The relations between mothers' narrative regarding the infant and the premature birth and the quality of mother-infant interaction were examined in mothers of 47 very low birth weight (< 1650 g) premature singletons prior to discharge. Maternal representations were assessed with the Clinical Interview for high-risk Parents of premature babies (CLIP), a semistructured interview that explores mothers' experiences of the pregnancy, delivery, hospitalization period, thoughts and feelings about the infant, and impending discharge. Ten minutes of mother-infant interaction were videotaped, and global and microanalytic codes were used to define three interactive variables: maternal adaptation, maternal touch, and infant withdrawal. Factor analysis of the CLIP items identified two factors with eigen values of 2.00 and above, termed Readiness for Motherhood and Maternal Rejection. Regression analyses were used to predict the three interactive variables by the infant's medical condition, maternal anxiety and depression, and the CLIP factors. Maternal adaptation to the infant's signal and maternal positive touch were each uniquely predicted by the mother's readiness for the maternal role, and were each negatively related to maternal depression. The infant's interactive withdrawal was independently predicted by maternal rejection. The clinical implications of the findings and the potential use of the CLIP for routine detection of early disruptions in the mother-infant relationship are discussed.