Carmen Luiza Correa Fernandes

Couples’ Relationships and Breastfeeding: is There an Association?

One hundred fifty-three Brazilian families with 4-month-old infants—51 cases (breastfeeding had ceased) and 102 controls (breastfeeding maintained)—were recruited to verify if a problematic couple relationship is associated with early breastfeeding termination. The relationships of the 118 cohabiting couples were assessed by clinical interviews and the Global Assessment of Relational Functioning and Beavers-Timberlawn scales, examining marital and parental functions, parents’ satisfaction with the quality of care each partnerprovided to their infants, mothers’ opinions of paternal breastfeeding support, and interviewers’ assessments of paternal breastfeeding support and involvement in the infants’ care. The quality of a couple relationship was not associated with the interruption of breastfeeding before 4 months postpartum. However, a good couple relationship was associated with more paternal breastfeeding support (P < .01) and involvement in the infant’s care (P < .0001). J Hum Lact. 20(1):46-55.

Fatores associados ao envolvimento do pai nos cuidados do lactente

OBJECTIVE To identify factors associated with the lack of active father involvement in infant care at four months of age. METHODS Cross-sectional study involving families of 153 infants at four months of age, interviewed in their homes by two family therapists. In addition to father involvement in infant care, sociodemographic, parental mental health (using the Self Report Questionnaire-20 scale and Diagnostic and Statistical Manual of Mental Disorders-IV criteria assessment) and quality of couple relationship characteristics (using the Assessment of Relational Functioning from Diagnostic and Statistical Manual of Mental Disorders-IV) were analyzed. Poisson regression was employed to assess the association between lack of father involvement in child care and the variables selected. Prevalence ratio was used to estimate the magnitude of associations. RESULTS Fathers of 13% of infants had no contact with their children. Among families whose parents lived together (78% of all), 33% of the fathers reported not actively participating in their childrens care. Problematic couple relationship and mother as a housewife were associated with lack of father involvement in infant care. CONCLUSIONS High prevalence of families whose father is not actively involved with infant care, especially when couple relationship is problematic and the mother does not have a paid job.

Problemas conjugais e outros fatores associados a transtornos psiquiátricos do pós-parto

OBJETIVO: Estudar a associacao entre transtornos mentais pos-parto e fatores demograficos e psicossociais, pre e perinatais. METODOS: Todas as familias com criancas de quatro meses da Vila Jardim - Porto Alegre (RS) - nascidos entre novembro de 1998 e dezembro de 1999 foram avaliadas. Utilizou-se o Self Report Questionnaire (SRQ-20) e entrevistas clinicas semiestruturadas individuais e do casal para fundamentar uma hipotese diagnostica segundo os criterios do da quarta edicao do Manual Diagnostico e Estatistico de Transtornos Mentais (DSM-IV). Realizou-se a avaliacao da relacao conjugal e do relacionamento da mae com as familias de origem e a rede social utilizando-se a Escala de Avaliacao Global do Funcionamento Relacional (GARF). RESULTADOS: Foram avaliadas 148 maes e os 116 pais que coabitavam. Segundo o SRQ, 34,4% das maes e 25,4% dos pais apresentaram suspeita de transtorno psiquiatrico. Clinicamente os percentuais foram maiores. Coabitar ou nao com companheiro nao esteve associado com transtorno mental materno. Na analise da totalidade do grupo de mulheres, estiveram associados: baixa renda familiar (OR=0,8; p<0,05) e a presenca de transtorno materno no passado (OR=2,2; p<0,05). O estudo apenas das mulheres que coabitavam (n=116) mostrou associacao exclusivamente com a ma qualidade da relacao conjugal (OR=7,3; p<0,05). CONCLUSAO: Este estudo reforca a necessidade de se verificar a presenca de transtorno mental materno da mae nas consultas de pre-natal e puericultura, e introduz dados sobre o pai e, especialmente, sobre a importância da relacao conjugal.

Problematic parent-infant relationships in two-parent families: prevalence and risk factors in a Brazilian neighborhood.

INTRODUCTION Although the quality of parent-child relationships is known to be associated with the offsprings mental health, little is known about the prevalence of problematic relationships in this scenario. This cross-sectional study aims to investigate the prevalence and risk factors of different types of early parent-infant relationships in a Brazilian population group. METHODS During 1 year, all families (n = 230) from an urban community of Porto Alegre, southern Brazil, with 4-month-old infants born in public hospitals were identified, and 148 were fully investigated by two family therapists. This study describes data on the 116 infants with two-parent families. Demographic, obstetric, and relational variables were collected through questionnaires and scales (Parent-Infant Relationship Global Assessment Scale, Global Assessment of Relational Functioning, and Self-Report Questionnaire). Prevalence ratios were calculated, and Poisson regression with robust variance was performed to adjust for covariates. RESULTS Almost 10% of mothers and 12% of fathers showed at least a significantly perturbed relationship with their 4-month-old infants. Inadequate mother-infant bonding coincided with evidence of paternal mental disorder, poor maternal social network, and discontinuation of breastfeeding at 4 months. A problematic father-infant relationship was associated with a dysfunctional couple relationship and with low infant birth weight. CONCLUSIONS There is a high prevalence of early parent-child relationship problems, suggesting a need for health system interventions. Parent-infant relational problems are prevalent very early in life and more associated with other relational problems than with socioeconomic burden.

Marital problems and other factors associated with postpartum psychiatric disorders

. A identificacao dos fatores de risco psicossocias pode levar a identificacao precoce e ao enfrentamento dos agravos a saude da mulher e de seu filho resultantes dos transtornos mentais nesse periodo da vida.Nosso grupo trabalha uma linha de pesquisa que estuda o desenvolvimento de familias atraves de seu acompanhamento longitudinal. No decorrer do ano de 1999, foram identificadas todas as familias (n = 230) de um bairro que tiveram filhos em hospital publico por meio das notificacoes de nascimento da Prefeitura de Porto Alegre-RS. As familias identificadas que aceitaram participar (n = 148) foram visitadas por dois terapeutas de familia, sendo realizadas observacoes, entrevistas semiestruturadas e aplicadas escalas. Fatores demograficos, psicossociais e relacionais foram estudados. A saude mental das maes e pais foi avaliada pelo