Disclosing HIV status: are mothers telling their children?

OBJECTIVE: Mothers living with HIV face a complex set of child-rearing decisions, often within the context of many competing stressors. One difficult decision for HIV-infected mothers is whether to disclose their HIV status to their children. The purpose of this study is to provide information to HIV-affected families and the professionals working with them as they approach disclosure-related decisions. METHODS: Eighty-seven HIV-infected African American mothers and one of their children who was not HIV-infected were separately interviewed on two occasions. Mothers reported whether they disclosed their HIV status to the child and provided their assessment of the child's functioning. Children also completed an assessment of their functioning. RESULTS: Results revealed that less than one-third of mothers disclosed their HIV status to their children. Disclosure was associated with mother's income level and perceived severity of physical symptoms. In addition, children disclosed to were more often older and female. Contrary to expectation, disclosure was not related to child functioning. CONCLUSIONS: Professionals should note the low rate of disclosure among these families. In the absence of conclusive data regarding impact on child functioning, professionals must remain aware of the complexity of disclosure-related decisions when working with HIV-affected families, particularly in terms of the family and cultural milieu within which families operate.     

Sleep problems and fatigue in chronically ill women

The objective of this study was to understand the quality and quantity of sleep in women with multiple sclerosis (MS) or rheumatoid arthritis (RA), who also had young children, and how their sleep behaviors were associated with their fatigue. A cross-sectional sample of mothers with MS and RA and a well comparison group completed mailed surveys. Participants included 103 mothers with MS, 68 mothers with RA, and 91 well mothers. Mothers answered questions about their sleep, fatigue, pain, and depression. Women with chronic illnesses reported more problems going to sleep than did well women, with pain, depression, or both as significant covariates. Women with chronic illnesses reported that their sleep was interrupted less often by their children than did well women. Sleep quality and quantity were worse for women with RA who were experiencing a flare. Mothers with chronic illnesses experienced more sleep problems, which was associated with their pain and depression.     

Maternal recognition of neonates through olfactory cues

The role of olfactory cues in maternal recognition of neonates was investigated. Mothers were able to identify the garments worn by their own infants (in comparison to garments worn by unfamiliar infants) through odor alone within the first 6 days postpartum. In a second experiment, mothers who had only limited pre-test exposure to their infants recognized the odor of their infant's garment during tests conducted at 20.5-41.7 hr after delivery. Olfaction may be an especially salient modality for recognition of infants.     

A national audit of joint mother and baby admissions to UK psychiatric hospitals: an overview of findings

Summary The Marcé Clinical Audit is an ongoing data collection exercise that gathers socio-demographic and clinical information about mothers and their infants, admitted jointly to specialist units in UK psychiatric hospitals. The maternal and parenting outcomes, in particular of mothers with schizophrenia and mothers who harm themselves and/or their infants, were determined and analysed. The majority of women had a primary diagnosis of either depression (43%) or schizophrenia (21%). Mothers with schizophrenia were three times more likely to experience a poor outcome than non-schizophrenic mothers, were more likely to be separated from their infant at discharge and were perceived, by staff, to be at greater risk of harming their infant. They were, however, shown to be no more likely to cause actual harm to their infant, or themselves, than non-schizophrenic mothers.     

Rapid diagnosis of pertussis in young infants: comparison of culture, PCR, and infant's and mother's serology.

The contribution of maternal pertussis serology comparing prepartum serum to serum collected during the infant's disease to the diagnosis of pertussis in infants was evaluated for 28 pairs of young infants with pertussis syndrome and their mothers and was compared to those of culture and PCR. Infants had a nasopharyngeal aspiration tested by PCR, and acute and convalescent sera were collected during their disease. Mothers had a first acute serum collected concomitantly with the infant's acute serum, and both acute sera were compared to a prepartum serum. Sera were analyzed by immunoblotting for the detection of anti-pertussis toxin (PT) antibodies. Serological evidence of pertussis in infants was assessed as either an increase in anti-PT antibody levels between the mother's prepartum and acute sera or the presence of antibodies in the infant's acute serum and their absence in both the mother's acute and prepartum sera. Culture and PCR sensitivity were 43 and 89%, respectively. Most infants (18 of 24) had no pertussis antibody detectable in their acute sera, confirming a delayed immune response at this age. A comparison of infant's and mother's serology, using prepartum serum, rapidly confirmed the diagnosis in 57% of the cases. Although less sensitive than PCR, this serological method should be used for a rapid diagnosis of pertussis in young infants when culture and PCR are either not available or negative.     

Mothers' beliefs about behavioral causes for their developmentally disabled infant's condition: what do they signify?

Mothers of young infants with perinatal medical problems orgenetic syndromes strongly associated with developmental disabilitywere interviewed about causes of the infant's condition. Motherswho assigned causal responsibility to their own behavior, motherswho blamed other behavior, and mothers who did not suspect behavioralcauses were compared on other variables measured concurrentlywith attributions and from follow-up home visits at 9 and 18months. Group differences were found for concurrently reported mood disturbance and caretaking difficulties; reported caretakingproblems at 9 months; maternal responsiveness, involvement withthe child and organization of the infant's environment at 9and 18 months; and total scores on the HOME Inventory, measuringsupport for the infant's social, cognitive, and emotional development,at 18 months. For each significant analysis, more optimal scoreswere associated with behavioral self-blame. Blaming others wasusually related to less optimal outcomes. The findings are interpreted in the context of theory and research on aitributionalprocesses in coping with victimization.     

Adolescent and adult low‐income mothers: How do needs and resources differ?

This study examined the living situations and self‐perceived needs and resources of 2,121 low‐income teen and adult mothers. African American and teen mothers were more likely to coreside with grandparental figure(s) than other ethnicities and older mothers. European American mothers and adult mothers were more likely to be living with a partner. While controlling for living situation and ethnicity, teen mothers indicated greater resources than adult mothers in three of four resource areas. Mothers who coresided perceived themselves as having greater basic needs and money resources than mothers in other living situations. Teen mothers perceive their resources positively, perhaps indicating that the support they receive, regardless of their coresidence situation, may be sheltering them from realities that low‐income adult mothers must face. © 2007 Wiley Periodicals, Inc. J Comm Psychol 35: 1037–1052, 2007.     

Mothers' intentions and the immunization of their infants

One hundred and seventy-eight mothers who had recently been delivered were interviewed before discharge from hospital to ascertain their initial intentions about vaccination of their children. Nine months later the behaviour of 154 mothers was checked from health service records; 24 were lost to follow-up.

One hundred and forty-one (92 per cent) of the infants had received at least one dose of vaccine against polio, diphtheria and tetanus. Eighty-five infants (63 per cent of 135) had received at least one dose of vaccine against whooping-cough; 19 mothers had been advised against the vaccine. Failure to have their children vaccinated against whooping-cough correlated with the mothers' initial intentions, although a high proportion of mothers who were initially against the vaccine had started vaccination by the time their child was nine months old. Mothers attending general practitioners were more likely to have their infants vaccinated against whooping-cough than those attending community health clinics, and this difference was not explained by the social characteristics of the mothers nor by more positive early intentions among the mothers who attended general practitioners.

     

Parenting stress in mothers of very-low-birth-weight (VLBW) and full-term infants: a function of infant behavioral characteristics and child-rearing attitudes

OBJECTIVE: To examine the moderating effects of child-rearing attitudes on the relation between parenting stress and infant behavioral characteristics for mothers of very-low-birth-weight (VLBW) and full-term infants. METHODS: Fifty-six 9-month-old infants (23 VLBW and 33 full-term) and their mothers were the participants. Mothers completed measures of parenting stress, child-rearing attitudes, infant temperament, and infant behavioral problems. RESULTS: The VLBW infants had a higher frequency of behavioral problems, and their mothers reported more child health concerns than the mothers of the full-term infants. Regression analyses showed that the relation between parenting stress and infant distress was moderated at medium and high levels of parental strictness for only the VLBW infants. CONCLUSIONS: The amount of stress the mothers of the VLBW infants experienced was a result of the congruence between their infant's behavioral characteristics and their own child-rearing attitudes.     

Social network characteristics of mothers in abusing and nonabusing families and their relationships to parenting beliefs

This study compares the social networks of mothers in families identified as abusive and mothers in control families and looks at the relationships between social networks and parenting beliefs and practices. Participants were mothers from 52 families who were part of a larger investigation of child-rearing in physically abusing versus nonabusing families. Mothers were interviewed about their social networks and completed the Family Environment Scale (Moos & Moos, 1981) and the Child-Rearing Practices Q-Sort (Block, 1981). Mothers in abusing families were found to be more socially isolated than were those mothers in nonabusing families. They had fewer peer relationships, more troubled relationships with relatives, and more limited contact with the wider community. A pattern linking social support and parenting beliefs emerged, suggesting that the presence of peers in the network is related to greater enjoyment of and openness in parenting.     

Individual Differences in Children's Reactions to Divorce

Children from families undergoing parental separation or divorce were interviewed about their own reactions and adjustment to this disruptive event. The children's mothers were also asked to report on their own reactions, as well as their children's. A subgroup was observed in a play session. Data were used to examine the factor surrounding children who manifested more behavior problems and more recent physical illnesses. Mothers of children who exhibited more behavior problems reported more mood disturbances; if this group consisted of boys, they engaged in less interactive play. Illness had opposite relationships with other variables for boys and girls; boys with more illness had more interactive play sessions with their mothers, whereas girls with more illness had less interactive and more noncontingent play periods. Results are discussed in terms of the different meaning that stress reactions have for both boys and girls and their mothers.     

Individual differences in salivary cortisol and alpha-amylase in mothers and their infants: relation to tobacco smoke exposure

Tobacco smoke exposure affects the activity of both the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS). Statistics reveal 41 million children in the U.S. are regularly exposed to tobacco smoke, but we know little about the effects of environmental tobacco smoke exposure on HPA and SNS activity in early childhood. This study assayed cotinine (a metabolite of nicotine), cortisol, and alpha-amylase (sAA) in the saliva of mother-infant dyads from 197 low income and ethnically diverse families. The dyads were identified as tobacco smoke exposed (N = 82) or nonexposed (N = 115) based on maternal self-reports of smoking and salivary cotinine levels greater or less than 10 ng/ml. As expected, higher rates of maternal smoking behavior were associated with higher levels of cotinine in mothers' and their infants' saliva. On average, smoking mothers' salivary cotinine levels were 281 times higher compared to their nonsmoking counterparts, and 23 times higher compared to their own infant's salivary cotinine levels. Infants of smoking mothers had salivary cotinine levels that were four times higher than infants with nonsmoking mothers. Mothers who smoked had higher salivary cortisol levels and lower sAA activity compared to nonsmoking mothers. There were no associations between maternal smoking behavior, infant's salivary cotinine levels, or tobacco exposure group, and cortisol or sAA measured in infant's saliva. The findings are discussed in relation to the influence of smoking tobacco on the validity of salivary biomarkers of stress.     

Communication within low income families and the management of asthma

This study examines the effects of communication between low income urban parents and children about a chronic disease on the extent to which parent and child effectively manage the illness. Four asthma communication factors were identified by principal component analysis. We found that mothers whose preferred language was Spanish, and families who were not receiving public assistance, communicated more frequently about asthma in general. Spanish speaking mothers and their children communicated more about potential home treatments for asthma, and the more adults in the household the less there was communication about the need for emergency services for asthma. Mothers who preferred to speak Spanish had higher levels of management of the most recent asthma attack. Those whose children communicated with them about asthma in general were higher level managers. Children who influenced their parents' decisions about school attendance, and those whose mothers were more highly educated, had higher levels of asthma attack management. More educated mothers, ones whose children were younger at the time of the onset of asthma, and one who received public assistance, were more involved "in general" in their child's asthma care.     

Where should my baby sleep: a qualitative study of African American infant sleep location decisions

BackgroundAfrican American infants are at higher risk for sudden infant death syndrome (SIDS) and accidental suffocation than other infants and are up to 4 times more likely to bedshare with their parents.ObjectiveTo investigate, using qualitative methods, factors influencing African American parents’ decisions regarding infant sleep location (room location and sleep surface).MethodsEighty-three mothers participated in focus groups or individual interviews. Questions probed reasons for infant sleep location decisions and influences on decision making.ResultsMost of the mothers in this study slept in the same room as their infant. Reasons for roomsharing included space, convenience, and safety. Mothers largely decided on infant sleep surface because of space for/availability of crib, comfort, convenience, and safety. Both roomsharing and bedsharing were often chosen to make feeding and checking on the infant more convenient. Mothers who chose not to bedshare cited privacy, concern that the infant would become attached to the parents’ bed, and fears about suffocation. Mothers who chose to bedshare often cited the ability to maintain vigilance while asleep. Low-income mothers also used bedsharing as a defense against environmental dangers.ConclusionAfrican American mothers in this study viewed both roomsharing and bedsharing as strategies to keep their infants safe. Efforts to encourage roomsharing without bed-sharing must address parental concerns about space for/ availability of a crib, convenience, infant and parent comfort, and infant safety.     

Prematurity stereotyping and mothers' interactions with their premature and full-term infants during the first year

OBJECTIVE: To longitudinally assess stability and correlates of prematurity stereotyping and perceptions of infant vulnerability in mothers of premature (N = 56) and full-term (N = 59) infants. METHOD: At 5, 9, and 12 months, mothers rated videotapes of unfamiliar infants with a full-term label (FTL) or a preterm label (PL), interacted with their own infant, and completed other questionnaires. A subgroup of infants were administered a developmental assessment at 32 months. RESULTS: Mothers rated PL infants more negatively than FTL infants at each age. Individual differences in stereotyping were not stable. Mothers who negatively rated infants labeled with the same birth status of their own infants exhibited more negative interactive behaviors with their infants. Mothers who viewed their own infant as more vulnerable and who showed more prematurity stereotyping at 5 months had infants with lower 32-month mental scores. CONCLUSIONS: The results suggest an association between early maternal cognitions and both contemporaneous maternal behavior and later child developmental outcomes.     

Perception of burden among at-risk women of raising a child with fragile-X syndrome

On a self-administered questionnaire 31 women at-risk for bearing children with fragile-X syndrome (FXS) were asked to judge the magnitude of the problems they perceived to be associated with raising an affected child. An age- and education-matched group of women with no family history of FXS was asked to predict the seriousness of problems they might encounter were they to bear a child with a handicapping condition. Mothers of children with FXS reported that they were experiencing fewer and different problems than FXS relatives who did not have affected children predicted they themselves would experience. The perceptions of the burden of raising a handicapped child of FXS relatives without affected children were more similar to those of the comparison group than to those of FXS mothers. This suggests that women who raise a child with FXS learn to cope with an unchangeable situation, and consequently their perceptions of the burdens ease with time. A direct relationship between the acceptability of selective abortion and the perceived seriousness of the problems associated with having an affected child was observed.     

The influence of perceived mother model attitudes on children's aggressive or prosocial behavior

The present experiment was to examine the influence of perceived attitudes of mother models on preschool children's aggressive or prosocial behavior. Based on the score of CCP (children's cognition of parents) Test, sixty four-year-olds were selected and then modeling sessions were administered to them. Their mothers and kindergarten teachers were asked to answer a questionnaire on aggression and altruism of children in daily life situations. Mothers were also required to make self-ratings on their aggression, altruism and rearing attitudes. The following results were obtained. Boys who perceived being rejected by their mothers displayed less imitative aggressive behaviors than other boys and they showed significantly more extrapunitive responses in the P-F Study. No relationships were found between children's modeling behaviors and their aggression or altruism. Children's aggression at kindergarten correlated positively with their aggression at home and with their mother's aggression. It was noteworthy that girl's altruism at kindergarten correlated positively with their mother's rejection, control, and aggression.     

Pre‐bereavement meaning and post‐bereavement distress in mothers of children who underwent haematopoietic stem cell transplantation

Objectives The purpose of this study was to explore the association of meaning‐making with psychological adjustment to bereavement among mothers of children who had undergone haematopoietic stem cell transplantation (HSCT). Design A prospective research design was used. Regression analyses were conducted to determine the relations between pre‐bereavement variables (distress, searching for meaning, and finding meaning) and distress post‐bereavement. Methods Thirty‐five mothers of children who had undergone HSCT were interviewed at the time of their child's HSCT and 3 months post‐bereavement. Results Mothers who reported searching for meaning at HSCT reported greater post‐bereavement distress, and mothers who reported finding meaning at HSCT reported less post‐bereavement distress. Distress at HSCT and the number of days between the time of death and the post‐bereavement time point were also found to be significant predictors of post‐bereavement distress. Conclusions This study provides partial support for the role of meaning in adjustment to loss.