The most difficult part of caring for a newborn baby, as parents discover when they bring one home from the hospital, is not the feeding or the diapering or even the waking in the night; it is living with the unknown. What must the baby be thinking as he lies awake, sucking on his hand and staring at the crib posts, when he cries and isn't hungry?
Faced with the baby's mysteriousness, parents seem to want the certainty experts proffer. Even in another age, when young parents were surrounded by an extended family of mothers, aunts, younger siblings, and cousins, they did not rely entirely on the experience of loved ones. Eager to do the modern and correct thing, they also turned for guidance to books. Benjamin Spock, whose Baby and Child Care has been the best-selling book of this century, is jut one in a long line of advice-wielding baby-doctors. In 1872, there was Combe's The Mother's Guide for the Care of Her Children; or the Management of Infancy; in 1881, Hartmann's Modern Baby; or the Art of Nursing and Raising Children. Around the turn of the century, Drs. L. Emmett Holt and J. P. C. Griffith each came out with a manual. Holt's The Care and Feeding of Children; a Catechism for the Use of Mothers and Children's Nurses went through at last a dozen printings, and successive editions of Grifith's The Care of the Baby were published over a period of twenty-five years.
The one thing all baby books have in common is a tone of absolute confidence. And yet the certainties differ from one era to the next. In the 1890s, an expert advocated a start on toilet-traininig at three months. In the 1940s, parents were cautioned not to begin before the second year. In the 1850s, an expert deplored bottle feeding. In the 1930s, scheduled feedings and bottles were in. By the 1960s, flexibility and the breast were coming back into favor.
On the subject of the interior life of the infant—what the infant himself or herself experiences—the differences of opinion are monumental. In 1895, Dr. Griffith, a clinical professor of diseases of children, at the University of Pennsylvania, insisted in his book that the infant experiences next to nothing. "When the baby is just born," he wrote, "... it is ...very little more intelligent than a vegetable. Its soul and its intellect are there, but they are dormant, waiting to be awakened. It has also little control over its body, and all its movements are automatic or instinctive. Probably there is not a single expression of the face or motion of the arms or legs which is caused by a distinctly willed action.... A new-born baby probably cannot see except to distinguish light from darkness and will not wink when the finger is brought close to its eyes. It seems also unable to hear, and at first cannot smell, although taste is well developed. It is, in fact, not directly conscious of anything." Protesting, perhaps, against parents' tendency to read intelligence into their little darlings' behavior, Griffith wrote: "When it nurses at the breast it does not know it is nursing, and when it cries it is ignorant of any sensation that makes it cry."
By the time Dr. Spock's Baby and Child Care first came out, in 1946, the infant was getting a little more credit. But he was still, in his early months at least, believed to be entirely absorbed in experiencing physical sensations, ignorant of the boundaries between himself and those who cared for him. Back in the fifties, when parents consulted Spock's book to find out about crying, they were advised to look for physical reasons for the baby's discontent: he might be hungry; he might be colicky; he might have an open safety pin: sticking into him. Or he might be fussing because he had an immature nervous system. But Spock went on to say that a crying baby was not fussing because of an emotion. "The baby is not mad at you," Spock told parents. "He doesn't know yet that you are a person or that he is a person. He's just a bundle of organs and nerves during his first month. Some kind of pain is spreading through his system, and it automatically sets all his limbs to thrashing."
In the past twenty years, and dramatically in the past ten, the "can't-do" baby that Spock described has been eclipsed by a "can-do" baby—a baby so attuned and responsive to his environment that, even in the uterus, he is reacting to voices, to light, and, perhaps, to his mother's moods. This "new" baby is activated not only by internal pain and appetite but by language and smiles and particular people. The operative word, in descriptions of this baby, is "competence."
"There's been a whole burst of knowledge about infant competence in the past twenty years," T. Berry Brazelton, a pediatrician, says, "demonstrating how much more the infant was paying attention to auditory; to visual, to tactile stimuli than we ever knew before." Dr. Brazelton is the author of Infants and Mothers and On Becoming a Family, which have replaced Baby and Child Care as the most popular sources of information about babies. He has also spent the close to twenty years developing the Neonatal Behavioral Assessment Scale, a measure of twenty-six behavioral and twenty reflex activities of the newborn, or the "neonate," as pediatricians say. In hospitals around the country, where it is used to assess newborns, the scale is known as "the Brazelton."
I visited Brazelton not long ago in his office at Children's Hospital Medical Center, in Boston, where he is chief of the child development unit. He is a tall, somewhat stooped man, and his half-moon glasses, perched low on his slightly dented nose, make him look professorial but kindly. He speaks with the ease of one who has stated his case many times before—to reporters, TV audiences, and parents. In one hand, he often fingers a small red-flannel bag, with the initials TBB stitched on the side—the talisman of his belief in infant competence. Inside the drawstring bag are the instruments of his science: a red plastic spice box, hinged on one side with a circular bandaid and partially filled with popcorn kernels; a small bell; a flashlight; an orange rubber ball one inch in diameter; a paper clip. He uses these to demonstrate just how competent he believes newborn infants to be.
Brazelton led the way over to Brigham and Women's Hospital and on to the maternity ward, where he asked the nurse at the desk if she could find him a baby. The nurse understood the request—"You want to do the Brazelton, right?"—and went off in the direction of the nursery to look for a subject. A few minutes later, a mother's permission had been granted and Brazelton cheerfully wheeled a small plastic bassinet out of the nursery. The subject, exactly one day old, was a boy named Adam. Brazelton, however, called the baby "she" at first; it was competence, not gender, that preoccupied him. He steered Adam's bassinet into a washroom barely large enough for us, closed the door, and turned out the light. We were together in a womblike twilight.
Adam was sound asleep on his stomach, his head turned to one side, a blue-flannel blanket tightly tucked around him. "It's good that he's sleeping," Brazelton said softly, "because it means we can try out more things." He reached into his red-flannel bag, pulled out the flashlight, and shone the beam onto the baby's blanket, well below his head. Then he directed it slowly upward, past the edge of the blanket and onto Adam's face. The first time, Adam grimaced in his sleep when the beam hit his face. The second time, his face barely twitched. The third time, nothing happened at all.
Brazelton slowly pulled the flannel blanket down to expose the tiny body in diapers and long-sleeved undershirt. Then he rattled the plastic box full of popcorn kernels in Adam's ear. This time, Adam's reaction was more dramatic: at the rude noise so near his ear, his tiny legs drew up in seeming annoyance and his face contorted in the beginning of a cry. Brazelton paused. Then he shook the box again. This time Adam jerked fleetingly. A pause and then a third rattle: Adam slept on, oblivious. Brazelton did a similar test with a paper clip: three times he poked Adam's tiny red foot—each time with a diminished response.
Brazelton was using the flashlight, the rattle, and the paper clip to demonstrate an ability possessed by normal newborns at the moment of birth to screen out intrusions into their peace and quiet. This "shutting-down" mechanism, as Brazelton proceeded to show, is just one of many abilities Adam and other newborns possess.
Lifted out of the bassinet and roused, Adam gazed interestedly into Brazelton's eyes and turned his head to follow them. With Brazelton cheering him on ("You can do it! You can do it!"), he followed the small orange ball in a semicircular arc as well. He was as good at finding sounds as at following with his eyes. When one of us spoke near his ear but out of his line of vision, he turned toward the voice. And his final aural feat was the most remarkable of all. Brazelton had told me about a surefire game he sometimes plays with newborns. If you place a baby within earshot but out of the line of vision of a man and a woman and have them talk simultaneously, the baby invariably turns toward the female voice. (The best guess as to why babies prefer the female voice is that it is more familiar than the male: they have already lived very near it for nine months in utero. In any event, this particular preference is one that, according to Brazelton, is demonstrated even by premature infants, many of whom are incapable of the other responses Adam made.) We tried the test on Adam. Sure enough, when he was held up to our eye level and heard, simultaneously; a female voice on one side and Brazelton's on the other, he turned toward the female.
By this time, our subject was clearly too hungry and restless to continue: he was alternating between fussy crying and sucking on Brazelton's finger. Brazelton wheeled Adam into his mother's room for his lunch. "I'm just sorry we got such a cranky baby," Brazelton remarked as we left the maternity ward. "They can be so much fun." Nevertheless, Adam's brief performance had succeeded in calling into question whole books of prior gospel about neonates. Certainly it gave the lie to Griffith's version of the newborn as vegetable—not conscious of anything in the outside world. And when Adam responded to the female voice rather than the male one, he demonstrated an ability even more surprising: the ability to discriminate. In fact, the discovery of the infant's capacity for choice is transforming the expert view of infancy.
The idea that infants can discriminate was first tested by a psychologist at Western Reserve University, Robert Fantz, more than twenty years ago, in 1958. Fantz, whose work until then had been with baby chimpanzees, asked what would seem to be a simple and obvious question: Do human babies like looking at one thing better than another? Other experimenters, before Fantz, had studied how babies respond to stimuli: light in their eyes, for instance, or a bang in the ear. But until Fantz, no one had suspected that babies could possess, let alone demonstrate, a preference. To answer his question, Fantz placed each of twenty-two infants in a sort of hammock, then slid the hammock into a box he called a "stimulus chamber." In two openings a foot above the infant's head, he placed two "targets"—cardboard squares for the baby to look at. The baby could choose between the two: various pairings of a bull's-eye, a stripe, a checkerboard pattern, and several plain geometric shapes. An experimenter, watching through a peephole in the chamber ceiling, would see the tiny image of the target reflected in the infant's pupils and activate a timer to record the length of each fixation.
It turned out that babies did have clear biases. They consistently gazed longer at a patterned target than at a plain one, and did so at one week as well as at six months. And their preferences changed, even within the first six months of life. During the first two months, infants preferred, by a wide margin, to look at the striped pattern rather than the bull's-eye. After two months, they switched, with similar enthusiasm, to a preference for the bull's-eye over the stripe.
Many variations on Fantz's experiment followed. The more researchers expected from babies, the more they seemed to get. In 1970, Genevieve Carpenter discovered that infants not only prefer certain patterns over others but are capable, at one month, of distinguishing between their mother's face and others. Another experiment has demonstrated that babies express themselves not only with their eyes but also with the rest of their bodies. In the early 1970s, two pediatricians at Boston University, William S. Condon and Louis W Sander, filmed adults talking to eleven newborn babies, then used the elaborate techniques of "kinesics" to find out whether there was any correspondence between an adult's words and a newborn's body movements. By slowing down the film, they were able to show that the babies' bodies were actually moving in synchrony with the words. This experiment was later reproduced in a film, The Amazing Newborn. When the film is slowed down, the undulations of a baby's body, in synchrony with the words "I love you," are unmistakable.
As a result of research in the past decade, timetables for various abilities have been moved way back. Jean Piaget, in his study of cognitive development, placed the ability to imitate facial gestures at about eight to twelve months. But two psychologists at the University of Washington now claim to have discovered, after making faces systematically at eighteen infants, that babies can copy facial expressions at twelve to twenty-one days.
Taken together, all these findings seem to suggest that babies enter the world with certain preferences and inclinations. The notion of the baby as a tabula rasa, in John Locke's phrase, or, as Henry James put it, a "blooming buzzing confusion, a blank slate to be written on by his world," no longer fits.
The implications of these discoveries were particularly intriguing in the psychological realm. Once it was clear that infants give off readable cues, it seemed possible that one could learn, by watching them carefully, something about the great unknown: the nature of infant experience. Furthermore, if the infant is, in fact, so "tuned in" to his environment, then it seemed likely that the way the baby and his family get along during the first two years of life might shape personality in ways that earlier theorists hadn't believed possible.
The theory of infant experience that prevailed in the sixties, when these new discoveries began to be made, was based on Freudian principles. Freud described the first two years of life as an oral phase, dominated by bodily experiences of hunger, nursing, satiation, and elimination. Freud, of course, had almost no experience treating children, so his ideas were based entirely on the memories of adult patients. But later psychoanalysts who did treat children provided a more detailed picture of infancy. Probably the most influential among this group is Margaret Mahler. Mahler has focused, in her work and writing, on how the child achieves (or fails to achieve) separation from his parents and individuation. She maintains, in her book On Human Symbiosis and the Vicissitudes of Individuation, that the early months are spent in a state of "normal symbiosis, in which the infant behaves and functions as though he and his mother were an omnipotent system—a dual unity within one common boundary." It is a state, she maintains, in which the infant is "fused" with the mother, "in which the 'I' is not yet differentiated from the 'not-I', and in which the inside and outside are only gradually coming to be sensed as different." When Spock tells parents that the baby "doesn't know yet that you are a person or that he is a person," he is passing on, in simpler language, the ideas of Margaret Mahler.
But the direct observation of babies, by Fantz and others, seems to suggest a baby who is something of a separate person—possessed of some clear likes and dislikes of his own. And, as a result, observers of normal infants are engaged in a debate with Mahler about the nature of infant experience. In particular, they question Mahler's method of learning about infancy. In large part, her conclusions are retrospective, based on her work with somewhat older children. Furthermore, many of the children she has observed are disturbed, and therefore may not be the best sources of information about normal infancy. "Margaret Mahler," as one infancy researcher put it, "is not a baby-watcher. She's a pathology-watcher."
It was his unhappiness with the retrospective approach to understanding infancy that prompted Daniel Stern, a research psychiatrist at Cornell University Medical Center, in New York City, to become involved in infancy research. "In psychiatry," Stern notes, "one of the things that you have to do all the time, after you write up cases, is to give a psychodynamic formulation—how somebody got to be the way they are. And I always found, and I think most of my colleagues found, that surmising what happened in the earliest years was one of the most painful intellectual exercises, because it was about 90 percent moonshine. You would say 'there was a trauma in the oral period, or in the mother-infant interaction.' You would weave this story. And that didn't seem right. Yet it seemed like such an important part of what everybody assumed was the beginning of things. And I never understood, when we would say, for instance, that the mother was intrusive—or whatever she was—what that would mean to the baby."