By Beverley A Lawrence Beech
Royal Society of Medicine - 8 March 2012
Brazelton came to my attention in the 1970s when he described the effect babies' behaviour and activities had on the parents and how the parents reacted. He developed the Brazelton Neonatal Behavioural Assessment Scale(NBAS) designed to assess the responses of the newborn and is used in examinations of the newborn up to two months old.
Berry Brazelton described how he developed the scale in 1955 when none in the medical profession would believe that infants could see and hear. He found that babies have different expressions when they look at an object from when they look at a human face and if he stood on one side of the baby with the father on the other the baby will choose the father's voice. He also pointed out that babies develop in spurts and just before they have a spurt they regress and then shoot forward, this can be a difficult time for mothers.
The objective of the NBAS is to help parents read their baby's behaviour, empower them and help them to communicate and change parent/infant behaviour. A video showed a woman who had not held her baby since giving birth and who was distant from the baby. As the video progressed the woman began to respond to the baby and by the time it had finished she was cradling it.
At no time did the psychologist instruct the woman but said such things as,
The woman chose. She did a test where she held the baby between them and then spoke to the baby and asked the woman to talk to her baby too, and when she did the baby immediately turned its head.
Susan Pawlby a research psychologist spoke about her studies of depressed and psychotic women and the effects of antenatal depression on the biology of pregnancy, outcomes for the mother and baby. The study is ongoing but they have observed that the babies of depressed mothers are less alert, and showed how they were less engaged with a rattle, they were more irritable and were less able to regulate their state. She commented that they can tell by two weeks of age if the mother is depressed, they observe how the mother will be distant but then leap at the baby and overwhelm him - the baby will then withdraw because it cannot cope with the sudden rush of activity.
After the break, we watched a video demonstrating how a baby can be embarrassed, how they respond to a mirror and demonstrated how a baby can anticipate what the mother is about to do, the example involved a two month old on a pressure mat and as the mother approached to lift the baby up, the baby began to arch his back. At seven to eight months they will copy behaviour and can tease. She showed a very funny video of a toddler who was engrossed with a piece of household equipment but heard her grandmother snoring. She turned, was rooted to the spot, but then pulled her cheeks in and copied grannies' snore. Everyone laughed, but the family got a bit bored with it after a while as the child kept on doing it to get a laugh.
A survey of the courses in Poland using the NBAS to prepare parents to care for their babies, found that the parents felt better prepared, more competent, more knowledgeable. She works in co-operation with midwives who select families whom they think will have problems and parents have commented that 'infants' behaviour is no longer meaningless for them.'
Presentations were made highlighting the areas where training of midwives and health visitors have been introduced successfully. Tameside and Glossop Early Attachment Service has trained 63 midwives and health visitors to intervene early and truly support those struggling with attachment and who are having emotional difficulties.
I came away from the conference thinking that this system should be standard for everyone who has contact with mothers and small babies, what a difference it would make. Instead of criticising, monitoring and ticking the boxes they could actually be empowering and respecting parents.
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