The significance of parental attachment representations for infant attachment and mental health has been supported by a growing evidence base. Elucidating parental representations in the context of stressful experiences can help to understand the development of attachment, the relationship to outcomes and shape approaches to support vulnerable infants and their parents. This symposium will review the research and clinical use of interviews which explore parental attachment representations, reflective capacity and the nature of the parent-infant relationship. Two studies which have utilised this type of interview to explore mothers’ representations in the context of the NICU, when their infants were very ill will be presented. In addition interventions provided in the NICU and a perinatal addiction service which support the infant parent relationship and enhance parental reflective functioning will be discussed. The important insights gained through these interviews into the developing parent-infant relationship, the impact of infant illness and NICU environment and emerging reflections will be discussed.