Written by Contributing Writer, Victoria Briltz, OTDS

As an occupational therapy student, one of my favorite topics is co-occupations! Occupations are anything that you do in your life that occupies your time. Anything from happy hours with friends, brushing your teeth, or working – if it’s occupying your time, it’s an occupation. What’s really amazing, is that we can participate in occupations together, which then become co-occupations.

Textbook definition – co-occupations occur when people perform an occupation in a mutually responsive, physical and emotional interconnected manner.

During a co-occupation, both participants (mama and little one) are actively engaged. Maternal-infant co-occupations happen all the time when a mother is in a caregiving/maternal role.

Co-occupation in action:

• A mother is engaging in the reciprocal occupation of breastfeeding (mother feeds, baby eats)
• A mama is helping her baby to go to sleep (mother comforts, mother-baby complete nighttime routine, baby sleeps)
• Even perinatal doctor appointments are a co-occupation (mother attends appointments, baby is healthy)

Per definition, co-occupations are mutually responsive in a physical and emotional manner.

When a mama is connecting emotionally with her baby, it is a reciprocal response to her child’s emotional tone (i.e., mother and baby smiling at each other). Why is this so important? Co-occupational engagement greatly influences a child’s brain and overall development.

Let’s talk maternal-fetal attachment and how it affects mamas

Maternal-fetal attachment is an emotional bond between a mother and her unborn child. Maternal-fetal attachment begins and evolves during pregnancy. It has been positively associated with the over all well-being of the mother and the fetus. The quality of the maternal-infant relationship is directly related to both the physical and emotional health of mama and baby.

As a future health care professional who plans to work with mother’s and their babies – knowledge about attachment, how to promote healthy attachment, and how to prevent a lack of attachment, is very important to me!

I have an opportunity to promote an optimal relationships between moms and babies and I take that responsibility seriously. When a insecure attachment forms between and a mother and her child, children can be significantly impacted in the way they are able to participate in every day occupations such as feeding and sleeping.

A lack of a secure attachment can also lead to children having trouble regulating their environment – this may look like a child getting overwhelmed more easily than other children, or having trouble processing every day emotions like disappointment or anger.

What does research say we can do to promote secure relationships between mama and baby?

Handling and holding babies

There are ways to hold a baby that creates more of an attachment. Any position where baby can see mama and feel securely held, can held lead to a feeling of safety and security. Communicating or singing to your baby while holding them is even better!

Everyday activities (occupations)

Bathing, dressing, diaper changes, feeding – you do to help your baby maintain their health and hygiene is a co-occupation and an opportunity to promote a secure bond.

Playing in the bath, singing a song while you change their diaper, and allowing babies the space to lead their feeding activities, can all be ways to increase your bond with your child.

Communication

Leah Foreman, OTDS, COTA/L wanted me to make sure I included a piece on communication, here is what she feels on the importance of communicating with your little one:

“Your infant knows what you are saying, and they understand more than you may know! Communicating with your baby is vital for a healthy bond and attachment. They understand your tone and they understand when you are paying attention to them and when you are not. They know how to read your facial expressions as early as 2 months. So communication matters! Tell your baby what you are doing when you are changing them. When they are crying for food, tell them you are working on it and you hear that they are hungry. When they are sad, tell them it’s okay to be sad and that you are right there with them. All of these are ways to help increase the health and security of your bond with your baby.”

Great point! Have you seen this video? It’s an amazing example!

There are so many ways to promote a healthy and secure attachment with your little one, I hope this blog provides some ideas on how to get started developing a bond with your child that will last a lifetime. Please do not hesitate to reach out with any questions!

Resources

Beetz, A., Winkler, N., Julius, H., UvnäS-Moberg, K., & Kotrschal, K. (2015). A Comparison of equine-assisted intervention and conventional play-based early intervention for mother–child dyads with insecure attachment. Journal of Occupational Therapy, Schools, and Early Intervention, 8(1), 17–39. https://doi.org/10.1080/19411243.2015.1026017

Evans, T., Whittingham, K., Sanders, M., Colditz, P., & Boyd, R. N. (2014). Infant behavior and development: Are parenting interventions effective in improving the relationship between mothers and their preterm infants ? Infant Behavior and Development, 37(2), 131–154. https://doi.org/10.1016/j.infbeh.2013.12.009

Johnson, S., & Marlow, N. (2014). Seminars in Fetal & Neonatal Medicine Growing up after extremely preterm birth : Lifespan mental health outcomes. Seminars in Fetal and Neonatal Medicine, 19(2), 97–104. https://doi.org/10.1016/j.siny.2013.11.004

Karin, J., Britt-Marie, T., & Jens, S. (2003). From alienation to familiarity: experiences of mothers and fathers of preterm infants. Journal of Advanced Nursing, 43(2), 120-129. Retrieved from http://search.ebscohost.com/login.aspx?direct=true&db=edsovi&AN=edsovi.00004471.200307020.00003&site=eds-live

Lazarus, K., & Rossouw, P. (2015). Mother ’s expectations of parenthood. The impact of prenatal expectations on self- esteem, depression, anxiety and stress post mothers’ expectations of parenthood: the impact of prenatal expectations on self-esteem, depression, and anxiety. International Journal of Neu, 3(August), 102–123.  https://doi.org/10.12744/ijnpt.2015.0102-0123

Maas, A. J. B. M., Vreeswijk, C. M. J. M., Braeken, J., Vingerhoets, A. J. J. M., & van Bakel, H. J. A. (2014). Determinants of maternal fetal attachment in women from a community-based sample. Journal of Reproductive & Infant Psychology, 32(1), 5–24. https://doi.org/10.1080/02646838.2013.853170

Muller–Nix, C., Forcada–Guex, M., Pierrehumbert, B., Jaunin, L., Borghini, A., & Ansermet, F. (2004). Prematurity, maternal stress and mother-child interactions. Early Human Development, 79, 145–158

Pierrehumbert, B., Nicole, A., Muller–Nix, C., Forcada–Guex, M., & Ansermet, F. (2003). Parental post-traumatic reactions after premature birth: Implications for sleeping and eating problems in the infant. Archives ofDisease in Childhood: Fetal and Neonatal Edition, 88(5), 400–404.

Pizur-Barnekow, K., & Erickson, S. (2011). Perinatal posttraumatic stress disorder: Implications for occupational therapy in early intervention practice. Occupational Therapy in Mental Health, 27(2), 126–139. https://doi.org/10.1080/0164212X.2011.566165

Spittle, A., & Treyvaud, K. (2016). The role of early developmental intervention to influence neurobehavioral outcomes of children born preterm. Seminars in Perinatology, 40(8), 542–548. https://doi.org/10.1053/j.semperi.2016.09.006

Treyvaud, K., Inder, T. E., Lee, K. J., Northam, E. A., Doyle, L. W., & Anderson, P. J. (2012). Can the home environment promote resilience for children born very preterm in the context of social and medical risk ? Journal of Experimental Child Psychology, 112(3), 326–337. https://doi.org/10.1016/j.jecp.2012.02.009