This blog was written together with my dear friend and colleague Katie Hazelgrove, who is a postdoctoral researcher in the Section of Perinatal Psychiatry at King's College London. Katie has a particular interest in understanding early infant behaviour.
Building a relationship with the baby: Understanding their cues
We have already discussed how a parent-infant relationship where the baby feels understood and secure is important for their development.
However, it’s not necessary to always understand perfectly what babies are saying and what they need. Babies don’t need perfection but rather parents that are emotionally connected with them. So don’t be afraid of confusing tiredness with hunger: this is not a problem!
The important thing is to communicate that you are there for the baby and you are trying your best to understand their language.
Understanding baby’s cues isn’t always straightforward and parent and infant often need time to get to know each other. After a period of adjustment, parents improve their ability to understand the baby, and usually from birth to 12 months, the level of parent-infant attunement improves.
However, in some situations, difficulties in the parent-infant relationship can persist or become more severe. Some parents in fact can have more difficulties in understanding babies’ signals and respond sensitively. Also, if parents themselves experienced a difficult relationship with their parents, or had traumatic experiences in childhood, these can re-emerge in the relationship with the new-born and influence the way parents care for their baby. In fact, the baby’s signals of distress may create additional stress in the parent and make it difficult to respond sensitively. This is why interactive styles and difficulties may remain stable across generations. However, if parents are aware of these dynamics, they can put strategies in place to avoid difficulties being transmitted to their children.
The amazing abilities of the new-born
Until recently, it was thought that new-born babies were a blank slate, unable to see or hear and only capable of responding with reflexive behaviour. Yet, we now know that babies can react to stimuli from pregnancy and are born with a well-developed sense of touch, taste, and smell, as well as the ability to see, hear, and interact with their caregivers.
Babies can see from birth, and initially can focus on things that are about 20-30cm away; that’s about the distance from their face to their parent’s face when being held. This is no coincidence, as babies love to spend time looking at their parents’ faces and interacting with them. Indeed, babies have clear visual preferences for faces; particularly faces with their eyes open and those with a direct gaze. They can also recognise, and show a preference for their mother’s face.
Furthermore, even at just a few days old, babies can imitate gestures and facial expressions, initiate interactions, and respond, demonstrating their willingness and ability to interact with their caregivers. Babies are indeed social beings from the moment they are born!
Parents may notice that their baby is fascinated by their eyes or hairline. This is because babies can focus more easily on visual contrasts, like black and white. As such, they may also enjoy looking at black and white pictures or other high contrast objects. However, this does not mean that babies can only see in black and white. Indeed, contrary to popular belief, new-born babies can see some colours, as long as they are vivid and in certain shades (e.g., red).
Babies can also hear and locate sounds. In fact, they can sense the sounds of their mother from pregnancy, and at birth can already recognise, and prefer their mother’s voice. Importantly, hearing the mother’s voice activates brain areas that are important for language development. Furthermore, the caregivers voice and face provide the baby with security, comfort, and stimulation. These strengthen the mother-infant relationship and support the baby’s social-emotional and cognitive development. Given the importance of these early interactions, faces and voices are considered the baby’s best toy!
New-borns can also recognise and prefer their mother’s smell. Furthermore, familiar smells, such as that of the mother or their breastmilk, can have a calming effect, and can even reduce pain in the new-born. During pregnancy babies also begin to learn about flavour by swallowing amniotic fluid, and at birth show preferences for sweet tastes like milk.
Finally, new-borns are also extremely sensitive to touch, like the light pressure of a hand on their tummy, and this can help soothe and reduce distress and pain. As we have previously discussed, mother-infant skin-to-skin contact has positive effects on emotional and behavioural development and the mother-infant relationship.
The new-born’s well-developed senses are just part of their amazing abilities. New-born’s behaviour also has an organised structured with a predictable pattern, so it is not just reflexive. Indeed, new-borns have six behavioural states (groups of behaviour with similar characteristics): three sleep states and three awake states (see picture below). These behavioural states can help us understand the baby’s behavioural cues and identify their needs.
Understanding new-born language and behaviour: What is my baby saying?
Dr Brazelton, a pioneer in Paediatrics, said, “A baby’s behaviour is his language… and you can trust that language”. Indeed, babies communicate and expect their caregivers to respond.
Of course, all babies are unique, with their own characteristics and some babies’ cues might be more difficult to interpret than others.
So, how can we better understand babies’ signals and what they are saying?
Firstly, spending time watching the baby and noticing their behavioural state helps us understand how best to respond to their needs in the moment.
For example, the best time to talk and play with a baby is when they are in a quiet alert state. In this state their eyes will be open, and they will be calm and focused.
Parents can use this opportunity to hold their baby face-to-face, talk in a gentle, "musical" voice, or make different facial expressions (e.g., smiling or sticking their tongue out). The parents’ "musical" and infant-modulated voice, also called "motherese", supports language development.
It is important to give the baby time to respond. Indeed, if parents wait, they may notice how their baby joins in with cooing and gurgling sounds or even copies them (e.g., poking their tongue out). Parents can then respond by copying their baby’s facial expressions and sounds. This will keep them engaged and show them their parents are watching and listening to them.
Babies will let us know when it’s time for a break. Interactions are hard work for babies and they may only manage a few minutes of face-to-face interactions! Signs such as looking away, fussing yawning, spitting-up, hiccupping, sneezing, and changes in skin colour (e.g., becoming more pale or red) can signal that things are getting too much.
When this happens, it’s important to respect their need for a break. Parents can slow things down or stop what they are doing. Once babies have had a break, they might signal that they are ready to start interacting again.
Parents’ faces and voices are often all they will need in the first few months, although babies will also enjoy looking at books, listening to stories and music, or hearing their parents’ sing.
After the first few months, babies will start becoming interested in playing with objects. Therefore, it's important to provide infants with stimuli that are developmentally appropriate, which we will talk about in the next blog.
As previously discussed, one of the main ways a baby can communicate with their caregivers is through crying. A baby might cry to let their caregivers know they’re hungry, tired, have a dirty nappy, are too hot, or that things are too much. Sometimes babies will be able to self-regulate, and so may suck on their hands, focus on something, or touch their ears or hair to help soothe themselves. However, this does not mean that we should leave a baby crying, as most of the time they will need our help to settle.
When you respond to a baby crying, you are saying that you are there for them and they can rely on you to feel safe and secure. In this way, you can create the basis for a trusting relationship.
Therefore, when your baby is crying, ask yourself: what are they trying to say? What might they need?
You can think of the list of needs they may be expressing: Hunger? Tiredness? Do they need comfort? Are things too much for them? And so on. You can then try your best to comfort the baby and satisfy their need.
If you think the baby does not need to be fed or changed, there are various steps you can take to try to soothe the baby (see picture below).
Much of what we discussed above is based on the work of Dr. Brazelton, who developed the Neonatal Behavioral Assessment Scale (NBAS), the most comprehensive assessment of new-born behaviour available. The Newborn Behavioural Observations (NBO), a relationship building tool, was subsequently developed by Prof. Nugent and colleagues from the Brazelton Institute. Both tools are designed to support parents in "getting to know" their baby, understanding baby behaviour and promoting healthy parent-infant relationships.
Why is all this important?
In conclusion, understanding infant language and behaviour is crucial, as this is the first step for parents in providing a sensitive response to the baby. For babies, the experience of being understood helps them develop trust in the people around them and in themselves. It is also the start of them gradually making sense of their emotions and, later, those of others. We need to always think of the adult that this baby will become, because, as previously said, the early experiences set the stage for their future development.