APPENDIX 28
Memorandum by Joanna Hawthorne (MS 34)
I am Joanna Hawthorne, research psychologist
at the Centre for Family Research, University of Cambridge.
My work has been on early parent-infant relationships and attachment
between parents and babies for 25 years. I am the Coordinator
of the Brazelton Centre in Great Britain, a charity with six cofounders,
and we train health professionals and those working with new babies
and parents, in the Neonatal Behavioural Assessment Scale (NBAS).
This neuro-developmental assessment helps workers and parents
to understand babies behavioural signals and cues, thereby helping
to understand how to care for the baby. It is particularly helpful
in identifying the baby's individual characteristics such as habituation,
state regulation and strategies for self-comforting. This information
helps to construct caregiving plans.
1. If parents have difficulty understanding
their babies' behavioural signals, problems can arise with infant
feeding, sleeping and crying behaviours.
2. Behavioural difficulties in late infancy
are strongly associated with maternal state in the postpartum
period, and a lack of maternal sensitivity in engaging with her
infant (Murray and Cooper, 1997).
3. There are sensitive periods in infant
brain development to do with emotional reactivity, self-organisation,
motivation, relationships, certain sensory experience (Fonagy,
1998).
4. If the infant receives inappropriate or
negative responses to their behaviours, a poor pattern of interaction
can be set up which can lead to relationship problems.
5. All babies can benefit from an understanding
of their behaviours, but 50% of babies who have been very premature,
or extremely low-birthweight will have social, emotional and behavioural
problems at school-age (Wolke, 2002).
6. Babies have amazing capacities from birth,
which need to be understood.
7. Research shows that parents who have been
shown the NBAS are more sensitive to their infant's cues, mothers
are more confident, fathers are more involved in caretaking, and
it promotes a collaborative relationship between parent and worker,
(Beal, 1986, 1989, Nugent and Brazelton, 1989, Britt and Myers,
1994).
8. Health professionals and workers have
little or no training in early parent-infant relationships, the
complexities of parenting behaviour, and the behavioural abilities
of babies from 0-3 months.
9. Since the Brazelton Neonatal Behavioural
Assessment Scale (NBAS) is an interactive assessment, information
about the baby's functioning and reactions to handling can be
assessed by the health professional or family worker and shared
with the parents.
10. The emotional care and support of the
mother-infant relationship, during pregnancy and the postpartum
period, by helping the mother to understand her baby's behaviour,
will reduce interactional difficulties between mother and baby,
and improve infant mental health.
RECOMMENDATIONS
All people working with parents and babies need
courses and training in infant behavioural cues in order to help
parents understand what their babies are telling them, thereby
improving early parent-infant relationships.
The Brazelton Centre in Great Britain offers
workshops and training for people working with parents and babies.
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