Preemie bonding delay is not mom’s fault

U. WARWICK (UK) — Some premature babies have trouble bonding due to neurological impairments, not due to the way their parents interact with them, say researchers.

Researchers report that most very preterm and very low birth weight (VP/VLBW) infants were securely attached to their parents. But they also found that these infants were at higher risk for what is termed “disorganized attachment”—when a child shows conflicting behavior in their relationship with their parents.

Healthy attachment sees a child using the parent as a secure base from which to explore the world, whereas with disorganized attachment the child displays contradictory behavior when interacting with the parent.

Disorganized attachment

Disorganized attachment can be an indicator of negative parenting and abuse in full-term infants, so the study, published in the journal Archives of Disease in Childhood: Fetal and Neonatal Edition, underlines the need for health professionals to know whether a child was born prematurely when assessing parent-baby relationships.

“Very preterm children often spend months in incubators and in hospital after birth. Despite this stressful start we found parents of very preterm children to be as sensitive in their parenting as those of healthy preterm children,” says Dieter Wolke, professor at the University of Warwick.


“However, very preterm children more often have neurological and developmental problems and these explained why they were more likely to be disorganized in their attachment or bonding despite sensitive parenting. ”

“Health professionals should be aware that disorganized attachment in preterm children is often a sign of these children’s developmental problems and not because they are harshly or abusively parented,” adds Wolke.

The study looked at 71 VP/VLBW children and 105 full-term children. It defined very preterm as babies born at less than 32 weeks gestation or weighing less than 1500g (3lb 5 oz).

The study found that most very preterm/very low birth weight infants (61 percent) were securely attached to their primary caregiver. That compares to 72 per cent of full-term children. However, 32 percent of VP/VLBW children showed disorganized attachment at 18 months, compared with 17 percent of full-term children.

Mom’s sensitivity

The researchers also studied maternal sensitivity in the way mothers interacted with their babies.

They found that the differences in attachment emerged despite mothers of VP/VLBW children being equally or more sensitive in their parenting in comparison with mothers of full-term infants.

This suggests that disorganized attachment is linked to neurological abnormalities, and not to maternal sensitivity.

However, parents of VP/VLBW children should take heart from separate research, which showed a more positive impact of parenting that can be seen in children at a later age.

For example, a study last year, also led by University of Warwick researchers, found that sensitive parenting did help older VP/VLBW children—aged between six and eight years old—to make up developmental delays.

Source: University of Warwick