Infant characteristics

So far, the evidence outlined has focused on the effects of the mother's depression on the child. However, there may also be effects in the other direction. There were some studies done in the 1980s which suggested that the babies of depressed mothers were difficult; for example, they cried more easily⁽⁶⁾. The studies suggested that depression was likely to last longer if you had a baby like that⁽⁷⁾, and even that someone else looking after the same baby would start behaving like a depressed mother⁽⁸⁾.

The question arises, therefore, whether some of the poor child outcomes associated with maternal depression, and even the depression itself, could reflect the influence of difficult infant temperament.

Unfortunately, the studies above did not start looking at the baby until the mother became depressed, so it is possible that the babies had become difficult because they had been spending their time with a depressed mother. We need to start from scratch if we are to examine the effect of infant characteristics on maternal depression.

In a study funded by the MRC, we selected a group of mothers who had risk factors for depression in pregnancy⁽⁹⁾. We recruited quite a large group of high-risk women and a smaller group of low-risk women, all of whom had normal healthy babies. The babies were assessed in the neonatal period using the Brazelton Neonatal Behavioural Assessment Scale^{(10, 11)}. We checked that the mother was not actually depressed at this point. We followed mother and baby up at six weeks and examined the relationship between what the baby's behaviour had been like earlier and whether or not the mother had become depressed.

Other assessments checked in the neonatal period were:

• that the baby's behaviour was not influenced by the mother's current mood
• the mother's perceptions of the baby.

We followed up maternal mental state, face-to-face interactions, and infant behaviour problems at 18 months.

Our results were striking. We found that the neonates' behaviour raised the risk of subsequent depression in the vulnerable group of mothers over three-fold. It should be noted that these were normal, healthy infants with no neurological problems. We also discovered that if their motor behaviour was poorly organised: either flat or sluggish, or else strung up and jerky, there was a strong increase in the risk of depression.

This effect of the infant's early behaviour occurred over and above the impact of the mother's early mood, or her 'blues' score, and her perception of whether or not the baby was difficult. These did contribute to the risk, but the baby's behaviour added significantly to that risk*

We then looked at how much the poor motor scores and irritability in the neonates affected the way the babies interacted at two months, and the way the mother behaved. By and large, the babies' behaviour got better over time. What was important for the mother's behaviour at two months, was whether or not she had become depressed. If a mother has a 'difficult' baby but has been well supported and kept her confidence she can have perfectly good interactions with the baby.

Later, at 18 months, if the mother has been pushed into depression, the chances are quite high that things will continue on a downward spiral. The baby is more likely to manifest infant behaviour problems such as temper tantrums, mood difficulties and sleep disturbance.

With these results and the other research evidence in mind The Social Baby⁽¹²⁾ was produced. This book aims to try to help parents understand more about difficult infant behaviour and to help health care professionals give appropriate support. A mother with an irritable baby can so often slip into thinking that she is the problem; she is the only one whose baby cries a lot and if she goes to the clinic, she will be shown up – made to feel a really 'bad' mother

In summary, it does seem that the infant's behaviour early on is important, but not because it is directly responsible for difficult child behaviour later on, but because it adds to the risk of depression, which in turn can lead to problems in the relationship between mother and infant, setting in motion a longer term pattern of materna1 rejection and difficult child behaviour. Such findings mean that it is important to give support to mothers in the early months and particularly to vulnerable mothers of difficult infants, in order to help prevent later child problems from developing.

Lynne Murray

Professor of Developmental Psychology, University of Reading.

Originally published: CPHVA conference proceedings, October 2001 20-23

References