by Dr. Lisa Michelle Noll, Pediatric psychologist at Texas Children’s Hospital
When we are pregnant, we dream of the first minutes and hours after birth, holding, kissing, and caring for our newborn baby. Attaching to and bonding with our newborn baby seems natural, not something we need to prepare for, but just rather something that happens intuitively in the hours and days following birth. That dream is disrupted when a newborn must spend those first hours, days, and even weeks or months in the Neonatal Intensive Care Unit (NICU).
As a psychologist providing support to parents in the NICU, I have had the opportunity to support parents and babies on their journey forming attachments with one another. I have heard the yearning in parents’ voices to form these bonds, all the while helping them celebrate the milestones in their relationship. As a mother of premature twins who spent their first months in the NICU, I know first hand the challenges that come with forming a relationship with your babies physically separated from you by an incubator, and the feelings that come with building on your relationship in new ways once they come home.
Bonding in the NICU vs bonding at home
Forming a bond with your baby in the NICU is different from how it would be if he or she was home. The normal cycle of feeding and interaction may be defined in the initial days by the fragility of the baby. As your baby grows in the NICU, the focus may be on gaining strength and meeting the milestones of breathing and feeding needed to go home. Once home, some parents may feel as though they are getting to know their baby, minus the monitors and nurses, and learning to navigate new routines and potential medical needs. Meeting developmental milestones and bonding now take center stage.
Parents may worry about attaching to their baby after the NICU experience. But what does bonding look like with an older baby and toddler?
Ways to create a bond with your child at home
Simply stated, attachment is an emotional bond to another person. The central theme of attachment theory, developed by John Bowlby, suggests when a caregiver is available and responsive to the baby’s needs, the child develops a sense of security. This in turn helps the baby know the caregiver is dependable and thereby creates a secure base from which the child can explore the world.
We know from attachment research that attachment occurs over time and is based upon experiences. These experiences, between parent and child, go beyond feeding, and include comfort, interaction, and predictability. Within cultural variations and individual differences, some simple things you can begin today, and may already be doing, include:
“Play with me, Mommy”
Play is an important aspect of early childhood and provides an opportunity for warmth and engagement and highlights for the child the parents’ interest in them. Taking into consideration your child’s developmental level, focus on just playing rather than trying to teach skills such as colors or letters. Sit with your child when both of you are relaxed and calm. Show interest in your child’s play and marvel in his or her exploration and excitement. By enjoying your child’s enjoyment, you can share smiles, laughs, and vocalizations.
“Talk to me, Mommy”
Talking with your child not only provides language stimulation, but creates opportunities for visual and verbal connection. Make eye contact with your child, and respond to language, even if it is in the form of simple vocalizations, by repeating back what you heard or respond as though having a conversation. Your focused attention on your child signals your availability and interest in the engagement and what your child is “saying.” Singing songs and reading books also are wonderful ways to create meaningful experiences with your child.
Memory Making
Parents love recording every little thing their children do as they grow. Recording “milestones” can occur at any stage of development. Even if you did not have a chance to capture newborn handprints, gathering handprints/footprints of your now older baby secures that moment in time. Celebrate your child’s NICU discharge anniversary, take monthly pictures, and document milestones, no matter how silly, messy or routine, such as holiday outfits, first tooth, first “food”, eating with a spoon and first steps.
Create Rituals
Routines and traditions are important markers for a family, including babies and toddlers. Rituals create predictability, which helps build a sense of security. Rituals can also begin at any stage of development. Create rituals around bath time, nighttime routine, Sunday afternoons, holidays, etc. There may be some rituals specific to each parent or some that you experience as a family. Take the opportunity to document these rituals, which also add to memory making.
Touch
Touching and being touched are the most important experiences in life. Touch plays a role in developing healthy emotional development and communication between babies and their parents. Touch also helps your child learn about the world. Massage is a wonderful tool that not only provides an opportunity to establish routines, but also to create an experience between baby and parent. As your baby grows and becomes more active, massage may be more challenging but can include a simple rub on the head, tender touch on his or her back, or rubbing his or her feet. As you touch your child, watch for cues and emotions and respond appropriately. There may be some touches he or she likes better than others leading to verbalization of what he or she may be experiencing. When you respond to your child’s cues, it helps reinforce your connection and helps your child know you understand his or her needs.
The key point to remember is that any experience you have with your child such as bouncing on your knee, singing a song, or snuggling and reading a book builds upon your emotional bond to one another. Some of these activities may be more challenging than others. Focus on what feels comfortable and what you and your child enjoy. If you have concerns about how you and your child are bonding with one another, and/or your feelings toward your child, it is important to reach out for support. You can talk to your partner, pediatrician, OB, or a religious/community leader who can help direct you to appropriate resources in your community.
In the end, regardless of where your journey began with your baby, in the NICU or at home, you and your baby can have a beautiful and special bond!
About Dr. Noll
Dr. Lisa Noll is an expert pediatric psychologist at Texas Children’s Hospital. In this role, Dr. Noll is passionately committed to helping children understand and work through both behavioral and emotional hurdles they may be facing. You can find more information about Dr. Noll and the entire Texas Children’s Hospital Clinical & Pediatric Health Psychology team here.