Children are supposed to naturally bond with their parents and use them as a stable base from which they can explore the world around them. This is a natural emotional and chemical reaction that most infants typically have. However, very preterm and very low birth weight children can often be born with neurological impairments that make them less likely to form this bond and attachment.

A study done at the University of Warwick has found that infants born very prematurely or infant with very low birth weight are more prone to develop disorganized attachment, which is when infants show conflicting behaviors with their parents and don’t form the paternal bond that is most commonly seen between infants and their parents. The study revealed that this disorganized attachment didn’t always occur though. Some children, even though they were very preterm and had very low birth weight, formed the traditional bond naturally without hindrance. Others showed more reluctance.

In full-term infants, the presence of disorganized attachments is usually associated with neglect and abuse of the infant. That’s why the research done with VP/VLBW infants emphasizes the need for health professionals to know if a child was born very prematurely or was born with very low birth weight while assessing parent-child- interaction.

Professor Dieter Wolke at the University of Warwick led the study and he says that “very preterm children more often have neurological and developmental problems and these explained why they were more likely to be disorganized in their attachment or bonding despite sensitive parenting. Health professionals should be aware that disorganized attachment in preterm children is often a sign of these children's developmental problems and not because they are harshly or abusively parented."

The research was produced by examining 71 VP/VLBW children as well as 105 full-term children to compare how securely attached the children were to their parents. The study revealed that 61% VP/VLBW children were securely attached to their parents or primary caregiver. This is compared to the 72% of full-term children. However, 32% of very preterm and very low birth weight children also showed disorganized attachment by 18 month compared to the 17% of full-term children that also showed attachment issues. The study also included how mother interacted with their children.

It was found that the attachment variances in the children developed despite mothers of VP/VLBW children being just as sensitive in their parents as mother of full-term children. The research team concluded that disorganized attachment is not linked to parental sensitivity, but is rather associated with neurological impairments due to preterm birth and low birth weight.


  • D. Wolke, S. Eryigit-Madzwamuse, T. Gutbrod. Very preterm/very low birthweight infants' attachment: infant and maternal characteristics. Archives of Disease in Childhood - Fetal and Neonatal Edition, 2013; DOI:10.1136/archdischild-2013-303788
  • University of Warwick (2013, July 15). Very preterm babies show bonding difficulties despite parental sensitivity. ScienceDaily.