It can be more challenging, but developing an early, healthy bond is vital for the long-term mental wellbeing of premature infants and their parents. The stresses of a premature birth can leave parents disconnected, traumatised and at greater risk of postnatal depression, says perinatal and infant psychiatrist Beate Harrison, from St John of God Murdoch Hospital.
"They are set up from the start with a very difficult situation - everything is very medicalised, their confidence in parenting can be shot and they can have had a range of traumas at the start of that baby-parent relationship," Dr Harrison said.
"Parents also tend to have very high levels of stress and dads seem to be more disengaged in the care-giving relationship.
"At one year mums rate very highly on post-traumatic stress symptoms and depression.
"We know that parents who don't receive intervention do develop a more anxious style of parenting with their infant."
It was vital that these problems were tackled early to ensure they did not affect further the social and emotional development of their premature infant, who already had a higher risk of neurological and cognitive delays because of the early birth, Dr Harrison said.
"These are babies who can have a lot of subtle, if not overt neurological impairment as a result of their premature birth. They are at risk already for a range of social, emotional and cognitive issues," she said.
Aimed at providing such early intervention, a new program, Care and Connect, at the neonatal intensive care nursery at SJoG, Murdoch is recognising parents and infants at high risk and helping them recognise and develop strategies to cope with stress.
"We work to help them process some of the trauma and experiences they have had and listen to any concerns they have about their baby's fragility and how it is coping," Dr Harrison said.
Parents were also taught to recognise signs of stress in the baby, such as changes in the autonomic or motor nervous systems, and responses that could be made to those.
"We are trying to look at signs of stress and see that coping strategies are developed around those," she said.
"We want the baby to leave the hospital with an optimal relationship with their parents established."
Support groups at the SJOG community Raphael Centre were planned so parents of premature babies could share experiences once they left hospital.
Dr Harrison said babies who were involved in a similar program, PremieStart in Victoria, had shown benefits including improvements in the subcortical structure of their brain when scanned at one year old.