Maternal sensitivity and mother-infant attachment are associated with antibiotic uptake in infancy

• In Event: Poster Session 02
  In Poster Session: PS 02 Topic - Health, Growth, Injury

Abstract

Secure attachment predicts better health and developmental outcomes than insecure mother-child attachment relationships (Meredith & Strong, 2019). Inversely, the insecure attachment is more likely to be observed in children: with chronic diseases (e.g., Cassibba, van Ijzendoorn, Bruno, & Coppola, 2004; Pietromonaco & Powers, 2015; Simmons, Goldberg, Washington, Fischerfay, & Maclusky, 1995), and with more somatic complaints (Lewis, Feiring, Mcguffog, & Jaskir, 1984). However, insecure-avoidant and insecure-ambivalent individuals seem to adopt different responses to pain and sickness (McCallum & McKim, 1999; P. Meredith, Ownsworth, & Strong, 2008). Faced with the same symptoms, avoidant attached children and teenagers display higher levels of emotional control and lower levels of negativity compared with insecure-ambivalent individuals (Feeney, 2000). Furthermore, compared with securely attached, insecure-ambivalent individuals have higher symptom-reporting and request more health visits (Andrews et al., 2011; Feeney, 2000).
Since attachment organization is a behavioural strategy to overcome stressful situations, it is especially elicited when infants feel pain, fatigue, or sickness (Bowlby, 1969). In response, attachment figures need to find appropriate help care and means to alleviate the infant’s pain. However, dyads react differently according to the infant’s attachment patterns. Therefore, we wonder how attachment relationships affect antibiotic uptake. In our study, we aim to explore potential predictors of antibiotic uptake by infants in the first 9 months of life from a large range of variables related with birth and infant health status, maternal variables, and infant and maternal interactive behavior; and to study the prevalence of infants’ attachment quality between those who consumed and did not consume antibiotics. For that purpose, we propose a longitudinal prospective follow-up study of a cohort of 134 mother-infant dyads from birth to 12 months. Dyads were recruited from three neonatal units of public Portuguese hospitals. Demographic and health information obtained through an anamneses interview performed with mothers when infants were 9 months old, followed by mother-infant free play interactions scored with Crittenden’s Care-Index. At the 12-month visit, dyads were videotaped in the Ainsworth´ Strange Situation. With a binary logistic regression, we found that the best determinant of antibiotic uptake in the first 9-months of life was maternal sensitivity (p<.01), rather than other potential determinants such as breastfeeding, daycare attendance, or gestational age. Furthermore, 89.7% of insecure-ambivalent infants consumed antibiotics during the first 9-months of life, which contrasts with 32.5% avoidant and 21.5% securely attached infants (p<.001). For children with insecure-ambivalent attachment, the odds of antibiotic consumption were 25.0 (95% confidence interval, 7.0 - 89.4) times higher than children with the other patterns of attachment (secure and ambivalent attachment combined). Our results suggest that parents, infant behavior, and attachment can impact antibiotic consumption, attesting the significance of parent-infant relationships in child development, health, and well-being. Yet, antibiotic consumption contributes to antibiotic resistance, and, when prescribed to infants, is associated with an increase in health problems later in life, including chronic diseases and susceptibility to infectious diseases.

Authors

• Marina Fuertes, Lisbon School of Education
  Presenting Author

• Francisco Dionisio, University of Lisbon
  Non-Presenting Author

• Joana Gonçalves, Faculty of Psychology and Education Sciences
  Non-Presenting Author

• Anabela Faria
  Non-Presenting Author

• Pedro Lopes dos Santos, University of Porto
  Non-Presenting Author

• Inês Conceição, Hospital Nossa Senhora do Rosário
  Non-Presenting Author