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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

Sonia Guillaume12, Natacha Michelin23, Elodie Amrani24, Brigitte Benier12, Xavier Durrmeyer245, Sandra Lescure236, Charlotte Bony12, Claude Danan245, Olivier Baud1278, Pierre-Henri Jarreau236, Elodie Zana-Taïeb236 and Laurence Caeymaex2459*

Author Affiliations

1 Réanimation et Pédiatrie Néonatales, Hôpital Robert Debré, APHP, Paris, France

2 PremUp, Paris, France

3 Service de Médecine et Reanimation néonatales, Hôpital Port-Royal Cochin, APHP, Paris, France

4 Service de Médecine Néonatale, Centre Hospitalier Intercommunal de Creteil, 40 avenue de Verdun, Créteil, France

5 CRC CHI, Créteil, France

6 Université Paris Descartes, Paris, France

7 Université Paris-Diderot, Sorbonne Paris Cité. Département Hospitalo-Universitaire "PROTECT", Paris, France

8 INSERM U676, Paris, France

9 INSERM U669, Université Paris Descartes UMR-S0669, Paris, France

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BMC Pediatrics 2013, 13:18  doi:10.1186/1471-2431-13-18

Published: 1 February 2013



During the first weeks of hospitalization, premature babies and their parents encounter difficulties in establishing early bonds and interactions. Only a few studies have explored what caregivers can do to meet parents' needs in relation to these interactions and help optimize them. This study sought to explore parents' perception of these first interactions and to identify the actions of caregivers that help or hinder its development.


Prospective study, qualitative discourse analysis of 60 face-to-face interviews conducted with 30 mothers and 30 fathers of infants born before 32 weeks of gestation (mean ± SD: 27 ± 2 weeks of gestational age), during their child's stay in one out of three NICUs in France. Interviews explored parental experience, from before birth up to the first month of life.


Data analysis uncovered two main themes, which were independent of parents' geographical or cultural origin but differed between mothers and fathers. First, fathers described the bond with their child as composed more of words and looks and involving distance, while mothers experienced the bond more physically. Secondly, two aspects of the caregivers' influence were decisive: nurses' caring attitude towards baby and parents, and their communication with parents, which reduced stress and made interactions with the baby possible. This communication appeared to be the locus of a supportive and fulfilling encounter between parents and caregivers that reinforced parents' perception of a developing bond.


At birth and during the first weeks in the NICU, the creation of a bond between mothers and fathers and their premature baby is rooted in their relationship with the caregivers. Nurses' caring attitude and regular communication adapted to specific needs are perceived by parents as necessary preconditions for parents' interaction and development of a bond with their baby. These results might allow NICU staff to provide better support to parents and facilitate the emergence of a feeling of parenthood.

Prematurity; Bond; Child development; Newborn; NICU; Nurses; Family centered care; Parenting