When children experience extreme or persistent stressors (e.g., maltreatment, housing insecurity, intimate partner violence), prolonged elevation of the stress-response system can lead to disrupted development of multiple physiological systems. This response, known as toxic stress, is associated with poor physical and mental health across the life course. Emerging evidence suggests that the effects of toxic stress may be transmitted through generations, but the biological and behavioral mechanisms that link caregivers\' childhood history with the health of the children they care for remain poorly understood. The purpose of this report is to describe the research protocol for The CARING (Childhood Adversity and Resilience In the Next Generation) Study, a cross-sectional study of caregivers with children aged 3-5 years designed to (1) examine the intergenerational transmission of toxic stress and protective factors; (2) explore three hypothesized pathways of transmission: parenting, daily routines, stressors, and supports; and (3) explore the extent to which genotypic variation in candidate genes related to caregiving and stress contribute to caregivers\' and children\'s susceptibility to the effects of early childhood experiences (i.e., gene × environment interactions). We expect that findings from this study will provide critical data needed to identify targets for precision health interventions, reduce health disparities related to toxic stress, and prevent cycles of adversity among families at risk.

Pregnant individuals and parents have experienced elevated mental health problems and stress during COVID-19. Stress during pregnancy can be harmful to the fetus and detrimental to the parent-child relationship. However, social support is known to act as a protective factor, buffering against the adverse effects of stress. The present study examined whether (1) prenatal stress during COVID-19 was associated with parent-infant closeness at 6 months postpartum, and (2) social support moderated the effect of prenatal stress on the parent-infant relationship. In total, 181 participants completed questionnaires during pregnancy and at 6 months postpartum. A hierarchical linear regression analysis was conducted to assess whether social support moderated the effect of stress during pregnancy on parent-infant closeness at 6 months postpartum. Results indicated a significant interaction between prenatal stress and social support on parents\' perceptions of closeness with their infants at 6 months postpartum (β = .805, p = .029); parents who experienced high prenatal stress with high social support reported greater parent-infant closeness, compared to those who reported high levels of stress and low social support. Findings underscore the importance of social support in protecting the parent-infant relationship, particularly in times of high stress, such as during the COVID-19 pandemic.
Individuos y progenitores en estado de embarazo experimentan elevados problemas de salud mental y estrés durante el COVID‐19. El estrés durante el embarazo puede ser dañino para el feto y perjudicial para la relación progenitor‐niño. Sin embargo, es sabido que el apoyo social actúa como un factor de protección, sirviendo como agente amortiguador contra los adversos efectos del estrés. El presente estudio longitudinal examinó si 1) el estrés prenatal durante el COVID‐19 se asociaba con la cercanía madre‐infante a los seis meses después del parto, y 2) el apoyo social moderaba el efecto del estrés prenatal en la relación madre‐infante. Un total de 181 participantes completaron cuestionarios durante el embarazo y a los seis meses después del parto. Un análisis de regresión lineal jerárquico se llevó a cabo para evaluar si el apoyo social moderaba el efecto del estrés durante el embarazo en cuanto a la cercanía progenitor‐infante a los seis meses después del parto. Los resultados indicaron una interacción significativa entre el estrés prenatal y el apoyo social sobre las percepciones que los progenitores tenían de la cercanía con sus infantes a los seis meses después del parto (β = .805, p = .029); los progenitores que experimentaron un alto estrés prenatal con un alto apoyo social reportaron una mayor cercanía progenitor‐infante, comparados con aquellos que reportaron altos niveles de estrés y bajo apoyo social. Los resultados subrayan la importancia del apoyo social para proteger la relación progenitor‐infante, particularmente en épocas de alto estés, tal como durante la pandemia del COVID‐19.
Les personnes enceintes et les parents font l\'expérience de plus grands problèmes de santé mentale et de plus de stress durant la crise du COVID‐19. Le stress durant la grossesse peut être néfaste pour le foetus et vient au détriment de la relation parent‐enfant. Cependant l\'on sait que le soutien social est un facteur de protection, faisant tampon face aux effets adverses du stress. Cette étude longitudinale a examiné si 1) le stress prénatal durant le COVID‐19 était lié à la proximité mère‐nourrisson à six mois postpartum, et 2) le soutien social a modéré l\'effet du stress prénatale sur la relation mère‐nourrisson. En tout 181 participants ont rempli des questionnaires durant la grossesse et à sic mois postpartum. Une analyse de régression linéaire hiérarchique a été faite pour évaluer si le soutien social a modéré l\'effet du stress durant la grossesse sur la proximité parent‐nourrisson à six mois postpartum. Les résultats ont indiqué une interaction importante entre le stress prénatal et le soutien social sur les perceptions des parents de la proximité avec leurs nourrissons à six mois postpartum (β = ,805, p = ,029); les parents qui ont fait l\'expérience d\'un stress prénatal élevé avec un soutien social élevé ont signalé une plus grande proximité parent‐nourrisson, comparé à ceux ayant signalé des niveaux de stress élevés et un faible soutien social. Les résultats soulignent l\'importance du soutien social dans la protection de la relation parent‐nourrisson, particulièrement en temps de stress élevé, comme durant la pandémie de COVID‐19.
Soziale Unterstützung federt die Auswirkung von Schwangerschaftsstress auf die Wahrnehmung der Nähe zwischen Eltern und Kind während der COVID‐19‐Pandemie ab Schwangere und Eltern leiden während COVID‐19 unter erhöhten psychischen Problemen und Stress. Stress während der Schwangerschaft kann für den Fötus schädlich sein und die Eltern‐Kind‐Beziehung beeinträchtigen. Es ist jedoch bekannt, dass soziale Unterstützung als Schutzfaktor wirkt und die negativen Auswirkungen von Stress abfedert. In der vorliegenden Längsschnittstudie wurde untersucht, ob 1) pränataler Stress während COVID‐19 sechs Monate nach der Geburt mit der Nähe zwischen Mutter und Kind zusammenhängt und 2) ob soziale Unterstützung den Effekt pränatalen Stresses auf die Mutter‐Kind‐Beziehung moderiert. Insgesamt füllten während der Schwangerschaft und sechs Monate nach der Geburt 181 Teilnehmerinnen Fragebögen aus. Es wurde eine hierarchische lineare Regressionsanalyse durchgeführt, um festzustellen, ob soziale Unterstützung den Effekt von Stress während der Schwangerschaft auf die Nähe zwischen Mutter und Kind sechs Monate nach der Geburt moderiert. Die Ergebnisse zeigten eine signifikante Interaktion zwischen pränatalem Stress und sozialer Unterstützung auf die Wahrnehmung der Eltern von Nähe zu ihren Kindern sechs Monate nach der Geburt (β = .805, p = .029); Eltern, die hohen pränatalen Stress mit hoher sozialer Unterstützung erlebten, berichteten von größerer Eltern‐Kind‐Nähe im Vergleich zu denen, die ein hohes Stressniveau und geringe soziale Unterstützung berichteten. Die Ergebnisse unterstreichen die Bedeutung sozialer Unterstützung für den Schutz der Eltern‐Kind‐Beziehung, insbesondere in Zeiten hohen Stresses, wie z. B. während der COVID‐19‐Pandemie.
流行期における親子間の親密さの認知に対する妊娠ストレスの影響の社会的支援による緩衝 COVID‐19の流行中、妊娠中の個人と親は、精神衛生上の問題とストレスの高まりを経験している。妊娠中のストレスは胎児に有害であり、親子関係にも悪影響を及ぼす可能性がある。しかし、社会的支援は保護因子として作用し、ストレスの悪影響を緩衝することが知られている。今回の縦断研究では、1)COVID‐19中の出生前ストレスが産後6ヵ月の母子密着度と関連するかどうか、2)社会的支援が出生前ストレスの母子関係への影響を緩和するかどうかを検討した。合計181名の参加者が、妊娠中と産後6ヶ月の時点でアンケートに回答した。社会的支援が妊娠中のストレスが産後6ヶ月の親子関係に及ぼす影響を緩和するかどうかを評価するために、階層的線形回帰分析を行った。その結果、出生前ストレスと社会的支援との間に、産後6ヵ月における両親の乳児との親密さの認識に対する有意な相互作用が示された(β = 0.805、p = 0.029);出生前ストレスが高く社会的支援が高いと報告された両親は、ストレスが高く社会的支援が低いと報告された両親に比べ、乳児との親密さが高いと報告された。特にCOVID‐19パンデミックのような高ストレス時には、親子関係を保護する社会的支援の重要性が強調された。.
在COVID‐19期间, 孕妇和父母会面临严重的心理健康问题和压力。 孕期压力可能对胎儿有害, 也不利于亲子关系。然而, 社会支持被认为是一种保护因素, 可以缓解压力带来的负面影响。这项纵向研究旨在探究以下两个问题:1)COVID‐19期间孕期压力是否与产后六个月母婴亲密程度存在关联, 2)社会支持是否调节了孕期压力对母婴关系的影响。总共有181名参与者完成了孕期和产后六个月的问卷调查。我们进行了分层线性回归分析, 以评估社会支持是否调节了孕期压力对产后六个月亲子亲密程度的影响。结果显示, 孕期压力和社会支持之间存在显著交互作用, 对父母在孩子六个月时感受到的亲密程度产生影响(β = .805, p = .029);与经历高压力但社会支持较低的父母相比, 经历高压力且拥有高社会支持的父母报告了更高的亲子亲密程度。研究结果强调了社会支持在保护亲子关系方面的重要性, 特别是在高压时期, 例如在COVID‐19大流行期间。.
دور الدعم الاجتماعي الوقائي في تخفيف أثر ضغوط الحمل على تصورات التقارب بين الوالدين والرضيع أثناء جائحة كوفيد‐19 يعاني الحوامل والآباء من مشاكل صحية نفسية مرتفعة وضغط نفسي خلال فترة انتشار فيروس كورونا. ويمكن أن يكون الإجهاد أثناء الحمل ضاراً بالجنين ويضر بالعلاقة بين الوالدين والطفل. ومع ذلك، من المعروف أن الدعم الاجتماعي يعمل كعامل وقائي، حيث يحمي من الآثار الضارة للتوتر. تناولت الدراسة الطولية الحالية ما إذا كان 1) الإجهاد العصبي والتوتر قبل الولادة أثناء كوفيد‐19 مرتبطاً بالتقارب بين الأم والرضيع بعد ستة أشهر من الولادة، و2) الدعم الاجتماعي يخفف من تأثير الإجهاد العصبي قبل الولادة على العلاقة بين الأم والرضيع. أكملت 181 مشاركة الاستبيانات أثناء الحمل وبعد ستة أشهر من الولادة. وتم إجراء تحليل الانحدار الخطي الهرمي لتقييم ما إذا كان الدعم الاجتماعي يخفف من تأثير الإجهاد أثناء الحمل على التقارب بين الوالدين والرضيع بعد ستة أشهر من الولادة. أشارت النتائج إلى وجود تفاعل كبير بين الإجهاد السابق للولادة والدعم الاجتماعي على تصورات الوالدين حول التقارب مع أطفالهم الرضع بعد ستة أشهر من الولادة p = .029)(β = .805, ؛ وأفاد الآباء الذين عانوا من ضغوط عالية قبل الولادة مع دعم اجتماعي مرتفع عن تقارب أكبر بين الوالدين والرضيع، مقارنة بأولئك الذين أبلغوا عن مستويات عالية من التوتر وانخفاض الدعم الاجتماعي. تؤكد النتائج على أهمية الدعم الاجتماعي في حماية العلاقة بين الوالدين والرضيع، خاصة في أوقات التوتر الشديد، مثل جائحة كوفيد‐19.

BACKGROUND: Although the importance of the dynamic intra-individual relationship between mother-to-infant bonding and postpartum depressive symptoms has been widely recognized, the complex interplay between them is not well understood. Furthermore, the potential role of prenatal depressive symptoms and infant temperament in this relationship remains unclear. This study aims to examine the bidirectional influence of mother-to-infant bonding on postpartum depressive symptoms within individuals and to elucidate whether prenatal depressive symptoms and infant temperament would influence deviations from stable individual states.
METHODS: Longitudinal data were collected from 433 women in early pregnancy. Of these, 360 participants completed the main questionnaires measuring impaired mother-to-infant bonding and postpartum depressive symptoms at least once during the postpartum period. Data were collected at early and late pregnancy and several postpartum time points: shortly after birth and at one, four, ten, and 18 months postpartum. We also assessed prenatal depressive symptoms and infant temperament. A random-intercept cross-lagged panel model was used.
RESULTS: Within-individual variability in mother-to-infant bonding, especially anger and rejection, significantly predicted subsequent postpartum depressive symptoms. However, the inverse relationship was not significant. Additionally, prenatal depressive symptoms and difficult infant temperament were associated with greater within-individual variability in impaired mother-to-infant bonding and postpartum depressive symptoms.
CONCLUSIONS: The present study demonstrated that the within-individual relationship between mother-to-infant bonding and postpartum depressive symptoms is likely non-bidirectional. The significance of the findings is underscored by the potential for interventions aimed at improving mother-to-infant bonding to alleviate postpartum depressive symptoms, suggesting avenues for future research and practice.

BACKGROUND: The birth of a pre-mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short-term health outcomes of pre-mature infants admitted to neonatal intensive care units (NICUs).
METHODS: In this quasi experimental study, 80 mothers of pre-mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother-infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant\'s Maternal Attachment Assessment Strategy. Moreover, infants\' short-term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis.
RESULTS: On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4-42/11) and 37 (31/85-42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05).
CONCLUSIONS: Instructing mothers in attachment behaviors clinically improved short-term health-related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre-mature infants.

Pregnancy frequently is associated with emotional conditions such as anxiety and depression. Perinatal depression has an incidence of around 12%. Only recently researcher put the attention on the effects of pre- and postpartum psychopathology on infant neurocognitive development. Neurobiology studies indicate that perinatal maternal depression can significantly affect the structure and function of children\'s prefrontal cortex and modulate the development of cognitive abilities from intrauterine life. On the topic, the scientific literature appears ambiguous, reporting mixed results. Some studies have found no significant differences in developmental outcomes between prenatal and postpartum exposure to maternal depression, others have suggested a greater burden of depression in pregnancy than in postpartum, and still others have emphasized the role of chronicity of symptoms rather than the period of onset. Few studies have examined the effects of different developmental trajectories of maternal depression on children\'s neurocognitive outcomes. The assessment of maternal health has for years been limited to postpartum depression often neglecting the timing of onset, the intensity of symptoms and their chronicity. These aspects have received less attention than they deserve, especially in relation to the effects on children\'s neurocognitive development. The aim of this Perspective was to highlight inconsistencies and gaps that need to be filled in the approach to the study of this problem. Given the wide heterogeneity of data in the current literature, further studies are needed to clarify these interactions. This Perspective provides an overview of current progress, future directions, and a presentation of the authors\' views on the topic.

OBJECTIVE: Some women who intend to breastfeed experience a breastfeeding aversion response (BAR) while breastfeeding.
BACKGROUND: Little is known about the experience of those who have feelings of aversion while breastfeeding.
OBJECTIVE: This study aimed to investigate the experiences of women who have an aversion response to breastfeeding while their infant is latched at the breast. This is the first study that aims to understand this breastfeeding aversion response (BAR) as described by women who experience this phenomenon.
METHODS: Interpretative phenomenological analysis (IPA) was used to conduct and analyse ten semi-structured in-depth interviews with women who self-identified as experiencing BAR.
RESULTS: Four overarching themes were identified: (1) Involuntary, strong sensations of aversion in response to the act of breastfeeding, (2) Internal conflict and effects on maternal identity, (3) The connection between BAR and relationships with others, and (4) Reflections on coping with BAR and building resilience.
CONCLUSIONS: Some women who intend to breastfeed can experience BAR, and this negative sensation conflicts with their desire to breastfeed. BAR can impact on maternal wellbeing. Those who experience BAR may benefit from person-centred support that directly addresses the challenges associated with BAR to achieve their personal breastfeeding goals.
CONCLUSIONS: The experience of BAR is unexpected and difficult for mothers. If support is not available, BAR can have detrimental effects on maternal identity, mother-child bonds, and intimate family relationships.

The present study, carried out during the first peak of the COVID-19 outbreak in Italy, aimed at investigating the mental health of mothers and children during the nationwide lockdown. More specifically, the study investigated children\'s depression and mothers\' individual distress and parenting stress, in comparison with normative samples. The mediating effect of mothers\' parenting stress on the relationship between mothers\' individual distress and children\'s depression was also explored. Finally, the study analyzed whether children\'s biological sex and age moderated the structural paths of the proposed model. A sample of 206 Italian mothers and their children completed an online survey. Mothers were administered self-report questionnaires investigating individual distress and parenting stress; children completed a standardized measure of depression. Mothers\' individual distress and parenting stress and children\'s depression were higher than those recorded for the normative samples. Mothers\' parenting stress was found to mediate the association between mothers\' individual distress and children\'s depression. With respect to children, neither biological sex nor age emerged as significant moderators of this association, highlighting that the proposed model was robust and invariant. During the current and future pandemics, public health services should support parents-and particularly mothers-in reducing individual distress and parenting stress, as these are associated with children\'s depression.

BACKGROUND: Atypical neurocognitive responses to emotional stimuli are core features of unipolar depression (UD) and bipolar disorder (BD). For mothers with these mood disorders, this may influence interactions with their infants and consequently infant development. The study aimed to investigate psychophysiological and cognitive responses to infant emotional stimuli, and their relation to mother-infant interaction and infant development, in mothers with BD or UD in full or partial remission.
METHODS: Four months after birth, mothers\' cognitive responses to emotional infant stimuli were assessed with computerized tasks, while their facial expressions, galvanic skin responses (GSR), gazes, and fixations were recorded. Infant development and mother-infant interactions were also assessed.
RESULTS: We included 76 mothers: 27 with BD, 13 with UD, and 36 without known psychiatric disorders, and their infants. Mothers with BD and UD were in full or partial remission and showed blunted GSR and spent less time looking at infant stimuli (unadjusted p values < 0.03). Mothers with BD showed subtle positive neurocognitive biases (unadjusted p values<0.04) and mothers with UD showed negative biases (unadjusted p values < 0.02). Across all mothers, some measures of atypical infant emotion processing correlated with some measures of delays in infant development and suboptimal mother-infant interaction (unadjusted p values<0.04).
CONCLUSIONS: Mothers with mood disorders in full or partial remission showed atypical cognitive and psychophysiological response to emotional infant stimuli, which could be associated with mother-infant interactions and infant development. The study is explorative, hypothesis generating, and should be replicated in a larger sample. Investigation of the long-term implications of reduced maternal sensitivity is warranted.

The aim of the study was to examine mother-child connectedness and father-child connectedness in adolescence as potential protective factors against a range of disordered eating symptoms in young adulthood among males and females.
This study used data from the National Longitudinal Study of Adolescent to Adult Health (N = 13,532). Sex-stratified logistic regression models adjusted for demographic covariates were conducted to examine associations of youth-reported mother-child connectedness and father-child connectedness in adolescence (mean age = 15.4 years) with disordered eating symptoms in young adulthood (mean age = 21.8 years).
In this nationally representative sample of U.S. young adults, 7.2% of participants reported binge eating-related concerns, 3.7% reported compensatory behaviors (e.g., self-induced vomiting) to control weight, and 8.6% reported fasting/skipping meals to control weight. Among females, both higher mother-child connectedness and higher father-child connectedness were associated with lower odds of binge eating-related concerns (mother-child: odds ratio [OR] = .83, 95% confidence interval [CI] = .74-.94; father-child: OR = .79, 95% CI = .69-.91), compensatory behaviors (mother-child: OR = .85, 95% CI = .75-.97; father-child: OR = .81, 95% CI = .69-.95), and fasting/skipping meals (mother-child: OR = .79, 95% CI = .72-.87; father-child: OR = .81, 95% CI = .73-.91). No statistically significant associations were observed for mother-child connectedness or father-child connectedness with future disordered eating symptoms among males.
These findings suggest that improving mother-child connectedness and father-child connectedness in adolescence may be valuable targets for eating disorders intervention, particularly among females.

Findings on nonprimate mammals place the issue of mother-infant lateralized relations in a broader context, demonstrating that humans are one of many species showing this feature. The remarkable interspecies consistency in the direction of lateralization points to a continuity between lateralized mother-infant interactions in primates and nonprimate mammals and suggests ancient evolutionary roots of human cradling bias. The results from species which, in contrast to primates, have no direct involvement of forelimbs in mother-infant spatial interactions clearly support the perceptual origin of this type of lateralization. A right hemisphere advantage for social functions relevant to mother-infant interactions is the most probable background for the left-sided biases in the behavior of mothers and infants. Recent findings suggest the contribution of lateralized mother-infant interactions to biological fitness. Mother and infant both can gain advantage from keeping the other on the left side.