Dealings
Bonding In The NICU And Beyond

By: Mara Tesler Stein, Psy.D. and Deborah L. Davis, Ph.D.

When a baby is born prematurely, many mothers and fathers worry about the lack of opportunity to have "bonding experiences". Where were those Kodak and Hallmark moments of meeting their newborn-- those "critical" first moments of skin-to-skin closeness and eye contact? Where were those intense feelings of pride, love and devotion? Instead, the post-delivery Kodak moment was reduced to a quick glimpse of an alien creature, surrounded by people in gloves and gowns. And the Hallmark moment consists of blinding love and hope, coupled with intense disappointment, and overwhelming fears. At a time when parents want to feel completely connected and in tune with their infant, they are instead feeling shocked, numb, detached and terrified. Later, after the baby is installed in the NICU, parents stare in disbelief at a scrawny, sickly being. They want to touch, but fear harming such a fragile creature. They yearn for those typical "bonding moments" such as cradling, feeding and cooing at their precious bundle.

What Bonding Is, and Isn’t

When the term "bonding" was first coined, it referred to the investment mother animals show in their newborn young. For many animals, there is a "critical period" after birth where certain things must happen, or the mother and sometimes the father won’t "know" that’s their baby, and their investment evaporates. Many mammals need to be able to smell and lick their newborns in order to feel a connection.

As with other animals, human bonding refers to the investment that parents have in their babies. But for humans, bonding is not an instantaneous superglue event that happens when the parents lay eyes on their baby, preferably within seconds after birth. There is no magic protocol of certain things that must happen in order to cement the parents’ interest in their infant. There is no critical period that you miss out on when your baby is whisked away after delivery. Instead, human bonding is a powerful and complicated process of falling in love with one’s baby over time. The process often starts before conception, when the parents imagine holding their future baby in their arms. The process continues throughout the pregnancy and into infancy, and is flexible enough to overcome many obstacles like anxiety, illness, NICU and separation.

Parental Bonding with Full Term Babies

When looking at your situation with your premature baby, it can help to have a yardstick against which you can measure your feelings of bonding. By knowing more about the "regular" bonding process, you may be reassured by how close to the mark you actually are.

For humans, bonding has peak moments that occur over time: When a couple actually stops using birth control; when they get a positive pregnancy test result; when they see the baby’s image on an ultrasound screen; when they feel the baby move for the first time; when they see and hold their baby after birth; when they gaze upon their baby sleeping peacefully. The father experiences his own special peak called "engrossment"—gazing in wonder at his newborn after birth, as if the rest of the world no longer matters. In general, bonding happens when parents feel a heightened level of commitment, and bonding is reinforced when they think about or spend sweet times with their baby.

While the parental bond may be well established early on, it is not an achievement that remains constant after a certain "critical" point. Rather, it is a dynamic process that rises and falls. During pregnancy and infancy, there will be times when the parents feel great swells of love and devotion and other times when they feel like running away. There will be times when they are so happy to have this child in their lives, and other times when they rue the day they invited him in. This is normal.

The parental bond also grows and adjusts over time. As the baby develops her own distinct personality and becomes a separate individual, the bond expands to accommodate the otherness of the child. As baby grows and leaves the breast, then leaves the lap, then leaves for school and then leaves home, the bond doesn’t lessen or disintegrate; it simply stretches and becomes more complex. As the child grows and develops, the nature of the attachment becomes richer – it includes more and more of what the child offers to the relationship. If the child remains dependent on caregivers, the bond doesn’t stretch quite so much but it does change as the child grows and the parents adjust their caregiving. And when a baby or child dies, the bond doesn’t disappear—it gradually changes as the parents grieve and adjust to a different relationship with the lost child.