Participants were integrants of a major project that aimed to investigate how digital media have been used in families with children up to 3 years old and how this has influenced child development (Frizzo et al., 2017). The project started following 465 mothers all over Brazil through an online survey. Mothers from this sample living in Porto Alegre or metropolitan region were invited to go to the university for the next data collection phase, which involved a qualitative interview and to be filmed interacting with their child. Thirty-four of them agreed to go to the university’s lab for the next phase.

Table 1

	Participants
Mother and Child (Case)	Adriana & Alice (Case 1)	Bruna & Bernardo (Case 2)	Cláudia & Camila (Case 3)	Débora & Daniel (Case 4)
Age	34	37	23	29
Maternal Education	Postgraduation	Postgraduation	College	Graduation
Mother’s Marital Status	Married	Married	Lived Together	Single
SRQ-20 Ratings	13	10	19	16
Toddler’s Gender	Female	Male	Female	Male
Toddler’s Age	22 months	24 months	14 months	22 months

The inclusion criteria for participation in the project were being the biological mother and, for the toddler, being healthy and up to 36 months old. As exclusion criteria, the following were considered: (1) regarding the toddlers: malformations, neurological problems, genetic syndromes, and/or other severe clinical issues detected upon parental report; (2) regarding the mothers: the presence of intellectual disability and/or other identified severe psychopathological issues according to the observation from the contact with the mother.

For the selection of the cases, maternal ratings were evaluated with the Self-Reporting Questionnaire (SRQ-20) instrument, considering 8 as a cutoff point for symptoms of common mental disorders (CMD) (Mari & Williams, 1986). Although seven out of the 34 mothers met the inclusion criteria (cutoff point greater than 8), the four mothers with the highest scores were selected based on the exhaust sampling criteria (Fontanella et al., 2008). This study also follows the recommendation that case studies should be dedicated to four cases to allow depth of analysis (Creswell, 2014).

As highlighted in Table 1, the participating mothers were aged between 23 and 37 and declared themselves to be White. Moreover, all of them declared themselves to be heterosexual and lived in the capital of a state in Rio Grande do Sul. Toddlers’ age ranged from 14 to 24 months; two were male, and two were female.

This is qualitative research with an exploratory character, in which a multiple-case study design was used (Yin, 2015). This design allows the researcher to thoroughly investigate a phenomenon, considering the similarities and distinctions within a specific group of people (Stake, 2006).

About the procedures, an online survey with the “Questionnaire on Sociodemographic Data” (NUFABE, 2017a) and the “Questionnaire on the Use of Media” (NUFABE, 2017b) was carried out in the bigger project, which invited mothers of children up to 36 months to answer questions about the use of digital media with their toddlers, their own mental health, and their child’s development. At the end of that survey, there was an invitation for mothers from Porto Alegre or its metropolitan region who were interested in continuing their participation to attend together with their children a research laboratory of the Psychology Institute of the university. When they arrived, they signed the Informed Consent Form upon agreement. Afterward, mothers were asked to participate in a parent-child interaction session, which was filmed. In the end, we carried out the “Interview on Family Interaction with the Use of Technologies” (NUFABE, 2017c).

The project from which this study is derived follows human research recommendations. It was approved by the University’s Ethics Committee under opinion n^o. 69947117.6.0000.5334. To reinforce confidentiality, data protection, and identity, this research used pseudonyms and omitted some information that could facilitate the identification of participants, such as their names (Creswell & Poth, 2018).

For data analysis, the SRQ-20, the Sociodemographic Data Questionnaire, and the Questionnaire on the Use of Media were used descriptively to characterize the participants. Then, the Interview on Family Interaction with the Use of Technologies was transcribed, read thoroughly, and analyzed with the aid of NVivo Qualitative Data Analysis Software (NVIVO) version 12 (QSR, 2018).

The mother-child interaction was assessed quantitatively and qualitatively, according to the scores obtained in the coding (Piccinini et al., 2007). It was used to enable triangulation between the two sources (interview and video recording), considered one of the main validity strategies in qualitative research (Creswell & Poth, 2018).

After collecting the data, two thematic axes were constructed: (1) Ways of Using Digital Media and (2) Digital Media as a Resource. Afterward, the crossed cases were synthesized to compare them in terms of their similarities (Yin, 2015).

Adriana was 34 years old, considered herself White, and was Alice’s mother. She had an administration degree and wasn’t working at the time of the study. She was married and lived with her daughter’s father, and the family’s annual income was approximately $26,400. Alice was 22 months old and wasn’t attending a daycare center in the data collection period.

Regarding the use of digital media, the mother felt the need to offer them to Alice when she was studying. She offered TV for her daughter to watch, especially in the morning when she was more energetic: “I use TV more in the early morning, which is when she has a lot of energy.”

To diminish motherhood’s distresses, the mother reported that technology served to provide moments of self-care. She stated that in this way, she remembered who she was before Alice was born:

In this dyad, the media also contributed to the toddler’s engagement with her mother. Adriana pointed out that Alice would try to get her attention by making verbal sounds when the video she was watching had finished: “She can already tell me when the DVD ends, so she picks up the letters, and she says ‘han, han,’ like, and then, will it continue now, or what will happen?” This aspect was also transposed to the interaction. In the “ignoring” episode of the interaction evaluation, Alice constantly tried to attract her mother’s attention through physical and verbal contact. Adriana, on the other hand, ignored her daughter’s attempts. In contrast, it is intriguing that the girl scored low on levels of involvement and responsiveness in the mother-child interaction evaluation, as shown in Table 2. Thus, one hypothesis is that the use of maternal media enabled Alice to attempt to get closer to her mother. Another plausible aspect is that the mother’s relative intrusiveness, combined with the suffering shown above, could hinder the daughter’s initiative through contact and the tuning of the dyad. Because of this, the appearance of another object, such as the smartphone, would be necessary for the child to find space to seek maternal care.

Bruna was 37 years old, declared herself White, and was Bernardo’s mother. She worked as a health professional, had a graduate degree, and was on work leave. She was married to her son’s father, and the family’s annual income was approximately $26,400. At the time of research, Bernardo was 24 months old and wasn’t attending a daycare center.

Bruna reported that she used digital media to distract Bernardo, especially in everyday moments such as at mealtimes: “At dinnertime, he is already in a sleepy time, it is a critical hour, and it’s a time in which I have more difficulty in entertaining him with the things he saw during the whole day”. Still, the use of technologies softened the demands of the process of becoming a mother:

Nonetheless, she said she felt guilty for offering a digital resource to her son: “I had nothing on the trip, no space for him, and I had to use the TV … because I didn’t have anything else to entertain him. Without having an extra resource like that, I felt quite guilty”.

Bruna’s narrative also showed that when she was talking on her smartphone, her son imitated her as a way of interacting: “Someone calls me, sometimes I put the phone on speaker, and I talk to the person, and he is ‘papapa’ a way for him to interact too.” Meantime, another report suggested that the maternal use of the screens created a reaction of displeasure in the child. In response to that, the child tried to win back his mother’s attention through physical contact: “He doesn’t like [social networks], he comes after me and keeps poking me … he is like, ‘Mom, I’m here, Mom, I want attention’.”

In this case, it was intriguing that the mother had the highest score for hostility, yet the son scored well on involvement and responsiveness. In the transition from the episode “playing with toys” to “playing with a smartphone” in the interaction evaluation, Bernardo cried copiously. He was furious at the removal of the toys and the insertion of the smartphone. At the same time, Bruna laughed at her son’s lack of control and just said, “you should be angry against her [the researcher], it wasn’t me who took your toys.” In the continuation of the scene, the boy tried to approach his mother, leaning his arms on her leg to hold him, and in response, Bruna took Bernardo’s arm away from her in a negative way without any eye contact. The toddler only managed to calm down when the mother put a video with music on the smartphone. At that moment, lowering his head towards the screen, Bernardo fixed his gaze on his smartphone and watched the video with full concentration.

Cláudia was 23 years old, considered herself White, and was Camila’s mother. She worked as an administrative assistant and was studying to complete higher education. She lived with her daughter’s father and with their two other children aged 11 and 14. The family’s annual income was approximately $5,280. At the time of data collection, Camila was 14 months old and attended a daycare center.

Cláudia felt a greater need to offer digital media to Camila when working or studying at home and receiving visitors. However, she used these digital media to provide an interaction between the pair, as she realized that Camila liked to take selfies with her smartphone and used this moment to communicate with her: “She really likes to take pictures, so we take pictures and show her. The baby takes a selfie, she presses there, takes it, then we ask her “who is this baby here?” and she claps her hands”.

Despite this, for Cláudia, the use of digital media with her daughter helped her to face the demands imposed by raising a child: “[The use of technologies] is comfortable for the parents, quite comfortable … she [the daughter] stays amused with that thing.”

Camila also resorted to using the media as her own resource. In the “ignoring” episode of the interaction evaluation, she exhibited behaviors of exploring objects, moved around the room, expressed positive attitudes such as by smiling, and made verbal sounds. Still, it is noteworthy that although Camila had moderate responsiveness and involvement ratings in the interaction evaluation, Cláudia scored the highest on intrusiveness.

Débora was 29 years old, declared herself White, and was Daniel’s mother. She had higher education, worked as a chemist, and earned about $5,280 per year. Débora was single, lived only with her son, and did not mention anything about Daniel’s contact with his father. At the time of the research, Daniel was 22 months old and was attending a daycare center.

Débora felt a greater need to offer digital media to Daniel when she was working at home, and when she received visits. However, she reported that she perceived that digital media did not catch Daniel's attention very much: “[the smartphone] is not something that captures him for a long time”. She also perceived her son as more relaxed without using any digital media, so she avoided using them: “I don't need to use anything [digital media], he stays fine. Sometimes he doesn't ask, sometimes he asks [to use digital media], but it's not necessary. During meals is actually the other way round, if I don't have anything connected, he [his behavior] even stays better that way”. Also, she was the only one who mentioned using the radio because she noticed that Daniel liked to dance and used the moment to dance together: "I use the radio for him to listen to music, he likes to dance, I dance with him, he likes it". In line with these data, in the interaction assessment, Débora was the only one who showed good levels of structuring, which means she encouraged and supported Daniel`s autonomy during the activities. And Daniel, in turn, showed good responsiveness and involvement, demonstrating he was happy and well engaged to his mother during the interaction.

Axis 1, Ways of Using Digital Media, details how the mothers reported using technologies with their children. Although all four mothers reported using digital resources with their children in their daily routine, there was a similarity in the use in Cases 1, 2, and 3. These mothers stated that they offered the media to their Toddlers to calm them down, distract them, or entertain them. This use of technologies does not seem to encourage interaction, which can negatively impact the mother-baby relationship (Radesky et al., 2015) and the child’s development (Antar, 2019).

It was noted that Cláudia and Débora, the mothers in Cases 3 and 4, mentioned that they used digital media to promote interactive exchanges with their children, for example, when taking selfies and dancing together, respectively. Accordingly, it is interesting that these same mothers had the two highest SRQ-20 scores for maternal mental health problems. Both showed inconsistent sensitivity and implicit hostility throughout the interaction evaluation. Despite this, in general, Camila scored moderately on responsiveness and involvement, while Daniel scored well on responsiveness and involvement. Dib et al. (2019) pointed out that mothers who assume a more affective and stimulating behavior also had children with greater involvement in the interaction. One might think that for Cláudia (Case 3) and Débora (Case 4), the use of digital media would support them to demonstrate more creative behaviors, which would potentially encourage their children to engage in interactions.

In this sense, in these two pairs, the use of media aimed to contribute to the mother-child interaction, seeming to favor their bond when carrying out an activity together with this resource and not using it centrally. This is in line with the American Academy of Pediatrics (Council on Communications and Media et al., 2016), proposes that the adult’s interaction with the child while using media is essential. Besides, it can also enrich the parent-child bond (Nikken, 2017). However, according to McDonald et al. (2016), in the context of postpartum depression, paying attention to the decrease in screen time can protect the child from possible developmental delays. In such a way, one may think that the moderate and good ratings of responsiveness and involvement of the two children in the mother-child interaction in this study were able to contribute to the more interactive mode of media use. Different studies corroborate this hypothesis by showing that children of mothers with symptoms of depression and anxiety invite their mothers to interact or maintain the same level of quality of interaction compared to children of mothers who do not have these symptoms (Dib et al., 2019). Nevertheless, the severity and chronicity of maternal symptoms were not evaluated in the present study.

Adriana (Case 1) and Bruna (Case 2) were the mothers who reported allowing their toddlers to use media alone. However, it is intriguing that, among the participants, these mothers were the ones who scored lowest on the SRQ-20. Furthermore, they registered, respectively, weak, and inconsistent sensitivity and structuring. Compared to the other two mothers, they both scored the highest on hostility, and this was also observed qualitatively during the mother-child interaction. It is known that hostility can be present in mothers who have emotional disorders, causing negative impacts on child development (Janßen et al., 2019). It is necessary to consider whether these mothers tend to leave their children alone with screens more to minimize hostile behaviors, echoing other difficulties in the relationship. Despite this, it is noted that all cases in this research revealed some level of hostility throughout the interaction, unlike other previous studies that evaluated the dyad interaction in different contexts, such as in the manifestation of child psychofunctional symptoms in children and marital adjustment (Peruchi et al., 2016) and maternal depression and child psychofunctional symptoms (Silva et al., 2018).

Thus, in this axis, it was identified that even in the presence of maternal mental health problems, two mothers made more creative use of media, which means that they provided greater interaction with their children. This might be due to the good maternal structure. The other two mothers did not report using media to provide a moment of interaction with their children. In this sense, higher hostility seems to be an essential component among these cases. The question is if maternal mental health problems would increase this hostility, or if not being able to play with the children would potentiate hostile behaviors in the interaction.

Axis 2, Digital Media as a Resource, shows the reasons the mothers reported the use of digital media and their crossings in dyadic interaction. Among the cases, all interviewees mentioned that they could carry out domestic chores or other pending activities while their children were using digital media. This result has already been found in mothers without mental health problems, pointing out that the use of digital media with children allow caregivers to accomplish their chores more easily (Mallmann & Frizzo, 2019).

In the presence of maternal mental health symptoms, the arrival of a child can be even more challenging for the mother, impacting her mental, physiological, and social health (Carvalho & Benincasa, 2019). Thus, it is possible to conjecture that digital media use would support mothers and compensate for the demands of the child-rearing process for the participants in this research. Nevertheless, research has revealed that mothers who experience numerous stressors related to raising children tend to resort to using their digital devices to escape stress (McDaniel & Radesky, 2018b). Regarding motherhood and psychological factors, Dau et al. (2019) found that parental stress and maternal chronic depressive symptoms resulted in lower sensitivity levels. In view of the evidence, it is worth thinking that digital media are used as a resource against stress, however, they can also negatively impact the quality of interaction, distancing mothers and children, forming a cycle of mutual influences.

The data analysis showed that in addition to technologies being a resource for mothers, the toddlers also used digital media as their own resource. In the episode of “ignoring,” Bernardo (Case 2) and Camila (Case 3) more freely explored the environment with positive gestures and facial expressions, smiles, and vocalizations as a reaction to that moment. It is known that intrusiveness is characteristic of interactions with mothers who show symptoms of mental disorders (Hakanen et al., 2019). There are also associations between hostile mothers and children’s worse mental health (Janßen et al., 2019). So, one may think that in the cases where there was greater intrusiveness (Case 3) and hostility (Case 1 and 2), the maternal use of the smartphone could have reduced these behaviors, because as much of the mothers’ attention was focusing on the smartphone. This, in turn, favored greater child involvement (Case 1) and child autonomy (Cases 2 and 3). Meanwhile, it is noteworthy that another qualitative study observed that when fathers and mothers used smartphones, the level of parental disengagement increased in relation to other distractors and could lead to problems, such as child endangerment (Lemish et al., 2019).

Evidence from the present study indicates that digital media has become a resource for mothers to vent the challenges of motherhood, and to facilitate their needs and daily routines. On the other hand, it was identified that there was less need for media use when there was higher maternal structuring and good child involvement, so the interaction happened satisfactorily. About digital media as a resource for children, it was possible to understand that maternal smartphone use helped to reduce maternal intrusiveness and hostility, which seemed to boost children’s autonomy and their closeness to their mothers.

It is also necessary to highlight that the mothers in this present study have a high level of educational attainment, which may influence how the mothers use media with their children. Most studies found that lower maternal education was associated with greater infant screen exposure and use (Cárdenas-Fuentes, 2022; Krogh et al., 2021; Wiltshire et al, 2021). In this sense, a study from the United States showed that maternal graduate school education compared with college was a strong correlate of children’s media exposure (Trihn et al., 2020). Still, the most recent census from Common Sense Media also presents a difference between screen use considering parents' education (Rideout & Robb, 2020). These differences can be explained by several factors, such as access to health professionals and services that may provide scientifically based information (Sousa et al., 2021). In addition, there is a well-known positive relationship between maternal education and mental health (Wickham et al., 2017), as evidenced in this study, in which Claudia (case 3), who had lower education, had more symptoms of common mental disorders.