ABSTRACT
The association between nutritional status (percentage of weight for height) and infant-mother relationship was studied over 4 years in 38 children diagnosed with cystic fibrosis in the first year of life. Infant-mother relationship was assessed in a standardized laboratory observation. Although they could not be distinguished medically from the others at the time of diagnosis, infants showing a specific form of insecure relationship with their mothers (insecure-avoidant) differed from the others in: (1) failure to improve in nutritional status in the first year; (2) continuing decline in weight for height in the first 3 years; and (3) significantly lower weight for height at 1, 2, and 3 years of age. These data suggest that attention to mother-infant relationships, particularly feeding interactions, may improve nutritional status in children with cystic fibrosis.
Subject(s)
Cystic Fibrosis/psychology , Mother-Child Relations , Nutritional Status , Object Attachment , Activities of Daily Living/psychology , Body Height , Body Weight , Child, Preschool , Failure to Thrive/psychology , Female , Follow-Up Studies , Humans , Infant , Longitudinal Studies , Male , Personality Assessment , Prospective StudiesABSTRACT
As part of a longitudinal study, children in three groups (healthy, n = 33; cystic fibrosis (CF) n = 28; congenital heart disease (CHD) n = 23) were seen between the ages of 12 and 18 months to assess infant-mother attachment and at two years to observe parent-child negotiation of autonomy/dependence in a puzzle task. Although the healthy group included the highest proportion of securely attached infants and the CHD group the lowest, the distribution of attachment patterns did not differ significantly between groups, or between any of the groups and established norms. At two years the healthy children had the most positive experience in the puzzle task while the children in the CF group had the least positive experience. When diagnostic groups were divided according to prior attachment status, the data for the healthy group were consistent with the prediction that securely attached children would have the most positive mother-child interaction at age two. This was not the case in either of the medically diagnosed groups. These data suggest that the influence of the early parent-child relationship may be altered by a child's health status. We may need different models to account for development in healthy and medically compromised children.
Subject(s)
Child Behavior Disorders/diagnosis , Cystic Fibrosis/psychology , Heart Defects, Congenital/psychology , Mother-Child Relations , Object Attachment , Adult , Child , Child Behavior Disorders/etiology , Child, Preschool , Dependency, Psychological , Female , Follow-Up Studies , Humans , Infant , MaleABSTRACT
In order to evaluate the effects of a chronic potentially lethal illness on infant-mother relationships, we assessed 23 infants diagnosed with cystic fibrosis (CF) in the first year of life and 23 healthy controls in Ainsworth's "strange situation" paradigm for attachment at 12-18 months of age. There were no differences in distribution of attachment patterns between the CF infants and the controls, or between either group and published norms. Comparisons between securely and insecurely attached infants in the CF group indicated that, although they did not differ in measures of initial severity of illness, the insecure group was diagnosed significantly earlier and had significantly lower weight and weight for height at 12-18 months. Although the sample is small, these findings point to the possible psychosocial impact of illness and the role that psychosocial factors can play in the health and growth of infants.
Subject(s)
Cystic Fibrosis/psychology , Mother-Child Relations , Object Attachment , Child Development , Female , Humans , Infant , Male , Sick RoleABSTRACT
The relationships between antepartum baseline fetal heart rate, baseline variability, accelerations, decelerations, and fetal movement and intrapartum fetal heart rate, fetal acid-base assessment at delivery, and Apgar scores 1 and 5 minutes after delivery were studied in 290 mature pregnancies. There was a significant relationship between antepartum and intrapartum baseline fetal heart rate and baseline variability. There was no relationship between antepartum and intrapartum accelerations or decelerations. There was no correlation between antepartum fetal heart rate or fetal movement and fetal acid-base status at delivery or Apgar scores 1 and 5 minutes after delivery. There was a trend for decreased accelerations and decreased fetal movements to be associated with a low Apgar score 1 minute after delivery.
