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Harbottle Z, Nötzel A, Golding MA, Bhamra M, Kopsch I, Wilking E, Jonsson M, Abrams EM, Halbrich MA, Simons E, Roos LE, Keddy-Grant JA, Gerstner TV, St-Vincent JA, Ekström S, Protudjer JLP. Infantile atopic dermatitis - increasing severity predicts negative impacts on maternal and infant sleep: a mixed methods study. Allergy Asthma Clin Immunol 2024; 20:21. [PMID: 38519963 PMCID: PMC10960393 DOI: 10.1186/s13223-024-00883-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/28/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND While the impacts of atopic dermatitis (AD) on maternal and child sleep outcomes have been previously explored, less is known about the associations between infantile AD and sleep quality and quantity. OBJECTIVE To describe the perceived causes of AD-associated maternal sleep disturbances and the association between AD severity and infant sleep outcomes. METHODS Mothers with infants aged < 19 months old with a diagnosis of AD were recruited from social media and medical clinics in Winnipeg, Canada between October 2021 and May 2022. Infant AD severity was classified using maternal-reported data on the Patient-Oriented Scoring Atopic Dermatitis tool (PO-SCORAD). Quantitative data were collected via a series of questionnaires with a subset of mothers subsequently completing semi-structured interviews. Quantitative and qualitative data were integrated in the discussion. RESULTS Mothers of infants with moderate/severe AD (6/12) were more likely to report their infant suffering from a higher degree of sleeplessness (i.e., ≥ 5 on a scale of 0-10) over the past 48 h compared to mothers of infants with mild AD (0/18). This was supported by qualitative findings where mothers described how their infant's sleep quality and quantity worsened with AD severity. Additionally, 7/32 mothers reported that their child's AD, regardless of severity, disturbed their sleep. Maternal sleep loss was most commonly attributed to infant itching (6/7), followed by worry (4/7). CONCLUSION Infantile AD severity was associated with worse sleep outcomes for both mothers and infants. We propose that maternal and infantile sleep quality and quantity can be improved by reducing AD severity through adherence to topical treatments.
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Affiliation(s)
- Zoe Harbottle
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Michael A Golding
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
| | - Manvir Bhamra
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - Marina Jonsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Elissa M Abrams
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michelle A Halbrich
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Elinor Simons
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
- Children's Allergy & Asthma Education Centre, Health Sciences Centre Winnipeg, Winnipeg, MB, Canada
| | - Leslie E Roos
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada
- Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada
| | - Jill A Keddy-Grant
- Department of Pediatrics and Child Health, Section of Dermatology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Thomas V Gerstner
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jo-Anne St-Vincent
- Children's Allergy & Asthma Education Centre, Health Sciences Centre Winnipeg, Winnipeg, MB, Canada
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.
- Children's Hospital Research Institute of Manitoba, 501G-715 McDermot Avenue, Winnipeg, MB, Canada.
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada.
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Batac ALR, Merrill KA, Golding MA, Bhamra M, Harbottle Z, Kopsch I, Wilking E, Jonsson M, Ekström S, Abrams EM, Halbrich MA, Simons E, Roos LE, Keddy-Grant JA, Gerstner TV, St-Vincent JA, Protudjer JLP. Infantile atopic dermatitis and maternal-infant bonding: a mixed methods study. Allergy Asthma Clin Immunol 2023; 19:100. [PMID: 38031081 PMCID: PMC10687835 DOI: 10.1186/s13223-023-00857-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 11/09/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Childhood atopic dermatitis can have a negative effect on caregivers' quality of life and stress levels due to the burdensome nature of its treatment. Given that the condition often emerges in infancy, atopic dermatitis-related stress also carries the potential to negatively affect the developing mother-infant bond. While it is plausible that atopic dermatitis has a negative impact on maternal-infant bonding, these relationships have not been studied directly. In light of this gap, the current study investigated the association between infantile atopic dermatitis and the maternal-infant bond using a mixed-method design. METHODS Mothers of infants (< 19 months) with atopic dermatitis were recruited from social media and medical clinics between October 2021 and May 2022. Mothers with infants unaffected by inflammatory skin conditions were also recruited to serve as a control group. Participants were asked to complete questionnaires related to their demographics, child's health, and mother-infant bond. Multiple linear regression analyses were used to assess bonding quality among cases and controls. A subset of cases were also asked to participate in semi-structured interviews focused on infantile atopic dermatitis and the maternal-infant bond. RESULTS The final sample consisted of 32 cases and 65 controls. Scores on the impaired bonding and risk of abuse subscales did not significantly differ between cases and controls. However, mothers of infants with atopic dermatitis did report lower levels of caregiving anxiety (b = - 1.47, p < 0.01) and pathological anger/rejection (b = - 1.74, p = 0.02) relative to controls. Qualitative findings suggest that the topical therapies required to manage atopic dermatitis may strengthen the bond between some mothers and infants. CONCLUSION Findings suggest that atopic dermatitis does not have a negative impact on maternal-infant bonding and may actually improve bonds in some cases. In light of this finding, clinicians may leverage the potentially positive impact of atopic dermatitis-related caregiving on the maternal-infant bond to encourage caregivers to remain adherent to their child's topical treatments.
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Affiliation(s)
- Ayel Luis R Batac
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Kaitlyn A Merrill
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Michael A Golding
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
| | - Manvir Bhamra
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Zoe Harbottle
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | | | | | - Marina Jonsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Elissa M Abrams
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Michelle A Halbrich
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Elinor Simons
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Allergy and Asthma Education Centre, Health Sciences Centre Winnipeg, Winnipeg, MB, Canada
| | - Leslie E Roos
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Department of Psychology, Faculty of Arts, University of Manitoba, Winnipeg, MB, Canada
| | - Jill A Keddy-Grant
- Department of Pediatrics and Child Health, Section of Dermatology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Thomas V Gerstner
- Department of Pediatrics and Child Health, Section of Allergy and Clinical Immunology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jo-Anne St-Vincent
- Children's Allergy and Asthma Education Centre, Health Sciences Centre Winnipeg, Winnipeg, MB, Canada
| | - Jennifer L P Protudjer
- Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Food and Human Nutritional Sciences, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, MB, Canada
- George and Fay Yee Centre for Healthcare Innovation, Winnipeg, MB, Canada
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