The Still-Face Paradigm: Babywearing As an Evidence-Based Intervention for Young Mothers

Background:Young mothers are at higher risk for child maltreatment and neglect and are more likely to experience difficulty bonding with their baby compared to other mothers: Their babies are more likely to have a difficult temperament (e.g., born premature, have prenatal exposure to substance use) and they are less likely to have the resources required to cope with heightened infant crying and infant sleep dis-regulation. A meta-analysis review found support for positive associations between infant positive affect during the still-face task and secure attachment at one year. Limited research on babywearing, holding or carrying a baby in a cloth carrier that is worn on the body, indicates that frequent close physical contact increases maternal responsiveness and promotes secure attachment between mothers and their infants. The purpose of this study is to assess the potential use of babywearing practices as an effective intervention to improve mother-infant bonding in a sample of young mothers.

Method: The Mother Baby Bonding Study is a community-based intervention study. Seventy-four mothers aged 15 to 25 years (M=19.2 years, SD=2.3; 47.8% White, 40.6% Hispanic; 40% <=11^th grade) participated in parent programing from Healthy Families or Teen Outreach Pregnancy Services. They were randomly assigned to an intervention condition (n=36; received an infant carrier with babywearing instruction from a Babywearing Educator) or a control condition (n=38; received a baby book set). Mother’s in the intervention condition were told to babywear at least one hour every day. Mother’s in the control condition were told to read to their babies. Mothers were assessed in their homes when their babies were 2-4 weeks of age (W1) and were followed up 3- (W2) and 6- (W3) months later. At W3, mothers and babies participated in the Still-Face Paradigm (2 minutes interaction, 2 minutes still-face, 2 minutes reunification). Videos were coded for observed infant and mother engagement behaviors based on Tronick’s scoring systems, including facial expressions, direction of gaze, and vocalizations.

Results: Mothers in condition babywore approximately 4.2 days a week (SD=1.4), 77 minutes a day (range=16-200 minutes), and 5.9 hours a week (range=1.3-16 hours). Preliminary results using repeated measures ANOVA indicated that compared to the control condition, infants in the intervention condition spent significantly less time in object/environment engagement (η_p²= .23), p<.05 and more time in social monitoring (η_p²= .20), p<.05, and mothers in the intervention condition spent significantly more time in social positive engagement (η_p²= .18), p<.05, and in exaggerated positive engagement (η_p²= .21), p<.05. Effect sizes were moderate to large. 

Conclusions and Implications: Babywearing is a cost-effective and culturally relevant practice across many cultures. Video data will be presented from the 6-month follow-up to highlight observed markers of mother-infant attachment problems. Preliminary results hold promising policy implications for Babywearing as an effective tool at promoting infant attachment and ultimately reducing child maltreatment.