By Dr. Colin Michie
Dr. Colin Michie has worked as a paediatrician in the United Kingdom, Africa, the Caribbean and the Middle East. He is specialised in nutrition, haematology and infectious diseases. Now the Associate Academic Dean for the American University of the Caribbean Medical School in St. Maarten, his enthusiasm is training medical students and healthcare teams to ensure they deliver better value health care.
The wonder of infants is just that – amazing; life-changing. They keep us entranced. One of the reasons we are attracted to them is that we enjoy trying to figure out what they enjoy. For a few weeks after birth, they spend long times sleeping and feeding; comforting them fills the days and nights. Once that magical smile arrives, we become tempted and driven to communicate with them even more enthusiastically. New techniques such as measures of blood flow on brain imaging, or sophisticated measures of brain electricity have helped describe more clearly how infants develop after birth.
The infant brain weighs about 350 grams; by 10 years of age, it has almost reached an adult weight around 1300 grams. Most of this growth in weight and volume happens in the first two years. If you count the connections between nerve cells, the synapses, these increase really rapidly, they bloom in this time. This is the fastest period of brain growth in our lives. By two or three years, the number of synapses is about twice as many as in adults. This allows the brain to take on, or capture, experiences or inputs.
These early years are an incredibly valuable window during which a small child can learn a great deal. They lay down the foundations for future skills and abilities to cope with life. This makes the first 1,000 days of our lives our most exciting, but also our most vulnerable. After three years, some of these synapses are pruned or removed: our brains are designed to forget as they become more efficient.
A foetus can hear you!
Do not be deceived, an infant has many sophisticated perceptions. Their responses to sound are impressive. During pregnancy, a foetus will usually respond to loud noises by moving. Rhythms and music can influence foetal movements too. Hearing is fully developed at birth, so new-borns startle in response to loud sounds.
New-borns should have their hearing checked in the week after birth, perhaps while still in the hospital, because problems with hearing need early management. Babies play close attention to a carer’s voice. They can discriminate between languages so from birth, they appreciate a lullaby in any language. Cradle-songs, music, rhythms, reading to your baby are part of our cultures wherever you are born.
By the age of four-five months, infants prefer to listen to their own names when compared with others: Isn’t that impressive?! Between seven and 10 months, they will recognise some words and comprehend others. Language circuits in the brain are consolidated in the first year, influenced strongly by the music and language or languages the infant hears. Being brought up in St. Martin and being exposed to several languages with their wide vocabulary has some great advantages!
Vision develops steadily
A foetus can distinguish between light and dark while in the womb – an ability that allows them to distinguish shapes and black and white stripes as new-borns. At one to two months, an infant can tell apart some shades of grey; the first colour they perceive well is red. So a red mobile will work earlier! Greens, blues and all the other colours can be perceived after three months as the infant’s retina matures. This maturation is important for focusing and tracking moving objects. In the first weeks, babies cannot focus well and may become cross-eyed.
Within days after birth, infants prefer their mother’s face to those of others. They distinguish between family members and there is no doubt that they prefer their mother’s face to all others. What is even more important is that they distinguish between expressions. Human faces have at least 40 muscles that deliver many thousands of expressions – unlike that rather limited tribe of emojis on your phone. Faces and facial expressions have power; infants pick up on this really rapidly!
An infant’s systems for recognition improve dramatically by three months; this coincides with improved vision, improved neck strength and significant growth in the hippocampus, a brain structure related to memory. Watching faces is something infants do a great deal. Later, when learning to crawl or walk on a possibly dangerous slope, an infant will look to the mother’s facial expressions to check that this move is okay. A toddler will avoid new objects if the mother shows fear, but will happily approach these if the mother is smiling. The expressions you use in front of your infant are important!
At birth, it is important to put baby onto the mother’s chest. Contact with her skin is valuable as it calms both mother and baby, improves recovery from the birth, and helps establish breast-feeding. Babies are comforted by this touch. Placing a hand on your baby's belly or cuddling close can help your baby feel more secure.
International agencies promote “skin to skin” as a central element of infant care. This is an important early element in the global Baby Friendly Initiative. Babies are comforted when worn in a sling or carrier. Where I was brought up in Africa, we were carried on our mother’s back; other cultures prefer the kangaroo arrangement with the infant in front.
New-borns have a strong sense of smell and prefer the smell of their own mothers, in particular her breastmilk. As human milk is relatively sweet, babies prefer sweet tastes over sour or bitter ones. These perceptions all support feeding and bonding, activity and sleep patterns in your infant.
Stimulation to enhance development
Life with a newborn will be positive, but daunting. An infant is being brought into a world that is so very different to yours when you were young, or that of most of the family. The time of introduction, the first weeks, the Omugwo is important. Our digital environments are ever wider and richer in sounds and images, language and colour. For infants, everything is new.
People are the most important source of stimulation for infants – no one has built a nanny robot that is effective! And, mothers, look after yourselves too – not only physically, but also mentally and emotionally. You may find getting together with other mums with new babies particularly useful.
Right from the get-go, a baby is ready to learn about the world outside. Mothers are associated with a voice, face and contact with food and comfort. So it is important to the baby for mothers to stimulate the baby’s senses by smiling, making soothing sounds, hugging and caressing or massaging. Make eye contact, talk and sing to your baby. This will give your baby’s brain crucial strong foundations for continued growth and learning.
If a baby experiences emotional or physical stresses, the brain signals the adrenal glands to release cortisol, a stress hormone. High cortisol levels cut back on the synapses, those blossoming connections between brain cells. This slows the development of important brain circuits. Babies with strong emotional attachments to their caregivers have lower cortisol levels. To develop a strong attachment, respond to your baby whether happy or crying in the middle of the night! Hold, touch and play!
You may wish to check your child’s development. The ages at which your infant smiles, rolls over, points or reaches or picks up a toy can all be compared with charts to estimate progress. Baby carers often need lots of advice – do not be afraid to ask! There are many good online resources to look at (see below), but beware, the advertising industry is powerful. And, crucially, the human race seems to have coped fairly well without the internet and baby shops for many generations, over thousands of years.