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by Maureen Lancaster
The Early Attachment Team, Pennine Care NHS Foundation Trust
Maureen Lancaster has been trained on the NBAS and is a member of the Early Attachment Team, a service which is jointly provided with Pennine Care NHS Foundation Trust, which provides NBO / NBAS support to families. Here she describes an NBAS, which she administered on a 24-hr old baby on the Post Natal Ward, at the request of Midwives.
The baby was a full-term, traumatic forceps delivery and was formula feeding on demand. This was a first pregnancy for a young Mum. Antenatally Mum had stated that she did not want the baby but she had progressed with the pregnancy. She had no family support. Dad was currently serving a prison sentence and the plan was to discharge home to a friend’s address. Mum was caring for the baby’s physical needs but she demonstrated poor interaction with her baby and had little understanding of the baby’s cues. This was of concern to the Midwives who requested that I complete an NBAS on this baby.
As I approached the Mum to explain what I wanted to share with her and to gain her consent, I observed a fractious baby. Mum was just about to put the dummy in the baby’s mouth and I suggested we just wait and see how the baby progressed. Mum agreed and sat behind me on the bed to observe the Assessment. I began by checking out some reflexes to support this baby in organizing himself. He achieved this and reached a State 4. I knew it would be difficult for him to maintain this so I commenced the Social Interaction items. He needed a great deal of facilitation to be able to follow my face and voice and could only open one eye at a time. He really tried to engage with me and did manage to follow my face alone, face and voice and the rattle.
At this point I asked the Mum who was sat slightly behind me to call her baby’s name. She did so, but in a very monotonous voice, which lacked both enthusiasm and tenderness. This elicited no response from baby. I encouraged her to try again. She did call his name in much the same way, however, this time the baby stilled, looked toward his Mum, opened both eyes, and focused on his Mum. I could only imagine the effort that this baby exerted to do this but he knew it was his Mum’s voice and worth the effort. At this point Mum’s whole demeanor altered and she moved closer towards her baby and said “Ahh little man“, in a very endearing, tender tone, now recognizing the baby’s connection with her, and requiring no prompts to then reclaim and connect with her baby.
She now proceeded to hold and talk to her baby. Later that day I received a phone call from one of the Midwives to say how amazed they were at the change in this Mum’s approach to her baby and how her interaction with him had increased and improved.
The wonderful power of the NBAS! Three months on, the family’s Health Visitor says that Mum and baby are doing well.
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.”