Effects of hospital treatment for Congenital Heart Defects on mother-infant bonding, maternal stress, and parenting

Congenital Heart Defects (CHDs) are a leading cause of hospitalization and infant mortality in Australia (Australian Institute of Health and Welfare, 2019), requiring intensive care, open-heart surgery and long hospital stays to survive (Lisanti et al., 2021). CHDs are complex clinical conditions that can negatively affect child growth and development as well as the wellbeing of the mother (Daymont et al., 2013; Jordan et al., 2014). The mother experiences high levels of stress in hospital which may disrupt Mother-Infant Bonding (MIB) and distort her parenting approach (Lisanti et al., 2021).

Infants with a Congenital Heart Defect (CHD) are now surviving longer with more medical treatment available. Many of these infants undergo hospitalisation in the first seven months for life-sustaining procedures. However, barriers to bonding and the psychological burden on parents while caring for an infant during this time can cause issues for the child-parent relationship. We aimed to assess links among intensive care factors, maternal stress, the Mother-Infant Bond (MIB), and parenting in these mother-infant dyads. 148 mothers of CHD children gave us important information about their experiences after we advertised via the Heart Kids Facebook page. An anonymous survey of demographic, hospital experiences, MIB, maternal stress and parenting variables, was completed retrospectively. We noted time since diagnosis and the current age of the child, but neither were related to other findings. No fathers responded but their experiences would be important to understand.

The results indicated that as reported bonding difficulties increased, so did maternal stress. Trying to breastfeed, having to rely on staff to handle their infant, and prolonged separation from their infants were associated with either maternal stress or MIB difficulties during their hospital stay. As a protective factor, mothers who recalled being parented with care themselves reported lower maternal stress and bonding difficulties as they parented their own infant. In contrast to suggestions that mothers of very ill babies can either become highly overprotective or permissive, that was not true in the mothers of the babies with CHD we surveyed. Subsequent parenting style was uniformly positive and unrelated to any other variable.

We tested a new way to assess the effects of barriers to infant contact and learned that individualised approaches are required when assessing these complex features of care. As expected, mothers of infants with CHD that did not require surgery reported fewer barriers to bonding as their babies may have been free of some medical monitoring devices and were less likely to be sedated, but this treatment variable requires a closer look. Balancing the benefits of breastfeeding with the significant stress it causes mothers and babies when they try to breastfeed a very sick baby in intensive care, may require more attention. Postpartum mothers living through the traumatic experience of supporting their infant while they received treatment for CHD need individualised psychological and social support to ensure that essential mother-infant bond.

The findings of the study are being prepared for submission for publication. Questions about the study can be directed to Dr James Donnelly ([email protected]).

by Belinda Besley and Dr James Donnelly

Psychology, Cairnmillar Institute