Black women are more likely to experience traumatic birthing events, more likely to experience perinatal depression, and less likely to receive mental health treatment than women of other racial and ethnic backgrounds, and yet largely overlooked in perinatal mental health research. This pilot study seeks to understand how unacceptable racial disparities and adverse perinatal outcomes influence Black maternal depression and maternal bonding by exploring how prior traumatic loss moderates the relationship between depression and bonding during a subsequent pregnancy among a sample of Black mothers. We use survey data collected from 75 Black mothers as part of the Black Fathers, Equal Partners in Promoting Maternal and Infant Health study, a collaboration between the University of Wisconsin Madison and the African American Breastfeeding Network in Milwaukee, Wisconsin, USA. Study results suggest there is a correlation between maternal depression and bonding; when traumatic loss is included as an interaction variable, it produces a moderating effect, changing the direction of the relationship between bonding and depression. As maternal depression increases, bonding increases when moderated by the variable traumatic loss. This finding has important implications for infant mental health research and practice, disrupting the expectation that depression necessarily poses a risk to maternal-infant bonding.

Reflective supervision (RS) has been viewed as best practice and is therefore incorporated-and often mandated-as a key feature of many relationship-based infant and early childhood serving programs. To promote the implementation of high-quality RS for infant and early childhood professionals, it is critical that a focus is placed on how infant and early childhood professionals are trained to build RS capacities. To this end, we describe Rhode Island, United States's journey developing, implementing, and iteratively adapting an RS professional development series. We describe the structure of the curricula as well as the content and learning objectives, which strive to bridge the gap between the theoretical concepts foundational to RS, process-oriented self-reflection, and the practical application of RS skills and strategies. We also outline the development and process of iterative adaptation that has refined the curricula over the past decade. Finally, we chronicle the history of coordination and collaboration that promoted the development and implementation of this series, which has been disseminated within home visiting and early care and education settings. This narrative can serve as a model for organizations, systems, and states that are undertaking efforts to provide professional development focused on RS.

Social understanding competence develops in sensitive and co-regulating caregiver interactions. Parental reflective functioning (PRF) and parenting stress can affect children's social understanding. This study investigated if children's social understanding was associated with PRF and parenting stress. Parents of 305 Italian children aged from 24 to 72 months (M= 48.2, SD = 13.9; 47.9% girls) completed an online survey. Parents completed the following questionnaire: The Parenting Stress Index-Short Form, the Parental Reflective Functioning Questionnaire, and the Children's Social Understanding Scale. Results showed that children's social understanding was predicted by lower parenting stress, b = .002, p = .017, and parent's interest and curiosity about the child's mental states, b = .07, p = .013. Findings confirm that high levels of parenting stress and low PRF constitute unfavorable conditions for preschoolers' socio-cognitive development. Thus, the present study can have implication for interventions aimed at improving children's social understanding that should focus on reducing parenting stress and enhancing parental mentalizing.

Children born to mothers with opioid use disorder (OUD) are at increased risk of maltreatment and out-of-home care (OOHC) placement. This study examines the parent-child interaction quality and home environments of 92 New Zealand children with prenatal opioid exposure (OE) and 106 non-opioid-exposed (NE) children. Experiences for those in maternal care versus OOHC were of particular interest. Biological mothers completed a lifestyle interview during late pregnancy/at birth. At 18 months, parent-child interaction observations, maternal/primary caregiver interviews, and the Home Observation for Measurement of the Environment were completed during a home visit. At age 4.5, children underwent developmental assessment. By 18 months, 20% of OE children were in OOHC. Mothers with OUD who were younger, less cooperative, and had increased polysubstance use during pregnancy were more likely to have lost custody of their child. OE children in their mother's care experienced less positive parenting and lower-quality home environments than NE children. OE children in OOHC had similarly resourced environments to NE children, yet experienced lower levels of parental warmth and responsiveness. Early parenting predicted child cognition, language, and behavior 3 years later, underscoring the critical importance of supporting the parenting and psychosocial needs of OE children's parents/caregivers to improve long-term outcomes.

There are considerable data documenting the importance of early experiences for healthy human development. Though widely accepted amongst mental health clinicians, developmental researchers and early childhood policymakers, this information is not well known by much of the public. We describe a specialized program designed for established and emerging leaders in Louisiana, United States of America, to help them become better informed to take action to support young children and their families and to facilitate connections across sectors for greater impact. Conducted annually for 6 years, the program drew leaders from a variety of professional sectors working in every region of the state. To evaluate the effectiveness of the program, we conducted semi-structured interviews of program graduates and tabulated responses by thematic analysis. We conclude that translation efforts delivered in this kind of format can lead to gains in knowledge among leaders and action to support early childhood development and well-being.

This study is the first to explore the relation between children's attachment classifications, assessed by Mary Ainsworth's Strange Situation Procedure (SSP), and mothers' acceptance-rejection behaviors from the lens of Interpersonal Acceptance-Rejection Theory (IPARTheory). As a pilot study, the sample consisted of 23 Egyptian mother-child dyads. The mean age of children in the SSP was 18.6 months (SD = 3.10). Mothers' acceptance-rejection behaviors were explored through the Parental Acceptance-Rejection/Control Questionnaire (PARQ/Control). The pilot study's findings revealed that maternal acceptance-rejection behaviors significantly differed across children's attachment classifications. The findings also shed light on gender differences in parenting, as mothers tended to show a higher level of hostility/aggression, undifferentiated rejection, and control with their daughters more than sons. This study is an important stepping-stone for attachment research in the Arab world. It highlights several cultural aspects to be taken into account for future research using the SSP in Egypt or any other Arab country.

Although mother-to-infant attachment begins during pregnancy, few studies have explored correlates of prenatal attachment and associations with later measures of attachment representations. This study explored whether prenatal attachment is related to attachment representations during toddlerhood and whether associations between them reflect the broader quality of mothers' relationships. Young, ethnically/racially diverse, low-income American women (n = 160) were followed from pregnancy through 30 months postpartum. Questionnaires assessed prenatal attachment (Maternal Antenatal Attachment Scale [MAAS]) and mothers' relationships prenatally (Inventory of Parent and Peer Attachment [IPPA]; Social Provisions Scale [SPS]). At 30 months, the Working Model of the Child Interview (WMCI) assessed attachment representation classifications (balanced, disengaged, distorted) and affective themes. Stronger prenatal attachment was associated with balanced representations of the child, greater positive affect, and less negative affect at 30 months, even when accounting for quality of mothers' other relationships. Relationship quality generally and with the parent figure and infant's father specifically, was associated with prenatal attachment, and relationship quality with the parent figure was related to 30-month attachment representations. Findings support theory that mother-to-child attachment formed during pregnancy contributes to attachment representations and affective qualities of the relationship years later. Data highlight the role young mothers' parent figures play during the transition to parenthood.

Parental cognitions, stress, depression, and infant regulatory challenges might reinforce each other in the early parent-infant relationship. A transactional model was used as a framework to investigate these relationships. Two hundred and twenty pregnant women and their partners were recruited during pregnancy and followed 7 months postnatally in the NorBaby study in Norway. To investigate risk and protective factors for parental stress and depressive symptoms at 2, 5, and 7 months postnatally, the following variables were entered antenatally: repetitive negative thinking, implicit associations to infants, parity, and social support. Postnatally, observed infant regulatory challenges at 2 months, parent's perception of infant temperament at 5 months, and signs of infant social withdrawal at 7 months. The model yielded that repetitive negative thinking predicted parenting stress and depressive symptoms, while infant regulatory challenges did not. Repetitive negative thinking is also related to infant temperament. For mothers, parity was beneficial against stress, depressive symptoms, and infant regulatory challenges. Implicit associations to infants were not related to parenting stress or depressive symptoms postnatally. Parenting stress and depressive symptoms were not related to infant social withdrawal at 7 months. In sum, how parents perceive their infant's temperament is associated with their own tendency to engage in repetitive negative thinking, and not by their infant's observed regulatory behavior. Accordingly, parental cognition and well-being should be considered when families struggle to adapt in the perinatal period.

The proposed study sought to investigate whether maternal experiences of racial discrimination and gendered racial stress are associated with offspring executive functioning. Total 266 Black mother-child pairs in the United States were assessed from pregnancy through child age of 4 years. We hypothesized that children whose mothers reported higher rates of perceived gendered racial stress during pregnancy and racial discrimination throughout their lifetime would have lower scores on executive functioning assessments. Furthermore, we hypothesized that low maternal education and income would act as risk moderators whereas social support would act as a protective moderator in the associations between maternal experiences of discrimination (EOD) and child executive functioning. Main effect findings support our hypothesis of an intergenerational association between maternal EOD and gendered racial stress and lower child executive functioning scores. Income was a significant moderator. As hypothesized, the association between mothers reports of lifetime discrimination and lower child executive functioning scores was stronger at lower levels of income. In contrast, however, the association between maternal prenatal reports of gendered racial stress and lower child executive functioning scores was stronger at higher levels of maternal education and income. Social support did not have a significant moderating effect on any of the association.

We compared referrals and connection to care between perinatal patients: 90 receiving OB/GYN care in clinics with integrated behavioral health consultants with infant mental health specialization (IMH-BHC), and 68 receiving traditional care, in the United States. Participants identified as: Native American/Alaskan native, 1.90%; Asian, .63%; African American, 58.23%; Middle Eastern, 6.96%; African National/Caribbean Islander, .63%; Latin-American, 8.86%; and White, 28.48%. Approximately 80% of families in each group were offered referrals. By design, intervention women received mental health services during pregnancy; 16% of women in either group received postpartum mental health services. Intervention group participants were over three times as likely to engage in IMH home visiting. Treatment families were less likely to follow up with infant referrals, but also had fewer infant emergency room visits. All intervention participants met with an IMH-BHC prior to recruitment; however, only 20% self-reported encounters with a mental health professional, indicating these interactions may not be identified by the participants as mental health care; therefore, openness to treatment may be increased for women who feel stigma around mental health care. Given the importance of perinatal mental health, OB/GYN clinics and others serving perinatal patients may consider integrating IMH providers as part of the care team.

This blended pilot-empirical and theoretical manuscript documents a reflective journey undertaken by a group of early childhood teacher educators located across different regions of the United States as they examined their course design, materials, and syllabi construction. Grounded in reflective practice, intersectionality, and critical pedagogy, their collaborative endeavor necessitated profound self-examination and recognition of oppressive structures inherent within the field and reproduced throughout course syllabi, thereby perpetuating societal inequities inside and outside the classroom context. Their iterative, evolving effort resembled a reflective consultation group, marked by continuous self-reflection, challenging assumptions, and transforming actions, vividly portrayed in their vignettes. A nonlinear spiral model emerged as a visual representation of the multiple entry points into an ongoing process-highlighting access points that encourage curiosity and interrogation of academic syllabi and course content. The inclusive nature of this inquiry invites faculty members and practitioners to confront racism, ableism, and other systems of domination, amplify marginalized scholarship, and redefine early childhood education-related fields, including the Infant and Early Childhood Mental Health landscape. It also underscores the imperative of sustained introspection and collaborative action in nurturing equity.

With the swift advancements in China's education system and society, preschool children's social-emotional competence is becoming increasingly important for adapting to complicated situations. While research shows parental marital quality as a key factor, studies on its specific mechanisms within the Chinese context are limited. Grounded in the framework of family systems theory and incorporating perspectives from the spillover hypothesis, emotional security theory, and attachment theory, this research explores how parental marital quality influences preschool children's social-emotional competence, emphasizing the mediating roles of parent-child and sibling relationships in China. This study examined 227 preschool children (124 boys and 103 girls) from two-child families in six kindergartens across China as research participants. Mother reports on the quality of marital, sibling, and parent-child relationships were collected cross-sectionally to assess the direct and indirect effects on children's social-emotional competence using path models. Results show that parental marital quality positively influences preschool children's social-emotional competence. Additionally, parent-child and sibling relationships not only serve as independent mediators but also create a chain mediating effect. This finding emphasizes the importance of parental marital quality in shaping preschool children's social-emotional competence. It underscores the necessity of nurturing healthy parent-child and sibling interactions via family education.

Maternal self-efficacy during infancy is shaped by many factors, including maternal mental health and social support. This study examines how depression, emotional support, and childcare support relate to maternal self-efficacy among mothers of infants in rural Pakistan. Participants included 885 mothers assessed at 3 and 6 months postpartum. At 3 months postpartum, mothers completed interview measures of depression, emotional social support, support with day-to-day childcare tasks (daily childcare support), and childcare support when they were unable to care for their child (childcare support when needed). At 6 months postpartum, participants reported on maternal self-efficacy. Generalized estimating equations were used to test the associations between depression and social support at 3 months and maternal self-efficacy at 6 months, as well as the interaction between depression and social support. Depression at 3 months was not associated with maternal self-efficacy at 6 months when controlling for depression at 6 months. Emotional support was associated with increased self-efficacy, but daily childcare support was not. We found weak evidence that childcare support when needed was associated with increased self-efficacy only among mothers with depression. Results suggest that emotional support and childcare support when needed may be helpful for promoting mothers' self-efficacy.

Parental reflective functioning is the parent's ability to reflect on the psychological processes in their child and in themselves as a parent. Recently, an infant version of the Parental Reflective Functioning Questionnaire, PRFQ-I, has been developed and validated using confirmatory factor analyses. The present study aims to validate the PRFQ-I using a Rasch model in a sample of 531 Danish mothers at risk of depression and their infants aged 2-11 months. Our findings indicate that seven response categories were too many for the mothers to distinguish across all items. Prementalizing showed adequate psychometric properties, while Certainty of Mental States and Interest and Curiosity required recoding with 4 and 5 as the optimal scores, respectively. After rescoring, both subscales overall showed adequate psychometric properties. However, shortening Certainty of Mental States may be advisable due to local dependency between items 8 and 17. Additionally, items 2 and 14 ("I always know what my child wants" and "I always know why I do what I do to my child") may function better as a separate subscale. We recommend that scores on both Certainty of Mental States and Interest and Curiosity should be analyzed and interpreted in a curvilinear rather than linear manner.

Mother-infant relationship development is influenced by maternal presence, proximity, and the frequency and duration of engagement. Proximity and dyadic engagement can be challenging when an infant is hospitalized in a neonatal intensive care unit (NICU). This study examined patterns of maternal proximity and engagement in a NICU in the Southwestern United States and identified thematic categories of alternate activities to engagement. Trained observers conducted 52 h of NICU observations, documenting maternal presence, patterns of proximity, engagement, nonengagement, and alternate activities to nonengagement and focused engagement. Results include data from 88 mother-infant dyads. Of the time mothers were in proximity to their infants, 83% of these instances occurred without active engagement. In contrast, focused dyadic engagement was noted in 97% of these observations, while unfocused engagement was recorded in 65% of instances. Mothers in proximity but not actively engaged were most often observed using a smartphone, a trend that was also observed when mothers were in unfocused engagement during nurturing social contexts. While it is expected that occasional interruptions to mother-infant interaction in the NICU will occur, more studies are needed to determine the implications of both brief and prolonged disruptions during dyadic interactions on interaction quality in the NICU.

The COVID-19 pandemic affected healthcare practices, especially the provision of face-to-face services due to restrictions and social distance. The aim of the study was to analyze the experience of childbirth care among mothers in Lithuania during the pandemic. A qualitative design was adopted in the study. Research data were collected as part of the international Babies Born Better survey. Data of 200 women who gave birth in Lithuania (February-June 2020 during the COVID-19 pandemic) was included. Participant responses to open-ended questions regarding childbirth care experiences were analyzed using an inductive thematic framework. Four themes emerged: "Subjective experience of birth care service," "COVID-19 policies," "Consideration of mother/baby needs," and "Perception towards staff." Emotional aspects of different care levels were highlighted in themes. Women expressed feelings of thankfulness for staff professionality and responding to their needs. However, perceived staff rudeness, lack of information and absence of an accompanied person negatively related to mothers' perceptions of satisfaction. The results revealed mothers' perceptions of strengths and challenges of the maternity care system in the country where the pandemic was managed with early vaccination, strict lockdown measures and social distancing-higher appreciation of service, regret for disturbed emotional aspects of communication, and lack of support from family members.

Differences in mind-mindedness and parental reflective functioning (PRF) were investigated in mothers and their 6-month-old infants from South Korea (N = 66, 32 girls) and the United Kingdom (N = 63, 26 girls). Mind-mindedness was assessed in terms of appropriate and non-attuned mind-related comments during infant-mother interaction; PRF was assessed using a questionnaire. British mothers commented more on infant desires and preferences, whereas Korean mothers commented more on cognitions and emotions, but there were no cultural differences in overall levels of mind-mindedness. For PRF, Korean mothers reported more certainty about their infants' mental states compared with their British counterparts, but there were no cultural differences in mothers' reported interest in their infants' mental states. Greater reported certainty about infants' mental states was positively related to self-reported parenting quality in both cultural groups, but this association was not seen for parenting quality as assessed observationally. Mind-mindedness and PRF were unrelated in both Korean and British mothers. Results are discussed in terms of the Korean concept of mother-infant oneness and the multi-dimensional nature of parental mentalization.

The purpose of this article is to share our story of conceptualizing Indigenous early relational wellbeing (ERW), specifically reflecting American Indian and Alaska Native worldviews. Our approach is grounded in Indigenous methodologies and guided by a Community of Learning comprised of Indigenous and allied Tribal early childhood community partners, researchers, practitioners, and federal funders. We describe the steps we took to conceptualize caregiver-child relationships from an Indigenous perspective, center Indigenous values of child development, apply an established Indigenous connectedness framework to early childhood, and co-create a conceptual model of Indigenous ERW to guide future practice and research. This model highlights relational practices as seeds of connectedness and relational wellbeing, and includes the roles of spirituality, culture, and ceremony in nurturing ERW; the manifestations of relational wellbeing across the lifespan; and the interdependence of relational wellbeing within communities and families, across generations, and with the environment. The model also informs the creation of a measure to understand practices that foster relational wellbeing among Indigenous children and families and their relationship to positive development, thus informing research, practice, and policy.

Parents serve as the primary informants about infant development, wherefore interparent agreement is essential for facilitating timely identification of children at risk. We studied interparent agreement about infant socioemotional adjustment among 323 mothers and fathers/co-parents of 11-month-old infants living in Denmark using The Ages & Stages Questionnaires: Social-Emotional, Second Edition (ASQ:SE-2). Agreement was assessed through correlation, mean differences, and agreement on different risk levels. We also examined predictors of agreement including child gender, duration of paternity leave, parental educational level, and parenting stress. Finally, interaction effects between parents' educational levels and parenting stress were also examined. Results showed moderate correlations and a small mean difference between parents' total scores, with mothers reporting better infant socioemotional adjustment than fathers. There were also significant differences in terms of placing the child at different risk levels, emphasizing the practical implications of interparent disagreement for screening purposes. Interparent disagreement was predicted by an interaction effect between parents' levels of parenting stress. Results showed that when fathers/co-parents experience low levels of parenting stress, higher levels of parenting stress among mothers are associated with more disagreement. The study is limited as the sample primarily comprises parents of Danish origin with high educational levels.

Promoting First Relationships (PFR) is an evidence-based home-visiting program for caregivers and their children from birth to age 5 years. It focuses on caregiver-child interaction, attachment, and relationship quality using video feedback of unedited recordings to elicit reflection and provide positive feedback linked to knowledge development. This paper provides a brief history of PFR and reports on a qualitative study of 222 caregivers' comments about their PFR experiences following participation in one of four randomized controlled trials conducted over the past decade in the United States (two studies within child welfare setting, one study with Native American families, and one study with Spanish and English-speaking mothers), using a thematic analysis approach to code excerpts from written satisfaction surveys and oral satisfaction interviews. Caregivers' comments about PFR were positive and were classified into four major thematic areas: a caring, trusting relationship with the provider; enthusiastic program endorsement; improved relationship with their child; and reports of their personal growth and development. The qualitative results align with the key components of the PFR program and confirm aspects of the PFR theory of change model.

Strength-based video-feedback (SB-VF) is an attached base and culturally sensitive video-feedback intervention which promotes maternal well-being and sensitivity through using mentalization technics. The goals of this study were to investigate the feasibility, acceptability, and preliminary effectiveness of internet-delivered SB-VF to mother with post-partum depression during COVID-19 pandemic. A pilot randomized, two arm controlled trial was conducted (trial registration NCT04748731) with depressive symptoms' women (n = 172) from Chilean public primary health centers, 79 were randomized to either experimental group (on-line SB-VF plus treatment as usual [TAU], n = 41) or control group (TAU, n = 38). Primary outcomes were feasibility measured by eligibility rate, recruitment rate and intervention completion, and acceptability measured by in depth interviews to mothers and therapists. Secondary outcomes were change in depressive symptoms, maternal sensitivity and parental reflective function. The study demonstrated favorable feasibility and acceptability. Despite moderate recruitment rates, the completion rate was notably high in comparison to other online interventions. Participants reported positive experiences, though some faced challenges with internet access and privacy. Maternal sensitivity improved in the intervention group with a small to large effect size. The SB-VF intervention is feasible and preliminarily effective in public health system, with potential for scaling up in similar contexts.