Updated: Jan 30
For new parents, one of the biggest challenges in the first few months is learning about what their baby needs. Every parent wants to know what their infant is communicating through their crying, sleeping patterns, the way they move and look at things around them, and understand how to manage it. Parents are often more confident once they are able to understand what their baby is telling them and how they can help them by responding to their needs. There is a way of getting to know this, from the first hours outside the womb, and it is through the Newborn Behavioural Observations (NBO).
What is the NBO?
The NBO is an interactive and systemic way of observing Newborn’s behaviour in the first 3 months of life. It is a chance to observe your baby´s individuality and getting to know them.
Through a sequence of interactions the practitioner will ask the baby questions in a way the baby can answer with his physical and psychological responses, showing his uniqueness, his likes and dislikes. The younger a baby is, the better, and the whole family can watch and learn from the intervention.
It was an approach created by the renowned paediatrician Dr Berry Brazelton used by health professionals to create an individual behavioural profile of the baby to watch and share with the parents. Dr Brazelton was at the forefront of science as one of the first professionals to consider a baby as a person with his own individuality, something that today we think unimaginable. He described, after decades of working with children and families, how it was possible to predict a child´s personality at an older age after observing them using the NBO.
The experience and knowledge that you will gather about your newborn can immensely facilitate the way you will care for your baby. The NBO has proved to be a valuable way of showing the individuality of the newborn and has a powerful impact on the parent and infant relationship. After an NBO session, parents are usually thrilled about all the things their baby can already do at such a young age.
The NBO is a recommended intervention by the National Health Visiting Core Service Specification (2015/16, NHS England) and Specialist Health Visitors in Perinatal and Infant Mental Health (2016, NHS Health Education England). For more information visit www.brazelton.co.uk.
What happens during a session?
A session will last about 45 minutes. We will talk about your birth experience and about the days or weeks since the birth of your baby. We will then observe the baby together, looking for signals and cues. We look at the baby’s physical appearance and start by observing his internal state. The session will be focused and guided by your baby; we will be able to gather information only from the questions the baby decides to answer.
At the end of each session, you will receive a special All about me booklet with our findings about your baby at this particular stage in his development.
You will learn about:
• Behavioural states. Learning about your baby´s 6 internal states and how he manages between states will help you understand your baby´s sensitivity to the environment and how he is able to cope with it. You will identify cues for when the baby needs reassurance, or just a break.
• Sleep. Through your baby´s response to sound and light when sleeping you will learn about how your baby is coping with the environment outside the womb and how he is able to protect his sleep. Depending on his response you will learn the level of support he needs from you when he wakes up from his sleep.
· Feeding. The quality of the baby´s cry when he is hungry is usually different from when he has a different need. There might be an opportunity during the session to observe these differences, and understand if feeding is what the baby needs or if he just asking to be soothed with your voice, your warmth, or even a break!
• Response to faces and voices. Human babies are born wired to relate socially to the people around them. You have an opportunity to learn about how social your baby is at this stage and whether he is a sensitive baby who needs a smooth introduction to social interactions.
• Crying and soothing. Crying is welcomed during an NBO session. It is communication. Learn about stress factors and what might trigger your baby´s response to stress. Observe the resources he is already using to manage crying.You will learn about a set of strategies to comfort your baby and find out which one your baby prefers. All babies are different and like different ways to be soothed.
• Activity and reflexes. Learn about your baby´s level of activity and you might see him responding to the crawling reflex with a little jump forward. Babies are born with this reflex, which will be dormant until they need it at a later stage of development when they start practising crawling. Learn about the strength of your baby´s muscles and his level of need for containment and support.
• Play. See if your baby stares and follows a red ball that will be moved in front of him and if he turns his head to the sound of the rattle. Learn about how he prefers to play and learn at this stage, and see if he is more interested in inanimate objects or human faces.
What tools are used during a session?
The NBO practitioner uses a kit that contains a torch, a red ball and a rattle to ask questions to your baby and observe how he responds.
‘By the end, parents learn a lot about their baby’s likes and dislikes and ways of supporting them. Parents say they feel they know their baby better, feel more confident and enjoy an even closer relationship as a result.’ (Brazelton Centre UK)