Читать книгу Lifespan Development - Tara L. Kuther - Страница 192

Imagine that you work as an HIV educator with women in an underdeveloped country. What challenges might you face in encouraging women to take steps to reduce the potential for HIV transmission to their infants? How might you help them?

Not only are low-birthweight infants at a physical disadvantage, but they often begin life at an emotional disadvantage because they are at risk for experiencing difficulties in their relationships with parents. Parenting a low-birthweight infant is stressful even in the best of circumstances (Howe, Sheu, Wang, & Hsu, 2014). Such infants tend to be easily overwhelmed by stimulation and difficult to soothe; they smile less and fuss more than their normal-weight counterparts, making caregivers feel unrewarded for their efforts. Often these infants are slow to initiate social interactions and do not attend to caregivers, looking away or otherwise resisting attempts to attract their attention (Eckerman, Hsu, Molitor, Leung, & Goldstein, 1999). Because low-birthweight infants often do not respond to attempts to solicit interaction, they can be frustrating to interact with, can be difficult to soothe, and are at risk for less secure attachment to their parents (Jean & Stack, 2012; Wolke, Eryigit-Madzwamuse, & Gutbrod, 2014). Research also indicates that they may experience higher rates of child abuse (Cicchetti & Toth, 2015).

Parental responses to having a low-birthweight infant influence the child’s long-term health outcomes, independently of perinatal risk, suggesting that the parenting context is an important influence on infant health (Pierrehumbert, Nicole, Muller-Nix, Forcada-Guex, & Ansermet, 2003). When mothers have knowledge about child development and how to foster healthy development, are involved with their children, and create a stimulating home environment, low-birthweight infants tend to have good long-term outcomes (Benasich & Brooks-Gunn, 1996; Jones, Rowe, & Becker, 2009). For example, one study of low-birthweight children showed that those who experienced sensitive parenting showed faster improvements in executive function and were indistinguishable from their normal-weight peers by age 5; however, those who experienced below-average levels of sensitive parenting showed lasting deficits (Camerota, Willoughby, Cox, Greenberg, & the Family Life Project Investigators, 2015). Likewise, exposure to sensitive, positive parenting predicted low-birthweight children’s catching up to their normal-birthweight peers at age 8 in academic achievement, but exposure to insensitive parenting predicted much poorer functioning (Jaekel, Pluess, Belsky, & Wolke, 2015). Longitudinal research has found that low-birthweight children raised in unstable, economically disadvantaged families tend to remain smaller in stature, experience more emotional problems, and show more long-term deficits in intelligence and academic performance than do those raised in more advantaged homes (Taylor, Klein, Minich, & Hack, 2001).

Interventions to promote the development of low-birthweight children often emphasize helping parents learn coping strategies for interacting with their infants and managing parenting stress (Chang et al., 2015; Lau & Morse, 2003). Interventions focused on teaching parents how to massage and touch their infants in therapeutic ways as well as increase skin-to-skin contact with their infants are associated with better cognitive and neurodevelopmental outcomes at age 2 (Procianoy, Mendes, & Silveira, 2010). One intervention common in developing countries where mothers may not have access to hospitals is kangaroo care, in which the infant is placed vertically against the parent’s chest, under the shirt, providing skin-to-skin contact (Charpak et al., 2005). As the parent goes about daily activities, the infant remains warm and close, hears the voice and heartbeat, smells the body, and feels constant skin-to-skin contact. Kangaroo care is so effective that the majority of hospitals in the United States offer kangaroo care to preterm infants. Babies who receive early and consistent kangaroo care grow more quickly, sleep better, score higher on measures of health, and show more cognitive gains throughout the first year of life (Boundy et al., 2015; Jefferies, 2012).

In summary, a remarkable amount of growth and development takes place between conception and birth. In 9 short months, the zygote transforms into a newborn. Although there are a variety of risks to health development within the womb, most newborns are healthy. Infants are born with a surprising array of competencies, such as well-developed hearing, taste, and smell. Additional physical, cognitive, and psychosocial capacities develop shortly after birth, as we will see in upcoming chapters.