Overcoming Obstacles to Bonding with Your Baby

*Ideally, a mother-infant bond develops easily. But if you or your baby is dealing with a problem that interferes with your ability to relax and focus on one another, the bond can be delayed. The sooner problems are identified, the easier they are to correct.*

## Potential barriers

Barriers include challenges in either the baby or the mother. We aim to identify mothers at an increased risk of bonding problems and support them as early as possible.

### Challenges for the mother

We are going to start with factors in the mother, as they are the easiest to address and modify; they include:

#### Maternal mental health problems

Depression and anxiety affect 15-20 % of women in the first postnatal year (NICE Guidelines, 2014). Post-natal depression interferes with the behavioural and emotional exchanges between mother and infant. Depressed mothers often have difficulties regulating their emotions. They gaze less at their infants, are less active, and have less well-timed responsiveness to their infants’ needs. Flat Emotion following depression may result in a vicious cycle of dysfunctional behaviours in both mother and child. For example, maternal emotional unavailability leads to gaze aversion in the infant, leading to feelings of rejection in the mother and withdrawal. This, in turn, increases feelings of inadequacy in the mother and hence feeds more into depressive symptoms.

Women at risk for post-natal depression include those having a history of mental health problems or close relatives who have experienced such disorders. The main problem is that most women usually downplay their mental health condition. Stigma, shame, and fear can prevent women from opening up. Non-judgmental care should be available, as no one is immune to such conditions.

To help with the early identification of such conditions, it is crucial to create a supportive relationship where the mother and her partner feel confident enough to talk about feelings. Awareness of postnatal depression will allow you to seek help early. So, please check our psychoeducation section for *perinatal anxiety and depression*.

Luckily, the treatment of postnatal depression is relatively easy. The sooner treatment is started, the better. That is why it is of utmost importance for women to gain access to psychological and psychiatric services during pregnancy and after delivery. Targeted interventions to improve the mother-infant relationship following postnatal depression are also helpful.

#### Maternal stress adapting to changing roles.

The psychological transitions for a new mother from a ‘competent woman’ in control of her life to an ‘inexperienced’ mother may entail some stress. Struggling with your new role and the new demands required of you as a new mom may make you wonder, “Am I a good enough mother?”

Also, having to compromise many things for your baby is a psychological struggle for many women. New moms are often unprepared for these changes in their sense of self. Almost every new mother needs time to adjust to her new role and life. Without acceptance that these are transitional changes, there may be resentment, guilt, and blame. That is why nurture has a whole section on *acceptance and commitment* to life as a new mother.

#### Lack of support

Social support is vital for new mothers' physical, mental, and emotional well-being. On the other hand, low social support is associated with mothers’ postpartum depression at 1 year after childbirth. Studies have also demonstrated the importance of having an involved partner during pregnancy and parenting to develop maternal-infant bonding. So, working on your relationship with your partner from pregnancy to after that is best. Prenatal partner support has been associated with a variety of other positive outcomes, such as maternal health behaviours during pregnancy (e.g., less likely to drink alcohol) and less maternal and infant distress after birth.

#### Unrealistic expectations about motherhood

Mothers-to-be may form a picture of their baby having certain physical and emotional traits. Accepting reality and working on adjusting your mental picture will help you bond better with your baby.

### Pre-natal mother-to-infant bonding

Bonding with your baby in pregnancy is positively associated with better post-natal mother-to-infant bonding quality. Talk, sense, and be in contact with your baby!

### Attachment

Mothers who did not experience a secure attachment in childhood may have trouble emotionally connecting with their babies. However, no worries—no permanent damage is done! Detecting and working on this problem as early as possible can help a new mom better enjoy her bond with her baby.

### Physical state

Last but not least, the maternal physical state is also a potential barrier to bonding— like pain, especially after cesarean section.

### Second: Challenges for babies

Most babies are born ready to connect to their caregivers, but some problems can get in the way. These include:

1. Babies who experienced problems in the womb or delivery.

2. Babies with health problems at birth.

3. Low gestational age and birth weight

If your baby spends some time in neonatal intensive care (NICU) for any of these reasons, you may initially be put off by the complexity of the equipment. But bonding with your baby is still important. The hospital staff can help you handle your baby through openings in the isolette (a special nursery bassinet). Meanwhile, you can spend time watching and talking to your baby. Soon, your baby will recognise and respond to your voice and touch.

## So, what if there is a problem?

No worries! It is important to note that the presence of any of these risk factors does not necessarily mean a mother will inevitably experience impaired bonding with her baby. And even if this happens, it is always easy to treat. The key is to identify and address those issues early.

So, the next QUESTION will be: *How can I build the bond with my baby?*