Patterns of proximity and maternal-infant engagement in a neonatal intensive care unit.

Mother-infant relationship development is influenced by maternal presence, proximity, and the frequency and duration of engagement. Proximity and dyadic engagement can be challenging when an infant is hospitalized in a neonatal intensive care unit (NICU). This study examined patterns of maternal proximity and engagement in a NICU in the Southwestern United States and identified thematic categories of alternate activities to engagement. Trained observers conducted 52 h of NICU observations, documenting maternal presence, patterns of proximity, engagement, nonengagement, and alternate activities to nonengagement and focused engagement. Results include data from 88 mother-infant dyads. Of the time mothers were in proximity to their infants, 83% of these instances occurred without active engagement. In contrast, focused dyadic engagement was noted in 97% of these observations, while unfocused engagement was recorded in 65% of instances. Mothers in proximity but not actively engaged were most often observed using a smartphone, a trend that was also observed when mothers were in unfocused engagement during nurturing social contexts. While it is expected that occasional interruptions to mother-infant interaction in the NICU will occur, more studies are needed to determine the implications of both brief and prolonged disruptions during dyadic interactions on interaction quality in the NICU.