Infant-mother interaction as a predictor of child's chronic health problems.
BACKGROUND
Psychological stress is associated with physical illnesses like asthma or infections. For an infant, situations perceived as stressful are highly dependent on the relationship with the caregiver. Constantly poor mother-infant interaction increases the child's vulnerability to stressful conditions and experiences. The aim of the study was to investigate the impact of the quality of early mother-infant interaction on the subsequent physical health of the child. Poor mother-infant interaction was hypothesized to be associated with chronic or recurrent health problems in the child.


METHODS
Fifty-seven mother-infant dyads from families at risk of psychosocial problems and 63 from non-risk families, altogether 120 dyads, participated in the study. Families were drawn from normal population, from well-baby clinics in the city of Tampere, Finland. Infants were full-term and healthy, families with severe risks like psychotic illnesses of the parents or a history of child protection concerns were excluded from the study.


METHODS
After the initial interview with the mother, the mother-infant interaction was videotaped when the infants were 8-11 weeks of age and the interaction was assessed using the Global Rating Scale for Mother-Infant Interaction (Murray et al. 1996a). After the 2-year follow-up mothers were interviewed again and the health problems of the child were elicited.


RESULTS
Poor dyadic mother-infant interaction and infant's poor interactive behaviour assessed at two months were separately associated with the physical health of the child during the two-year follow-up. After adjusting for other factors in the logistic regression analysis infant's poor interactive behaviour remained as a significant predictor of chronic or recurrent health problems in the child. Infant's health problems at the time of the initial interview and day care centre attendance were also significant predictors.


CONCLUSIONS
The results suggest that interactional issues between a mother and her infant are related to the child's subsequent physical health. Children with recurrent or chronic health problems may have relationship difficulties with which they need help. Also, early avoidant behaviour of the infant should be regarded as an indicator of the infant's distress with possibly adverse outcomes in the child's physical health, among other consequences.
Mäntymaa
M
M
Medical School, Department of Child Psychiatry, University of Tampere and Tampere University Hospital, Finland. mirjami.mantymaa@uta.fi
Puura
K
K
Luoma
I
I
Salmelin
R
R
Davis
H
H
Tsiantis
J
J
Ispanovic-Radojkovic
V
V
Paradisiotou
A
A
Tamminen
T
T
D000328:Adult; D002908:Chronic Disease / Q000523:psychology*; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D018730:Infant Behavior; D008297:Male; D008425:Maternal Behavior; D009034:Mother-Child Relations; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012008:Recurrence; D012044:Regression Analysis; D013315:Stress, Psychological / Q000150:complications; D014741:Video Recording