Respond with Sensitivity

Caregiver sensitive responsiveness is considered a central characteristic in healthy parenting, parent-child relationships, and child development. Responsiveness itself is a component of sensitivity, and attachment literature is interested in the patterns of caregiver sensitivity and responsiveness that meet or fail to meet a child’s need for a secure base.

Though sensitivity is generally associated with observational assessments of mothers and infants, researchers explore a variety of settings and caregivers. Evidence continues to demonstrate that sensitivity can be successfully promoted through a variety of caring behaviors that benefit children and families in nearly every circumstance. Because caregiver sensitivity is impacted by stress, emotions and even breastfeeding, we gain more insight about the influences on and the support of parental sensitivity from this research.

Breastfeeding, Brain Activation to Own Infant Cry, and Maternal Sensitivity

Kim, P., Feldman, R., Mayes, L. C., Eicher, V., Thompson, N., Leckman, J. F., & Swain, J. E. (2011). Breastfeeding, brain activation to own infant cry, and maternal sensitivity. Journal of Child Psychology and Psychiatry, 52(8), 907-915.

Breastfeeding changed the mother’s brain, activating brain regions associated with empathy, greater maternal sensitivity, and mother-infant bonding.

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Sample

  • N: 17
  • Subject Ages: Infants 2 to 4 weeks postpartum
  • Location: United States, New Haven, Connecticut
  • SES: Not available
  • Eligibility: Biological mothers with full-term, healthy infants
  • Additional: All mothers were Caucasian and married or cohabiting

Hypotheses

  1. Brain regions related to maternal behaviors including the hypothalamus, midbrain, amygdala, striatum, cingulate cortex and prefrontal cortex would show greater activation in breastfeeding mothers relative to formula-feeding mothers in response to own baby-cry.
  2. Breastfeeding mothers would show greater levels of maternal sensitivity at three months postpartum.
  3. The level of brain activity in response to own baby-cry at the first month postpartum would be associated with maternal sensitivity in dyadic interactions videotaped at three to four months postpartum.

Variables Measured, Instruments Used

  • Maternal brain activation in response to her own baby’s cry versus control baby-cry one month postpartum - fMRI scanning
  • Maternal sensitivity - videotaped in the home three to four months postpartum and coded with the Coding Interactive Behavior (CIB) Manual (Feldman, 1998)

Design—Descriptive

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Findings

  1. In the first postpartum month, breastfeeding mothers showed greater activations in the superior frontal gyrus, insula, precuneus, striatum and amygdala while listening to their own baby-cry as compared to formula-feeding mothers.
  2. For both breastfeeding and formula-feeding mothers, greater activations in the right superior frontal gyrus and amygdala were associated with higher maternal sensitivity at three to four months postpartum.
  3. Results suggest links between breastfeeding and greater response to infant cues in brain regions implicated in maternal-infant bonding and empathy during the early postpartum. Such brain activations may facilitate greater maternal sensitivity as infants enter their social world.
  4. First evidence using brain imaging that breastfeeding at the first month postpartum has a significant link to both enhanced maternal brain responses to infant stimuli and maternal behaviors.

Limitations

  • Small sample 
  • Although infant cries from the two groups and the control infant cry were rated as having a similar level of emotional intensity by independent raters, because mothers selected samples of their own babies' cries by themselves, it is possible that one group of mothers may have selected cry samples that they perceived as being more emotionally salient.
  • No measure for maternal sensitivity at two to four weeks postpartum when the brain responses to infant stimuli were assessed
  • Because factors related to a mother’s decision to breastfeed may also be associated with these parental outcomes, future research is needed to understand whether breastfeeding moderates the relationship between a mother’s decision to breastfeed and neurological responses to her infant with pre- and post-intervention studies.
  • More research is also required to examine whether the increase in brain response related to breastfeeding and the significant associations between early maternal brain responses and later parenting behaviors influence the infant’s cognitive, social and emotional development.

 

 

 

 

Predictors of Maternal Sensitivity to Infant Distress

Leerkes, E. M. (2010). Predictors of maternal sensitivity to infant distress. Parenting: Science and Practice, 10(3), 219-239.

A mother’s emotional goals predicted her sensitivity to infant distress more so than her own emotional reaction. In addition, her prenatal ability to detect an unfamiliar infant’s distress was associated with more maternal sensitivity with her own infant.

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Sample

  • N: 101
  • Subject Ages: Mothers ages 15-37, mean maternal age 27.79 years
  • Location: United States
  • SES: $6,000-$190,000 annual income, mean $65,000
  • Eligibility: Primiparous mothers
  • Additional:
    • Education ranged from less than a high school diploma to graduate degrees
    • 72% European American, 25% African American, 2% Asian American, 1% Latin American
    • 11 mothers were single mothers with no father involvement

Hypotheses

  1. Maternal detection of infant distress, empathy, infant-oriented emotion goals and emotion efficacy will correlate positively with maternal sensitivity, whereas negative maternal emotions will correlate negatively with maternal sensitivity.
  2. Observed infant distress will interact with mothers’ emotional and cognitive responses to infant distress to predict sensitivity during the arousing tasks.

Variables Measured, Instruments Used

  • Depressive symptoms, prenatal and postnatal - the Epidemiologic Studies-Depression Scale (CES-D; Radloff, 1977)
  • Distress detection - interviews
  • Mother emotions - interview
  • Infant-oriented emotion goals - interview
  • Efficacy - questionnaire was modeled after Teti & Gelfand’s (1991) Maternal Self-Efficacy Scale, which has predicted sensitive maternal behavior in a number of studies (Hess, Teti & Hussey-Gardner, 2004; Teti & Gelfand)
  • Behavioral coding -
    • the Observer 5.0 (Noldus Information Technology, Wageningen, Netherlands)
    • emotion-eliciting tasks adapted from Braungart-Rieker & Stifter (1996)
    • maternal sensitivity: observed

Design—Cross-sectional

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Findings

  1. Mothers' emotional and cognitive responses to infant distress predicted significant variation in maternal sensitivity to distress independently of one another and in conjunction with observed infant distress.
  2. Mothers' emotional goals were the most consistent predictors of sensitivity to distress, followed by their emotional reactions to distress.
  3. Mothers' prenatal negative emotions in response to crying were related to sensitivity to distress cues.
  4. Both prenatal and postnatal negative emotions moderated the link between observed infant distress and total sensitivity.
  5. Postnatal empathy, but not prenatal empathy, was positively associated with sensitivity to distress.
  6. Accurate detection of the unfamiliar infants’ distress during the prenatal period was positively related to sensitivity to distress.
  7. Efficacy was the only predictor that was unrelated to sensitivity as a main effect or in conjunction with infant temperament.

Limitations

  • The majority of the participants in this study were high-functioning, non-minority adults and all were first-time mothers.
  • The duration of infant distress was relatively brief, and some infants did not become distressed.
  • Due to small sample size, infant-oriented and mother-oriented goals were combined even though they did not correlate significantly.

The Relation Between Early Mother-Infant Skin-to-Skin Contact and Later Maternal Sensitivity in South African Mothers of Low Birth Weight Infants

Bigelow, A. E., Littlejohn, M., Bergman, N., & McDonald, C. (2010). The relation between early mother-infant skin-to-skin contact and later maternal sensitivity in South African mothers of low birth weight infants. Infant Mental Health Journal, 31(3), 358-377.

Early mother-infant skin-to-skin contact predicted later maternal sensitivity.

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Sample

  • N: 34 (12 mother–infant dyads)
  • Subject Ages: Infants under 1 year
  • Location: South Africa, Cape Town
  • SES: Not available
  • Eligibility: Infants born with low birth weight (1,385-2,199 g) in a large, public maternity hospital

Hypotheses

  1. Early mother-infant skin-to-skin contact (SSC) would correlate with subsequent scores of maternal sensitivity.
  2. Early mother-infant SSC would be an independent predictor of later maternal sensitivity scores on these measures.
  3. Examination of the amount of mother-infant SSC over the infants’ early life to determine the consistency of the SSC infants received.

Variables Measured, Instruments Used

  • Amounts of SSC - hospital records and home interviews
  • Maternal sensitivity - videotapes of mother-infant interactions in the home, scored on the:
    • Maternal Behavior Q-Sort (Pederson, Moran & Bento, 1999)
    • Maternal Behavior subscale of the Nursing Child Assessment Teaching Scale (Sumner & Spietz, 1994)

Design—RCT

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Findings

  1. Amount of (skin-to-skin contant) SSC in infants’ first 24 hours correlated with amount of SSC through the first month.
  2. Amount of SSC in infants’ first 24 hours independently accounted for maternal sensitivity on both measures, indicating that early mother-infant SSC predicted subsequent maternal sensitivity.

Limitations

  • Small sample size: The number of dyads followed was small, and the age range of the infants at the time of the follow-up visit was large. The significant results obtained with the small sample suggest that the findings are robust; yet, whether early mother-infant SSC would be associated with later maternal sensitivity in a larger sample or with a more restricted age range of infants remains to be tested.
  • Maternal report: With the exception of the amount of SSC  documented in hospital records during the infants’ first few days of life, the amount of SSC the mothers provided was collected from mothers’ reports at the time of the follow-up visits; thus, these amounts were subject to subjective recall. However, mothers’ reports of the SSC provided during the infants’ first few days corroborated with the amount reported in hospital records, suggesting that the mothers’ memories were accurate.
  • Low generalizability: The dyads were from a high-risk population, which limits how the results can be generalized to other populations.

 

 

 

Unequal in Opportunity, Equal in Process: Parental Sensitivity Promotes Positive Child Development in Ethnic Minority Families

Mesman, J., van IJzendoorn, M. H., & Bakermans-Kranenburg, M. J. (2012). Unequal in opportunity, equal in process: Parental sensitivity promotes positive child development in ethnic minority families. Child Development Perspectives, 6(3), 239-250.

While low-income, ethnic-minority families displayed less sensitivity overall to their children, positive father involvement and close mother-father relationships were especially beneficial in the case of maternal risk.

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Sample

  • N: 39 publications, 34 individual studies
  • Locations:
    • United States, 27 studies;
    • Netherlands, six studies;
    • Canada, one study
  • Search Method: Web of Science database Search conducted on January 12, 2011, using search terms: (cultur* OR ethnic* OR race OR racial OR minority OR minorities OR migrant OR immigrant OR Hispanic OR Latino OR Mexican OR African-American OR Chinese-American OR Asian OR Native American) AND (sensitiv* OR responsive* OR contingen* OR synchron* OR warmth OR ‘‘positive parenting’’ OR ‘‘maternal behavior’’) AND (parent* OR mother OR maternal OR father OR paternal) AND (child* OR toddler OR preschool* OR infant OR baby)
  • Inclusion Criteria: The sample includes at least one ethnic  minority group; the study targeted children zero to five years of age; sensitivity is measured through standardized observations: the sensitivity construct includes at least a measure of appropriate responsiveness; the article reports results on at least one of the following topics: a) comparison of sensitivity means between majority and minority groups; b) association between sensitivity and child outcomes separately for minorities.

Objective

  1. Systematic review of the literature on parental sensitivity and its outcomes in ethnic minority families to discern whether these assumptions are empirically valid

Design—Systematic literature review

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Findings

  1. Ethnic minority parents display significantly lower levels of sensitivity to their young children than do majority families.
  2. The evidence points toward a central role of social and economic stress in sensitivity differences between majority and minority groups.
  3. There is clear evidence for substantial covariation between minority status and low (socioeconomic status) SES in predicting lower parental sensitivity.
  4. When controlled for SES, the link between minority status and sensitivity disappears.
  5. Paternal sensitivity is related to positive social outcomes in ethnic minorities.
  6. There is evidence that positive involvement by fathers and high mother-father relationship quality may buffer against the negative effects of maternal risk.

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