ANYBODYS CHILD - SEVERE DISORDERS OF MOTHER-TO-INFANT BONDING

Background This paper describes severe, disorders of maternal affectio n and behaviour and suggests that there is an early process of mother- to-infant bonding which can go seriously wrong. Method Forty-four self -selected women who had suffered from at least one episode of postnata l mental illness described an unexpected and often catastrophic failur e to love one or more of their babies. Results These women reported ab sent affection, sometimes hate, rejection, neglect or impulses to harm , in relation to at least one of their children. These feelings often began immediately or very shortly after the birth, and with one except ion, were specific to one child; such characteristics are best encapsu lated by the term 'maternal bonding disorder'. Twenty-nine of the wome n were multiparae; first-borns were not significantly more likely to b e the focus for such feelings. There was no direct evidence or predisp osing maternal personality traits or previous experiences. Postnatal m ental illness and recalled severe pain during labour were significantl y associated with such disorders which, in their severe forms, did not occur in the absence of postnatal mental illness. Conclusions The nat ure of the link between postnatal mental illness and disorders of mate rnal bonding remains unclear Because, in multiparae, the disorder ofte n 'missed' the first child, factors such as maternal personality trait s or early childhood experiences cannot be regarded as sufficient caus es.