Do infant behaviors following immunization predict attachment? An exploratory study

ABSTRACT

Objectives. The relationship between infant behaviors during routine immunization, pre- and post-needle, and infant attachment was explored. Methods. A total of 130 parent–infant dyads were recruited from a larger longitudinal study and videotaped during routine immunization at 12 months and the Strange Situation Procedure (SSP) at 14 months. Six infant behaviors were coded for 1-minute pre-needle and 3-minutes post-needle. Attachment was operationalized according to the secure/avoidant/resistant/disorganized categories. Results. As expected, none of the pre-needle behaviors predicted attachment. Proximity-seeking post-needle significantly discriminated attachment categorizations. Secure infants were more likely to seek proximity to caregivers post-needle in comparison with avoidant and disorganized infants. Proximity-seeking following immunization was positively correlated with proximity-seeking during the SSP and negatively correlated with avoidance and disorganization during the SSP. Conclusions. Infant proximity-seeking during immunization is associated with attachment security and parallels behaviors observed during the SSP. More research is needed to identify behavioral markers of disorganization.

KEYWORDS:

• pain
• attachment
• infancy
• affect regulation
• immunization

Acknowledgments

The authors thank the staff at the pediatric clinics and the Hospital for Sick Children for their assistance with this project. This work could not have been completed without the dedicated support, mentorship, and expertise of Sandi Bento and Dr. David Pederson. The authors are grateful to the OUCH cohort families for their participation and continued support over the years.

Additional information

Funding

This work was supported by the Canadian Institutes of Health Research through a New Investigator salary award and operating grant [grant number MOP84511], Canadian Institutes of Health Research Pain in Child Health Strategic Training Program [grant number MOP111140], Ontario Ministry of Research and Innovation Early Researcher Award program [grant number ER08-05-219], Ontario Graduate Scholarship Program, The York Research Chairs Program, and York University’s Lillian Wright Maternal–Child Health Scholarship program.