PMH-C Infant Bonding 2 — Questions and Answers
Question 1: Which neurotransmitter system is most directly activated during skin-to-skin contact between a mother and newborn?
- Dopaminergic system
- Oxytocinergic system (Correct answer)
- Serotonergic system
- GABAergic system
Correct answer: Oxytocinergic system
Skin-to-skin contact triggers oxytocin release, which promotes maternal bonding behaviors and reduces stress in both mother and infant.
Question 2: A mother with opioid use disorder is receiving medication-assisted treatment. How should her care team approach infant bonding?
- Delay bonding until the mother completes treatment
- Encourage bonding immediately while continuing MAT and monitoring neonatal abstinence (Correct answer)
- Separate the infant to prevent withdrawal complications
- Limit contact to prevent the infant from being exposed to maternal stress
Correct answer: Encourage bonding immediately while continuing MAT and monitoring neonatal abstinence
Mothers on MAT should be encouraged to bond with their infants immediately, as bonding supports recovery and infant outcomes, while the team monitors for neonatal abstinence syndrome.
Question 3: Which attachment behavior in a 4-month-old infant most clearly indicates a developing secure bond with the caregiver?
- Showing no distress when left with a stranger
- Preferentially smiling and vocalizing to the primary caregiver (Correct answer)
- Consistently crying regardless of who holds them
- Showing interest in objects over social interaction
Correct answer: Preferentially smiling and vocalizing to the primary caregiver
Preferential social responses to the primary caregiver around 3–4 months reflect the early formation of a selective attachment bond.
Question 4: A father reports feeling emotionally distant from his newborn two weeks postpartum. Which response is MOST appropriate?
- Reassure him this is permanent and refer immediately to psychiatry
- Normalize that paternal bonding often develops more gradually and explore his experience (Correct answer)
- Advise him to spend less time with the infant to reduce pressure
- Tell him bonding problems are only relevant in mothers
Correct answer: Normalize that paternal bonding often develops more gradually and explore his experience
Paternal bonding frequently develops over weeks and normalizing this while exploring barriers is the most supportive clinical response.
Question 5: Which of the following maternal behaviors is MOST associated with promoting secure infant attachment according to Ainsworth's research?
- Strict feeding schedules
- Sensitive and consistent responsiveness to infant cues (Correct answer)
- Minimizing infant crying through pacifier use
- Encouraging independent sleep from birth
Correct answer: Sensitive and consistent responsiveness to infant cues
Ainsworth identified maternal sensitivity—reading and responding consistently to infant signals—as the primary predictor of secure attachment.
Question 6: A mother with postpartum depression (PPD) expresses guilt about not feeling connected to her infant. Which intervention BEST supports both maternal mental health and bonding?
- Instruct her to engage in bonding activities even when depressed to force connection
- Treat her PPD while simultaneously supporting structured bonding interactions with coaching (Correct answer)
- Advise her to wait until depression resolves before focusing on bonding
- Refer the infant to another caregiver until mother recovers
Correct answer: Treat her PPD while simultaneously supporting structured bonding interactions with coaching
Treating PPD and simultaneously supporting bonding through coaching maximizes both maternal recovery and infant attachment outcomes.
Question 7: What is the primary clinical concern when an infant in the NICU displays 'withdrawal' behaviors such as gaze aversion and arching away from the caregiver?
- The infant is demonstrating disorganized attachment
- The infant is signaling overstimulation and a need to regulate (Correct answer)
- The caregiver is using inappropriate touch
- The infant has a neurological disorder
Correct answer: The infant is signaling overstimulation and a need to regulate
NICU infants often have immature nervous systems and use withdrawal cues like gaze aversion to signal overstimulation, not attachment disorder.
PMH-C Infant Bonding 2
Which neurotransmitter system is most directly activated during skin-to-skin contact between a mother and newborn?