Attachment

Did you know?

Children who develop more secure attachments with their parents or caregivers are more likely to:

* enjoy more happiness in their relationships with parents/caregivers

* feel less anger at their parents/caregivers

* turn to their parents/caregivers for help when they're in trouble

* learn to solve problems on their own

* get along better with friends

* have lasting friendships

* solve relationship problems they have with friends

* have better relationships with brothers and sisters

* have higher self-esteem

* know that most problems have an answer

                                                                                               * trust that good things will come their way

                                                                                               * trust people they love

                                                                                               *know how to be kind to those around them

Helen Stevens from Safe Sleep Space and Dr Carol Newnham conduct Circle of Security programs (to help parents achieve secure attachment) for all parents, including those who have had a premature baby. Please contact us for dates and enrollment details

Premature babies and their mothers have a difficult start to life together. Babies have to be cared for in hospital nurseries, often by multiple carers and with many unpleasant procedures. Mothers are often overwhelmed and shocked by the unexpected early birth of their precious baby. It is not what they dreamed of. Both the babies and their mothers can be difficult social partners to each other - they misunderstand each other. Sometimes mothers try too hard and sometimes they hold back in fear. Often babies are overwhelmed by physical contact.  Secure attachment, the beautiful relationship we all aspire to have with our babies, is often more difficult when babies are born early.

THE most important tip for raising your premmie after

• safety
• good nutrition
• sleep

is   ATTACHMENT.

After these critical basics, the next most important tip for raising a premmie is to develop a close, loving, safe, secure relationship together. In psychology, we call this the "Attachment" relationship. 

Through no fault of their own, the attachment relationship between premmies and their parents can be difficult. Many studies show that secure attachments are much lower in premmie-parent relationships and insecure attachments higher. This is one very important area where expert help has been shown to help. Many psychologists use attachment to help families. In addition, many early-childhood specialists are trained in Circle of Security programs that are normally run in groups. These are evidence-based and prove that attachment can be taught.

Ref: Nuccini F et al., (2015) The attachment of prematurely born children at school age. Clinical Child Psychology and Psychiatry, 20(3), 381-94.

A Quick History of Attachment Theory

Only last century, wet nurses and nannies were hired and little boys sent to boarding schools in the wealthiest families. It was thought that emotions were not important, and that too much physical comfort (especially for boys!) would make children weak and spoilt.

John Bowlby  (the “father” of Attachment Theory) was the fifth of six children,  born in a wealthy English medical family. A second nanny was hired by the family when he arrived, and all was well until she left for another position when he was four years old. He was not without a mother. They lived in the same house and he saw her every afternoon for one hour with the rest of the children. However, John had, in reality, lost his "mother" (The theme of the film "The Help" is similar). When he grew up. became a doctor and a psychiatrist, he understood that something was wrong with him, and that all his training could not explain it.

It was the post-war years in England and the children who had missing or distracted parents, or who had been sent to the country for safety, were starting to cause social problems. From personal experience, and then with a whole generation of troubled children to observe and help, Bowlby developed his theory of attachment.

The World Health Organisation sponsored Bowlby’s study called “Maternal Care and Mental Health”. He reviewed previous studies on the effects of institutionalisation on child development and the distress experienced by children when they are separated from their mothers. In three books he argued that the mother-child relationship and the physical contact between them is critically important to the child’s future development. In 1953 a colleague produced a short documentary called A Two-Year-Old Goes to Hospital, which showed the immediate effects of maternal separation. 

At about the same time Harry Harlowe was studying the effect of maternal absence on baby monkeys. They were given food and something soft to cuddle, yet these monkeys grew up with many social problems when they were put together with normally-reared "child" monkeys. They did not know how to act and mostly stayed separate from the group. They were often aggressive and later unable to develop mating relationships. Harlowe concluded infant monkeys needed nurturing from the mother monkey, and that this was critical in forming the ability to interact with other monkeys. He generalised this conclusion to human children.

These men (!) showed the importance of the primary caregiver (usually mother, although it can be father or another adult) in both human and primate development.

Since those early studies, the long-term effects of secure  and insecure attachment have been studied. Insecure attachment is not the same as neglect and abuse which can often be observed from outside the family. Attachment is all about relationships, where children feel safe,  understood ("got") and valued. Poor attachments can occur in families where children are well-dressed, well-fed and to an outsider, seem to be well-cared for. It is often only in later mental health or behavioural troubles that poor parent-child attachment can be seen in retrospect as the cause. Insecure attachment patterns have long-lasting effects, including low self-esteem, depression, anxiety, social and personality problems, learning difficulties, externalising behaviours and inter-generational parenting problems.

Studies of children adopted out of the Romanian orphanages in the 1990s were able to show that the later a child had access to sensitive, caring, and involved parents, the worse their outcomes. 

Emotional Intelligence, the concept developed by Daniel Goleman, is argued to be even more important than cognitive intelligence, and develops within secure attachment relationships between babies and their carers.

Comment:  The theory of attachment is widely, universally, used by "professionals" who work with families. Yet it seems to be unknown in the general community. The details described above about John Bowlby's early life were recounted by his son Sir Richard Bowlby at a conference in Sydney in about 2008. For me, a psychologist, it was the equivalent of "touching" the son of a great man who has given us an amazing theory and evidence (unlike the much better-known Sigmund Freud) to explain human suffering.  

While attachment is important for all parents to understand, it is so much more so for parents of premmies. They need the best efforts and knowledge of their parents more than ever.

A new study shows that mothers of even the smallest and sickest premmies are just as sensitive with their babies as mothers of full-term babies. Previous research suggested that the stress, separation and increased tendency to develop depression may impair a mother's parenting behaviour and then adversely affect her premmie's development. Despite the initial shock and stress, mothers of premmies in this study provided the same sensitive parenting.

"However, recent findings indicate that preterm children might need even higher levels of maternal sensitivity and facilitation to achieve similar cognitive and behavioural outcomes to full-term children. There is a need to provide parents of preterm children the necessary assistance in parenting ... for their children to develop at their full potential." (Dieter Wolke, lead author).

Reference: A. Bilgin, D. Wolke. Maternal Sensitivity in Parenting Preterm Children: A Meta-analysis. PEDIATRICS, 2015;DOI:10.1542/peds.2014-3570

Comment: Maternal sensitivity is important for establishing secure attachment in a child. It also helps a little child learn about the world. This  article is referring to the need for extra sensitivity for the child's peak learning