The Riggs Blog
Community Gathers in Support of Parent-Infant Connection
By Claudia M. Gold, MD
“Do they realize we don’t know what we’re doing?” Riggs Research Psychologist Dr. Katie Lewis asked her husband on the ride home from the hospital, after being educated and advised by nurses and doctors following the birth of their first child.
Lewis shared her experience at a Newborn Behavioral Observations (NBO) training held recently at the Austen Riggs Center. She remarked that had she and her husband been given an opportunity to listen to their baby’s communication alongside a clinician using the NBO, it might have had a significant impact on this terrifying feeling of helplessness – a feeling that is not uncommon for new parents. “[The NBO] offers opportunity for transfer of agency and authority,” says Lewis
“Dr. Lewis’ comment is a terrific way of capturing the essence of the NBO – through this intervention parents come to recognize their own expertise when it comes to understanding and responding to their baby,” states Dr. Donna Elmendorf, director of the Austen Riggs Therapeutic Community Program and leader of the Riggs Human Development Strategic Initiative. This training launched the first community intervention of the initiative, the “Discovering Your Baby Project.” The initiative’s overarching aim is to support infant, child, and family mental health in Berkshire County, while also bringing a deeper understanding of the developmental process to the Riggs staff and patients.
J. Kevin Nugent, PhD, director of the Brazelton Institute, and I led the NBO training together. The NBO is a relationship-building tool that grew out of the work of pediatrician Dr. T. Berry Brazelton, who was among the first to recognize the tremendous capacity of the newborn for complex connection and communication.
While the medical model of care often puts the professional in the role of expert, this intervention seeks to shift that mindset, mobilizing parents’ unique capacity to tune into and respond to their newborn. The 18 neurobehavioral observations of the NBO are not an assessment or evaluation. Rather, they offer a frame in which to support parents’ earliest efforts to get to know their baby.
When all goes well, the newborn period offers a kind of magical falling in love. Given this expectation, it can be all the more painful when families struggle, due to factors in the baby, caregiver, or both. Using the NBO as a population-based intervention normalizes and destigmatizes these struggles, and provides an opportunity for all families to have a healthy start.
During the NBO training at Riggs, the room held a palpable energy as maternity nurses, pediatricians, nurse practitioners, early intervention specialists, lactation consultants, and home visitors shared ideas and observations. Many delightedly exclaimed how they were now able to put a face to a name. We hope that these new connections will help create a holding environment for new families in South Berkshire County.
Fairview Hospital maternity nurses, who were among the 35 who attended the training, intend to implement the NBO into routine care at Fairview’s Family Birthplace. Simultaneously, Riggs staff will conduct a pilot study at Fairview examining aspects of parent-infant relationships. “Obviously, your passion came through [in the training],” remarked Doreen Hutchinson, RN, vice president of operations and patient care at Fairview Hospital, who said she has been hearing great feedback from the nurses.
A number of Riggs staff members also attended the NBO training. Staff psychologist Dr. Amy Taylor said that what she learned gave her a nuanced view of infancy and will change the way she takes an early developmental history with families of her adult patients.
Dr. Nugent, who developed the NBO and oversees trainings and NBO-related research worldwide, said that he has seen nothing like this in North America. “Having different (such committed) professionals from different disciplines and from different settings within the greater community all coming together with the same set of goals made this training really unique.”
Funding for this program has been generously provided by the Berkshire United Way, the John Leopold Weil and Geraldine Rickard Weil Memorial Charitable Foundation, Inc., and an anonymous donor.