Hand to Hold's Official Blog: Written by Parents for Parents

Kangaroo Care and Beyond: Building Attachment with Your Baby, One Hug at a Time

Photo by Kara Whalin

Photo by Kara Whalin

For me, attachment was one of those things. One of THOSE things. It gave me a pang when for the first couple months of my son’s life I had to ask permission to hold him. I had been one of those moms that had hoped to have my boys laid on my chest after birth, to just lay and cuddle and engulf myself in the pure smell and feel of them for as long as I could. That possibility was negated when I went into preterm labor and they were born at a tiny two pounds apiece, and were immediately shuffled off to the intensive care unit to be placed on life support. When Elliott was to be discharged from the NICU, I planned on baby-wearing him as often as possible for the first year of his life to make up for the months he had spent in his isolette. I searched for the perfect wraps and slings, imagined us going around together everywhere: him sleeping, safely tucked into a carrier. I would smell his head and go about my day and we could salvage/build our attachment. Attachment, I thought, would be something I could make up for by doing everything in my power to make it really strong once we were home and together. And in the meantime, I kangarooed at the hospital any chance I got.

It turns out the lesson I learned was in this case proffered by Elliott himself. Because, no. He was not into the sling. He was not into the sling at all. And if I wanted to continue down this path of trying to carry him in this sling, he cried? I would regret it because he would writhe and scream furiously every time I tried.

At first, it was one of the harder sacrifices I experienced in the NICU and beyond, the notion of attachment I had held onto prior to going into preterm labor. It was difficult to let something that I valued so very much become, for the first three months, dictated by medical necessity, and for the rest of his first year look completely different from what I had theorized it would be. However, I now know that the attachment lessons I learned from going through this experience taught me more valuable tenets about parenting than I’d possibly ever been exposed to, and that continue to help me in my parenting challenges to this day.

Attachment. It’s a word that’s thrown around a lot these days. But what do we truly mean when we use it? Basically, psychologists and neuroscientists came to the realization that the active and loving relationships that we have with our caregivers (especially from birth to 3 years old) have a profound influence on our brain development, our mental health and happiness, and our ability to build relationships with others as an adult. A healthy, secure attachment indicates that an infant feels safe with their caregiver, that they feel loved, that their world is predictable, that they can be curious without having to fear for their lives. It’s theorized (and neuroscientific research has shown) that infants with a secure attachment with their primary caregiver develop more “organized” brains, which in turn can mean that as children and adults, those infants will feel more apt to learning, exploring their boundaries, and building relationships with others around them. It’s a very powerful concept to think that the way that you love your infant as a caregiver can affect their happiness, intelligence and wellbeing in the future. And something that, under normal circumstances is, for the most part, under the parents’ control. Right?

That’s the bit I learned about from Elliott, from the NICU, from learning the dance blindly rather than following the written music. Nothing is truly under our (the parents’) control. This goes for all parents, NICU and otherwise. And that’s ok. In fact, in some ways it’s optimal for parents to have that realization before trying to enforce whatever notion of “healthy attachment” that they may have held onto based on the things they’ve read or the experiences they’ve had. What research has shown is that it’s crucial that we as parents acknowledge the uniqueness of our babies, and meet them where they are rather than forcing something that doesn’t work. Attachment is found in the relationships we have with others; it is dynamic. It does not lie in the individual knowledges or beliefs of the individuals involved in these relationships (although those can sometimes help to guide us); it lies in our ability to connect with our babies in the moment, our ability to develop reciprocal nonverbal communication with each other, in our ability to fearlessly love, regardless of the circumstances.

So what does this mean for NICU parents? It means that in a sense we have a step up in developing healthy attachment with our babies, because from day 1 we are forced to acknowledge it is not on our terms, but on the terms set for us by our babies. Understanding that notion, and adjusting your expectations to meet the needs of your baby (instead of having your baby meet your attachment needs), is a terrific first step towards building and/or strengthening your healthy attachment.

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Photo Credit: John McGibbon

It means, kangaroo, kangaroo, kangaroo. Both parents can kangaroo with the baby, which sets an incredible, physical precedent that is BEYOND beneficial for the infant. Read any of the numerous published research articles about kangaroo care, and you will find that the close relationship that it establishes benefits everything from lactation to brain development to length of hospital stay and susceptibility to illness. Another great thing to think about is that touch has been found to be so beneficial for infants, and the practice of kangarooing that you establish at the NICU can be something really fantastic to continue with at home.

It means meeting them where they are. It’s beneficial to mirror your baby, meaning that you reflect back to them what they express to you. Is your baby in the newborn phase, smiling at you? Smile back. Are they looking away because they feel overstimulated? Give them that break they need. Is your child a toddler, exploring the world around them bit by bit? Give them the freedom to explore, but be there for them should something frighten them or should they need a break for a moment. Attachment relationships are amazing, because with repetition, the nonverbal communication of reassurance and love becomes second-hand, and it empowers them with that ability to explore safely.

Let go of that notion of the “milestone police”, because as we all learn with babies who have spent time in the NICU, each individual child has their own little way of growing, and that’s ok. I think new parents in general are put under a lot of pressure to “perform” their parenting styles and to show that their child is the brightest or fastest or tallest or what have you. Letting go of that, and surrounding yourself with others who have the capacity to let go of that, can be so empowering to you, your baby, and your relationship with them. Does your baby have special medical needs that prevent them from being able to do certain things? That’s ok. Encourage them, communicate with them, be happy with them where they are to the best of your ability.

Touch. A lot. The more research that’s done on the value of physical touch for infants, the more scientists realize that it truly is crucial for development, and what’s more? It’s awesome. Make hugging a daily part of your routine. Research infant massage and try it out. Set aside a certain time of the day that you hold your baby and read to them. Even if they can’t understand the words, the impact of making that space to simply be with them is incredibly beneficial.

To sum, did my attachment with Elliott suffer due to the fact that I couldn’t carry him around in a sling or cuddle him in the moments after birth (and months thereafter)? Not in my opinion. Did it gain from the fact that I went into the job of parenting him with a genuinely curious attitude, trying to gauge his needs before meeting my own? Absolutely.

What has been your experience of attachment in the NICU and beyond? Do you find that your attachment with your little one might be different from what you may have expected?

Two fantastic books for further reading on attachment:

The Whole-Brain Child

Parenting from the Inside Out

Kara Wahlin About Kara Wahlin

Kara (CA) is a marriage and family therapist/art therapist located in southern California. Since the preterm birth of her twin sons Elliott and William at 26 weeks and the loss of William at six days old, she's made it her mission to try and use her skills as a therapist to reach out to help, empower, and nurture other families going through the NICU experience. She loves art, exploring, literature, music and doing wild and wooly projects with her son and husband. You can learn more about her on her website, NICUHealing, as well as her personal website. You can follow her on Facebook or Twitter.

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