Imagine if your baby’s first pediatrician’s exam could tell you if she’ll be a good sleeper, why she cries so much or what she’s thinking when the skin around her lips subtly changes color. With recent innovations in the field of newborn brain development, this could soon be a common reality.
Consider the following test from an infant assessment system called Newborn Behavioral Observations (NBO): A doctor shines a light in a soundly sleeping newborn’s eyes to see how many times it takes her to stop reacting to the stimulus. A baby who can block out and ignore the light entirely after three or four flashes is good at what’s called “protecting sleep.” Stray stimuli probably won’t bother her; she’s likely to be an easy sleeper. A baby who’s still agitated by the light after eight or nine flashes will likely be a sensitive little person, requiring more help from her parents, such as a dark, quiet room for sleeping.
This kind of interest in infants is a far cry from the era in which I was born—the 1970s—when the science surrounding babies’ brains taught that newborns were blank slates, functioning only at the brain-stem level, roughly the biological equivalent of a flatworm. Newborns could breathe, eat, excrete and circulate blood, but they couldn’t see, hear or think. And they certainly couldn’t communicate.
A lot of the change that’s occurred since then is thanks to the work of a group of scientists headed by Dr. T. Berry Brazelton. Brazelton’s discoveries about the complex realities of babies’ brains eventually led to the development of an assessment scale to help evaluate newborn brain capacities. Some call it “the Brazelton," though its official name is the Neonatal Behavioral Assessment Scale, or NBAS. The test evaluates 46 of a newborn’s innate capacities, from following a red rubber ball with her eyes to grasping the examiner’s finger with her hand.
Now in its fourth edition, the NBAS handbook is co-authored by Brazelton and Irish child psychiatrist Kevin Nugent. What Nugent has brought to the table is a shortened, easier set of interactions to test. The original NBAS took almost an hour to perform and record, so it was often overlooked by healthcare providers who didn’t have the time. But Nugent’s NBO is simpler, takes less time, and rather than being a quantitative test, is more about developing the relationship between baby, parent and medical professionals.
Consider the parents who believe there’s not really much going on with their infant—she doesn’t even seem to recognize their voices. But when the subtleties of her body language is spelled out with NBO, these parents begin to see that their baby is far more connected to her world, and to them, than they think.
Or perhaps a mother can’t seem to bond with her newborn because she cries whenever being held or touched. It’s a frustrating situation for both of them. NBO can help determine just how sensitive this baby is to stimulus. If it turns out mama does have a very sensitive baby for whom, say, both holding and singing is too much, she can begin to modify how she cares for her. Too, she won’t take her crying personally and react with as much fear.
In his book, Your Baby Is Speaking To You, Nugent lays out the dozens of subtle signs NBO practitioners are trained to recognize. A baby’s growing stress might manifest itself in color changes, sneezes, yawns, clenched fists or furrowed brows. Jerky movements might actually say, “Swaddle me. Cuddle me. I want to be contained.” Rooting—jerking her head side to side—says, “I’m hungry.” On the flip side, wide eyes and relaxed toes can mean, “I’m happy and fascinated,” and a tiny sleep smile, “I’m at ease. Please don’t disturb me.”
I wish someone had told me about NBO last year, when I still had a newborn on my hands. But I’m glad that there are more and more people out there reading Nugent’s work and getting trained in NBO. Because of this, I see even greater things ahead for the little beings who’ve come here to teach us so much as well as for those of us who are here to learn.