Synchrony between a mother and her infant is fundamental to the attachment relationship and encompasses multiple constructs characterizing the relationship as being mutually responsive.  Feeding is an essential activity that provides an opportunity for interaction between a mother and her infant.  The purpose of this study was to test a coding system, the Maternal-Infant Synchrony Scale (MISS), for assessing synchrony of feeding interaction between a mother and her preterm infant and describe mother-infant synchrony during feeding and during feeding over time.

Design:

A descriptive, longitudinal design using data collected during an earlier study.  The study had IRB approval.

 Setting:

As part of a larger study examining maternal feeding competence 43 mothers were videotaped while feeding their preterm infants at three intervals – just before discharge in the nursery and in their home at 1 month and 4 months corrected gestational age (CGA).

 Patients/Participants:

A convenience sample of 10 mother-infant dyads from the larger dataset who completed all three data collection points (30 data subsets) were used for this study.

 Methods:

The Noldus Observer XT 8.0 (Noldus Information Technology b.v., 2006) was used for coding and data review. The MISS was created from pilot data and definitions further refined. The frequency of occurrence for selected behaviors, the percentage of time behaviors occurred during the feeding and the changes in behaviors over the three observations periods were calculated.

 Results:

The synchrony tool developed in this study is one of only a few tools designed to measure synchrony early in the development of the mother-infant relationship.  The MISS demonstrates that changes occur in mother and infant behavior over time. Mothers were attentive and focused during feedings and monitored their infants’ sucking intently but there was little interaction between the dyad. Infant attempts at interaction were greater than the mother attempts to engage her infant. The influence of infant maturation on feeding behaviors was evident across observations.

 Conclusion/Implications for nursing practice:

This study revealed behaviors that are descriptive of the interaction and can be used to develop interventions that would support the developing relationship. Use of the MISS with a larger sample size and a cohort of healthy, term newborns is needed to establish the MISS as a valid and reliable measure of synchrony.

 Keywords:   mother-infant synchrony, mother-infant interaction, synchrony tool, preterm infant feeding