Mother‑Infant Interaction
Early contact between infants and mothers is vital for initiating their relationship (Hunt 2008 p48). Neonatal nurses play a crucial role in assisting the attachment process by promoting and encouraging early mother‑infant interaction (Chia and Sellick 2005 p20). Ways in which the nurse can support the mother and infant to interact directly are presented within the following three sub‑themes of kangaroo care, breastfeeding and participation in routine care.
Kangaroo care
It was concerning that many mothers expressed a feeling of separation, exclusion and powerlessness in the NICU (Wigert et al 2006; Roller 2005). Mothers involved in Kangaroo Care (KC) were found to have different experiences. Kangaroo care provides skin‑to‑skin contact by placing the infant naked or wearing a nappy, prone and upright onto the bare chest of the mother (Chia and Sellick 2005 p20; Feldman 2004 p145). Seven studies reported that KC enabled mothers to have physical contact with their infant, which enhanced mother infant attachment and contributed to early development. Mothers felt KC was a ‘warm, calming and comforting bonding experience’, that provided both the mother and infant the opportunity to get to know one another in a profound and beneficial way (Wigert et al 2006 pp215‑16; Roller 2005 p215). KC was expressed by mothers as a method that enabled them to get close to their infant, enhanced a reciprocal pleasure, encourage and strengthen attachment with their infant in an environment that inhibits this process (Flacking et al 2006 pp74‑5; Wigert et al 2006 p216; Roller 2005 p216). Similarly, Neu (1999 p161) and Johnson (2007 p570) highlight the fact that mothers felt an intense feeling of connectedness during KC, which provided them with a sense that they were nurturing their infant. This in turn enhanced maternal confidence. Research by Feldman et al (2002 p21) revealed that the level of dyadic reciprocity between mothers who provided KC to their infants, including those classed as high‑risk was significantly higher than those who did not provide KC.