To Your Health

by Positive Parenting

By Paulette Avery, R.N., M.S.N.

A few months ago I was privileged to attend a luncheon where Dr. T. Berry Brazelton was the featured speaker. Dr. Brazelton is a well-known pediatrician recognized worldwide for his contributions, particularly in the area of the parent-newborn relationship. Though past his 80th birthday, he continues to speak, write books and newspaper columns, and appear on TV.

What came across to me most clearly about Dr. Brazelton is that he truly loves babies and their parents and wants to do all he can to help families be the best they can be. I can only imagine how wonderful it must have been for the families who had Dr. Brazelton as their pediatrician. One of his major contributions is the Newborn Behavioral Assessment Scale, a tool used to determine a newborn s capabilities by measuring their response to stimuli and by eliciting a series of reflexes. Results of the assessment can be used to help parents become acquainted with their newborn s unique abilities and responses, and to teach them how best to interact with their child to enhance their developing relationship.

Known as "the Brazelton" and first published in 1973, the tool was revised in 1984 and 1996. Originally, Dr. Brazelton recommended assessing the baby on the third day after birth, allowing the infant some time to adjust to the world. But with current hospital discharge most commonly occurring 24 to 48 hours after birth, research is now underway to see how the tool can be used to enhance these early discharges.

The goal of the luncheon I attended was to begin discussion among healthcare and political leaders about how best to incorporate support for early childhood development into the managed healthcare system. As an example, Dr. Brazelton addressed the issue that new parents receiving care through an HMO may not have the benefit of seeing the same provider at each visit. So to enhance continuity and encourage parents to seek regular health checks for their child, his suggestion was this: At each visit, the healthcare provider would note in the chart not only how the baby was doing physically and developmentally, but would also make notes about the parent. For instance, "Mrs. M. was wearing a pretty red dress and expressed concern about lack of sleep." At the next visit, the provider seeing the family could use these notes and greet the new mother with, "Mrs. M., Dr. Smith thought it was wonderful that you wore your lovely red dress to the first visit. How are you doing now with getting enough sleep?" Personally, I would be thrilled with any doctor who showed that kind of caring.

San Mateo County has incorporated much of Dr. Brazelton s work into their Prenatal to Three Initiative, a program for MediCal-eligible families. The program provides help to families through frequent home visits, support groups for parents, incentives to encourage early literacy, and help with the coordination of health care. All staff members in the program have received training in Dr. Brazelton s "Touchpoints" approach to childhood development.

All of us can contribute to Dr. Brazelton s goal of helping parents do their best at the hardest job in the world. Give encouragement to the parents you know. Even if you don t agree with their overall parenting style, you can find something positive to say. Offer advice only when it is requested, and avoid criticism. We can all do our part to make our country one that does better to support parents and children.

Paulette Avery is a registered nurse and a freelance writer specializing in health issues.