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by Nicholas Kasovac, MA, R-DMT, CBC
Healthy Steps for Young Children, Summit Healthcare - Show Low, Arizona
In the couplet care unit at our hospital, I met a mother and father who just delivered their fifth child. During the administration of the NBO, I was holding the baby attempting to get the child to respond to my voice. The baby would not open his eyes for me, and was continually “adjusting” as if to get comfortable. I commented on the baby’s minimal response to me, despite my attempts to engage him. I asked his father, who was watching from about 10 feet away from where I was standing with the baby, to call his name. When the father called the baby’s name, the baby immediately turned toward the father’s voice and began to open his eyes. The father almost gasped, he looked so excited and a big smile spread across his face. I said, “Did you see that?!” to both mother and father. Even the baby’s mother, whose expression had been neutral to this point, was smiling after this event. Clearly, the father was pleased with his new son’s accomplishment, and I passed the baby to him so that he could flood him with love and attention, which he did.
Frequently, as part of the NBO administration, the babies I see in the couplet care unit appear to be somewhat bothered by my picking them up and holding them. My attempts to calm them and help them get organized do not seem to help. When the baby’s father is present, I say to the baby, “You don’t seem very happy with me holding you. Shall we see if Dad can help you calm down?” At that point, I pass the baby to the father to hold and, invariably, the baby calms easily and quickly once in the father’s arms. This offers a rich opportunity to highlight the obvious connection the baby has with his/her father, even at 24-48 hours of age. I suspect all the fathers feel a strong sense of competence and pride that they’ve been able to accomplish something with their baby which I was not able to do.
I met a first-time, 17-year-old mother in the couplet care unit at our hospital. She was in her room, alone with the baby. When I started to administer the NBO, I asked the mom if she had yet discovered any ways to calm her baby. Sheepishly, she responded that the baby calmed when she held her. I reflected inquisitively, “So she likes to be held by you and calms down when you hold her?” She responded, “Yes.” Continuing with the NBO, I began to unwrap the baby who started to fuss. I mentioned that part of what we were wanting to discover was what kind of support the baby needed to help her calm down. Before I could try anything, the mother stated, “She likes to suck on her fingers,” and I said, “She does?” The mother then said “She also likes to be swaddled tight and I leave her hands so she can get them to her mouth.” I said “Really? So, you know a couple different things that help your baby calm down and pull herself together! You know a lot about your baby already! That’s terrific!” The mother had a very big smile on her face, seemingly pleased with herself that she already knew so much about her baby that she hadn’t realized.
While it may be my personal bias, one interesting effect that I’ve noticed is the difference between how mothers and fathers respond to the baby’s needs. Mothers respond to the baby and his/her needs by trying to “fix the baby” (e.g, patting, rocking, holding closer, etc), whereas fathers seem to focus on changing the environment to affect a change in the baby’s behavior (eg, re-swaddling, closing the window blinds, positioning himself and baby in another part of the room, moving the baby through space in a different way). Granted, the mothers are usually in bed recovering from the delivery, yet there seem to be clear gender differences that are similar across families. Most (if not all) parents who report the baby responds readily to the father’s voice also share that the father regularly and routinely spoke to the baby while in utero. When this bit of family history is offered by the mother, she seems to have a hint of pride in her partner and his display of loving behavior.
Frequently I meet with young couples (usually around 19-22 years of age, some married and some not) who are first-time parents. When the NBO is introduced to them as a way for all of us to “discover” the skills and capacities of this baby, they are generally very interested. Most are amazed when they witness the habituation to light and sound. At that point, they are curious to learn more about their baby. Typically, these young parents already know some things about their baby but they often haven’t yet recognized the importance of this knowledge.
Administering the NBO creates a rich environment that promotes learning and increases parental competence and confidence. At the same time, it fosters and honors the families’ values and highlights the meaningfulness of this time in their lives. For this provider, the NBO engenders a sense of “naofacht” and a deep, personal significance. I’m eternally grateful to Dr. J. Kevin Nugent and his colleagues for sharing his wonderful work.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”