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by Marie Fabre Grenet
CAMSP Nord, CHU Nord
This is a short observation of the powerful effects of the NBAS.
I see premature babies and their parents at my special consultation in Marseilles. It is an early prevention practice with a multidisciplinary team (psychologist, physiotherapist, social worker, nurse, speech therapist and nutritionist). We take time to listen, observe and support “at risk” babies and mothers.
Ryan was a premature baby, a 27 weeker. He returned home at 3 weeks. Ryan and his mother came to their first consultation at the beginning of a long-term follow-up (7 years). He was the first-born baby of a young mother, 18 years old. She came from a gypsy family who had been settled for one generation. Her sister-in-law, an older woman. accompanied her. I usually receive parents without family members because family can be intrusive; however, I do make exceptions if they are okay with It. The sister-in-law asked to come in, and the mother agreed.
My first impression made me uncomfortable. The mother was “floppy”, sitting on the chair in front of me, not really sitting, more drooping on it. She laid the baby across her knees, without really holding him. She seemed totally depressed. Her sister-in-law invaded the space and took over the conversation. She answered all the questions for the mother and then she said, “My family and I are very worried about her. She is not able to take care of this baby.”
It seemed to me that this young mother was being controlled by her sister-in-law. She had no chance to talk or answer. The young psychologist, who used to consult with me, was trying unsuccessfully to engage in conversation with the young mother, and was consistently interrupted by the aunt. I felt the urge to try something since the mother did not respond to talking and also because of the dominating sister-in-law.
I decided to use the NBAS without announcing it. I asked the mother to put her baby on the examination table. I changed my voice to a soft but consistent tone, smooth enough to not overwhelm the baby, but strong enough to catch his attention. Ryan performed quite well. He had a nice neurological exam. The pull-to-sit was perfect, he held up his head, looking straight at me, and he followed my face and my voice. The mother began to look at us and she started to straighten up. Her eyes looked brighter. I asked her to call her son, and he turned his head repeatedly on both sides and engaged with her. I asked her if she would like to hold her baby, and she held him confidently and proudly. The end of the consultation was totally different. She answered my questions and asked some of her own, as well.
One month later she came back with her son and no other family members. She was smiling and proudly holding her son. We spoke about the previous consultation and she told me that her sister-in-law had been having difficulties conceiving a baby and had been trying to appropriate Ryan.
I am still following Ryan. He is 4 years old now, goes to school, and is very lively. The family is doing well.
In this case, I decided to use the NBAS spontaneously. It seemed to me that the only way to reach this mother was through her son. As soon as he responded to her voice, she immediately responded, took her rightful place, and assumed her role. By creating conditions that allow the newborn to show the mother that s/he recognizes her, we can observe the mother emerging from the depths of herself. This young teen mother, devastated by a premature delivery and dismissed by the family, did not trust her own capabilities. The NBAS enabled Ryan to show her how he knew her as his mother, and she became it. This first meeting also laid down the foundation for a constructive follow-up relationship based on the confidence she had with our team - a “touchpoint.”
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.”