Maternal bonding in mothers of infants with excessive crying, sleeping, and/or eating disorders: the role of maternal stress and infant temperament

Abstract

Excessive crying, sleeping and/or eating disorders are among the most common mental health diagnoses in the first 3 years of life and can occur in the context of early childhood regulatory problems (RPs). They are associated with impairments in mother-infant bonding, which in turn is linked to reduced mentalization, maternal stress and maternal psychopathology as well as infant's temperament, particularly elevated negative affect (NEG), fussiness, and irritability, reflecting a more difficult temperament. The aim of the present study was to investigate maternal bonding in mothers of infants with excessive crying, sleeping and/or eating disorders. We assumed that maternal bonding impairment would be associated with maternal mentalization, stress, psychopathology as well as the degree of infant's regulatory problems and infant's temperament. The sample comprised 119 mothers of infants aged 0–24 months ( M = 11.41) diagnosed with an excessive crying, sleeping, and/or eating disorder according to DC:0–5 at a socio-pediatric clinic in Germany. Maternal bonding was assessed using the Postpartum Bonding Questionnaire. Maternal mentalization was measured with the Parental Reflective Functioning Questionnaire. Parenting stress was assessed with the Parenting Stress Index (PSI), and psychopathology with the Symptom-Checklist-90. Infant symptom severity was measured using the Questionnaire for Crying, Feeding, and Sleeping. Infant temperament was assessed with the Infant Behavior Questionnaire–Revised Very Short Form or the Early Childhood Behavior Questionnaire Very Short Form (ECBQ VSF). Correlational analyses showed negative associations between maternal bonding impairments and certainty about mental states and infants' temperament [surgency (SUR) and effortful control (EC)] as well as positive associations between maternal bonding impairments and pre-mentalizing mode, stress and psychopathology, as well as with infants' crying and sleeping problems. A regression analysis showed that only increased parenting stress and lower infant effortful control were significantly associated with maternal bonding impairments. Both maternal and infant factors contribute to maternal bonding impairments. Although the cross-sectional design precludes causal conclusions, the findings suggest that infants' low self-regulation may increase parenting stress, which in turn may elevate the risk of bonding difficulties. Bidirectional effects cannot be ruled out. These highlight the association between parental psychosocial stressors and infant regulatory characteristics in shaping bonding experiences.