Supporting “The First Relationship” in Northern India III

workshopKNS01

After the presentation of the book, Your Baby is Speaking to You (Nugent, 2011), I introduced the workshop by stressing the importance of the role as nurses in scaffolding the healthy development of children through their support of the “first relationship”. I told them that (1) Babies are speaking to their mothers; (2) mothers can listen to their babies; and (3) they, as nurses, could help mothers learn to listen to their babies in a way that could make a great difference to the future health and wellbeing of the children. Ginger and I stressed the importance of making the mother feel that she can gain competence in listening to her own baby, that she can become the expert of his communications.

Then, using Kevin’s book as a guide, we introduced some of the basic ways that infants communicate through manifestations of their state – quiet, alert, crying, fussy, deep or light sleep, etc. We talked about the way babies make transitions among these states. Then, we talked about how individual babies have different and characteristic ways of making transitions, and how through learning how to “read” these communications from the baby, the mother can comfort her baby’s natural distress as he moves through transitions. At that point, without our original plan for demonstrating the NBO in the maternity ward, we had to improvise. It occurred to me that Ginger and I could play the roles of mother and nurse, and when I suggested this to Ginger, she immediately and enthusiastically rose to the occasion. I had not previously realized that my teammate was such a good comedian and creative improviser.

Ginger snatched up her small cloth purse to represent “the baby”. Playing the nurse, I pretended to enter the room and greet a mother with her newborn. “You have a beautiful baby!” I pronounced. Ginger smiled, but then told me, “But he is crying all the time!” I suggested to the group that the natural response of a nurse to a crying baby might be to pick up the baby and comfort him. Then, I asked the group how they imagined the mother might respond if the nurse picked up the baby and was able to comfort him. One student answered that she thought the mother would be pleased. We then acted this out with my taking up the baby and comforting him, and Ginger making a woe face to indicate her feelings of inadequacy at being less competent than the nurse at comforting her own baby. The students laughed and seemed to understand our point quite well.

Then, Ginger told “the nurse”, “I think my baby is uncomfortable, and I don’t know what to do.” Ginger – who has a more substantial background in the NBO and also in home visiting mothers and infants – was luckily cueing me at every step. In response to her cue, I responded, “How does your baby like to be held? Do you think that if you held him in a different position he might be more comfortable? Why don’t you try some different ways of holding him and see what you discover.” Ginger pretended to hold her baby in different positions and did indeed “discover” a way that made him more comfortable. I congratulated her on “knowing” her baby.

Ginger then said, “But even so, my baby seems to cry a lot of the time.” I responded – again to Ginger’s cues (which actually were quite transparent and often elicited a laugh from the students), “Maybe you have a sensitive baby. Have you noticed that he is sensitive to light?” Ginger said, “Yes, I have noticed that he makes his eyes go like this (squinting) in the daylight.” Another appreciative laugh. I said, “Well, let’s lower the window shade and see what happens.” I pretended to do so, and Ginger agreed that this seemed to have a positive effect and seemed pleased at this new knowledge about her baby. The street noises were very loud and sometimes drowned out our speech, so it was easy to play out a baby who was sensitive to loud noises. This elicited more laughter, as the noises of trucks and motorcycles and the banging of construction intruded into the room.

My favorite part was when we wanted to demonstrate a mother discovering that her baby needed to be swaddled. Ginger made her soft purse strings flap around until she and I decided to swaddle the baby so that his little “arms” were held close to his body. Continuously, we repeated the necessity of helping the mother feel competent, and as if she knew her own baby better than anyone else.

The workshop was a very enjoyable experience for us, and I did have the impression that the students learned something important. I was touched by the sign in the nursing school, listing the qualities of a nurse: N=nobility; U=usefulness; R=righteousness; S=simplicity; E=efficiency.

nursingsign

photographs by Ginger Gregory

2 thoughts on “Supporting “The First Relationship” in Northern India III

  1. Alayne Stieglitz

    Hi Alex,
    I’ve been so excited to read the accounts of your trip and the workshop and especially interested in the introduction of the NBO. I’ve done the observation with six new mothers since the IPMH Napa program and have seen this shared experience have an immediate impact on the mother’s view of her baby’s competence and her own ability to know and understand him/her.
    In my World of the Infant class at Bank Street I was delighted to see Dr. Nugent’s book on the syllabus. I, too, have given this beautiful book as a gift to every new parent I have encountered since he introduced it to us in a Napa.
    I’m looking forward to reading more,
    ~ Alayne

  2. Deborah Weatherston

    Dear Alex,
    You may remember me from our all too brief conversation at the WAIMH dinner. This particular blog is something that I think people in MI-AIMH and the larger league of states (endorsement league partners) might especially enjoy. It is simple, concrete and so very in tune with our approach through infant mental health home visiting. Is there a chance that I might reference what you are writing about on our webpage and direct people to your blogs?

    It would also give me space to reference Kevin Nugent’s book which is so glorious.

    Do let me know, Debbie

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