The Fourth Trimester. Susan Brink. Читать онлайн. Newlib. NEWLIB.NET

Автор: Susan Brink
Издательство: Ingram
Серия:
Жанр произведения: Медицина
Год издания: 0
isbn: 9780520954519
Скачать книгу

      But we now know that every newborn cry of life ushers in a human being who isn't quite ready to be separated from his mother's womb. It is his first and, for a while, only tool of communication to signal hunger, fear, or discomfort—needs that were effortlessly met in the three trimesters that preceded birth. His very survival during the transition that is the fourth trimester depends on this signaling cry.

      THE BABY'S POINT OF VIEW

      Think for a few moments about what birth is like for a newborn. If parents are overwhelmed at this time, we can only imagine the surprise of their infant. Emerging from a snug, temperature-controlled, and highly customized personal sac, she is suddenly in an alien environment. All she knows and craves—food, warmth, and security—has been left behind. In the uterus, she didn't have to ask for a thing. Now, during this phase of development that is so closely linked to her fetal life, her only way of asking is to cry. She's been a contented parasite for forty weeks, and though she's ready for life, she can handle it only with lots of help and definitely on her own demanding terms. It's up to parents and caregivers to quickly figure out what those terms are.

      Her lungs fill with air for the first time, taking over respiratory function from the placenta. The amniotic fluid and mucous in the respiratory tract may not have been fully cleared by the forceful compression of the chest during birth—an even greater likelihood if the birth is cesarean—so her nose has to be cleared. Eyedrops make it hard for her immature visual system to see even the outline of her mother's face. The delivery room is filled with light, brighter than anything she's experienced before, and with sounds louder than anything she's heard before.

      

      And yet, despite all the fussing that goes on immediately after delivery, some things are familiar to the baby. Colostrum, the first breast secretion before milk comes in, and the scent of her mother's nipples, both influenced by the food a mother eats, remind the newborn of the smells and tastes of amniotic fluid, also influenced by diet. That smell represents a sturdy bridge between fetal life and this new phase of development.

      He hears mom coo, “Welcome, my boy,” and the singsong, high-low pitch of the words is familiar. The sound is clearer now, without the muffling effect of amniotic fluid and layers of uterus and skin, and it's yet another bridge between “then” and “now.” He understands nothing, but he's getting his first crude lesson in the yearslong effort to learn a language—that sounds make words. But for now the sounds are all strung together, and, like his mother, the baby is so exhausted from his birth adventure that he will probably fall sleep.

      When he wakes, he feels something damp, but it's unlike the constant and soothing wetness of his nine-month amniotic-fluid bath. This is a wet, soggy, and perhaps chilly diaper, and he cries for help. His cries release cortisol, and his heart rate and temperature rise. He's picked up and cuddled within the warm circle of loving arms, and this feels vaguely familiar. His cries lessen. Then he is on a changing table, his clothes changed, and a dry diaper fastened around him. At the same time, he feels hunger pangs. His cries increase.

      From the newborn's point of view, there's a lot to complain about. It's little wonder that, almost immediately, newborn infants add their own sounds to the mix of worldly noise around them—their cry of life. They are in an alien world and need help adjusting to it. Their cry is their first insistent request that attention must be paid, that care must be taken.

      

      WHY NEWBORNS CRY

      Babies are supposed to cry. It's the primary tool they have with which to communicate about a messy diaper, an empty stomach, and a need for reassurance or human connection. A baby's health is initially measured, in part, by a strong, lusty cry. Her cries communicate—loudly—her feelings, her needs, and her wants. Adults can't help but sit up and pay attention.

      Research shows that normal, healthy infants have two cries.3 They have a basic cry and a pain cry. The two are distinct enough to show up differently on printouts of acoustical analyses of infants’ cries. The pain cry is urgent—usually high-pitched and loud. It comes on suddenly and includes long periods of breath holding. It's that pause between one loud, high-pitched waaah and the second outburst that puts parents on edge. They most likely are running to the infant's side as the next waaah comes through, signaling that the infant is still breathing. That's an instinct worth trusting. When the cry sounds like the baby is signaling pain, a physician should check to see if there's a physical cause. But an urgent cry of pain is also the cry of colic—signaling that parents might be in for a short-term, bumpy ride.

      The other cry, the basic cry, is for everything else—hunger, discomfort, a need to be held. It is somewhat lower in pitch with a more gradual buildup in intensity. There are no interminable periods of breath holding, and overall, there's a less frantic sound to it.

      By about six weeks, the infant has gained enough control of his vocal cords that he makes the amazing discovery that he can cry at will. Imagine the power! He is learning that this vocal tool brings someone to his side. At this point, he may not be crying for a basic need like food or a clean diaper. He may be crying because he needs attention, something he received twenty-four hours a day in the uterus.

      Attention is a serious need for infants. They may need a burp, they might have gas or indigestion, or they may be getting tired. They may be too warm. They may want to move—in someone's arms, a rocking chair, a stroller, or a car seat gliding down the highway. They may simply be lonely and want the sound of a human voice or a cuddle. Or maybe it's just that fussy time of the day, and all a parent can do is try to provide comfort as the crying runs its course. That kind of attention teaches him that a caring adult is still there for him, just as his mother was always there for him during the first three trimesters, in the happy times and through the inconsolable times.

      EVOLUTION HAS MADE NEWBORNS ADORABLE FOR A REASON

      There's a lot of crying and demanding coming from such a diminutive body. Researchers once held that crying was the sole biological siren that alerted and motivated mothers and caregivers to come to the rescue.4

      Turns out, there's more going on in the initial communication. If crying were the only tie designed by evolution to connect babies’ needs and mothers’ responses, the human race might have died out millions of years ago. If high-pitched, incessant screaming were the only thanks mothers living in caves got for their pain and effort, they might have thrown up their hands in frustration and walked away in a huff—hang the future of the human race.

      

      Luckily, infants have other ways of keeping caregivers hooked. Those other physical and behavioral skills, too, have been evolving over millions of years. Think “baby” and see wide eyes, round face, large head, chubby cheeks, small nose and mouth, short and thick extremities, and a plump body shape.5 It's likely that evolution favored infants with characteristics that are universally thought of as adorable. Combine it all in one package, and we're inspired to take care of the baby's every need. In evolutionary terms, our attraction to the endearing details of this demanding being ensures the survival of the human species.

      Babies of just about any species are adorable to adult humans—think kittens, puppies, and penguins. Walt Disney, Steven Spielberg, and Jim Henson understood the human nurturing reaction very well as they created some of the most beloved characters in American culture. What else could explain the appeal of creatures like Mickey Mouse with his oversized head, ET with his (her?) enormous eyes, or Elmo with his short, pudgy body?

      The bottom line is that it's a good thing for the human race that babies are so adorable. Infants with waiflike eyes, plump thighs, and other classically appealing characteristics trigger activity in the reward centers of our brains. In the 1950s, the Nobel laureate Konrad Lorenz described a set of baby characteristics universally considered “cute.” Those cute newborn attributes trigger a nurturing response and motivate us to respond with caretaking, Lorenz found. Our brains are wired to respond to typical baby adorableness. There is much more to our loving response than attempts to quiet those incessant wails of distress.

      In 2009, a group of scientists brought technology to Lorenz's