Attachment of Premature Infant

Attachment of Premature Infant




Attachment of Premature Infant


            Neonatologists as well as parents are increasingly being concerned regarding the impacts of the survival of immature infants with respect to emotional, behavioral, mental, and motor development. A plethora of studies have been conducted on attachment development in high-risk infants. However, the findings on the attachment quality of preterm infants, especially on low-birthweight preterm infants have been found to be contradictory as well as inconsistent (Brisch et al., 2005).  Studies have found out that psychosocial, low socioeconomic statues and prematurity factors have a significant effect on emotional development. In particular, the psychological distress of the parents of preterm infants has been found to change early interactions. Premature birth has the potential to impact upon parental attitudes and perceptions hence affecting child behavior (Borghini et al., 2006). A good number of studies have demonstrated that the interaction styles of parents of premature preterm infants and full-term infants are not similar. Whereas full-term infants smile more and fuss less, preterm infants have been found to smile less and fuss more. Besides, parents of full-term infants have less level of activity and simulation as compared to parents of preterms.

Borghini, A., Pierrehumbert, B., Milijkovitch, R., Muller-Nix, C., Forcada-Guex, M., &

Ansermet, F. (2006). Mother’s attachment representations of their premature infant at 6 and 18 months after birth. Infant Mental Health Journal, 27(5), 494-508.

This article sought to explore parental attachment representations towards low-birthweight preterm infants. Borghini et al. (2006) hypothesized that parental attachment representations will be changed in the course of the first months after being discharged from the hospital.  A control group of thirty families with full-term infants as well as 50 families with a premature infant between 25 and 33 gestation weeks took part in this study.  The study assessed perinatal risks in the course of hospitalization. In addition, the Working Model of the Child Interview (WMCI) was administered to parents when their children were between six and eighteen months old.  The findings of this study indicated that the severity of the perinatal risks has a considerable effect on the parents’ attachment representations.  At 18 months, 30% of the parents of a premature born infant had secure attachment representations while at six months, only 20% of the parents of a premature born infant had secure attachment representation.  In the control group, 57% of parents of full-term infants had secure attachment representations at 18 months while 53% of the parents of full-term infants had secure attachment representations.   Borghini et al.  (2006) also found out that parents of low-risk premature infants in most cases have detached representations.  Distorted representations were also found to be common in high-risk cluster of premature infants.  Results from this study therefore suggest that mothers’ reaction to a premature birth is closely associated with severity of postnatal risks.  Since secure attachment representations were found to be affecting both parents of high-risk infants and low-risk infants, Borghini et al.  (2006) recommended that further studies should be conducted to examine whether preventive intervention for both high-risk and low-risk premature. This study had several limitations. For instance, the study had significant differences in rates of participations between control and clinical groups and as such, Borghini et al. (2006) pointed out that there is need to examine the parental reasons for refusing or accepting to take part in such kind of research. Another limitation for this study is that parental socioeconomic status might have influenced the findings of this study. In particular, a socioeconomic level was found to be low in the high-risk group and as such, it might have affected the results of this study.

Brisch, K.H., Bechinger, D., Betzler, S., Heinemann, H., Kachele, H., Pohlandt, F…Buchheim et

al.(2005).  Attachment Quality in Very Low-Birthweight Premature Infants in Relation to Maternal Attachment Representations and Neurological Development. Parenting: Science and Practice, 5(4), 11-29.

This article attempted to examine the development of attachment within very low-birthweight pretern infants in terms of maternal attachment representations as well as neurological development.  The Strange Situation Procedure was employed to classify the quality of attachment in preterm infants at 14 postnatal months.  The Adult Assessment Interview was utilized to assess maternal assessment representations and was associated with the quality of attachment in preterm infants.  The study also took into consideration neurological development at 14 months.  Results from this study demonstrated that the distribution of the quality of attachment within preterm infants (2.9 not classifiable, 10% insecure-disorganized, 2.9% insecure-ambivalent, 2.5% insecure-avoidant and 60% secure) was similar with the findings of studies of term infants.  Brisch et al. (2005) also found out that there was no correspondence between infant quality of attachment and maternal representations of attachment. Nonetheless, this study found out that neurologically impaired infants were in most cases insecurely as opposed to securely.  Brisch et al. (2005) concluded that if the neurological outcome of very low-birthweight preterm infants is damaged, they in most cases have insecure quality of attachment. To this effect, Brisch et al. (2005) argued that reducing risk factors for the development of neurological impairments may have a preventive impact on the emotional as well as somatic development of high-risk infants. The study recommended that further research need to be conducted to get answers about the interplay among emotional development, neurological risk factors and somatic development. Brisch et al. (2005) also indicated that there is need to assess the infant’s disorganized attachment quality, trauma as well as unresolved maternal loss.  This study had several limitations. For instance, the study relied upon normative information from other studies with term infants as opposed to having a control group of term infants, which of course would have been advantageous to the study. Second, there also the possibility that informing the raters of the SSP regarding vision handicaps as well as bilateral hearing of premature infants might have biased their ratings.

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