Newborn Behavioral Observation

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Newborn Behavioral Observation
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I am often asked what an NBO, or Newborn
Behavioral Observation, is and why I do them. I
was certified to practice the NBO in 2013 through
the Brazelton Institute, and find it one of my
most useful tools to use with new parents and
their babies.
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During the NBO I spend about 90 minutes with each
family, though so many interesting topics come up
we could easily spend more time if we had it.
Usually Mom and/or Dad are present with the baby
for the NBO, but any family member or caregiver
can participate.
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We start off by talking about what the family has
already learned about the baby.  The NBO can be
done at any time from birth to three months so
the family may have had just those nine months
before the baby was born to get to know him or
her, or more time since birth.
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The purpose of the NBO is to get to know what is
unique about each baby. It is not an evaluation
or a comparison to other babies or to what is
normal, but a way to give each baby his or her
own voice. Together we discover this babys
preferences and vulnerabilities this babys
strengths and challenges.
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I explain what all infants experience when they
leave the protected world of their mothers body
and emerge into a new world where they are
bombarded with new stimuli and are learning every
moment. With this general knowledge as a
background, we look at how this baby has come
into the world and how he or she is experiencing
sensory stimuli.
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There are eighteen structured observation items
on the NBO for us to look at together. If we can
start while the baby is asleep, we will look at
his or her ability to protect sleep against
visual and auditory stimuli.
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Well watch how the baby transitions from sleep
to being awake, and at the babys own capacity
and strategies for self-regulation. Well watch
the babys body and facial expressions for clues
about how he or she is handling things, and
discuss how the babys parents or caregivers can
support the baby where needed.
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Throughout the NBO well watch the babys skin
color and movements for signs of stress, and
together monitor the babys motor tone and
activity level. Well talk about and listen to
babys cry, what crying means, and what it feels
like for both parent and baby.
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I will put on a glove and let the baby suck on my
finger to see how the baby reacts to the new
taste and feel, and also to see how strong the
sucking response is. This often leads to
conversations about how feeding is going and how
the baby can be supported to have good breast- or
bottle-feedings.
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We also look at how the baby is prepared to
interact in the social world. I will see if the
baby is interested in tracking my red ball, and
how she or he responds to my face and voice, and
to the faces and voices of family members.
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Well see how baby responds when he or she hears
a new sound nearby. Together, well listen to
what the baby has to tell us, sharing information
with each other as we watch and interact.
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In general, people seem to have an expectation
that when babies are born they are all pretty
similar.  I have found that nothing is further
from the truth! From the moment of birth, every
baby is his own special person, and it is so much
fun to learn to watch for his individuality and
help parents learn how to respond to best meet
their babys needs.
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When parents start feeling as though they know
and understand their babies, they feel more
confident as parents, and the relationship is
able to thrive. Learning to parent a new baby is
a challenge, but the NBO provides tools to make
the transition smoother for everyone.
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Recently a couple called me for an NBO with their
new baby. We had done an NBO with their first
child two years ago.   When I asked what the
biggest thing they took away the first time was,
they said, Confidence! They described feeling
like they understood their baby better and had
more insight to what he needed.
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Their second baby was very different from the
first, and the second NBO gave us a lot of
opportunities to learn new strategies that
supported the new baby, and gave us all insight
into how he is different, not just from his
brother, but from every other baby. Thats a
special feeling indeed!
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