Bonding in neonatal intensive care units: Experiences of extremely preterm infants' mothers

Background: The birth of an extremely preterm infant can disrupt normal mother-infant physical contact and the care provided by the mother. This situation has an impact on the process of bonding between the mother and the child. Aim: The objective of this study was to describe and understand the experiences of mothers who have extremely preterm infants admitted in Neonatal Intensive Care Units with regard to their bonding process. Methods: An interpretive, qualitative research methodology using Gadamer's philosophical hermeneutics was carried out. A focus groupand eleven in-depth, semi-structured interviews were conducted. Datawere collected between June and September of 2016. Findings: Sixteen women with a mean age of 34.4 years participated in the study. Two themes emerged from the data analysis: (1) premature labour and technological environment, a distorted motherhood, with the subthemes 'feeling of emptiness and emotional crisis' and ` the complexity of the environment and care generate an emotional swing'; (2) learning to be the mother of an extremely preterm infant, with the subthemes " the difficulty of relating to a stranger" and ` forming the bond in spite of difficulties'. Conclusions: The bonding with extremely preterm infants is interrupted after giving birth. The maternal emotional state and the environment of the neonatal intensive care unit limit its development. Nursing care can facilitate mother-infant bonding by encouraging communication, participation in care, massaging or breastfeeding. (c) 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.