By watching for the signs, knowing the causes, and following the keys to bonding for high-risk infants you can:

Avoid a lot of heartache
Have a child who trusts and respects you
Have a child who knows how to love and cares about others
Avoid raising an angry, aggressive, defiant child
Stimulate brain development so your child can be successful in school and in life

Causes

Any of the following conditions occurring to a baby during the first 36 months of life puts them at risk:

Unwanted pregnancy
Pre-birth exposure to trauma, drugs or alcohol
Abuse (physical, emotional, sexual)
Neglect (not answering the baby’s cries for help)
Separation from primary caregiver (i.e. Illness or death of mother or severe illness or
hospitalization of the baby, or adoption
On-going pain such as colic, hernia or many ear infections
Changing day cares or using providers who don’t do bonding
Moms with chronic depression
Several moves or placements (foster care, failed adoptions)
Caring for baby on a timed schedule or other self-centered parenting

High Risk Signs in Infants

Does not use crying appropriately to get someone to address needs
Often does not settle when needs are met by Mom (primary caregiver)
Overreacts or often startles to touch, sound and/or light
Listlessness with no medical reason (infant depression)
Limited holding onto or reaching for caregiver
Lack of appropriate stranger anxiety between 6 and 9 months of age
Poor sucking response
Does not smile back or respond with activity to smiles or baby talk
Developmental delays
Poor eye contact, lack of tracking
Self abusive behavior (head banging- self biting- hair pulling)
Is resistant to cuddling (stiff)

Keys to Bonding High Risk Babies

Every minute you invest holding your child, smiling into their eyes is 1 HOUR less pain when they are teens. If mom must be away four or more hours a day, she must hire someone for the baby to bond to. This person becomes primary and must remain in the baby’s life for the first three years to prevent a bonding break during this crucial time.

Breast-feed if possible
Always hold bottle (NEVER prop it)
Carry the baby in a snugli or fabric carrier on the front, facing mom 4 to 6 hours daily
Massage baby 20 minutes each day while smiling and using high voice
Hold & rock infant with loving eye contact, smiles and singing or reading in happy "baby talk" each day
Feed sweet milk in Mom’s arms with soft eye contact, touch (stroke baby’s face, hold fingers) loving voice
Baby should nap daily resting skin to skin on Dad’s chest
Baby sleeps with or near parents at night, be careful to avoid falls
Do not allow baby to self-feed
No "baby carrier," baby is in arms
No stroller facing away from Mom
No one feeds baby except Mom
No one holds baby except for Mom and Dad unless less than 5 min per day
Baby must not be left to cry alone for longer than 3 minutes
Hold baby facing you-heart to heart
No exposure to TV for one full year
Delay painful medical procedures, if possible, until child is bonded
Play Mozart’s music to soothe baby
Respond to baby’s attempts to get your love and attention with joy!!

For more information:

Taming The Tiger While It's A Kitten 2 CD set
Attachment, Trauma, and Healing by Levy & Orlans CWLA press
Hope for High Risk by Foster Cline MD available at ACE (303) 674-1910
Holding Time by Martha Welch MD Simon & Shuster publishing
When Love is Not Enough a guide to parenting children with RAD by Nancy Thomas