As a psychiatric consultant in an inner-city level III neonatal intensive care unit (NICU), I have seen several cases involving premature infants who did not have a caring, consistent adult in their lives. This neglect appeared to contribute to the development of behavior problems (eg, irritability) or feeding problems (eg, failure to thrive), and sometimes an infant failed to progress medically or experienced an exacerbation of medical problems. These infants were assigned the diagnosis of reactive attachment disorder of infancy. This is a recognized psychiatric entity that is defined, as follows, in the Diagnostic and Statistical Manual of Mental Disorders (3rd ed, revised):
