Newborn behaviors and early interactions

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Newborn behaviors and early interactions

• Daniel Messinger

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Questions

• Neonate What do studies of neonatal imitation
  indicate? Based on your observations, can
  neonatal macaques imitate? What form do neonatal
  smiles have? Are they due to gas? Are they a
  reflex? What is a reflex?
• What are advantages of breast-feeding? What
  issues are relevant to promoting breast-feeding?
• What is the central issue in investigating the
  effects of breast-feeding  vs. bottle-feeding?
  How do infant and mother interact (influence each
  other) during feeding? How is this and how is it
  not interaction? How do your observations of
  feeding relate to this topic?
• Discuss the Brazelton exam and what it reveals
  about the individuality of neonates (give
  examples from film).

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Neonates are newborns

• Subjectivity
• Neonatal imitation - video
• Characteristics and capacities
• Evaluation of individuality through the Brazelton
  exam
• film
• Reflexes
• Neonatal smiling
• video
• Feeding

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Neonates are

• Weak with limited motor capacities and
  self-regulatory capabilities
• But an impressive array of reflexes and learning
  abilities that aid self-preservation
• Functional but immature sensory capacities
• Strident expressive abilities such as crying
• Engage in primitive interactions such as during
  feeding

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Subjectivity

• The baby, assailed by eyes, ears, nose, skin, and
  entrails at once. Feels that all is one great
  blooming buzzing confusion.
• William James, 1890

Some support Enhanced neural intermingling newbor
n sensations mixed together like a
boulillabaisse (Maurer Maurer, 1988).
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Contemporary subjectivity

• Some multimodal comprehension
• imitation
• Continuous, rapid integration
• Infant is always learning about, interacting with
  world.

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Neonatal imitation

• Infants between 12 and 21 days
• Imitation implies that human neonates can equate
  their own unseen behaviors with gestures they see
  others perform.

ANDREW N. MELTZOFF 1 and M. KEITH MOORE 21
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Monkey see, monkey do?

• Macaque imitation (Ferrari et al., 2006)?
• day 1 mouth openings elicited a similar matched
  behavior (lip smacking).
• confined to a narrow temporal window.
• Mouth opening http//www.youtube.com/watch?vk72W
  FYv6WMw
• Tongue protrusion http//www.youtube.com/watch?v
  -9k4Y8x-L6E
• Chimps imitate mouth opening (Bard, 2007)
• Debate What exactly does infant do in response
  to exactly what stimulus?
• Human example http//www.youtube.com/watch?vk2Yd
  kQ1G5QINR1

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What does it mean?

• Amodal ability
• Means to explore world
• Why does it disappear?

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methodological aspects

• imitation of tongue protrusion for both two- to
  three-day-old and three-week-old infants but not
  at three months old.
• No effect for imitation of mouth opening.
• short-term stability in imitative tendencies
  exists between the first and second observation.
• overall imitation found for tongue protrusion is
  demonstrated to be dependent on how the infants'
  responses are coded.

• Heimann M, Nelson KE, Schaller J. Scand J
  Psychol. 198930(2)90-101.

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Neonatal Imitation in the First Hour of Life
Observations in Rural Nepal

• 12 Maithil neonates (6 boys and 6 girls) during
  first hour.
• Lips widened and lips pursed.
• neonates moved their lips more in accordance with
  model's lip position than at variance with the
  positions.
• Developmental Psychology, 1988, Vol. 24, No. 4,
  464--469 Nadja Reissland

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Neonatal SmilingA Developmental Puzzle
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Whats known

• Endogenous smiles while asleep (REM)
• Not more frequent after feeding
• Not gas
• More smiling in premature infants
• Smiling in microcephalic infant
• Suggests neonatal smiling is subcortical
• Nothing is known about how neonates smile
• type of smile

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Smile meaning

• Duchenne smiles associated with positive
  experiences
• Involve cheek raising
• Open mouth smiles also associated with positive
  experiences, and especially with arousal
• Involve jaw dropping
• Open mouth Duchenne smiles (combined) may be the
  most positive
• Involve cheek raising and jaw dropping

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Duchenne gt open-mouth smiles

• Half of smiles are Duchenne, suggests joy
• 52 of neonates, .21 times per minute
• Few open mouth smiles (which suggest social
  arousal), 8, .02 times per minute

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How neonates smile
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Smiling issues

• Are babies feeling joy (but not much arousal) or
  is this a muscular synergy?
• Why does smiling disappear after the neonatal
  period and before social smiling?
• Neonates smile in non-sleep states, but not as
  frequently.
• Naïve observers perceive neonatal smiles at less
  than half the rate of coders.
• Video

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Altricial-------------------Precocial

• altricial - young are relatively immobile, lack
  hair, require adult care
• Precocial mature sensory and motor apparatus,
  mobile 
• What are humans?

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Tasks of the neonatal period

• Infant
• Energy conservation
• Gain body weight
• Born 7 ½ pounds, 20 inches long
• Parent
• Coordinate schedule
• Sleep about sixteen hours a day
• Eat approximately every three hours
• In first year, most infants grow about ten inches

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Importance of feeding

• Young babies must conserve energy
• But sucking serves nutrition
• So they will suck to produce interesting stimuli
• before they will kick to produce the same stimuli

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Time feeding decreases with age
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Committee on NutritionAmerican Acad. Of Peds

• Three overlapping stages
• Nursing Birth to 6 months
• Transitional period - 4 - 12 months
• Modified adult - 12 - 24 months

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Nursing Period (0 - 6 months)

• Who breast feeds?
• 50 - 60 of mothers
• Highest among college educated, high-income
  mothers above 30
• Lowest among young , less educated, black,
  Hispanic, economically disadvantaged
• MLS
• Resources (La Leche League, J. of H. Lact.)

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Breast-feeding Advantages

• Human milk - the nutritional standard
• Sterile (vs. formula use in underdeveloped
  countries)
• Confers antibodies to baby
• Lactose (from milk) is the primary carbohydrate
  in the young infants diet.
• Too little protein - restricted growth.
• For mother, breastfeeding promotes
• uterine contraction

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Bottle feeding is ok

• Harder to breast-feed when working
• Formula provides whats needed for healthy growth
• Normal growth - the best index of good nutrition

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Breastfeeding Long-term outcomes?

• Breastfed babies do better than bottle-fed babies
  - and the longer they are breastfed, the better
  they do - on various measures of cognitive
  achievement and outcome
• WISC intelligence at 8 and 9 years of age
• Math and reading from 8 to 12 years
• High school attainment exams at 15 16
• L. John Horwood and David M. Fergusson (1998).
  Breastfeeding and Later Cognitive and Academic
  Outcomes. Pediatrics, 101 (1), e9

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Other factors may be responsible

• Breastfed babies have other advantages
• Better educated mothers
• More well to-do familes
• Mothers less likely to smoke
• Infants a little heavier at birth

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But . .

• Breasteeding is still associated with positive
  outcomes after statistically controlling for
  other factors
• What might be producing the breastfeeding effect?
  

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Other issues

• Schedule vs. demand feeding
• Historical changes expert advice
• Cross-cultural evidence, cues and common-sense

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Infant sucking a specialized process

• Gums make the seal
• Not lips
• Lower jaw drops to create negative pressure
• Not by by breathing in
• Tongue expresses milk from back of nipple to
  front
• Which is why young infants expel solids
• Which triggers swallowing

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Sucking process figure
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Feeding is interaction

• Bi-directional
• Each partner influences the other
• Infant can continue suck or pause sucking
• Mother can jiggle or not jiggle nipple
• Forerunner of face-to-face interaction and
  conversational turn-taking?

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Bi-directional detail

• Baby pauses elicit mom jiggling nipple
• should be rare when the baby is sucking
• If jiggle continues, infant least likely to suck
• If there is no jiggle, intermediate likelihood of
  sucking
• If jiggle-then-stop, infant is most likely to
  suck
• Experimental data show the jiggle must be brief
• Mothers shorten duration of jiggles in 1st 2
  weeks

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Moms influence on baby

• Mothers are inserting jiggles in cycles of infant
  sucks and pauses
• So infant would start sucking even if mom did not
  jiggle
• But jiggling and then stopping jiggling does
  encourage suck

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Psychology of early feeding

• Early anaclitic model
• interaction depends on nourishment
• Current interactive view
• Breast or bottle doesnt matter for interaction
• Reading babys cues
• Interactive process

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Paired concepts from Video

• Mother and infant
• Interaction and feeding
• Sensitivity and matter-of-factness
• Quantitative and qualitative measures

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Sensory system development
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Sensory capacity

• Smell
• Turn down the corners of their mouths to bad
  smells, such as rotten eggs
• Facial relaxation to sweet smells like chocolate
• Taste is similar
• Discriminate bitter, neutral, and sweet (Oster)
• Prefer sweet tastes to all others
• Evolutionary advantages

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Sensory capacity Vision

• Vision is functional from birth
• But acuity is 1/25 that of adults
• 20500,
• blurry but in color
• Improves to 2020 by six months

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Auditory Abilities Hearing

• 40-50 Db. Not 10
• Sound localization is good
• Detect one note differences

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Reflexes

• Definition A given stimuli produces a
  stereotypic response
• Relatively invariant
• Is smiling a reflex?
• Spinal cord control Present in anencephaly
• Primitive reflexes
• Sucking and grasping

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Reflex functionality

• Survival and protection
• Sucking
• Grasping (evolutionary environment)
• Habituation
• Development
• Bases for later action
• Sucking (Piaget)
• But also drop out

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Brazelton Scale (NBAS)

• Assesses Four Dimensions of Infant Behavior
• Motor Behavior and Reflexes
• Physiological Control
• Response to Stress
• Interactive Behaviors

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Integrated into a

• Behavioral "portrait" of the infant, describing
  the baby's strengths, individuality, adaptive
  responses and possible vulnerabilities.
• These individual differences are used for
  different purposes
• Clinical (neurological)
• Research
• Parent education

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Behavior depends on state

• Links input and output
• Though babies can influence behavioral state
  through their activities
• Self-regulating

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Simplified system

• (1) Sleeping eyes closed throughout feeding
  session.
• (2) Drowsy eyes may be open but dull and heavy
  lidded, eyelids fluttering, Gaze does not shift,
  baby may stare.
• (3) Alert eyes opened, seems to focus on the
  caretaker or bottle.
• (4) Fussy/crying whimpering or crying during
  food.

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Most time sleeping
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Mean duration of waking increases
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Brazelton exam overview

• Individual differences
• Best performance
• State as baseline for behavior
• Examiner changes behavior
• Allowing infants to express individual
  differences in self-comforting, attentiveness,
  state-regulation, etc.
• Video

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Brazelton doing the Brazelton

• State as baseline for behavior
• Habituation
• Unwrapping
• Reflexes
• Hand to Mouth to Comfort Self
• Upper extremities
• Sucking reflex
• Coordinated with Swallowing and Breathing
• Response to stress Sequence

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Grasping reflex

• Stimulation Palm of babys hand is stroked
• Behavior Baby makes strong fist can be raised
  to standing position if both fists are closed
  around a stick.
• Approx. Age of dropping out 2 months

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Walking

• Stimulation Baby is held with bare feet touching
  flat surface
• Behavior Baby makes step-like motions that look
  like well-coordinated walking
• Approx. Age of dropping out 2 months
• Why does it drop out?
• Under what circumstances can it be seen
• even after two months
• What does this tell us about developmental
  process?

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Placing

• Stimulation Backs of babys feet are drawn
  against edge of flat surface.
• Behavior Baby withdraws foot
• Approx. Age of dropping out 1 months

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Moro (startle)

• Stimulation Baby is dropped or hear loud noise
• Behavior Baby extends legs, arms, and fingers
  arches back draw back head.
• Approx. Age of dropping out 3 months

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Other reflexes

• Defensive response
• Remove cloth
• Spin

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Behavioral regulation

• Self other
• Cuddling
• Self-calming
• Series of interventions
• Dressing

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Tonic neck

• Stimulation Baby is laid down on back
• Behavior Baby turns head to one side, assumes
  fencer position, extends arms and legs on
  preferred side, flexes opposite limbs.
• Approx. Age of dropping out 2 months

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Orientation animate

• Interactive behaviors
• Voice and face
• Face only
• Voice only
• Auditory localization

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Orientation inanimate

• Rattle
• Sight and sound
• Sound only
• Ball
• Visual only
• Continuous sight
• Up?

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Babinski

• Stimulation Sole of babys foot is stroked
• Behavior Babys toes fan out foot twists in
• Approx. Age of dropping out 6-9 months

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Immunity

• Newborns have immature immune systems
• but receive antibodies from mother prenatally
• conferring some resistance.
• Immunities from mother gone by 6 - 12 months
• so infants are most vulnerable between 6 - 24
  months
• immune system is relatively mature by 3 years

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Diarrhea

• 3 episodes by age 3
• Leading cause of childrens death in developing
  countries
• 23 under five years of age
• Kills by dehydration
• oral rehydration therapy
• water with salt and glucose

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Epidemiology

• Infancy is a hazardous time.
• Worldwide deaths during infancy
• 2 million deaths from measles
• 600,000 from whooping cough
• 1,000,000 from tetanus
• Easily avoided . . .

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Additional neonate readings

• Brazelton et al. on neonatal individuality
• Lester et al. on neonatal individuality through
  differences in pain cries
• Colic as an individual difference that does not
  predict
• Can neonates imitate? (Meltzoff et al.)
• Causes and consequences of imitation. By Heyes,
  C. Trends in Cognitive Sciences. 2001 Jun Vol
  5(6) 253-261
• No compelling evidence that newborns imitate oral
  gestures. Anisfeld, M Turkewitz, G Rose, SA.
  Rosenberg, F R. Sheiber, F J. Couturier-Fagan,
  D A. Ger, J S. Sommer, Infancy. 2001 Vol 2(1)
  111-122
• Multimodal perception studies
• Wolff

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Additional Feeding Readings

• L. John Horwood and David M. Fergusson (1998).
  Breastfeeding and Later Cognitive and Academic
  Outcomes. Pediatrics, 101 (1), e9
• Kaye Wells (1980).
• Rovee-Collier and the energy budget

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Heart rate classic orienting index
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Heart rate variability ? vagal tone ? index of
optimal functioning