Mother's mental representation of her infant and its effect on infant organization and mother's perception of self

Abstract

The mother-infant relationship can be viewed in terms of visible interaction behaviors and invisible mental representations that guide the interaction. The focus of nursing in relation to the mother-infant relationship has been on assessing and changing the mother's visible interaction behaviors. The purpose of this study is to expand the understanding of the mother's mental image of her infant as it affects the mother-infant relationship.Forty-three first time mothers were recruited through prenatal classes offered by a community hospital located in a large Northwest city. Neonatal Behavioral Assessment (BNBAS, Brazelton, 1984) was performed when the infant was a few days old. An in-home interview examining the mother's mental representation of her infant (Working Model of Child Interview by Zeanah, 1989) was conducted and recorded on audio tape approximately two weeks postpartum. During the same visit, a feeding interaction was video taped and scored (NCAFS) and a questionnaire (Postpartum Self-Evaluation Questionnaire by Lederman, 1981) was administered. Finally, the infant's sleep/awake activity was recorded (NCASA) by the caregiver for seven consecutive days starting the day of the home visit.Three types of mental representation of infants (Balanced, Estranged, and Disengaged) are found among this group of mothers. Those with Balanced representation had a rich perception of her infant, intense emotional involvement, and were sensitive to infant's needs. Those with Disengaged representation had less clear idea of her infant as a person, task oriented caregiving perception, and cool detachment. Those with Estranged representation presented a sense of confusion, most of them conveyed a sense of estrangement from their infant, and many were struggling with issues ranged from being overwhelmed by infant care, preoccupied by one aspect of the infant, or a self centered fantasy.Infant's crying (length of crying at one time, and distress episode during feeding interaction) were found to be associated with mother's mental representation. Mother's satisfaction and confidence were closely related to her mental representation. Infant's birth characteristics and interactive behavior pattern did not seem to affect mental representation.It is suggested that: (a) nurses need to pay attention to relationship development in early postpartum; (b) research is needed in examining the long term consequences of this phenomenon; and (c) more theoretical and clinical work is necessary in order to develop appropriate clinical protocols.