Bonding

The process by which parents form a close personal relationship with their newborn child.

Bonding is the process by which parents form a close personal relationship with their newborn child. The term "bonding" is often used interchangeably with " attachment," a related phenomenon. For the purposes of this essay, bonding is confined to the newborn period. Attachment develops over the larger period of infancy and is treated in a separate entry.

The way parents feel about a new child is highly subjective and emotional, and can be very difficult to measure. Some researchers in the United States and elsewhere have attempted to show that there is a "sensitive period" soon after birth, in which the newborn is quietly alert and interested in engaging the mother, and the mother is able to attune to the new child. It is assumed, but not proven, that if mothers are given the opportunity to interact with their infants at this time, they are most likely to become bonded to the child—to begin to respond to him, love him, and take care of him. Fathers who are with their partners at the birth also respond to the infant in characteristic ways immediately after birth.

American pediatricians John Kennell and Marshall Klaus pioneered scientific research on bonding in the 1970s. Working with infants in a neonatal intensive care unit, they often observed that infants were often taken away from their mothers immediately after birth for emergency medical procedures. These babies often remained in the nursery for several weeks before being allowed to go home with their families. Although the babies did well in the hospital, a troubling percentage of them seemed not to prosper at home, and were even victims of battering and abuse. Kennell and Klaus also noted that the mothers of these babies were often uncomfortable with them, and did not seem to believe that their babies had survived birth. Even mothers who had successfully raised previous infants seemed to have special difficulties with their children that had been treated in the intensive care nursery. Kennell and Klaus surmised that the separation immediately after birth interrupted some fundamental process between the mother and the new baby. They experimented with giving mothers of both premature and healthy full-term babies extra contact with their infants immediately after birth and in the few days following birth. Mothers who were allowed more access to their babies in the hospital seemed to develop better rapport with their infants, to hold them more comfortably, smile and talk to them more.

Studies conducted in the 1970s making these claims have come under attack in the 1980s and 1990s. Much of

Research shows that instinctive behaviors in new mothers facilitate bonding with their infants. (Goujon/Jerrican. Photo Researchers, Inc. Reproduced with permission.)

the earlier research has been difficult to duplicate, and many mitigating factors in parent-child relationships make the lasting effects of early bonding experience difficult to pin down with scientific rigor. Nevertheless, bonding research brought about widespread changes in hospital obstetrical practice in the United States. Fathers and family members were allowed to remain with the mother during labor and delivery in many cases. Mothers were allowed to hold their infants immediately after birth, and in many cases babies remained with their mothers throughout their hospital stay. Bonding research has also led to increased awareness of the natural capabilities of the infant at birth, and so has encouraged many others to deliver their babies without anesthesia (which depresses mother and infant responsiveness).

One important factor in the parents' ability to bond with the infant after birth is that the healthy, undrugged newborn is often in what is called a "quiet alert" state for 45 to 60 minutes after birth. Research has demonstrated that immediately after birth the newborn can see and has visual preferences, can hear and will turn his head toward a spoken voice, and will move in rhythm to his mother's voice. Mothers and fathers allowed to interact with their newborns in this time frame often exhibit characteristic behaviors, such as stroking the baby, first with fingertips, then with the palm, looking in the baby's eyes, and speaking to the baby in a high-pitched voice. Researchers have also found physical changes in the mother right after birth, such as hormonal increases triggered by the infant licking or sucking her nipples, and increased blood flow to her breasts when hearing the infant cry. Some scientists speculate that there are instinctual behaviors triggered in the mother in response to the infant immediately after birth that facilitate her bonding with the infant, and thus promote the infant's survival.

Research on the bonding process has been scrutinized. Detractors call attention to the often poor research design of early studies and reject bonding as a scientific fallacy thrust on women to make them feel that they must react to their infants in certain prescribed fashions. Some people have misinterpreted bonding to mean that if the early sensitive period is missed, they cannot become successful parents. Obviously, parents can form close attachments to infants they did not see at birth, either because of medical emergencies or because their children are adopted. Thus, early experience with the newborn is only one factor in the complex relations of parents to children.

Despite some problems with quantifying bonding as a scientific phenomenon, there is a wealth of anecdotal evidence on the positive effects of an after-birth bonding experience. Most hospitals are now much more sensitive to parents' desire to be with their newborn than in the past. Parents-to-be may wish to find out their hospital's policies regarding the period immediately after birth. Questions to ask may include: Will the mother be allowed to hold the baby immediately if there is no problem? If tests are needed, can they be delayed until after the first hour? What family members can be present at the birth? Can family members be present at a cesarean birth? Will the baby stay in the same room with the mother or be sent to a central nursery? Some hospitals reportedly score mothers on how well they seem to bond with their infants, allegedly to flag potential future child abuse. This in effect makes early and rapid bonding a test, with failure potentially criminal, and egregiously violates the spirit of the hospital reform that bonding research brought about. If a hospital admits to "testing" for bonding, parents may ask if they may decline the test, or if they can have access to the test results. Ideally, both the birth and the period immediately after should be handled according to the parents' wishes.