The Center for Excellence in Nursing Practice
BWH’s Connors Center involved in “baby talk” study
BWH, along with Brockton Hospital, was a site for a “baby talk” study to test the efficacy of an interactive coaching intervention in promoting maternal-infant responsiveness between mothers with depression symptoms and their infants.
Detta Quigley-Lavoie, RN, MA, CWN-7 Nurse Manager, organized BWH’s involvement in the two-phased study while staff nurses on CWN 7, 8, and 9 assisted with study recruitment. Quigley-Lavoie collaborated with the study’s principal investigator June Andrews Horowitz, PhD, RN, CS, FAAN, at Boston College School of Nursing.
Postpartum depression can adversely affect babies as well as their mothers. In addition to threatening infant health and development, it can interfere with the developing mother-infant relationship and therefore compromises mothers’ sensitivity to infants’ cues.
To explore ways to mitigate the consequences of postpartum depression, a total of 1,215 mothers were voluntarily screened for postpartum depression at two to four weeks after delivery. From this group, 122 of those who showed symptoms of depression agreed to participate in the second phase of the study. These mothers were randomized to either the treatment or control group. Mothers in both groups received three home visits over a two-month period from study nurses who videotaped the mothers while they played with their babies. Those in the treatment group were coached to play with their babies using techniques designed to promote increased responsiveness between mother and infant. A team member who did not know which mothers received the intervention later coded the videotaped interactions.
Two findings resulted. The first is that 18% of the mothers who participated in the study experienced mild to severe depression symptoms at two to four weeks after delivery, a finding consistent with other reports in the literature which supports the need for routine screening for postpartum depression, as well as for increased parental education about this common problem and what to do if symptoms occur.
The second finding is that maternal-infant interaction was significantly higher among those mothers who received coaching in the treatment group. The cost-effective coaching strategy used in this study—teaching mothers how to talk and play with their babies—could have a positive effect on maternal-infant interaction in vulnerable mothers who experience postpartum depression.
Horowitz and Quigley-Lavoie have recently begun a follow-up investigation among those who participated in the second phase of the study. It focuses on the course of maternal depression and mothers' perceptions of their postpartum experience and parenting over time.
The study was funded by the March of Dimes and a Boston College Incentive Grant.
—submitted by Lucy Field, PhD, RN, CS