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Am J Perinatol 2021; 38(13): 1358-1365
DOI: 10.1055/s-0040-1712963
Original Article

Parental Perspectives on the Postpartum Bonding Experience after Neonatal Intensive Care Unit Transfer to a Referral Hospital

Yvonne Yui
1   Department of Neonatology, Children's National Hospital, Washington, District of Columbia
,
Tessie W. October
2   Department of Critical Care, Children's National Hospital, Washington, District of Columbia
3   Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
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Abstract

Objective The aim of this study is to describe the postpartum bonding experience of parents whose newborns were transferred to a referral hospital while their mothers remained at the delivery hospital.

Study Design A total of 18 semi-structured interviews conducted with mothers within 2 weeks of birth were completed. Thematic analysis was performed.

Result In total, 72% of mothers were unable to hold their newborns, and mothers spent a median of 15 minutes with their newborn prior to transfer. Thematic analysis revealed five themes: three barriers to bonding (medical, hospital, and family barriers) and two themes of interventions that helped promote bonding (parent and hospital-initiated interventions). Using technology such as bedside cameras, recording of heart beats, and video chatting on rounds were extremely popular.

Conclusion Parents identified multiple barriers to maternal–infant bonding and suggested several parent-focused and hospital-focused interventions to enhance bonding. Strategies that address barriers should be used to help parents promote bonding during separation from their newborns.

Key Points

  • Transfer to referral neonatal intensive care units interrupts bonding.

  • Interviews reveal multiple barriers to bonding.

  • Interventions can be parent or hospital initiated.

  • Technology is playing a growing role.

Keywords

neonate - transfer - postpartum - bonding - separation


Publication History

Received: 16 October 2019

Accepted: 27 April 2020

Article published online:
08 June 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Davis DH, Hawkins JW. High-risk maternal and neonatal transport: psychosocial implications for practice. Dimens Crit Care Nurs 1985; 4 (06) 368-379
    CrossrefPubMedGoogle Scholar
  • 2 Mullaney DM, Edwards WH, DeGrazia M. Family-centered care during acute neonatal transport. Adv Neonatal Care 2014; 14 (Suppl. 05) S16-S23
    CrossrefPubMedGoogle Scholar
  • 3 Mosher SL. The art of supporting families faced with neonatal transport. Nurs Womens Health 2013; 17 (03) 198-209
    CrossrefPubMedGoogle Scholar
  • 4 Flacking R, Thomson G, Axelin A. Pathways to emotional closeness in neonatal units - a cross-national qualitative study. BMC Pregnancy Childbirth 2016; 16 (01) 170
    CrossrefPubMedGoogle Scholar
  • 5 Nyström K, Axelsson K. Mothers' experience of being separated from their newborns. J Obstet Gynecol Neonatal Nurs 2002; 31 (03) 275-282
    CrossrefPubMedGoogle Scholar
  • 6 Karlsen KA, Trautman M, Price-Douglas W, Smith S. National survey of neonatal transport teams in the United States. Pediatrics 2011; 128 (04) 685-691
    CrossrefPubMedGoogle Scholar
  • 7 Benahmed N, San Miguel L, Devos C, Fairon N, Christiaens W. Vaginal delivery: how does early hospital discharge affect mother and child outcomes? A systematic literature review. BMC Pregnancy Childbirth 2017; 17 (01) 289
    CrossrefPubMedGoogle Scholar
  • 8 Blumenfeld YJ, El-Sayed YY, Lyell DJ, Nelson LM, Butwick AJ. Risk factors for prolonged postpartum length of stay following cesarean delivery. Am J Perinatol 2015; 32 (09) 825-832
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 Flacking R, Lehtonen L, Thomson G. et al; Separation and Closeness Experiences in the Neonatal Environment (SCENE) group. Closeness and separation in neonatal intensive care. Acta Paediatr 2012; 101 (10) 1032-1037
    CrossrefPubMedGoogle Scholar
  • 10 Moore ER, Bergman N, Anderson GC, Medley N. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2016; 11: CD003519
    Google Scholar
  • 11 Sullivan R, Perry R, Sloan A, Kleinhaus K, Burtchen N. Infant bonding and attachment to the caregiver: insights from basic and clinical science. Clin Perinatol 2011; 38 (04) 643-655
    CrossrefPubMedGoogle Scholar
  • 12 Rand K, Lahav A. Maternal sounds elicit lower heart rate in preterm newborns in the first month of life. Early Hum Dev 2014; 90 (10) 679-683
    CrossrefPubMedGoogle Scholar
  • 13 Filippa M, Devouche E, Arioni C, Imberty M, Gratier M. Live maternal speech and singing have beneficial effects on hospitalized preterm infants. Acta Paediatr 2013; 102 (10) 1017-1020
    CrossrefPubMedGoogle Scholar
  • 14 Krueger C, Parker L, Chiu SH, Theriaque D. Maternal voice and short-term outcomes in preterm infants. Dev Psychobiol 2010; 52 (02) 205-212
    PubMedGoogle Scholar
  • 15 Webb AR, Heller HT, Benson CB, Lahav A. Mother's voice and heartbeat sounds elicit auditory plasticity in the human brain before full gestation. Proc Natl Acad Sci U S A 2015; 112 (10) 3152-3157
    CrossrefPubMedGoogle Scholar
  • 16 Picciolini O, Porro M, Meazza A. et al. Early exposure to maternal voice: effects on preterm infants development. Early Hum Dev 2014; 90 (06) 287-292
    CrossrefPubMedGoogle Scholar
  • 17 Pennestri MH, Gaudreau H, Bouvette-Turcot AA. et al; Mavan Research Team. Attachment disorganization among children in neonatal intensive care unit: preliminary results. Early Hum Dev 2015; 91 (10) 601-606
    CrossrefPubMedGoogle Scholar
  • 18 Obeidat HM, Bond EA, Callister LC. The parental experience of having an infant in the newborn intensive care unit. J Perinat Educ 2009; 18 (03) 23-29
    CrossrefPubMedGoogle Scholar
  • 19 Mörelius E, Ivars K, Gustafsson PA, Theodorsson E, Nelson N. Salivary cortisol circadian rhythm in infants at psychosocial risk showed more variations than previous studies of healthy full-term infants. Acta Paediatr 2017; 106 (12) 2060-2061
    CrossrefPubMedGoogle Scholar
  • 20 Hane AA, Myers MM, Hofer MA. et al. Family nurture intervention improves the quality of maternal caregiving in the neonatal intensive care unit: evidence from a randomized controlled trial. J Dev Behav Pediatr 2015; 36 (03) 188-196
    CrossrefPubMedGoogle Scholar
  • 21 Spinner MR. Maternal-infant bonding. Can Fam Physician 1978; 24: 1151-1153
    PubMedGoogle Scholar
  • 22 Baylis R, Ewald U, Gradin M, Hedberg Nyqvist K, Rubertsson C, Thernström Blomqvist Y. First-time events between parents and preterm infants are affected by the designs and routines of neonatal intensive care units. Acta Paediatr 2014; 103 (10) 1045-1052
    CrossrefPubMedGoogle Scholar
  • 23 Guillaume S, Michelin N, Amrani E. et al. Parents' expectations of staff in the early bonding process with their premature babies in the intensive care setting: a qualitative multicenter study with 60 parents. BMC Pediatr 2013; 13: 18
    CrossrefPubMedGoogle Scholar
  • 24 Granrud MD, Ludvigsen E, Andershed B. Parents' experiences of their premature infants' transportation from a university hospital NICU to the NICU at two local hospitals. J Pediatr Nurs 2014; 29 (04) e11-e18
    CrossrefPubMedGoogle Scholar
  • 25 Fernández-Medina IM, Granero-Molina J, Fernández-Sola C, Hernández-Padilla JM, Camacho Ávila M, López Rodríguez MDM. Bonding in neonatal intensive care units: Experiences of extremely preterm infants' mothers. Women Birth 2018; 31 (04) 325-330
    CrossrefPubMedGoogle Scholar
  • 26 Feeley N, Genest C, Niela-Vilén H, Charbonneau L, Axelin A. Parents and nurses balancing parent-infant closeness and separation: a qualitative study of NICU nurses' perceptions. BMC Pediatr 2016; 16: 134
    CrossrefPubMedGoogle Scholar
  • 27 Epstein EG, Arechiga J, Dancy M, Simon J, Wilson D, Alhusen JL. Integrative review of technology to support communication with parents of infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46 (03) 357-366
    CrossrefPubMedGoogle Scholar
  • 28 Garfield CF, Lee YS, Kim HN. et al. Supporting parents of premature infants transitioning from the NICU to home: a pilot randomized control trial of a smartphone application. Internet Interv 2016; 4 (Pt 2): 131-137
    CrossrefPubMedGoogle Scholar
  • 29 Psychogiou K, Ashworth C, Weaver-Lowe L, Carroll C, Callow C, Edi-Osagie N. Novel use of Facetime in supporting maternal-infant bonding. J Neonatal Nurs 2020; 26: 106-108
    CrossrefPubMedGoogle Scholar