title: The Contribution of Infant, Maternal, and Family Conditions to Maternal Feeding Competencies.
abstract: OBJECTIVE: Because little is known about the role of family problem-solving processes in the development of mothers' competencies in feeding a very low birth-weight (VLBW) infant, we explored the contribution made by the competence in negotiating displayed by a mother and family member as they jointly problem solve infant-care issues. The infant's neonatal biomedical condition, maternal depressive symptoms, and family poverty status may also contribute to feeding competencies.  DESIGN: A sample of 41 mothers of VLBW infants from 2 longitudinal studies who were observed during feeding at 1 and 8 months infant postterm age, with a family member of their choosing, participated in a dyadic problem-solving exercise. We assessed maternal feeding competencies with the Parent-Child Early Relational Assessment (Clark, 1997) and dyadic negotiating competence using an observational scale from the Iowa Family Interaction Rating Scales (Melby & Conger, 2001). We classified infant condition through medical record audit. Maternal depressive symptoms were assessed with the Center for Epidemiologic Studies-Depression (CES-D) Scale (L. S. Radloff, 1977), and family poverty status was determined through the mother's report of family income.  RESULTS: Mothers' feeding competencies, structured into 2 factors, Parental Positive Affective Involvement, Sensitivity, and Responsiveness (PPAISR) and Parental Negative Affect and Behavior (PNAB, scored in the direction of low negativity) were stable from 1 to 8 months, accounting for the entire set of predictor variables. Neonatal biomedical condition had no effect on either PPAISR or PNAB; depressive symptoms were negatively associated with PNAB at 8 months; poverty status negatively predicted both PPAISR and PNAB at 1 and 8 months; and negotiating competence of the mother-family member dyad was positively associated with PNAB at 1 month.  CONCLUSIONS: Evidence that family poverty status and dyadic negotiating competence were both associated with maternal feeding competencies supports inclusion of these family-level variables in a model of feeding competencies. A mother's negotiating competence with another family member who takes a responsible role in infant care may support maternal feeding competencies during a VLBW infant's early weeks when parenting patterns are forming.
authors.affiliation: Helen Denne Schulte Professor Emerita, University of Wisconsin-Madison School of Nursing. H6/293 Clinical Science Center, 600 Highland Ave., Madison, WI 53726-4054.  kpridham@wisc.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Pridham
authors.forename: Janet N
authors.initials: JN
authors.lastname: Melby
authors.forename: Roger
authors.initials: R
authors.lastname: Brown
authors.forename: Roseanne
authors.initials: R
authors.lastname: Clark