Merras-Salmio Laura, Salo Saara, Pelkonen Anna S, Kuitunen Mikael, Aronen Eeva T, Mäkelä Mika J, Kolho Kaija-Leena
Division of Pediatric Gastroenterology, Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Acta Paediatr. 2013 Dec;102(12):1180-5. doi: 10.1111/apa.12408. Epub 2013 Sep 18.
To characterize mother-child interaction in children with suspected gastrointestinally manifested cow's milk allergy (GI-CMA) and to explore factors associated with the parentally perceived symptoms.
We invited a randomly selected group of children with suspected GI-CMA and their mothers to take part in a video recording of them playing together. The mother-child interaction was rated using the Emotional Availability Scales (EAS, 4th edition) and compared with national normative data.
Video recordings were conducted with 24 patients (15 girls and nine boys) with a median age of 10.1 months (range 2.1-20.5 months) undergoing a double-blind, placebo-controlled food challenge for cow's milk allergy. The EAS profile in the challenge negative group (17/24) was significantly different from the normative data. The scores for maternal sensitivity (p = 0.0049) and nonintrusiveness (p = 0.0192), together with child responsiveness (p = 0.0053) and involvement of mother (p = 0.0085), were all significantly lower when compared to the normative data. The dimensions of maternal nonhostility and structuring, as well as the scores of the challenge positive group, did not differ from the normative data.
Dysfunctional mother-child emotional interaction was frequent in young children with suspected GI-CMA ruled out by the cow's milk challenge. Appropriate psychological support should be considered.
描述疑似有胃肠道表现的牛奶过敏(GI-CMA)儿童的母婴互动情况,并探讨与家长所感知症状相关的因素。
我们随机邀请了一组疑似GI-CMA的儿童及其母亲参与他们一起玩耍的视频录制。使用情感可用性量表(EAS,第4版)对母婴互动进行评分,并与全国常模数据进行比较。
对24例患者(15名女孩和9名男孩)进行了视频录制,这些患者年龄中位数为10.1个月(范围2.1 - 20.5个月),正在接受针对牛奶过敏的双盲、安慰剂对照食物激发试验。激发试验阴性组(17/24)的EAS概况与常模数据有显著差异。与常模数据相比,母亲敏感性得分(p = 0.0049)、非侵扰性得分(p = 0.0192)、儿童反应性得分(p = 0.0053)以及母亲参与度得分(p = 0.0085)均显著更低。母亲非敌意和结构化维度以及激发试验阳性组的得分与常模数据无差异。
在经牛奶激发试验排除疑似GI-CMA的幼儿中,功能失调的母婴情感互动很常见。应考虑给予适当的心理支持。