School of Nursing, University of Wisconsin, Madison, Wisconsin 53792, USA.
J Dev Behav Pediatr. 2010 Jun;31(5):414-26. doi: 10.1097/DBP.0b013e3181dd5049.
To examine effects of newborn screening and neonatal diagnosis on the quality of mother-infant interactions in the context of feeding.
Study compared the quality of mother-infant feeding interactions among 4 groups of infants classified by severity of newborn screening and diagnostic results: cystic fibrosis (CF), congenital hypothyroidism, heterozygote CF carrier, and healthy with normal newborn screening. The Parent-Child Early Relational Assessment and a task-oriented item measured the quality of feeding interactions for 130 dyads, infant ages 3 to 19 weeks (M = 9.19, SD = 3.28). The Center for Epidemiologic Studies Depression Scale and State-Trait Anxiety Inventory measured maternal depression and anxiety.
Composite Indicator Structure Equation Modeling showed that infant diagnostic status and, to a lesser extent, maternal education predicted feeding method. Mothers of infants with CF were most likely to bottle feed, which was associated with more task-oriented maternal behavior than breastfeeding. Mothers with low task-oriented behavior showed more sensitivity and responsiveness to infant cues, as well as less negative affect and behavior in their interactions with their infants than mothers with high task-oriented scores. Mothers of infants with CF were significantly more likely to have clinically significant anxiety and depression than the other groups. However, maternal psychological profile did not predict feeding method or interaction quality.
Mothers in the CF group were the least likely to breastfeed. Research is needed to explicate long-term effects of feeding methods on quality of mother-child relationship and ways to promote continued breastfeeding after a neonatal CF diagnosis.
在喂养的背景下,研究新生儿筛查和新生儿诊断对母婴互动质量的影响。
本研究比较了 4 组婴儿的母婴喂养互动质量,这些婴儿根据新生儿筛查和诊断结果的严重程度进行分类:囊性纤维化(CF)、先天性甲状腺功能减退症、CF 杂合子携带者和健康且新生儿筛查正常。采用亲子早期关系评估和面向任务的项目测量了 130 对婴儿(年龄 3 至 19 周,M=9.19,SD=3.28)的喂养互动质量。采用流行病学研究中心抑郁量表和状态-特质焦虑量表测量了母亲的抑郁和焦虑程度。
综合指标结构方程模型显示,婴儿的诊断状况,以及在较小程度上,母亲的教育程度,预测了喂养方式。CF 患儿的母亲最有可能采用奶瓶喂养,这与母乳喂养相比,母亲的任务导向行为更多。任务导向行为较低的母亲对婴儿的暗示表现出更高的敏感性和反应性,与婴儿互动时的消极情绪和行为也较少,而任务导向行为较高的母亲则相反。CF 患儿的母亲焦虑和抑郁的发生率显著高于其他组。然而,母亲的心理状况并不能预测喂养方式或互动质量。
CF 组的母亲最不可能进行母乳喂养。需要研究阐明喂养方式对母婴关系质量的长期影响,以及在新生儿 CF 诊断后促进持续母乳喂养的方法。