Objective This study examined the feasibility of observing mother–child interactions in the neonatal intensive care unit (NICU), whether NICU interactions related to later interactions, and how interactions related to child and maternal characteristics. Methods The sample included 130 preterm infants and their mothers, observed in a feeding interaction in the NICU. Dyads were observed through 36 months postterm. Results Observed maternal positive affective involvement and verbalizations in the NICU were associated with the same parenting behaviors at 24 months, social support, socioeconomic status, and being born in the late preterm period. Maternal negative affect and behavior were unrelated to later maternal negativity or child and maternal characteristics. Conclusions Positive parenting assessed in the NICU appears related to later parenting interaction quality, suggesting early assessment is possible. Maternal negative affect and behavior toward children may not consistently emerge until later in development.