Defining Attachment and Bonding: Overlaps, Differences and Implications for Music Therapy Clinical Practice and Research in the Neonatal Intensive Care Unit (NICU)

Int J Environ Res Public Health. 2021 Feb 10;18(4):1733. doi: 10.3390/ijerph18041733.


Preterm birth and the subsequent hospitalization in the Neonatal Intensive Care Unit (NICU) is a challenging life event for parents and babies. Stress, anxiety, and depressive symptoms, limitations in holding or touching the baby, and medical complications during the NICU stay can negatively affect parental mental health. This can threaten the developing parent-infant relationship and might adversely impact child development. Music therapy in the NICU is an internationally growing field of clinical practice and research and is increasingly applied to promote relationship building between parents and babies. The two most commonly used concepts describing the early parent-infant relationship are 'attachment' and 'bonding'. While frequently used interchangeably in the literature, they are actually not the same and describe distinctive processes of the early relationship formation. Thus, it is important to discuss the overlaps and differences between attachment and bonding and the implications for music therapy clinical practice and research. Whereas providing examples and possible scenarios for music therapists working on either bonding or attachment, the distinction between both concepts is relevant for many health care professionals concerned with early parenting interventions in the NICU. This will hopefully lead to a more precise use of theory, and ultimately, to a more informed clinical practice and research.

Keywords: Neonatal Intensive Care Unit (NICU), family-centered care; attachment; bonding; music therapy; preterm infants.

MeSH terms

  • Child
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal
  • Music Therapy*
  • Object Attachment
  • Pregnancy
  • Premature Birth*