Date of Award
2023
Degree Name
Doctor of Philosophy (School of Physiotherapy)
Schools and Centres
Physiotherapy
First Supervisor
Professor Beth Hands
Second Supervisor
Dr Vivienne Travlos
Abstract
The nurturing, handling and positioning exposures infants experience during daily caregiving contribute to their physical, motor, cognitive and social–emotional development. A relationship exists between infant sleep and wake-time positioning, the emergence of motor skills and the development of head shape deformities diagnosed as non-synostotic plagiocephaly (NSP). However, the underlying causal mechanism of the specific caregiving behaviours that may play a role remains unclear.
The purpose of the study was to investigate the association between maternal caregiving behaviours and the developmental outcomes of ‘low-risk’ term infants in the first 10 months of life. The first phase of the research involved the establishment of an expert panel of experienced clinical practitioners and researchers to design, construct and validate an observational scale—the Infant Handling Measure—to measure the physical capabilities of an adult to move, lift, hold, position and play with a young infant (neonate to four months) during regular infant caregiving activities.
The second phase was an exploratory prospective longitudinal birth cohort study. Data were collected over eight collection points (three home-based and five online telephone sessions) to explore the patterns and possible mechanisms by which early infant caregiving exposures may influence the developmental outcomes of healthy ‘low-risk’ term infants. Observations of infant motor and head shape outcomes were obtained at one, three and 10 months, and observations of maternal–infant handling were obtained at one and three months. Self-reported parenting measures were collected at the eight time points, and infant caregiving measures were collected at the seven postnatal time points. A final sample of 48 ‘low-risk’ term singleton infant (24 male; 27 firstborn)–mother dyads completed all observational measures.
Mothers had the strongest influence on infant motor and head shape outcomes. Maternal knowledge about infant development and insufficient parenting instruction on infant handling, positioning and care practices were found to be important factors influencing caregiving abilities. The number of adverse perinatal health events, knowledge of infant development and mothers’ early infant handling skills contributed to infant motor development. Risk analysis confirmed maternal knowledge of infant development, the consistent provision of centred head and body positions and the vi adoption of rotational movements in infant care activities were protective and reduced the risk of delayed motor development.
Three factors contributed to adverse infant head shape outcomes: insufficient parenting instruction on infant care practices, infants spending more than 17 hours per day in supine position during the first six months of life and the late adoption of rotational movements in daily infant care routines. Risk analysis confirmed that prior learning of handling techniques and adopting rotational movements in infant care activities were protective and reduced the risk of NSP.
Early mastery of infant handling by mothers in the first months of life may be a salient mechanism of protection for infant motor and head shape development. Low maternal knowledge about infant development and insufficient parenting instruction on infant care practices highlight the gaps in current parenting strategies. A collaborative revision of early infant handling education, including consumers and stakeholders, is recommended.
Publication Details
Beaton, H. E. (2023). Early Movement Matters: Examining the Influence of Early Postnatal Caregiving Experiences of Term Infants on Motor and Head Shape Outcomes Across Infancy [Doctor of Philosophy (School of Physiotherapy)]. The University of Notre Dame Australia. https://researchonline.nd.edu.au/theses/381