants of depressed mothers who breastfeed and bottle feed: the mediating role of infant temperament.

Successful breastfeeding involves a dyadic interaction between a mother and her infant. The present study was designed to examine the association between breastfeeding and temperament in infants of depressed mothers. Seventy-eight mothers, 31 who were depressed, and their infants participated. Depressed mothers who had stable breastfeeding patterns were less likely to have infants with highly reactive temperaments. Multivariate analyses of variances (MANOVAs) showed that infants of depressed mothers who breastfed did not show the frontal asymmetry patterns, i.e., left frontal hypoactivity, previously reported. Moreover, breastfeeding stability, even in depressed mothers, was related to more positive dyadic interactions. Finally, a model was supported, in which the effects of maternal depression on infant feeding are mediated by infant frontal EEG asymmetry and infant temperament. These findings could provide a foundation for developing intervention techniques, employing breastfeeding promotion and support, directed toward attenuating the affective and physiological dysregulation already noted in infants of depressed mothers.

Adult↗

PubMed1987

Increased cerebrospinal fluid beta-endorphin immunoreactivity in infants with apnea and in siblings of victims of sudden infant death syndrome.

To gain further insight into the possible role of endogenous opioid peptides in the respiratory difficulties associated with the apnea of infancy and other disorders possibly related to apnea, the levels of beta-endorphin immunoreactivity were measured in the cerebrospinal fluid (CSF) of five groups of infants: (1) infants with proved apnea, (2) infants with histories of an apparent life-threatening event (ALTE), (3) siblings of victims of the sudden infant death syndrome (SIDS), (4) infants with suspected but unproved apnea, and (5) infants undergoing investigation for other acute illnesses. Twenty-two infants considered at risk for an ALTE (groups 1 to 3) had significantly higher CSF beta-endorphin equivalents (88 +/- 7 pg/mL) than did the 22 control patients in groups 4 and 5 (31 +/- 3 pg/mL). Plasma beta-endorphin immunoreactivity, which was also measured in some of the infants, did not correlate with levels in CSF and, in fact, was significantly lower in the groups at risk for an ALTE (50 +/- 9 pg/mL; n = 14) than in the control subjects (80 +/- 6 pg/mL; n = 11). These studies indicate that elevated beta-endorphin immunoreactivity in CSF may be a marker in infants who have apnea and who may be considered at risk for an ALTE.

Adult↗

PubMed2003

Serial head ultrasound studies in preterm infants: how many normal studies does one infant need to exclude significant abnormalities?

OBJECTIVE: We hypothesized that preterm infants with two normal head ultrasound (HUS) screening studies > or = 7 days apart would have subsequently normal follow-up studies. POPULATION: We reviewed reports of all HUS studies performed in preterm infants < or = 32 weeks gestation admitted to our nursery between January 1998 and July 2000. SETTING: Regional perinatal referral center. DESIGN: A normal HUS screening study was defined as either no findings; or grade I intraventricular hemorrhage (IVH) (Papile classification), germinal matrix irregularity or cyst, or normal but unequal ventricular size. An abnormal study was defined as any with IVH > or = grade II, periventricular leukomalacia (PVL), ventriculomegaly (VM), or periventricular echogenicity (PVE). RESULTS: Of 98 infants, 92 infants (94%) who had two normal HUS studies > or = 7 days apart had normal repeat studies subsequently, and six (6%) were abnormal. Four of the six abnormal infants were <25 weeks gestation at birth. One infant (27 weeks) became abnormal after culture-positive bacterial sepsis and necrotizing enterocolitis with bowel perforation requiring surgery. The remaining infant (29 weeks) had a question of PVE, and a normal repeat study. The positive predictive value for having a normal HUS after two previously normal studies > or = 7 days apart was 94% with a specificity of 86%. CONCLUSION: Stable premature infants > or = 25 weeks gestation without intervening deterioration may not need repeat screening HUSs after having had two normal studies > or = 7 days apart. Unstable or extremely premature infants <25 weeks gestation may be subject to late severe IVH, VM, and PVL, and therefore need a repeat study before hospital discharge, even if two initial studies > or = 7 days apart were normal.

Cerebral Hemorrhage↗

PubMed2002

Epidemiological investigation of sudden infant death syndrome infants--recommendations for future studies.

In recent years the study of infant care practices within the sleeping environment has proved to be the single most important set of observations for reducing the risk of Sudden Infant Death Syndrome (SIDS). To further reduce the number of deaths and resolve the debate on safe infant care practice, a closer scrutiny of this environment is required. However, anecdotal observation from uncontrolled death-scene investigations and a reluctance to diagnose SIDS because of adverse social conditions or circumstantial evidence at the time of death is undermining future research. To investigate SIDS now means investigating the wider umbrella of all Sudden Unexpected Deaths in Infancy (SUDI) because of the potential for misdiagnosis. In trying to find out why SIDS infants die we have increasingly been forced to search for why infants survive in the first few months of life and it is this comparative component of epidemiological observation that has saved so many lives. A death-scene investigation is vital to any planned future investigation of SIDS but equally essential is a sleep-scene investigation of surviving infants to put any findings into context. SIDS infants are no longer scattered across the social strata and the cot is not the only environment in which they are found, social deprivation and use of the parental bed are now more discernable. Future studies should therefore reflect these changes with a second control group of surviving infants more closely matched to the type of environment in which SIDS infants might be found.

Case-Control Studies↗

PubMedDate not supplied

[Cow milk-specific humoral and cellular immune response in infants with high risk of atopy under feeding a whey hydrolysate infant formula].

BACKGROUND: Hypoallergenic infant formulas (HAF) were developed for atopy prevention in infants with high risk of atopy if these cannot be breastfed. HAF mount an antigen-specific immune response in infants. The aim of the study was to analyse the immune response in infants fed with a new infant formula based on a whey hydrolysate (HAF) and to compare it with that of exclusively breastfed controls. PATIENTS AND METHODS: Plasma concentrations of cow milk-specific IgE were analysed in 94 infants with high risk of atopy, 44 were exclusively breastfed, 50 were fed with HAF. In addition, cow milk-specific IgG antibodies (26 breastfed, 30 fed with HAF) as well as proliferation of periph-eral blood mononuclear cells to bovine beta-lactoglobulin (BLG) (41 breastfed, 47 fed with HAF) were tested. Specific IgE and IgG antibodies were determined using enzymoimmunometric assay (Alastat). Cellular proliferation was measured using tritiated thymidine incorporation assay after 6 day stimulation with BLG. RESULTS: Elevated IgE to cow milk antibodies (> 0.35 kU/L) were detected in two infants from the breastfed group and in one from the HAF-fed group. The plasma concentrations of milk specific IgG antibodies in HAF-fed infants were insignificantly higher than those in breastfed ones. No significant difference was found in bovine BLG-specific cell proliferation between both groups. CONCLUSION: Concerning the properties investigated like antigenicity, allergenicity and immunogenicity, the extensively hydrolysed whey based hypoallergenic formula does not significantly differ from mother milk in 6 month-old infants with an increased atopy risk.

Age Factors↗

PubMed1998

Pulmonary mechanics of normal very-low-birth-weight infants at 40 weeks postconception: a comparison with normal term infants.

We evaluated pulmonary function status in healthy, nonventilated very-low-birth-weight (VLBW) infants at 40 weeks postconception because little is known about the pulmonary function status of these infants at the time of discharge. Seven normal VLBW infants were evaluated at 40 weeks postconception, and five normal term infants were examined as a control. The neonates were placed supine with their heads in the neutral position. Data were obtained while the infant was resting quietly and breathing spontaneously prior to feeding. Pulmonary mechanics and energetics were measured with a CP-100 pulmonary monitor (Bicore Co. Ltd.). Pulmonary mechanics and energetics were determined by the least mean square technique. Dynamic compliance (Cdyn), resistance (Rtot, Re), and work of breathing (WOB) were calculated for the total breath, and tidal volume, minute ventilation, ratio of inspiratory time to respiratory period (Ti/Ttot), and respiratory rate were measured. There were no significant differences between normal VLBW infants and term infants in regard to ventilation, mechanics, or energetics. Although the respiratory system of normal VLBW infants is immature at birth, its development caught up to term infants by the time of discharge.

Aging↗

PubMed1982

Neurological and neurobehavioural differences between preterm infants at term and full-term newborn infants.

A detailed neurological and neurobehavioural examination was done in 80 preterm infants of 27 to 35 weeks gestation in the first week of life and again at 40 weeks postmenstrual age, and in 40 appropriately-sized full-term infants on the first and fifth days of life. There were several consistent differences between the preterm infants reaching term and the newborn full-term infants. The preterm infants reaching 40 weeks showed less flexion in their posture, and less arm traction, arm recoil and leg recoil than the full-term infants on day 1, although this difference was less apparent by day 5. The preterm infants appeared not to develop the flexor tone of the full-term newborn. The preterm infants demonstrated better visual and auditory orientation and alertness than the full-term infants. The significance of these findings, both for initial neonatal examinations and for subsequent assessments, is evaluated.

Arousal↗

PubMed2004

Influence of soya-based infant formula consumption on isoflavone and gut microflora metabolite concentrations in urine and on faecal microflora composition and metabolic activity in infants and children.

The urinary excretion of soya isoflavones and gut microflora metabolites was investigated in infants and children who had been fed soya-based infant formulas in early infancy. These infants and children were compared with cows'-milk formula-fed controls, to determine at what age gut microflora metabolism of daidzein to equol and/or O-desmethylangolensin (O-DMA) was established, and whether exposure to isoflavones in early infancy influences their metabolism at a later stage of development. Sixty infants and children (aged 4 months-7 years) participated in the study; thirty in each of the soya and control groups. There were four age groups. These were: 4-6 months (seven in the soya group and seven in the control group); 7-12 months (seven in the soya group and nine in the control group); 1-3 years (six in the soya group and eight in the control group); 3-7 years (ten in the soya group and six in the control group). Urine samples were collected to measure isoflavonoids by MS, and faecal samples were collected to measure gut-health-related bacterial composition, by fluorescent in situ hybridisation with oligonucleotide probes, and metabolic activity. A soya challenge (typically a soya yoghurt alternative product containing 4.8 g soya protein and on average 22 mg total isoflavones) was given to control-group infants (>6 months) and children, and also to soya-group children that were no longer consuming soya, to determine their ability to produce equol and/or O-DMA. Urinary genistein, daidzein and glycitein were detected in all infants (4-6 months) fed soya-based infant formula; O-DMA was detected in 75 % of infants but equol was detected in only 25 %. In the controls (4-6 months), urinary isoflavonoids were very low or not detected. In the older age groups (7 months-7 years), O-DMA was found in the urine samples of 75 % of the soya group and 50 % of the controls, after the soya challenge. Equol excretion was detected in 19 % of the soya-group infants and children, and in only 5 % of the controls. However, in the oldest (3-7 years) children, the proportion excreting O-DMA and equol was similar in both groups. Faecal bacterial numbers for bifidobacteria (P<0.001), bacteroides and clostridia (P<0.05) were significantly lower for the soya group compared with the control group. There appears to be no lasting effect of early-life isoflavone exposure on isoflavone metabolism.

Aging↗

PubMed1997

Calcium and phosphorus supplementation of iron-fortified infant formula: no effect on iron status of healthy full-term infants.

One objective of this clinical trial was to determine whether calcium and phosphorus supplementation of infant formula affects the iron status of healthy full-term infants. One hundred three infants were randomly assigned to receive iron-fortified, cow milk-based infant formula (465 mg Ca and 317 mg P/L) or the same formula with added calcium glycerophosphate (1800 mg Ca and 1390 mg P/L) for 9 mo. Reported calcium intake for supplemented infants was about four times that of control infants, ranging from a mean of 1741 mg/d at baseline to 1563 mg/d at 9 mo. There was no difference by treatment group in mean or median change from baseline of serum ferritin, total-iron-binding capacity, erythrocyte protoporphyrin, or hematocrit at 4 and 9 mo after enrollment. Incidence of iron deficiency was similar for both groups and no infant developed iron deficiency anemia during the trial. This study indicates that the well-documented inhibitory effect of calcium and phosphorus on iron absorption is not clinically important in infants fed iron-fortified infant formula.

Absorption↗

PubMed1998

Daily intake and urinary excretion of genistein and daidzein by infants fed soy- or dairy-based infant formulas.

Our aims were to measure isoflavone intake from soy- and dairy-based infant formulas and breast milk and to assess the ability of infants to digest and absorb soy isoflavones by measuring daily urinary excretion rates. We recruited 29 infants: 4 received soy-based formula and 25 received dairy-based formula. We collected pooled urine samples from 3-5 disposable diapers worn during a 24-h period and developed and validated methods for extracting isoflavones from the diapers. Infants were studied every 1 or 2 wk, starting at 2-6 wk of age and continuing until 16 wk. Only soy-based formulas contained isoflavones in concentrations detectable by HPLC (limits: 0.05 mg/L for liquids and 0.1 mg/kg for solids). Soy-based formulas provided a mean (+/-SEM) daily dose of isoflavones (genistein plus daidzein) of 3.2 +/- 0.2 mg/kg body wt, which remained fairly constant (CV: 12%) regardless of age < or = 16 wk. Isoflavones were measurable in all samples from soy-fed infants, but not in urine from dairy-fed infants. Daily isoflavone excretion rates varied little among infants [range of mean individual values (mg x kg(-1) d(-1)): daidzein, 0.37 +/- 0.03 to 0.58 +/- 0.06; genistein, 0.15 +/- 0.03 to 0.32 +/- 0.04] and did not change with age < or = 16 wk. The mean percentage of the daily intake recovered in the urine of soy-fed infants was 38 +/- 4% for daidzein and 13 +/- 3% for genistein, and remained constant with age. These values are similar to those for adults and indicate that young infants are able to digest, absorb, and excrete genistein and daidzein from soy-based formulas as efficiently as do adults consuming soy products.

Adult↗

PubMed1993

Diet during lactation associated with infant behavior and caregiver-infant interaction in a semirural Egyptian village.

Potential processes through which nutritional and non-nutritional factors can relate to infant state and behavior and mother-infant interactions were examined in 41 mother-infant pairs from semirural Egyptian households. All infants were breast-fed, and breast milk was the main source of their nutrient intake. Median birth weight was close to reference median; however, most infants showed growth faltering when they were 3-6 mo of age. Among the infant behavioral and state variables, only drowsiness (a proxy for activity and alertness) was significantly associated with the nutritional and non-nutritional factors examined. Among these factors, mothers' intakes of animal source foods and certain B vitamins were the strongest predictors of drowsiness. The nature of the association between maternal diet and drowsiness, examined by multiple regression analysis, showed clearly that inadequate diet of the mother was the major risk factor. Alertness of infants was further compromised when there were several children in the households. The small, less vocal and less alert infants received less vocalization from their mothers. In this environment, infants of undernourished mothers may not receive the extra care and stimulation needed and are at risk for subsequent developmental disabilities.

Behavior↗