We're Not Geese: Rethinking Bonding, Attachment, and Identity in NICU Parenting
- Mindy Wara
- Sep 29
- 4 min read
NICU parents often arrive in therapy with the same worry: Did I miss my chance to bond with my baby?
The “golden hour” has become shorthand for something essential, irreplaceable, and for many parents - unreachable. But as Mara Tesler Stein, PsyD, PMH-C clinical psychologist, author, and NICU parent herself, reminded listeners in a recent episode of The NICU Space Podcast:
“We’re not geese. We have a lot of time to bond.”
It’s a simple statement that carries profound implications for how clinicians support families after the NICU. Bonding, attachment, and parental identity are too often collapsed into one category. In reality, they are distinct - and mislabeling them can add unnecessary shame to an already difficult journey.
To hear Mara share these insights in her own words, listen to the full podcast conversation below.
Bonding ≠ Attachment
In therapy sessions and medical charts alike, the words “bonding” and “attachment” are used interchangeably. Mara urges us to resist that shorthand.
“Attachment is a developmental process… Attachment refers to the development of the child's sense of their caregivers and themselves in relation to their caregivers.”
Bonding, on the other hand, is the parent’s side of the relationship: the love, protectiveness, and even fear that signal deep investment in their child. A parent who hesitates to touch their fragile infant isn’t “failing” at bonding. As Mara explains, “Not wanting to touch a very fragile baby… is protective. That’s bonding.”
For clinicians, this reframe opens up space to validate what parents are already doing to keep their baby safe, even when those behaviors look like avoidance.
The Shifting Identity of NICU Parents
Beyond bonding and attachment lies another critical theme: identity. Mara reminds us that every parent in the NICU must learn to become “a different kind of parent to a different kind of baby.”
Parents ask themselves:
Am I competent when my baby’s care is run by machines?
Am I broken as a birthing person?
Do I belong in the community of parents when my story looks nothing like theirs?
These identity ruptures can follow families far beyond discharge. Trauma evolves. Identity does too. The NICU is not just a medical crisis; it’s a developmental one for parents.
Rethinking the “Golden Hour”
Parents often describe grief over not experiencing the so-called “golden hour” after birth - but Mara is clear: “There’s nothing different about that first hour from all of the hundreds of millions of hours that are going to follow.”
The myth stems from imprinting research in animals, she explains: “We’re not geese. We don’t imprint.” Bonding unfolds across time, through rupture and repair, moments of closeness and moments of distance. Our role as clinicians is to normalize that reality - and protect parents from internalizing unnecessary shame.
Skin-to-Skin and the Pressure of “Zero Separation”
Recent years have seen a surge in evidence for skin-to-skin care. As Mara says, “Your body… to our babies is medicine.”
The World Health Organization (2023) now recommends kangaroo mother care (KMC) as routine for all preterm and low-birth-weight infants. Ideally, KMC means 8–24 hours of skin-to-skin contact per day, initiated as soon as possible after birth - even before clinical stabilization in most cases. Importantly, WHO also calls for a policy of “zero separation”, urging hospitals to provide space, food, and support so parents can remain continuously with their infant.
But here’s where clinicians need nuance: WHO’s recommendations are directed at hospitals and systems, not at parents.
For parents, the implications are different:
Any amount of skin-to-skin is beneficial.
When separation occurred, it often reflected system barriers, not parental inadequacy.
Guilt or grief over “not enough” skin-to-skin is legitimate and deserves space in therapy.
Empathy means meeting parents where they are, not measuring them against an impossible ideal.
For more guidance on supporting parents who carry guilt, grief, or self-blame around these early caregiving experiences, Mara’s on-demand course, NICU Parenting: A Practitioner’s Guide to Working with Families in the NICU and Beyond, is a valuable resource. Co-taught with developmental psychologist Deborah L. Davis, PhD, this course provides essential strategies for helping families integrate disrupted or missed early bonding experiences into their ongoing parenting journey.
NICU Parenting: A Practitioner’s Guide to Working with Families in the NICU and Beyond
▶️ On-Demand
Gain essential skills to support NICU families with confidence.
Distinguishing Trauma from Grief
Even when babies thrive after the NICU, parents may still carry unacknowledged grief. Missed milestones, disrupted rituals, or memories of fear can resurface years later. As Mara notes, “These losses are legitimate… Even when your baby comes home and their development is going beautifully.”
One of the most important tasks for clinicians is helping parents separate trauma from grief. Trauma keeps the nervous system “stuck.” Grief allows parents to acknowledge losses and move forward.
“You can’t grieve effectively if you're still re-experiencing trauma. That hijacks the whole brain” says Mara.
Parents don’t need reassurance that it “wasn’t so bad.” They need space for both trauma processing and grief recognition. Trauma-focused interventions like EMDR can free parents to engage in healthy grieving, opening the way for meaning-making and integration.
Language That Regulates
Clinicians cannot change the NICU story. But we can change the language parents hear about themselves:
Instead of “You’re experiencing bonding problems” → “You’re protecting your baby, even when it feels scary.”
Instead of “You’re too emotional” → “Your emotions make sense in this setting of fear and love.”
Instead of “Treat them like a regular baby” → “This is a different way of parenting a different kind of baby.”
At the end of her interview, Mara provides us with the reminder every NICU parent deserves to hear:
“You are enough. Your love, however it's getting expressed… your presence, however you show up… It is enough.”
Bonding, attachment, identity, grief - each carries weight for NICU parents. And each can be misunderstood in ways that compound shame. For clinicians, understanding these distinctions can prevent unnecessary pathologizing, ease parent guilt, and create space for healing. When we hold space for both trauma and resilience, we offer NICU parents not just treatment, but the reassurance that their love has always been, and will always be, enough.
References
Tesler Stein, M. (Guest). (2025, September 15). Attachment, bonding and EMDR after NICU trauma with Clinical Psychologist Dr. Mara Tesler Stein [Audio podcast episode]. In F. Harrison & G. Robinson (Hosts), The NICU Space Podcast. Miracle Moon. https://www.miraclemoon.co.uk/podcast/attachment-bonding-and-emdr-after-nicu-trauma-with-clinical-psychologist-dr-mara-tesler-stein
World Health Organization. (2023). WHO recommendations for care of the preterm or low-birth-weight infant. World Health Organization. https://iris.who.int/bitstream/handle/10665/363697/9789240058262-eng.pdf?sequence=1
Reading this made me think deeply about how early attachment and identity shape long-term healing. The way the article explores bonding in the NICU really resonates with how recovery begins with rebuilding trust — in ourselves and others. I’ve seen similar patterns in people going through addiction treatment. Emotional reconnection plays such a vital role in both parenting and recovery. That’s one of the reasons I value the compassionate approach at port hope rehab, where restoring human connection is central to healing. It’s inspiring to see that, whether in neonatal care or addiction recovery, empathy remains the foundation for transformation.