Understanding the Impact of Prematurity on Attachment

Abstract

This dissertation was undertaken to develop an understanding of the internal world of premature infants and their developing relationships. Initially, the literature regarding attachment in normal infant-mother dyads is reviewed. An overview of the world of the preterm infant in the Neonatal Intensive Care Unite (NICU) is provided. Factors that are special to mother-preterm dyads are evaluated: the emotional challenges facing preterm mothers, the availability of the preterm infants to be in relationship and the ‘facilitating environment’ (the NICU). Holding an understanding of the above factors, a review of articles that consider the security of attachment in infants born prematurely was conducted. The resilience of the attachment relationship became clear. However, it is evident that this relationship can be significantly compromised by psychosocial factors in the mother or by extreme prematurity or severe medical complications in the infant. The paucity of data addressing long term relationship stability for these tiny graduates is of concern. The developmental model of care proposed by Als (1986) offers an intervention that integrates the psychosocial and biologic needs of the infants and their families.