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The quality of maternal�infant interaction is a critical factor in the development of infants' autonomic function and social engagement skills. In this secondary data analysis, relationships among infant and maternal affect and behavior and quality of dyadic interaction, as measured by the Parent�Child Early Relational Assessment, and infant autonomic function, as measured by heart rate variability, were examined during feeding at 2 weeks and 2 months of age in 16 healthy infants and in 15 infants with transposition of the great arteries (TGA). Contrary to previous research, at 2 weeks infant age, mothers of infants with TGA had significantly higher scores in affect and behavior than did mothers of healthy infants. The affect and behavior and quality of dyadic interaction of infants with TGA also did not differ from that of healthy infants. Although infants' social engagement skills did not differ by health condition (TGA or healthy), these skills did differ by parasympathetic nervous system function: infants better able to suppress vagal activity with challenge had more positive and less dysregulated affect and behavior, regardless of health status. These findings suggest that maternal�infant interactions for some cardiac disease subgroups may not differ from healthy dyads. Additional research is required to identify both healthy and ill infants with delayed autonomic maturation and to develop and test interventions to enhance critical interactive functions.
