Dear Mardrey,
Thank you for your thoughtful note.
You are absolutely correct to state that reflexes are characterized by sensory input
with a stereotypical motor output. In addition, the sensory input is very specific
(and has to reach a certain threshold of intensity...like a tap on the patellar
tendon has to be in the right place AND strong enough) although the output may vary
the state (and other temprorary conditions, e.g. the rooting reflex is much more
difficult to elicit when a baby has just eaten). Primitive reflexe are subcortical
and they fade after a few months and are often replaced by voluntary behaviors.
As you will see when you watch the DVD (I highly recommend the DVD as the tool you
recommend to parents, not THBOB book) you will see the very stereotypical response
of calming that occurs almost immediately to a specific sensory input at a specific
threshold level. For example, the shush abruptly works when it gets to a threshold
deceibel level (inner ear auditory stimulation) and the side position works when
the baby's head is rolled just past midline to slightly face down (middle ear
vestibular stimulation). This response is almost irresistable in fussy babies during
the first few months, but then becomes a conditioned behavior and is no longer obligatory.
This too fits the characteristics one would expect of a neonatal reflex.
I fully admit this is just a theory. The "calming reflex" has not yet
been proven to be a reflex (demonstrated in anencephalic babies or emerging in brain
damaged adults), but it certainly fits many of the criteria used to describe a primitive
neonatal reflex. And, it makes sense teleologically (you can read the explanation
in the book).
I do disagree with your comment about not teaching this idea to parents. In fact,
it is an easy way for parents to conceptuialize what they are need to do and makes
a great deal of intuitive sense to them.
I also would take exception to your belief that you could calm the baby because
you are "serene". Studies show that premature babies ahve a delayed on
set of colic (it doesn't begin until after their due date, so if a baby born
3 months preemature develops colic it won't even begin until the baby is 3 months
old). This would not comply with your statement about parent anxiety and fussiness...because
these parents tend to be extra anxious for months before the fussy behavior begins.
Also, a parent's 5th baby is as likely to have colic as their first, yet parents
are much less anxious after having several children. It seems more liekly that you
have learned how to hold and handle a baby through your years of experience and
so you are naturally (even unconsiously) adept at doing it well.
Finally, the research on cry characteristics early in life (computer acousitic
analyses and the reports of experienced nurses) do not support the contention that
there is a predictable difference in a baby's cries that allows a parent to
predict the cause of the upset...at least not during the first month or two.
As per your request, I have attached a lecture handout that icludes an extensive
bibliography.
I look forward to your further comments and your feedback after viewing the DVD.
Best wishes,
H
>
>Date: Sun, 18 Feb 2007 16:31:54 EST
>From: Mardrey Swenson <[log in to unmask]>
>Subject: calming reflex
>
>
>One thing about which you've written, Dr Karp, is one I'd hoped to see
>addressed in your e-mails to Lactnet. But other than stating it, I didn't see
>anything about how you came to conclude that there is a calming reflex.
>
>I'd read in a pediatric text book a decade or so ago that often babies'
>reflexes guide them into behavior. After a certain amount of time appropriate
>learning usually occurs, and the reflex fades when it is no longer needed. We
>also know that something like the Babinski reflex exists until the nerves
>become fully myelinated, then that disappears.
>
>I guess that when I think of a reflex, I think of a sensory input that is
>integrated within the baby and results most often in a motor response.
>
>The rooting reflex, the step reflex and the grasp reflex would be examples
>of that. Then are ones like the Moro response, the tonic neck reflex, the
>startle reflex, the grasp. Some of these reflexes are used to determine if
>the infant is neurologically intact.
>
>In the late 1980's - 1990's the research in Sweden by Dr. Righard and
>Margaret Alade shows newborns capable of a complex behavior of crawling to the
>breast after birth. They speak of a reflex involved -- the step reflex that
>helps in propelling them there. And we can see in that video that the rooting
>reflex appears to help the baby turn toward the breast. But these researchers
>don't call this breast-seeking behavior a reflex. Reflexes do seem to be
>assisting the babies in what may be a behavior hard-wired to their systems.
>
>I guess I'm having difficulty with the use of the term calming 'reflex'. I
>think that I would chose to use caution before using a term such as reflex
>with a baby behavior, especially when explaining things to parents. There
>are so many different types of cries, the ones parents come to recognize: anger,
> frustration, discomfort, pain; and then are other cries like those
>associated with the genetic disorder cri du chat syndrome, or the cephalic cry.
>Crying is a complex behavior and because of that I'd rather see caution used when
>creating a phrase to describe the ease of bringing a baby to a state of
>calm. Perhaps baby's response to calming ways of parents is a behavior
>hard-wired into them. But is it a reflex? Reflex implies an automatic response, most
>often a motor one. Even if the results of tools to calm a baby seem to happen
>almost instantaneously, I still not convinced that qualifies as a reflex.
>
>I do know how extraordinarily fast a baby can calm from a loud screaming cry
>to a total alert quiet state. A couple was bringing their new baby boy - I
>think going on two days old -- down to show him to their childbirth
>classmates -- who'd made it to the breastfeeding class before their babies were born.
>;-) This baby was screaming loudly. I think the Dad was probably
>distressed. But they came in all happy wanting to show off their son.
>
>I asked if I might try to calm him to show the class how it's done. He was
>hardly in my arms a minute before he was totally relaxed and calmly looking
>around the room. The parents and parents -to-be were very impressed.
>Probably too much so. Why to I say that? Because I think that the parents were
>distraught about the crying and didn't know what to do. I knew I could calm the
>baby and I was calm and serene myself. I do think that at first parents who
>are stressed are going to need to build the confidence that they can calm
>their babies and yes, tools like you describe can help them to do so. And I
>did share with them some of the ideas involved. And your book is in our lending
>library.
>
>Since I'm still looking for more to read about all this, I 'd very much like
>that bibliography that you offered. Thank you,
>
>Mardrey Swenson, IBCLC
>
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET email list is powered by LISTSERV (R).
There is only one LISTSERV. To learn more, visit:
http://www.lsoft.com/LISTSERV-powered.html
|
