Fathers of preterm babies are less likely to attach securely with their infant

preterm babies

The first study to compare the concerns of parents of preterm babies compared to parents of babies born at term has found that fathers of preterm babies are less able to “mentalise” than mothers, an ability that is associated with future parent-child attachment. This difference is not found between mothers and fathers of babies born at term. The study has implications for how to design support for fathers of preterm babies.

Parents who can mentalise are inclined to interpret their child’s behaviour in terms of mental states, such as emotions, thoughts, desires and intentions. This is important for children before they can express their thoughts and feelings. A measure of parents’ capacity to mentalise has been developed – the Parental Reflective Functioning (PRF) Index.

A high score on the PRF index has been shown to predict secure parent-child attachment. Other just published research has found that, not only are fathers of preterm babies likely to struggle more with mentalisation, but also that father-child attachment is less secure.

Perhaps this is linked to the fact that fathers of preterm babies must, in a situation of trauma and loss of control, typically focus more on managing other family activity (work, older siblings, family, home).

The ability to mentalise in this research was measured through the “Parent Development Interview”, during which parents were invited to share thoughts and feelings about the child, about parenting and about the parent-child relationship. The Parental Reflective Functioning score was derived from specific questions during the interview focusing on mentalising, for example, “Tell me about a time in the last week or two when you felt really angry as a parent. What kinds of situations make you feel this way? How do you handle your angry feelings? When you child is upset, what does he/she do? How does that make you feel? What do you do? Does your child ever feel rejected?”

The researchers went further and analysed the topics that mothers and fathers focused on during these interviews. Using an algorithm, “Latent Drichlet Allocation”, they identified 11 broad topics and found additional differences between mothers and fathers. Fathers talked more about their roles and activities, for example, their daily care routines, how they balanced work and parenting and how they entertained the child. Meanwhile, mothers talked more about the child’s thoughts and feelings, child development and how they shaped the family atmosphere. Furthermore, these differing emphases were stronger for fathers who scored highly for reflective functioning and for mothers of preterm babies who scored highly for reflective functioning.

These differences in the nature of mentalising by mothers and fathers might also help to explain the difference in attachment found between mothers and fathers of preterm babies, because reflective functioning that relates to the child (what mothers do more of) has been found to predict parent-child attachment better than reflective functioning that relates to parenting activity (what fathers do more of).

These differences between mothers and fathers might be explained by the sample in this study – highly educated Austrian parents (322 parents of 173 children) with a very strong gendered division of paid work and home care. The average weekly working hours of fathers in the sample was 39 and for mothers, only 10. Another possibility is more general socialisation of Austrian men and women into different roles in caring for children.


Ruiz N, Witting A, Ahnert A & Piskernik B (2019), Reflective functioning in fathers with young children born preterm and at term, Attachment & Human Development

Ruiz N, Piskernik B, Witting A, Fuiko R & Ahnert L (2018), Parent-child attachment in children born preterm and at term: A multigroup analysis, PLoS ONE 13.8

Photo: Jim Lynch. Creative Commons.