This document discusses mother-infant attachment. It defines attachment as the pattern of interaction developed between mother and baby, which affects the baby's development. Both parental and infant roles influence attachment. The infant's abilities like interaction, modulation of arousal, and behavioral states help form the relationship, while the parent must be responsive and sensitive to signals. Factors like prenatal stress, postpartum depression, and social support also impact attachment. Assessing the interactions and referring mothers if needed can help promote secure attachment.

1. PARENTAL AND INFANT ROLE IN
MOTHER–INFANT ATTACHMENT
Dr. Susmita Tripathi
3rd Year resident
Department of pediatrics
1

2. ATTACHMENT
 Attachment is a pattern of interaction and
communication established and developed between
mother and baby
 Affects the baby’s cognitive and socio-emotional
development
 Attachment behaviour is the result of the emotions
including alienation, disease, distress, hunger,
danger, and fear
2

3.  Attachment relations start in the prenatal
period and the fetus reacts to the mother’s
emotions with their perception, reaction, and
capturing ability from the 26th week of
gestation
3

4. HISTORY OF ATTACHMENT
 John Bolwby: Father of attachment theory; 1969
 Believed that attachment promotes survival in 3
ways
 Safety
 Safe base for exploration
 Internal working model: First relationship forms a
template that acts as a prototype of all future
relationship
4

5. HISTORY OF ATTACHMENT
 Mary Ainsworth proposed 3 attachment styles
 Secure attachment
 Ambivalent attachment
 Avoidant attachment
5

6. 6

7. 7

8. 8 PRINCIPLES FOR ATTACHMENT PARENTING
 Prepare for pregnancy, birth and parenting
 Feed with love and respect
 Respond with sensitivity
 Use nurturing touch
 Ensure safe sleep physically and emotionally
 Provide consistent love and care
 Practice positive discipline
 Strive for balance in personal and family life
8

9.  Parenting a newborn infant requires
dedication
 Parents must attend to an infant's signals
and respond empathically
9

10. FACTORS AFFECTING ATTACHMENT
10

11. PRENATAL FACTORS
 Recent death of a loved one
 Previous loss of or serious illness in another child
 Prior removal of a child
 History of depression or serious mental illness
 History of infertility or pregnancy loss
11

12. PRENATAL FACTORS
 Recent move or no community ties
 No friends or social network
 Unwanted pregnancy
 No good parenting model
 Experience of poor parenting
12

13. PRENATAL FACTORS
 Troubled relationship with parents
 Financial stress or job loss
 Drug and/or alcohol abuse
 Extreme immaturity
 Marital discord or poor relationship with the
other parent
13

14. PERIPARTUM AND POSTPARTUM INFLUENCES
 Early skin to skin contact
 Postpartum Depression
14

15. SOCIAL SUPPORT
 Support from father and other family
members
 Early return to work
15

16. INFANTS ROLE IN MOTHER INFANT
ATTACHMENT
 Interactional abilities
 Neonates are alert and ready to interact and
nurse after birth
 Hearing is well developed
 Neonates are nearsighted
 Modulation of Arousal
16

17. Behavioral States
 Six states have been described:
 Quiet sleep
 Active sleep
 Drowsy
 Alert
 Fussy
 Crying
17

18. Mutual Regulation
 Parents actively participate in an infant's state
regulation
 Parents are regulated by the infant's signals
 Basis for the emerging psychologic relationship
between parent and child
18

19. WHAT IS OUR ROLE????
 Prenatal Pediatric visit
 Supportive hospital policies
 “Baby Friendly Hospital”
 After discharge, home visits by nurses and
lactation counselors
 First office visit should occur during the 1st
2 wk after discharge
19

20. 20

21. ASSESSING PARENT–INFANT INTERACTIONS
 Ask new mother about her own emotional
state
 Enquiring specifically about a history of
depression, facilitates referral for therapy
 Detect postpartum depression
21

22. NEWBORN BEHAVIOR ASSESSMENT SCALE
(NBAS)
 A formal measure of an infant's
neurodevelopmental competencies
 State control, autonomic reactivity, reflexes,
habituation, and orientation toward auditory and
visual stimuli
 Used to demonstrate to parents an infant's
capabilities and vulnerabilities
22

23. 23

24. REFERENCES
 Nelson’s Textbook of Pediatrics, 21st edition
 M. Saul; Attachment Theory: Bowlby And
Ainsworth’s Theory Explained;
www.simplypsychology.org; June 4,2023.
24

25. They only spend a short time in your
arms, yet the imprint of love and
availability lasts for lifetime.
25