The New Family

Humans are social creatures, seeking interaction with their families and their societies. We have already seen how crucial social support is during pregnancy; social interaction may become even more important once the child is born.

The Newborn

Before birth, developing humans already affect their families through fetal movements and hormones that trigger maternal nurturance (food aversions, increased sleep, and more). At birth, a newborn’s appearance (big hairless head, tiny feet, and so on) stirs the human heart, as becomes evident in adults’ brain activity and heart rate. Fathers are often enraptured by their scraggly newborn and protective of the exhausted mothers, who may appreciate their husbands more than before, for hormonal as well as practical reasons.

Newborns are responsive social creatures in the first hours of life (Zeifman, 2013). They listen, stare, cry, stop crying, and cuddle. In the first day or two a professional might administer the Brazelton Neonatal Behavioral Assessment Scale (NBAS), which records 46 behaviors, including 20 reflexes. Parents watching this assessment are amazed at the newborn’s responses—and this fosters early parent–child connection (Hawthorne, 2009).

Technically, a reflex is an involuntary response to a particular stimulus. That definition makes reflexes seem automatic, with the person having no role. Actually, the strength of reflexes varies from one newborn to the next, an early indication that each person is unique. Humans of every age instinctively protect themselves (the eye blink is an example). Newborns do this also, with three sets of reflexes. (See Visualizing Development, p. 118.)

• Reflexes that maintain oxygen supply. The breathing reflex begins even before the umbilical cord, with its supply of oxygen, is cut. Additional reflexes that maintain oxygen are reflexive hiccups and sneezes, as well as thrashing (moving the arms and legs about) to escape something that covers the face.
• Reflexes that maintain constant body temperature. When infants are cold, they cry, shiver, and tuck their legs close to their bodies. When they are hot, they try to push away blankets and then stay still.
• Reflexes that manage feeding. The sucking reflex causes newborns to suck anything that touches their lips—fingers, toes, blankets, and rattles, as well as natural and artificial nipples of various textures and shapes. In the rooting reflex, babies turn their mouths toward anything that brushes against their cheeks—a reflexive search for a nipple—and start to suck. Swallowing also aids feeding, as does crying when the stomach is empty and spitting up when too much is swallowed quickly.

Other reflexes are not necessary for survival but signify the state of brain and body functions. Among them are the:

• Babinski reflex. When a newborn’s feet are stroked, the toes fan upward.
• Stepping reflex. When newborns are held upright, feet touching a flat surface, they move their legs as if to walk.
• Swimming reflex. When held horizontally on their stomachs, newborns stretch out their arms and legs.
• Palmar grasping reflex. When something touches newborns’ palms, they grip it tightly.
• Moro reflex. When someone bangs on the table they are lying on, newborns fling their arms outward and then bring them together on their chests, crying with wide-open eyes.

These reflexes are responses to experiences, not unlike an adult’s sudden fear, or lust, or anger.

The senses are also responsive: New babies listen more to voices than to traffic, for instance. Thus, in many ways newborns connect with the people of their world, who are predisposed to respond (Zeifman, 2013). If the baby performing these actions on the Brazelton NBAS were your own, you would be proud and amazed; that is part of being human.

New Fathers

As we have seen, fathers-to-be help mothers-to-be stay healthy, nourished, and drug-free. The father’s role in birth may also be crucial.

Being There

At birth, the father’s presence reduces complications, in part because he reassures his wife. I observed this with my own daughter, whose anxiety rose when the doctor and midwife discussed a possible cesarean without asking her opinion. Her husband told her, “All you need to do is relax between contractions and push when a contraction comes. I will do the rest.” She listened. He did. No cesarean.

Whether or not he is present at the birth, the father’s legal acceptance of the birth is important to mother and newborn. A study of all live single births in Milwaukee from 1993 to 2006 (151,869 babies!) found that complications correlated with several expected variables (e.g., maternal cigarette smoking) and one unexpected one—no father listed on the birth record. This connection was especially apparent for European American births: When the mother did not list the father, she was more likely to have long labor, a cesarean section, and so on (Ngui et al., 2009).

VISUALIZING DEVELOPMENT

A Healthy Newborn

Just moments after birth, babies are administered their very first test. The APGAR score is an assessement tool used by doctors and nurses to determine whether a newborn requires any medical intervention. It tests five specific criteria of health, and the medical professional assigns a score of 0, 1, or 2 for each category. A perfect score of 10 is rare—most babies will show some minor deficits at the 1 minute mark, and many will still lose points at the 5 minute mark.

SOURCES & CREDITS LISTED ON P. SC-1
SOURCE: CENTER IMAGE SEKUNDATOR/SHUTTERSTOCK

REFLEXES IN INFANTS

Never underestimate the power of a reflex. For developmentalists, newborn reflexes are mechanism for survival, indicators of brain maturation, and vestiges of evolutionary history. For parents, they are mostly delightful and sometimes amazing.

ASTIER/BSIP/SCINCE SOURCE/PHOTO RESEARCHERS, INC.
PETIT FORMAT/PHOTO RESEARCHERS
JENNIE WOODCOCK; REFLECTIONS PHOTOLIBRARY/CORBIS

Currently, about half of all U.S. women are not married when their baby is born (U.S. Bureau of the Census, 2010), but fathers may still be on the birth certificate. When fathers acknowledge their role, birth is better for mother and child.

Couvade

Fathers may experience pregnancy and birth biologically, not just psychologically. For example, levels of the stress hormone cortisol correlate between expectant fathers and mothers, probably because they make each other anxious or relaxed (Berg & Wynne-Edwards, 2002). Beyond that, many fathers experience symptoms of pregnancy and birth, including weight gain and indigestion during pregnancy and pain during labor (Leavitt, 2009). Among the Papua in New Guinea and the Basques in Spain, husbands used to build a hut when birth was imminent and then lie down to writhe in mock labor (Klein, 1991).

Paternal experiences of pregnancy and birth are called couvade; they are expected in some cultures, a normal variation in many, and considered pathological in others (M. Sloan, 2009). In developed nations, couvade is unnoticed and unstudied, but many fathers are intensely involved with the early development of their future child (Brennan et al., 2007).

New Mothers

About half of all women experience physical problems soon after birth, such as healing from a c-section, or painfully sore nipples, or problems with urination (Danel et al., 2003). However, worse than any physical problems are psychological ones. When the birth hormones decrease, between 8 and 15 percent of women experience postpartum depression, a sense of inadequacy and sadness (called baby blues in the mild version and postpartum psychosis in the most severe form) (Perfetti et al., 2004).

With postpartum depression, baby care (feeding, diapering, bathing) feels very burdensome. The newborn cry may not compel the mother to carry and nurse her infant. Instead, the mother may have thoughts of neglecting or abusing the infant, a thought so terrifying that she is afraid of herself.

The first sign that something is amiss may be euphoria after birth. A new mother may be unable to sleep, or stop talking, or push aside irrational worries. Some of this behavior is normal, but family members and medical personnel need to be alert to the mother’s emotions. After the initial high, severe depression may set in, with a long-term impact on the child. Fathers are usually the first responders; they may be instrumental in getting the support the mother and baby need (Cuijpers et al., 2010; Goodman & Gotlib, 2002). But fathers are vulnerable to depression, too; other people need to help.

From a developmental perspective, some causes of postpartum depression (such as financial stress) predate the pregnancy; others (such as marital problems) occur during pregnancy; others correlate with birth (especially if the mother is alone and imagined a different birth than actually occurred); and still others are specific to the particular infant (such as health, feeding, or sleeping problems). Successful breast-feeding mitigates maternal depression, one of the many reasons a lactation consultant is an important part of the new mother’s support team.

Parental Alliance

Remember John and Martha, the young couple whose amniocentesis revealed that their fetus had trisomy-21 (Down syndrome)? One night at 3:00 a.m., after about seven months of pregnancy, Martha was crying uncontrollably. She told John she was scared.

This episode ended well, with a long, warm, and honest conversation between the two prospective parents. Each learned what their fetus meant to the other, a taboo topic until that night. Adam, their future son, became an important part of their relationship.

Their lack of communication up to this point, and the sudden eruption of unexpressed emotions, is not unusual, because pregnancy itself raises memories from childhood and fears about the future. Yet honest and intimate communication is crucial throughout pregnancy, birth, and child rearing. Such early communication between new parents helps to form a parental alliance, a commitment by both parents to cooperate in raising their child.

The parental alliance is especially beneficial when the infant is physically vulnerable, such as having a low birthweight. The converse is also true: Family conflict when a newborn needs extra care increases the risk of child maladjustment and parental divorce (Whiteside-Mansell et al., 2009).

Bonding

To what extent are the first hours after birth crucial for the parent–infant bond, the strong, loving connection that forms as parents hold, examine, and feed their newborn? It has been claimed that this bond develops in the first hours after birth when a mother touches her naked baby, just as sheep and goats must immediately smell and nuzzle their newborns if they are to nurture them (Klaus & Kennell, 1976).

Better Care Kangaroo care benefits mothers, babies, and hospitals, saving space and medical costs in this ward in Manila. Kangaroo care is one reason Filipino infant mortality in 2010 is only one fifth of what it was in 1950.

ROLEX DELA PENA/EPA/NEWSCOM

However, the hypothesis that early skin-to-skin contact is essential for human nurturance has been proven false (Eyer, 1992; Lamb, 1982). In fact, substantial research on monkeys begins with cross-fostering, a strategy in which newborns are removed from their biological mothers in the first days of life and raised by another female or even a male. A strong and beneficial relationship sometimes develops (Suomi, 2002).

This finding does not contradict the generalization that prospective parents’ active involvement in pregnancy, birth, and care of the newborn benefits all three. Factors that encourage parents (biological or adoptive) to nurture their newborns may have lifelong benefits, as has been proven with mice, monkeys, and humans (Champagne & Curley, 2010).

The role of early contact has become apparent with kangaroo care, in which the newborn lies between the mother’s breasts, skin-to-skin, listening to her heartbeat and feeling her body heat. Many studies find that kangaroo-care newborns sleep more deeply, gain weight more quickly, and spend more time alert than do infants with standard care (Feldman et al., 2002; Ferber & Makhoul, 2004; Gathwala et al., 2010). Father involvement may also be important, including father–infant kangaroo care (Feeley et al., 2013).

Kangaroo care benefits babies, not only in the hospital but months later, either because of improved infant adjustment to life outside the womb or because of increased parental sensitivity and effectiveness. Which of these two is the explanation? Probably both.

Implementation of many strategies, especially for fragile infants and their parents, is especially needed in developing nations, where kangaroo care and other measures could reduce deaths by 20 to 40 percent (Bhutta et al., 2008). From a developmental perspective, the most difficult time for high-risk infants occurs when they leave the hospital, weeks after birth. At this juncture, measures to involve parents in early care are crucial. As we will see in later chapters, the relationship between parent and child develops over months, not merely hours. Birth is one step of a lifelong journey.