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Objective: To examine the relationship between emotional distress and mother-preterm infant interactions among mothers who used skin-to-skin care and to explore their experiences of childbirth and continuous skin-to-skin care., Design: A sequential, explanatory, mixed-methods design., Setting: A neonatal nursery in a tertiary-level hospital in Malawi., Participants: Forty-four mother-preterm infant dyads; we interviewed 15 of these mothers., Methods: We administered surveys to assess emotional distress (i.e., depression, anxiety, posttraumatic stress, and worry about infant health) and video-recorded mother-infant interactions. We used regression analysis to assess the relationship between indicators of emotional distress and mother-infant interactions and further examined whether skin-to-skin care was associated with maternal distress. We used in-depth interviews to collect qualitative data and used content analysis to identify common themes., Results: Symptoms of emotional distress were negatively associated with the frequency of infant negative behaviors and gestures, infant smiling, and mother looking and infant smiling when we controlled for the number of days administering continuous skin-to-skin care, gestational age, and severity of the infant's condition. Mothers reported that they felt stressed by providing continuous skin-to-skin care but appreciated its positive effects on the infant., Conclusion: Emotional distress while providing continuous skin-to-skin care was associated with poorer mother-preterm infant interactions The mental distress that mothers undergo while delivering continuous skin-to-skin care to their infants can be draining. It is essential for nurses to offer the required psychological support to enhance maternal mental health and encourage positive infant behavior and development. Health care systems need to support this level of nursing care., Competing Interests: Conflict of Interest The authors report no conflicts of interest or relevant financial relationships., (Copyright © 2024 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.)

Background: Mother-infant interactions are necessary for infant growth and development. However, preterm birth is associated with less positive mother-infant interactions than full-term birth. Malawi has the highest preterm birth rate in the world, but studies of the mother-infant relationship in Malawi are limited and studies that observed mother-infant interactions could not be located., Purpose: This study explored mother-infant interactions among Malawian mothers of early-preterm, late-preterm, and full-term infants., Methods: This observational study explored maternal and infant interactive behaviors. We recruited 83 mother-infant dyads (27 early-preterm, 29 late-preterm, and 27 full-term dyads)., Findings: Mothers of early-preterm infants looked at and rocked their infants less, and their infants looked at their mothers less, than mothers of either late-preterm infants or full-term infants. The infants in all groups were asleep most of the time, which contributed to low levels of interactive behaviors. Factors that were related to infant behaviors included marital status, maternal occupation, maternal education, infant medical complications, infant gender, history of neonatal deaths, and multiple births., Implications for Practice: Our findings provide evidence about the need to encourage mothers to engage interactive behaviors with their infants., Implications for Research: Future studies of factors that contribute to positive interactions in Malawi are needed.

Background: Mothers of preterm infants, early or late, report more distress than mothers of full-term infants. Malawi has the highest preterm birth rate in the world, but nothing is known about the relation of preterm birth to maternal mental health., Purpose: To compare emotional distress among mothers of early-preterm, late-preterm, and full-term infants., Methods: We recruited 28 mothers of early-preterm, 29 mothers of late-preterm, and 28 mothers of full-term infants. Emotional distress was assessed 24-72 hr following birth. One-way ANOVA and regression analysis were used to compare the three groups., Findings: Mothers of early-preterm infants reported more distress symptoms than mothers of full-term infants, and scores of mothers of late-preterm infants fell between the other two groups. Having a support person present was associated with lower symptoms and caesarean birth was associated with more symptoms., Discussion: Promoting maternal mental health is important following preterm birth and health care providers need to support mothers., (Copyright © 2019 Elsevier Inc. All rights reserved.)