Beyond the feeding relationship: mothers' descriptions of interaction within the mother-child dyad

Master Thesis


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University of Cape Town

The mother-child relationship is a key determinant of child health. Current evidence acknowledges that impaired mother-child interaction affects social, emotional, cognitive and behavioural development in infants. Disrupted interaction within the mother-child dyad can be caused by a variety of factors including prolonged separation, illness, abusive relationships, maternal stress and other psychosocial disturbances. Post-Partum Depression (PPD), in particular, compromises mother-child interaction. Despite the fact that recent studies have demonstrated that the prevalence of PPD in low-income communities is approximately three times that found in first world countries, mother-child interaction is seldom evaluated and facilitated in primary care. Physical growth is often the only measure of infant health and development. The objectives of this qualitative study were to explore the mother's description of mother-child interaction; the importance that the mother ascribes to this interaction; and the mother's perception of the factors which facilitated interaction within the mother-child dyad. First-time mothers were purposively sampled and semi-structured interviews were conducted. After general inductive analysis of the verbatim transcriptions of the interviews, five main themes emerged. These were: (2)"What I expected" which described expectations around the birth and the impact on mother-child interaction, (2) "Isn't one supposed to feel ... ?" explored the mothers concerns regarding interaction, emotions and adaptation, (3) "Connecting with my baby" described a process of physical connectedness which enhanced emotional connectedness, (4)"We reflect each other's feelings " illustrated how feelings are echoed between mother and baby and empathy developed, and (5) "That helped/hindered our interaction " described factors which eased the fluency of mother-child interaction. These findings are discussed in relation to neuro-scientific developmental theories; namely Porges' Polyvagal Theory of subconscious adaptation for social behaviour and security strategies, and The Mirror Neuron Theory which describes mechanisms of imitation and the development of empathy. Factors which enhanced mother-child interaction are discussed within the context of a changing society. The findings suggest the potential value of including the facilitation of mother-child interaction in the practice of health professionals, particularly midwives and other workers in maternal and child health. This may include training in non-directive counselling of mothers, the recognition of disengaged mother-child interaction, and relationship facilitation. This study emphasizes the importance of mother-child interaction and that health professionals need to be aware of the potential for maternal mental health problems after birth, and the long-term consequences of poor mother-child interaction on infant health.