The effect of mother-infant skin-to-skin contact on Ghanaian infants’ developing social expectations for maternal behavior was investigated. Infants with high and low mother-infant skin-to-skin contact experience in the infants’ first month engaged with their mothers in a Still Face Task at 6 weeks of age. Infants with high skin-to-skin contact experience, but not those with low skin-to-skin contact experience, demonstrated the still face effect with their smiles. Infants with both high and low skin-to-skin contact experience demonstrated the still face effect with their visual attention. The behaviors of the Ghanaian infants and their mothers during the task were compared to archival evidence of Canadian mother-infant dyads’ behaviors in skin-to-skin and control groups who engaged in the Still Face Task at the infant ages of 1 and 2 months. Similarities and differences between the behaviors of the mother-infant dyads in the two cultures were assessed.
Mothers were recruited prior to the birth of their infants during prenatal visits at the Komfo Anokye Teaching Hospital, a large public hospital in Kumasi, the capital city of the Ashanti Region and the second largest city in Ghana. The Antenatal Clinic at Komfo Anokye Teaching Hospital serves pregnant women residing in the urban area and surrounding villages. The Ashanti Region adheres to a matrilineal tradition in which people have an attachment to villages of their mothers’ family. Pregnant women typically spend time in these villages prior to, and after, the birth of their infants. Thus traditional means of child care are prevalent for both urban and village women. Although English is the official language of Ghana, in the Ashanti Region Twi is the common language. All the communications with the mothers were conducted in Twi by native speakers. The participants were 26 infants (14 males) and their mothers. The mean age of the mothers at the infants’ birth was 28.1 years (SD = 4.0 years). The percentage of mothers with a university degree was 15%, 15% had some post-secondary training, 31% had only a high school diploma, and 39% were without a high school diploma. The mothers were predominantly from the ethnic group Akan (92%) with a minority from Ewe (8%). For 40% of the mothers, this was their first child; 28% of the mothers had one previous child, and 32% of the mothers had two or more previous children. All the mothers had telephones, necessary for SSC reporting. The infants’ mean gestation age was 38.3 weeks (SD = 1.9 weeks). Their mean birth weight was 3005.3 g (SD = 489.3 g). The videotaped mother-infant Still Face Task was conducted at the infants’ 6 week checkup (M age = 46 days, SD = 5 days). The participants were 80 infants (38 males) and their mothers. Mothers were recruited prior to the birth of their infants through perinatal clinics at two hospitals with similar demographics in northeastern Canada. One hospital recruited for the SSC group and one hospital recruited for the control group. Approximately halfway through the study, the recruitment sites were switched; the former SSC site became the control site and vice versa. Dyads of the recruited mothers were included if the infants were over 37 weeks gestation age and had no medical problems. Twenty-eight dyads were in the SSC group and 52 dyads were in the control group. Socioeconomic status (SES) of the infants’ families was measured by a Canadian index (Blishen, Carroll, & Moore, 1987) based on education and income. In the index, occupations are divided into 514 groups, ranging in SES scores of 17.81–101.75 (M = 42.74, SD = 13.28). The scores of the higher status parent in the infants’ families yielded a SES mean score of 50.41 (SD = 11.80). The mean age of the mothers at the infants’ birth was 29.7 years (SD = 5.0 years). The percentage of mothers with a university degree was 42%, 41% had some university education, 16% had only a high school diploma, and 1% were without a high school diploma. The racial-ethnic composition of the mothers was 99% non-Hispanic White and 1% Asian. For 47% of the mothers, this was their first child, 29% of the mothers had one previous child, and 24% of the mothers had two or more previous children. The infants’ mean birth weight was 3647.11 g (SD = 530.95 g). The videotaped mother-infant Still Face Tasks used for comparison with the Ghanaian mother-infant dyads were conducted when the infants were 1 month (M = 32 days, SD = 5 days) and 2 months (M = 64 days, SD = 8 days). The study received ethical clearance from the first author’s university research ethics board. Women coming for prenatal checkups at Komfo Anokye Teaching Hospital were told about SSC, encouraged to provide SSC for their infants, and asked if they would be willing to participate in the study, which involved keeping daily records of the amount of SSC they provided for their infants through the infants’ first month and engaging in a videotaped Still Face Task with their infants at the 6 week checkup. Women who agreed to participate filled out demographic forms. The first author was notified when the participating mothers gave birth and was given access to the infants’ sex, birth weight, and gestation age. A research assistant telephoned participating mothers weekly through the infants’ first month to gather the daily records of amount of SSC the mothers provided during the previous week. At the infants’ 6 week checkup, the mother and infant engaged in the Still Face Task in a private room in the hospital. In the Still Face Task, the mother and infant sat facing each other approximately 50 to 60 cm apart. The infant sat in an infant car seat that was situated on a table. The mother sat in a chair that allowed her to be at eye level with the infant. Behind and to the side of the infant was an upright mirror (60 cm × 40 cm) in a frame that could be angled to reflect the mother seated opposite the infant. The angle was typically 70–75°. The research assistant videotaping the Still Face Task was behind and to the side of the mother, out of the direct view of the mother and infant. The videotape recorded the infant (full frontal body) and the mother’s reflection (frontal body from the waist up). The Still Face Task consisted of three phases that sequentially followed each other without pause: initial interactive phase, still face phase, reunion phase. For the initial interactive phase, the mother was asked to interact with her infant as she wished for two minutes. For the still face phase, she was asked to become still with a neutral expression, looking at her infant but not talking or touching the infant for one minute. For the reunion phase, the mother was asked to interact with her infant again as she wished for two minutes. The research assistant gave the mother a verbal cue at the beginning of each phase and at the end of the task. The behavior of the mother and infant was scored in the lab of the second author on the Observer Video-Pro 5.0 (Noldus Information Technology, 2003) computer software program by a coder blind to the amount of SSC mothers provided. Infants were scored for duration of visual attention, and positive and negative affect in facial expressions (smiles, frowns) and in vocalizations (non-distress vocalizations, distress vocalizations) during each of the three phases of the Still Face Task. Visual attention was scored as the presence or absence of looking at the mother’s face. Smiles were scored as upward lip movements with or without vocalizations. Frowns were downward lip movements with or without vocalizations. Non-distress vocalizations excluded distress vocalizations (fussing, crying) and digestive sounds (e.g., burps, hiccups). Distress vocalizations excluded non-distress vocalizations and digestive sounds. The duration times were converted to percentage of time within each phase. Mothers were scored for duration of visual attention to the infant’s face, smiles, vocalizations, and physical contact with their infants during the two interactive phases of the task. Mothers’ vocalizations, which were all non-distress vocalizations, were further coded as arousing (energetic, highly stimulating) or neutral (excluding arousing vocalizations). Mothers’ physical contact with their infants was coded as arousing (e.g., pumping the infant’s legs), attention getting (e.g., tapping the infant’s face when not looking at mother), soothing (e.g., gentle stroking), adjusting (e.g., repositioning infant), or passive holding (e.g., hands passively on infant’s body). The duration times were converted to percentage of time within the interactive phases. The coder was blind to the amount of SSC the mothers provided. Coding of the infant and mother behaviors followed that of previous studies (e.g., Bigelow, 1998; Bigelow & Power, 2012; Bigelow & Walden, 2009), with the addition of mothers’ type of vocalizations (arousing, neutral) and physical contact (arousing, attention getting, soothing, adjusting, passive holding). For reliability purposes, a second coder, who was also blind to the amount of SSC mothers provided, independently scored the behaviors of 19% of the dyads. For infant and mother behaviors, the range of intraclass correlations, absolute type with raters random, was between .821 and .997 (all p ≤ .01). After the study received ethical clearance from the two participating hospitals and the second author’s university research ethics board, the perinatal clinics in the two hospitals distributed Consent to be Contacted Forms to pregnant women in the third trimester of their pregnancy. The women who signed the form were contacted by a research assistant, who explained the study. Mothers who agreed to participate had notices put on their medical charts so that attending nurses would notify the research assistants when the women gave birth. Research assistants (N = 8) visited the mother-infant dyads in their homes when the infants were 1 week, 1 month, 2 months, and 3 months. Mothers were seen by the same research assistant from the contact interview through the data collection visits. Mothers in the SSC group were requested to provide six hours of SSC with their infants cumulative throughout the day during the infants’ first week, and then two hours per day until the infants were one month. No request for mother-infant SSC was made to control group mothers. Mothers in both the SSC and control groups recorded the amount of SSC they provided to their infants each day and records were collected at each visit. The present report presents the results from the Still Face Task conducted in the home when the infants were 1 month and 2 months of age. The setup and procedure of the Still Face Task was identical to that done in Ghana with the exception that the initial interactive phase lasted for 3 min. Coding of the mothers and infants was done in the lab of the second author as described in the Ghana sample by a coder blind to whether the dyads were in the SSC or control groups. For reliability purposes, a second coder, who was also blind to whether the dyads were in the SSC or control group, independently scored the behaviors of 13% of the dyads. For infant and mother behaviors, the range of intraclass correlations, absolute type with raters random, was between .824 and .999 (all p ≤ .01).
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DIMA AI Care
