The interplay between emotional and breastfeeding difficulties in first-time mothers.

AIM/BACKGROUND: Both mental maternal health and breastfeeding difficulties impact maternal and infant health. The present study analyses the association between psychosocial and breastfeeding variables and maternal mental health. DESIGN/METHODS: The participants were 107 first-time mothers from Chile. Sociodemographic variables and breastfeeding difficulties were assessed at 6 weeks postpartum. Depression and anxiety symptoms, parental self-efficacy, and perceived social support were measured using validated, self-report questionnaires at 6 weeks and 5 months postpartum. This study is a secondary analysis of an intervention trial. RESULTS: 76% of the women reported having experienced some breastfeeding difficulty in the first postpartum weeks. The number of breastfeeding difficulties was associated with maternal mental health symptoms at 6 weeks postpartum and parental self-efficacy at both assessment times. Women who did not experience breastfeeding difficulties presented significantly fewer depressive (t(102) = 2.5, p = .015) and anxiety symptoms (t(50) = 2.3, p = .028) at 6 weeks postpartum than those who did. Mothers who exclusively breastfed at 5 months postpartum presented significantly higher parental self-efficacy (t(94) = 2.4, p = .044). A higher number of breastfeeding difficulties and low perceived social support contributed to higher depressive symptoms (R2 = .30; F(3,103) = 14.6, p < .001), anxiety symptoms (R2 = .32, F(3.103) = 17.27, p < .001) and lower parental self-efficacy at 6 weeks postpartum (R2 = .39; F(2,103) = 9.4, p < .001). CONCLUSION: Breastfeeding difficulties and social support are associated with fewer mental health symptoms and higher parental self-efficacy during early postpartum in first-time mothers.

Quality of mother-infant interaction, breastfeeding, and perinatal mental health.

INTRODUCTION: The quality of mother-infant interactions is crucial for child development. Studies show that breastfeeding contributes to maternal sensitivity and the development of a positive mother-infant bond. Maternal mental health difficulties negatively impact both maternal sensitivity and breastfeeding. Thus, it is unclear whether breastfeeding contributes to the quality of mother-infant interactions independent from mental health. The purpose of this study is to examine the contribution of exclusive breastfeeding at 3 months postpartum to the quality of the mother-infant relationship at 6 months postpartum, controlling for maternal mental health in a community sample of mothers in Chile. MATERIALS AND METHOD: Eighty women completed self-report measures of mental health and breastfeeding during the third trimester of pregnancy and 3 and 6 months postpartum. At 6 months after childbirth, the mother-infant interaction was assessed by coding a free-play session between mothers and infants. Logistic regression analysis was used to examine the contribution of breastfeeding practices and mental health to the quality of mother-infant interactions. RESULTS: Exclusive breastfeeding at 3 months postpartum increased the likelihood of displaying positive mother-infant interactions controlling for maternal mental health. Mothers who continued to breastfeed at 6 months postpartum reported less symptoms of antenatal depression and anxiety and higher levels of sensitivity and cooperation towards their infants. CONCLUSION: Breastfeeding contributes to maternal sensitivity and cooperation even when controlling for maternal mental health. Implications for health practitioners and limitations due to the sample characteristics are discussed.

Online Intervention Targeting Postnatal Depression and Anxiety in Chilean First-Time Mothers: Feasibility Trial.

OBJECTIVE: Internet-based interventions may positively impact maternal symptoms of postnatal depression and anxiety. This study assessed the feasibility, acceptability, perceived usefulness, and preliminary effectiveness of an m-Health version of "What Were We Thinking?" (m-WWWT). METHODS: A mixed-methods with a 2-arm randomized parallel design was used. From a total of 477 women, 157 met the inclusion criteria. 128 first-time mothers of full-term infants, aged 4-10 weeks, who received health care at primary public health centers in Chile, were randomly assigned to the experimental (EG, n = 65) or control (CG, n = 63) groups; data of 104 of them (53 and 51, respectively) was analyzed. We used percentages and rates to measure feasibility outcomes and mixed analysis of variance (ANOVA) and latent class analyses (LCA) to assess preliminary effectiveness. Participants completed questionnaires on mental health, social support, and maternal self-efficacy upon recruitment and 3 months after completing the intervention. For the qualitative component, 12 women from the EG were interviewed. RESULTS: Quantitative results show good feasibility outcomes, such as high recruitment (82%), low attrition (EG = 12% and CG = 17%), and high follow-up (EG = 97% and CG = 91%) rates. Qualitative results indicate high acceptability and perceived usefulness of m-WWWT. Mixed ANOVA did not show significant differences between the groups (all p >.05). However, multinomial regression analysis in LCA showed that women with low baseline symptoms of depression and anxiety benefit from the intervention (B = 0.43, 95% confidence interval 1.09-2.16). CONCLUSION: m-WWWT is feasible to be implemented in Chile; future studies are needed to assess the intervention's effectiveness.

Sociodemographic, biological, and developmental characteristics of preschool children born full-term and preterm. / Desarrollo, antecedentes biológicos y características sociodemográficas en preescolares con y sin antecedentes de prematuridad.

In Chile, preterm birth is the main cause of infant mortality and morbidity. However, there is little information on the particular characteristics of preterm-born preschool children. OBJECTIVE: To describe the sociodemographic, biological, and developmental characteristics of Chilean preschool children born full-term and preterm. SUBJECTS AND METHOD: A secondary analysis of the databases of the 2010 Longitudinal Survey of Early Childhood (ELPI) was conducted. Children between 2 and 4 years of age with information on gestational age at birth were selected. Late-term infants were excluded. The sample included 8,571 children, of whom 9.78% were preterm newborns. Variables related to sociodemographic characteristics, biological risk factors, and psychomotor development were considered. A descriptive and association analysis (Chi-square) was performed to establish whether the differences between the compared groups were significant. RESULTS: No differences were observed regarding the proportion of sex, geographic area of residence, and health prognosis. Most premature infants reside in urban areas and they have higher biological risk factors. In addition, they have lower average scores than those born at term in all development areas. CONCLUSIONS: The information presented raises the need to analyze the interaction of prematurity with social risk in the development of preterm infants of different gestational ages.

Maternal mental health and impact on the newborn during the COVID-19 pandemic. / Salud mental materna y efectos en el recién nacido durante la pandemia por COVID-19.

The deterioration of mental health in the general population has been one of the main consequences of the COVID-19 health crisis, with differences in diverse groups. Specifically, recent studies report an increased risk for the development of symptoms of anxiety and depression during the perinatal period, as well as a negative impact on the newborn. OBJECTIVE: The objective of this study was to examine the differences in mental health, infant and obstetric variables, and childbirth experience in the public and private health systems in Chilean primiparous women before and during the CO- VID-19 pandemic. SUBJECTS AND METHOD: This quantitative study compared two cohorts. The first one included mothers with babies born before the COVID-19 pandemic (N = 81) and the second one involved mothers who delivered during the pandemic (N = 71). Sociodemographic and obstetric history, depression, anxiety, and stress were evaluated in both groups using self-report questionnaires (EPDS, DASS-21). Differences between groups were assessed with ANCOVA, t-tests, and chi-square tests. RESULTS: Women who delivered during the pandemic reported greater depressive symptoms and their babies were smaller and had less weeks of gestation than babies born before the COVID-19 pandemic. However, this group maintained exclusive breastfeeding for a longer period. There were no differences in the experience of childbirth between the groups, but there were differences in relation to the public or private nature of the hospital where the mothers were seen. CONCLUSIONS: The pandemic negatively affected the mental health of mothers, posing significant challenges to promoting the emotional well-being of mothers and their infants.

Mecanismos neuroendocrinos a la base de la asociación entre salud mental materna y lactancia / Neuroendocrine mechanisms underlying the association between maternal mental health and breastfeeding

La lactancia materna es fundamental para la salud del infante y se ve influida por diversos factores, entre ellos la salud mental materna. En particular, las madres que tienen síntomas depresivos tienen mayor riesgo de presentar dificultades de lactancia y de interrumpir tempranamente la lactancia exclusiva y la lactancia en general. Por otra parte, la lactancia materna actúa como un factor protector de la salud mental materna en algunas circunstancias, en tanto las dificultades de lactancia tienen un impacto negativo en la salud mental de la mujer. La presente revisión describe algunos de los mecanismos fisiológicos que subyacen al establecimiento y la mantención de la lactancia, asociados a la prolactina, la oxitocina, la dopamina y la serotonina, así como a la experiencia de la lactancia y la presencia de dificultades en esta área, y como estas interactúan con las dificultades emocionales de la madre. Se ofrece un modelo integrativo que considera aspectos hormonales y fisiológicos para comprender la asociación compleja y bidireccional entre el establecimiento de una lactancia exitosa y la salud mental materna.

Breastfeeding is essential for infant health and development. It is influenced by multiple factors, including maternal mental health. In particular, mothers who present depressive symptoms are at greater risk of presenting breastfeeding difficulties and presenting shorter exclusive breastfeeding and breastfeeding in general. On the other hand, breastfeeding acts as a protective factor for maternal mental health in some circumstances. Also, breastfeeding difficulties have a negative impact on womens mental health. This review describes some of the physiological mechanisms underlying the establishment and maintenance of lactation, associated with prolactin, oxytocin, dopamine, and serotonin. As well as how the lactation experience and the presence of difficulties in this area interact with the mothers emotional functioning. An integrative model is proposed, which considers hormonal and physiological aspects involved in the complex and bidirectional association between breastfeeding successful establishment and maternal mental health.

Trajectories of Parental Daily Stress: An Ecological Momentary Assessment Study during the COVID-19 Lockdown.

The COVID-19 pandemic was a source of significant stress due to health and safety concerns and measures to control the virus' spread, such as mobility restrictions. This measure was especially demanding for parents with school aged children, who had to find new work-family balance as their children participate in online education while attempting to work remotely. To evaluate parents' stress trajectories during the pandemic, we conducted Ecological Momentary Assessments (EMAs) during lockdown for 29 days in 68 families in Santiago, Chile. In addition, we evaluated the role of educational level and income, co-parenting, and number of children in parents' stress trajectories. Our results showed that during the first weeks of lockdown expected protective factors (i.e., income and co-parental support) were not able to influence parents' daily stress management. Moreover, parents with higher educational levels reported worse stress adaptation than less educated parents. On the other hand, co-parental conflict was significantly associated with parent's stress. Our study captured an acute response to COVID-19 related challenges. This study contributes to understanding how parents adjust to stress during adverse circumstances such as the COVID-19 pandemic.

Examining the association between subjective childbirth experience and maternal mental health at six months postpartum.

PROBLEM: Childbirth experience can have long-lasting effects on maternal wellbeing. BACKGROUND: Positive childbirth experiences may strengthen maternal self-confidence, in contrast, negativeexperiences may promote a sense of failure or distrust. AIM: To examine the contribution of maternal hospital childbirth experience on mental health at 6 months postpartum in a community-based, Chilean sample. An additional aim is to examine which childbirth-related aspects contribute to the global birth experience. METHODS: One hundred and forty-eight women completed self-report measures of mental health during the third trimester of pregnancy and 3 and 6 months postpartum. At 3months after childbirth, subjective childbirth experience was assessed. Logistic regression analysis examined the contribution of childbirth experience to maternal mental health. FINDINGS: Negative subjective experience of childbirth contributes to maternal depression and anxiety up to 6 months after childbirth, controlling for mental health during pregnancy and at 3 months postpartum. Quality of care from health professionals made the largest, statistically significant contribution to the global perception of childbirth. DISCUSSION AND CONCLUSIONS: Subjective experience of childbirth is a modifiable risk factor for the development of postpartum maternal depression and anxiety. Health providers in direct contact with childbearing women may promote maternal emotional wellbeing through sensitive and respectful care.

Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial.

Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an understudied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.

An explanatory model of parental sensitivity in the mother-father-infant triad.

Quality of early family interactions has been associated with child development, bonding, and mental health. Childhood adversity, stress, and depression impact parenting, affecting the quality of the interaction within the mother-father-child triad. The aim of the present study was to analyze the influence of parents' adverse childhood experiences, depressive symptoms, and parental stress, on their sensitive response toward their tooddler and quality of traidic interactions. A correlational cross-sectional method was used. The sample included 80 mother-father-child triads, of toddlers with social-emotional difficulties. Parents early adverse experiences, parental stress, and depressive symptoms were assessed through self-report measures. Observational measures on parental sensitivity and triadic interaction were used. For mothers and fathers, adverse childhood experiences were associated with depressive symptoms in adulthood. Sensitivity toward their child and stress were positively associated among both parents. Symptoms of depression in mothers were associated with lower sensitivity toward their child, but in fathers, their sensitive response was influenced by the level of parental stress in the mother. In both parents, greater sensitivity in the dyadic interaction with the child was associated with a higher quality of the triadic interactions, in the triad as a whole, and in the regulation and involvement of the child.

Se ha asociado la calidad de las tempranas interacciones de familia con el desarrollo, la unión afectiva y la salud mental del niño. La adversidad en la niñez, el estrés y la depresión tienen un impacto en la crianza, lo cual afecta la calidad de la interacción dentro de la tríada madre-padre-niño. El propósito del presente estudio fue analizar la influencia que las adversas experiencias de niñez de los padres, los síntomas depresivos y el estrés de crianza ejercen sobre sus sensibles respuestas hacia su niño pequeñito y la calidad de las interacciones tríadicas. Se utilizó un método correlacional entre las secciones. El grupo muestra estuvo compuesto de 80 tríadas madre-padre-niño, de niños pequeñitos con dificultades socio-emocionales. A través de medidas de auto-reportes, se evaluaron las tempranas experiencias adversas de los padres, el estrés de crianza, así como los síntomas depresivos. Se usaron medidas de observación de la sensibilidad de los padres y la interacción tríadica. Para mamás y papás, las adversas experiencias de niñez estuvieron asociadas con síntomas depresivos en la edad adulta. La sensibilidad hacia su niño y el estrés se asociaron positivamente entre ambos padres. Se asociaron los síntomas de depresión en las madres con una más baja sensibilidad hacia su niño, pero en los papás la respuesta sensible estuvo influida por el nivel de estrés de crianza de la madre. En ambos padres, una mayor sensibilidad en la interacción diádica con el niño se asoció con una más alta calidad de las interacciones tríadicas, en la tríada en general, así como en la regulación y participación del niño.

La qualité des interactions précoces de la famille a été liée au développement de l'enfant, à la connexion et à la santé mentale. L'adversité durant l'enfant, le stress et la dépression impactent le parentage, affectant la qualité de l'interaction au sein de la triade mère-père-enfant. Le but de cette étude était d'analyser l'influence d'expériences négatives de l'enfance, de symptômes dépressifs et de stress parental sur leur réaction sensible envers leur petit enfant et la qualité des interactions triadiques. Une méthode transversale corrélative a été utilisée. L'échantillon a inclus 80 triades mère-père-enfant, de jeunes enfants avec des difficultés socio-émotionnelles. Les expériences négatives précoces des parents, le stress parental, et les symptômes dépressifs ont été évalués au travers de mesures d'auto-évaluation. Des mesures d'observation de la sensibilité parentale et de l'interaction triadique ont été utilisées. Pour les mères et les pères les expériences négatives de l'enfance étaient liées à des symptômes dépressifs à l'âge adulte. La sensibilité envers leur enfant et le stress étaient liés de manière positive chez les deux parents. Les symptômes de dépression chez les mères étaient liés à une sensibilité moindre envers leur enfant mais chez les pères leur réaction sensible était influencée par le niveau de stress parental chez la mère. Chez les deux parents une plus grande sensibilité dans l'interaction dyadique avec l'enfant était liée à une qualité plus élevée des interactions triadiques, dans la triade dans son ensemble, et dans la régulation et l'engagement de l'enfant.

Adapting to Adversity: Effects of COVID-19 on Parenting in Chile.

The pandemic outbreak in March 2020 and its associated sanitary regulations and restrictions triggered an abrupt and significant change for society in general and for families' organization in particular. In Chile, the Santiago Metropolitan District was under a strict lockdown that involved the closure of the entire educational system. From a systemic-family stress perspective, the impact of these changes might have consequences not only for each individual family member, but for the parental dynamic and, consequently, for children's well-being. This paper presents the results of a follow-up study showing changes in self-reported parental depression and the perceived home organization of mothers and fathers assessed at three different moments: before the pandemic, at the initial outbreak, and after 1 month of strict lockdown. Relevant moderators were explored using linear mixed models to understand the within-subject changes in mothers' and fathers' self-reports across the different assessment times. Financial strain, personality traits of self-criticism and dependency, previous parent-child quality interaction, recent major stressful events, and number of children are highlighted as relevant factors that moderate changes in home chaos and parental mental health perception. Significant risks and protective factors are described for fathers and mothers. The use of pre-pandemic measures as baseline levels enabled the identification of personal and family characteristics that were related to better outcomes. The results help increase our understanding of the sanitary regulations' impacts on the family system and identify vulnerability indicators that should be considered.

Mother's mental health and the interaction with her moderate preterm baby in the NICU.

INTRODUCTION: Moderate preterm infants, born between 320/7 and 336/7 weeks, represent a significant number of preterm-born infants; however, they remain a poorly studied group despite their vulnerability. The objective of this correlational study is to describe the impact of having a moderate preterm infant hospitalised in the NICU on the mothers' mental health and how this relates to the interaction between the dyad. METHOD: During the hospitalisation period, 85 moderate preterm mother-infant dyads participated in this study. The participants provided self-reports of depression, parental stress, and skin to skin and breastfeeding practices. Also, mother-infant interaction was assessed in the NICU with an observational scale. RESULTS: Mothers evidenced high levels of stress and depressive symptoms during the hospitalization. The stress experienced by these women was significant, although weakly, associated with the interaction with their babies; and mothers of small for gestational age babies showed difficulties in this area. CONCLUSIONS: The results of this study could represent a contribution to a better understanding of the relation between the characteristics of moderate preterm babies, maternal emotional wellbeing, and the quality of mother-infant interactions in NICU settings.

Evaluación de las propiedades psicométricas de la Escala de Ansiedad Perinatal en una muestra de madres en Chile / Psychometric properties of the Spanish version of the Perinatal Anxiety Screening Scale (PASS) in a sample of Chilean mothers

Background and Aim: Maternal mental health difficulties during the perinatal period are prevalent and have a negative impact on both women and their infants. Universal perinatal mental health screening has focused primarily on symptoms of depression, with limited attention given to anxiety, despite its high prevalence. This is partly due to the lack of valid maternal anxiety symptom screening tools. The aim of this study was to assess the factor structure, validity, and reliability of the Spanish version of the Perinatal Anxiety Screening Scale.Participants and Method: 265 women participated in the study, 138 of them were assessed during their third trimester of pregnancy and 127 at 3 months postpartum. An Exploratory Factor Analysis was used to examine the factor structure of the PASS, the number of factors was determined using a Velicer MAP test. Results: A four-factor solution was obtained, which slightly differed from the original version of the instrument. High reliability for the subscales and the global score, as well as adequate validity, and test-retest reliability were observed. Conclusions: The Spanish version of the Perinatal Anxiety Screening Scale has good psychometric properties, which warrants its use in Chile. Future studies are needed to assess the validity of the instrument in other Latin-American contexts.

Antecedentes y objetivo: Las dificultades de salud mental materna durante el periodo perinatal son prevalentes y tienen graves consecuencias para las madres y sus bebés. Las iniciativas de pesquisa temprana se han centrado en la sintomatología depresiva y han puesto menor atención a los síntomas de ansiedad, pese a su alta prevalencia. Uno de los factores que contribuye a la escasez de protocolos para la pesquisa de sintomatología ansiosa es la falta de instrumentos validados para tal fin. El objetivo de esta investigación fue evaluar la estructura factorial, validez concurrente y confiabilidad de la Escala de Ansiedad Perinatal, desarrollada para facilitar la pesquisa de sintomatología ansiosa en mujeres embarazadas y puérperas. Participantes y métodos: Las participantes fueron 265 mujeres, 138 de las cuales fueron evaluadas durante el tercer trimestre de gestación y 127, a los 3 meses postparto. La estructura factorial del instrumento fue analizada mediante un Análisis Factorial Exploratorio, el número de factores se definió con el test MAP de Velicer. Resultados: Se obtuvo una solución de cuatro factores con algunas diferencias en relación a la escala original. Se observó una alta consistencia interna para las subescalas del instrumento y para el puntaje global, además de una adecuada validez concurrente y confiabilidad test-retest. Conclusiones: Se concluye que la versión en español de la Escala de Ansiedad Perinatal posee características psicométricas adecuadas para su uso en Chile. Futuros estudios son requeridos para evaluar la validez de este instrumento en otros contextos latinoamericanos.

[Interactions between mothers and their moderate preterm babies during hospitalization]. / Interacciones entre las madres y sus bebés prematuros moderados durante la hospitalización.

Moderately preterm infants are physiologically immature, their brains must mature and adapt to the extrauterine environment, which can affect their neurological development. Interaction with their caregivers is crucial for their development, however, these may show mental health problems such as depressive symptoms and parental stress. OBJECTIVE: to evaluate how depressive symptomatology and stress perception of mothers of moderately preterm infants during hospitalization may affect dyad interaction. PATIENTS AND METHOD: 85 dyads participated. During the second and third weeks of hospitalization, mothers answered a sociodemographic questionnaire, the parental stress scale, and the Edinburgh postnatal depression scale. Mother-infant interaction was assessed and coded with the Hospitalized Mother-Infant Bonding Observation Scale. RESULTS: mothers of moderately preterm infants hospitalized in a neonatology unit may present significant depressive symptomatology which correlate with the stress experienced by the mother. Parental stress and being small for gestational age showed a negative association with dyad interactions. CONCLUSIONS: Having a moderately preterm baby can impact the mental health of mothers and this, at the same time, is related to the interactions they have with their children. Likewise, variables related to the babies were detected that can also decrease the interactions and contact between the dyad.

The role of interpersonal emotional regulation on maternal mental health.

PURPOSE: Symptoms of depression and anxiety during the perinatal period have a negative impact on mothers and their developing children. A significant body of research has demonstrated an association between mental health and both individual and interpersonal emotion regulation. Yet, this association has not been studied during the perinatal period. The aim of this study was to explore the association between emotion regulation, maternal mental health, and interpersonal emotion regulation during the transition to motherhood in a sample of Chilean women. METHODS: Women in their third trimester of pregnancy (n = 253) provided self-reports of emotion regulation and symptoms of depression and anxiety during pregnancy and three months postpartum. Additional self-reports of interpersonal emotion regulation were obtained from individuals who were identified as social support persons by these women. Results: Maternal emotion regulation contributed to maternal symptoms of depression and anxiety during pregnancy and after childbirth. The association between emotion regulation and maternal mental health was moderated by specific interpersonal emotion regulation strategies reported by the participant's social support persons. Strategies including modulating the emotional response, situation modification, attentional deployment and cognitive change, modified the association between poor regulation strategies and anxiety symptoms. Also, an infrequent use of these interpersonal emotion regulation strategies strengthened the association between these maternal emotional regulation difficulties and anxiety symptoms. CONCLUSION: Our findings suggest that interpersonal emotional regulation strategies impact the association of maternal emotional regulation strategies and maternal emotional wellbeing.

[Developmental care of premature newborns: Fundamentals and main characteristics]. / Cuidados del desarrollo en recién nacidos prematuros: Fundamentos y características principales.

Premature newborns, especially the extreme ones, need to be cared for in the different units in the neonatal services. In addition to ensuring the survival of these newborns, these services have gra dually incorporated interventions to promote their development. This review provides an updated synthesis of developmental-focused neonatal care. First, it describes the neurobiological theoretical foundations that explain how the so-called "neonatal stress" can affect the development of a prema ture child. Later, it reviews the Synactive Theory, which is one of the theoretical models that contri bute to understanding the characteristics of the care focused on development. Regarding this care, the evidence and challenges for implementing are described and addressed from a critical perspective, pointing out the strengths and weaknesses. This article highlights the importance of improving the quality of care that preterm newborns received in NICUs, promoting resilience and/or the best pos sible developmental potential in these children, in addition to strengthening the role of parents in neonatal care.

Cultural adaptation of an intervention to prevent postnatal depression and anxiety in Chilean new mothers.

Objective: The aim of this study was to culturally adapt What Were We Thinking (WWWT), an Australian psychoeducational intervention to prevent symptoms of depression and anxiety among first-time mothers, to be used in the Chilean primary health system.Background: Mental health symptoms are common in first-time mothers. Despite the availability of effective screening and referral in the Chilean primary health system, very few women access treatment due to diverse barriers. This highlights the importance of using a preventive approach. The evidence that culturally-adapted, evidence-based preventive programmes can reduce maternal mental health problems supports the development of this study.Methods: WWWT materials were translated into Spanish. Cultural Adaptation and field testing were conducted following the Cultural Adaptation Model.Results: Modifications to the intervention included adding an explicit infant mental health approach, a simplification of written information, and changes in the number and duration of the sessions. The adapted version of WWWT was considered understandable and relevant for local perinatal mental health specialists, new mothers and their partners.Conclusion: The Spanish version of WWWTis a culturally sensitive intervention, its potential for effective use in the Chilean context warrants further investigation. Limitations and implications for future studies are discussed.

The Role of Perinatal Anxiety and Depression in Breastfeeding Practices.

Objective: Maternal mental health difficulties are common during the perinatal period and have a negative impact on breastfeeding practices. Most research has focused on the role of postpartum depression, whereas maternal anxiety has been less studied, despite its high prevalence. A better understanding of the mental health variables that impact breastfeeding practices is necessary to support maternal and infant health and well-being. The aim of this study is to explore the association between breastfeeding practices and maternal mental health, with an emphasis on maternal anxiety. Materials and Methods: Two hundred twenty-nine women were followed from the third trimester of gestation to 3 and 6 months postpartum. The participants provided self-reports of depression, anxiety, and breastfeeding practices. Mental health symptoms were compared between participants who reported exclusive versus mixed breastfeeding at 3 months postpartum, and between mothers who maintained breastfeeding versus those who had weaned their infants at 6 months postpartum. Logistic regression analysis was used to explore the variables contributing to breastfeeding practices. Results: High levels of depressive symptoms during pregnancy were associated to nonexclusive breastfeeding at 3 months postpartum. At 3 months postpartum, both high levels of anxiety and depression were associated with nonexclusive breastfeeding at that time. Logistic regression analyses revealed that exclusive breastfeeding at 3 months postpartum predicted breastfeeding continuation at 6 months after childbirth. Conclusion: Both maternal depression and anxiety negatively impact breastfeeding practices. Early identification of maternal mental health problems during the perinatal period is relevant to promote maternal emotional well-being and to prevent breastfeeding difficulties.

Development and preliminary evaluation of a group intervention targeting maternal mental health and mother-infant interactions: a combined qualitative and case series report.

OBJECTIVE AND BACKGROUND: The purpose of this study was to investigate the outcomes of an Emotional Wellbeing Group intervention developed to treat maternal depression and anxiety while concurrently supporting positive development of the mother-infant relationship. METHOD: Five women diagnosed with depressive and/or anxiety disorders and their infants completed the Emotional Wellbeing Group. The participants completed pre- and post- intervention assessments which included self-report measures of mood and the motherhood experience, and a video-taped, unstructured play session between mothers and their infants. RESULTS: Four of the participants reported a clinically significant decrease in their symptoms of anxiety. All mothers reported more positive perceptions of their infants and their experience of motherhood, and showed enhanced maternal sensitivity and responsiveness towards their infants. Depression levels were not shown to improve consistently. CONCLUSION: This study provides initial positive evidence to support future research directions and clinical efforts to develop interventions that target both the treatment of perinatal depression and anxiety and the quality of mother-infant interactions. Clinical insights for mental health professionals working with mothers and infants are presented.

Is maternal depression related to mother and adolescent reports of family functioning?

While adolescent-parent disagreements about family functioning are common, they may also be indicative of family members' health problems and may compromise adolescent adjustment. This study examines the association between maternal depressive symptoms and family functioning perceptions, considering both the adolescents' and their mothers' points of view. A sample of 943 Chilean dyads of adolescents (69% female, Mage = 14.43 years old) and their mothers (Mage = 43.20 years) reported their perceptions of family cohesion and adaptability. Mothers also reported their depressive symptoms. Results indicated that mothers perceived their family as more cohesive and more adaptable than their children. There was a negative association between maternal and adolescent reports of family cohesion and maternal depressive symptoms. In the mother' reports, this association depended on adolescent's age. In the case of adolescents' reports, this association depended on adolescent's gender. Finally, maternal depressive symptoms were a significant predictor of mother-adolescent agreement about family cohesion.