Can Infant Carrying Improve Mother-Infant Interactions? Evidence from an Intervention with Vulnerable Adolescent Mothers

Background: Young mothers are at higher risk for child maltreatment and neglect and are more likely to experience difficulty bonding with their baby compared to other mothers: Their babies are more likely to have a difficult temperament (e.g., born premature, prenatal exposure to substance use) and they are less likely to have the resources required to cope with heightened infant crying and infant sleep dis-regulation. Close proximity to infants increases mothers’ awareness of her infants’ needs (e.g., hunger) and also promotes the neuropeptide oxytocin, which is associated with maternal behavior (e.g., affectionate touch, positive affect during mother-infant interactions, and “motherese”). Limited research on infant carrying (i.e., holding or carrying a baby in a cloth carrier that is worn on the body) indicates that frequent close physical contact increases maternal responsiveness and promotes secure attachment between mothers and their infants. The purpose of this study is to assess the potential use of infant carrying practices as an effective and cost-effective intervention to improve mother-infant bonding in a sample of vulnerable young mothers.

Methods: The Mother Baby Bonding Study is an intervention study of 74 mothers (M=19.2 years, Mothers participated in Healthy Families or Teen Outreach Pregnancy Services programming. They were randomly assigned to the intervention condition (n=36; received an infant carrier) or the control condition (n=38; received a baby book set). Mothers in the intervention condition were told to carry their babies in the carrier for at least one hour every day. Mother’s in the control condition were told to read to their babies. In-home assessments were conducted at 2-4 weeks postpartum (W1), and 3- (W2) and 6- (W3) months later. At W3, 34 mothers and babies (n=17 intervention, n=17 control) participated in the Still-Face Paradigm to assess observed mother-infant interactions (2 minutes interaction, 2 minutes still-face, 2 minutes reunification). Videos were coded for observed infant and mother engagement behaviors based on Tronick’s scoring systems, including facial expressions, direction of gaze, and vocalizations. A meta-analysis review supports positive associations between infant positive affect during the still-face task and secure attachment at one year.

Results: Repeated measures ANOVA indicated that compared to the control condition, infants in the intervention condition spent significantly less time in infant protest, F(1,32)=4.22, η_p² =.12, p< .05, and object/environment engagement, F(1,32)=6.95, η_p² =.18, p<.05, and mothers in the intervention condition spent significantly more time in social positive engagement, F(1,32)=6.52, η_p² =.17, p< .05, and in exaggerated positive engagement, F(1,32)=7.10, η_p² =.18, p<.05. Effect sizes were moderate to large.

Implications: Promoting the use of infant carriers is a cost-effective and culturally relevant practice across many cultures. Video clips from the 6-month follow-up will be used in the presentation to highlight observed markers of strengths and challenges within mother-infant interactions. Preliminary results hold promising policy implications for the promotion of infant carriers and the practice of infant carrying as an effective tool at promoting infant attachment and ultimately reducing child maltreatment.