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"A valuable resource for any clinician seeking to enhance the engagement of new parents with their infants."
Giving babies a "voice" helps parents understand their baby's unique strengths and needs. This observational tool and handbook, complete with beautiful four-color photographs by a Pulitzer prize-winning photographer, gives professionals a systematic way to help parents respond with confidence to their baby's individual needs-and build positive parent-professional relationships in the process. Flexible, easy to integrate into everyday practice, and based on more than 25 years of research, this system includes A short, easy-to-use, interactive observational tool. With the Newborn Behavioral Observations (NBO) system, professionals will have a structured set of 18 observations (see sidebar) for infants from birth to approximately 3 months. Including parents as partners, professionals guide the observation, discuss the baby's abilities and behaviors with parents, encourage parent insights and questions, and suggest specific ways to support the child's development. (Appropriate use of the NBO tool in clinical practice requires training through the NBO training program.) A complete guide to the NBO system. Through realistic case studies, step-by-step how-to instructions, and color photos illustrating each NBO item, professionals will understand how to use the NBO effectively with a wide variety of families. Invaluable professional guidance. More than a tool, the handbook helps professionals improve their daily work with in-depth information on infant and parent development, cultural competence, premature and at-risk infants, family-centered care, and more. An essential resource from the co-author of the highly regarded Neonatal Behavioral Assessment Scale (NBAS) and his colleagues, this system is just what clinicians in hospital, clinic, or home settings need to help new mothers and fathers get to know their baby, increase their confidence and competence as parents, and support their child's growth and development.
Excerpted from Chapter 5 of Understanding Newborn Behavior and Early Relationships: The Newborn Behavioral Observations (NBO) System Handbook, by J. Kevin Nugent, Ph.D., Constance H. Keefer, M.D., Susan Minear, M.D., Lise C. Johnson, M.D., Yvette Blanchard, Sc.D., PT, with invited contributors.
Copyright © 2007 by Paul H. Brookes Publishing Co. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Use of the NBO During Common Pediatric Encounters in the Early Newborn Period
For convenience, the role of the NBO for clinicians in the early newborn period is outlined somewhat chronologically. Although every interaction differs, common themes do emerge from one family to the next, providing a framework for discussion. Although this is to some extent an artificial organization of concepts, the following themes are discussed as a â€œroundingâ€ pediatrician or nurse practitioner might encounter them:
Day 1: The first encounter—strengths and needs within the family system
Day 1/Day 2: Feeding support and easing transition
Day 2/Day 3: Crying and soothability
Day 2 and beyond: Individualized caregiving guidelines
The reader will see how concepts from one theme weave throughout other themes and how the NBO adapts itself to a variety of professionals. As is discussed in the latter part of this chapter, the NBO is most powerful when it is used by all of the clinicians the family encounters; it helps if everyone is using the same language.
Day 1: First Encounter—Strengths and Needs within the Family System
The first pediatric physical assessment often is the first meeting between the clinician and the family. The pretext of the visit is to complete the physical examination of the infant and discuss newborn health maintenance issues. Its richness, however, comes from clinician and parents looking together at the new infant as a person. Therefore, as discussed earlier, this examination should be done, whenever possible, in the presence of the family. Although each provider builds relationships in his or her own style and there are cultural differences in the ways in which such an introduction may be presented, a useful first question is, â€œHow did you choose his name?â€ Most parents care deeply about the name they have chosen for their infant; usually much thought has gone into their decision. There often are stories that spring from the parents as they begin to recount their story of the infantâ€™s name. Listening carefully to the answer, the clinician can elicit important social and family history without asking uncomfortable or intrusive questions (e.g., the fatherâ€™s involvement, key support people who participated in choosing the name, religious and cultural traditions, hopes and dreams for the new infant). Using the infantâ€™s name throughout the subsequent examination gives parents one of their first opportunities to hear their infant addressed by his or her name—an intimate joy to share.
Early in this first encounter, the clinician can invite the parents to bring their concerns to the fore: â€œWhat questions do you have about your infant so far?â€ Typical concerns may revolve around unresolved worries or fears from the pregnancy, prenatal testing findings, medication exposure, effects of maternal illness on the infant, delivery room events, transitional difficulties that the infant may have experienced, or physical findings that were noticed by a parent or other family member. Many of these issues, of course, may not be raised at first. Nevertheless, the question should be posed at the start of the visit as a standing invitation for parents to raise concerns when they feel comfortable doing so. Indeed, in a study by Wolke, Dave, Hayes, Townsend, & Tomlin (2002), the opportunity to discuss health care