Using the Five Minute Speech Sample to Assess Reflective Functioning in Young Mothers Who Babywear: A Prospective Study

Young mothers are more likely to experience difficulty bonding with their baby compared to other mothers due to compounding environmental, social, and developmental factors. Research on babywearing (holding or carrying a baby in a soft cloth carrier that is worn on the body) is limited but suggests that frequent close physical contact increases maternal responsiveness, sensitivity, and subsequent healthy attachment. Parental reflective functioning (PRF) is an indicator of parents’ ability to understand their child’s mental processes. Interpersonal, developmental, and environmental risk factors limit opportunities for parents to develop high PRF, which is costly to infants’ development and attachment. Young mothers’ developmental stage and ecological stressors can limit their PRF abilities. In the present study, we hypothesize that maternal PRF in early childhood will be predicted by stress (negatively) and babywearing (positively) during infancy.

Seventy-five mothers (M=19.1 years, SD=2.0; 45.3% White, 44.0% Hispanic; 42.7% <=11^th grade) and their infants participated in the Mother Baby Bonding Study when their infants were 2-4 weeks old (W1). Follow-ups occurred at 4- (W2), 7- (W3), and 42-47 (W4) months old. At each wave, mothers completed a self-report stress inventory and were asked open-ended questions about their experiences with babywearing. At W4, mothers completed the Reflective Functioning Five-Minute Speech Sample (RF-FMSS) through a private recording. The RF-FMSS is an innovative measure that can efficiently assess PRF across development.

 We conducted a mixed methods analysis. A qualitative analysis of experiences with babywearing using an open coding scheme resulted in five primary themes in order of salience: bonding (“she can always be with me”), calm/soothing (“when he’s fussy, he’s a lot calmer when I wear him”), convenience (“I can have her up here and I have my hands free”), infant well-being (“he’s walking around with me and watching me do things which I think helps him to learn”), and disliked carrier (“I feel like I’m burning up”). Point-biserial correlation coefficients were conducted between each of the themes (1=primary experience, 0=not primary experience) in infancy and PRF scores in early childhood. Pearson’s correlation coefficient prospectively examined the association between parental stress and PRF. Mothers who babywore to calm their infant (r=.28) or to improve their infant’s well-being (r=.40) had higher PRF 3 years later, mothers who disliked the carrier (r=-.33) or had greater stress when infants were 7 months had lower PRF (r=-.37). All findings were statistically significant, p<.05.

Babywearing in infancy can increase, while stress can decrease, PRF in young mother. This study demonstrates that babywearing is an effective, culturally relevant, and cost-effective parenting tool that can increase maternal mentalization among high risk groups. Additionally, the RF-FMSS is a practical and efficient assessment tool that can be used among young mothers to assess the impact of attachment-based interventions.