Sleep wake states:

  • Synchronization of cyclic motor activity with HR and REM occurs by 28 weeks gestation.
  • Distinct active sleep (AS) & quiet sleep (QS) states present by 27-30 weeks gestation.
  • More AS earlier in development.
  • Less QS earlier in development.
  • Patterns of AS – QS brain activity change in utero and postnatally.

Sleep wake regulation:

  • Circadian pacemaker located in anterior hypothalamus, very sensitive to light.
  • Not present as newborn; emerges at 5-6 weeks after birth.
  • Diurnal sleep first seen at 12 weeks.
  • Circadian rhythm well developed by 4-13 months.

Sleep wake effect on brain maturation:

  • AS favors maturation of brain, induces CNS development in fetus and newborn.
  • AS = intense, endogenous generalized neuronal firing, retinas, and visual system.
  • QS stimulates synaptogenesis.
  • Information acquired during wakefulness is processed during QS.
  • QS enables cortical plasticity.

Tactile sensory responses:

  • Fetal tactile response by 2-4 months gestation.
  • Cutaneous sensitivity to touch developed by 28 weeks, increases greatly first 5 days after birth.
  • Tactile stimulation is generally pleasurable –cuddling, rocking, stroking, massage.
  • Sensitive tactile areas – mouth, lips, fingers, hands, toes, feet.
  • Sucking = pleasurable tactile, stimulation of mouth and lips…
  • major method of calming and soothing.
  • Newborn’s taste is keener than adults.
  • Laryngeal taste receptors can distinguish autologous from heterologous milk.
  • Taste preferences:
    • Sweeter breast milk produces greater suck and milk consumption.
    • Bitter or salty taste decreases sucking.
  • Newborns smell and recognize mother by 6 days age.

Vestibular sensitivity present at birth:

  • Rotation and acceleration produce nystagmus.
  • Newborns are soothed by carrying rocking, jiggling.
  • Upright posture (being picked up to shoulder) is more soothing than contact per se.
  • Briefly soothes hungry infant and arouses sleepy infant.
  • Increase visual attention in alert infant.

Carrying of baby provides to infant:

  • Postural change, repetitiveness, constancy.
  • Rhythmicity, proximity to mother, increases sensory stimulation.
  • Increases maternal responsiveness.
  • Decreases maternal response time.
  • Anticipates infant behavioral deterioration.

Good maternal care =

  • Positive sensory experience with vestibular stimulation.
  • Picking-up and holding.
  • Rocking.
  • Moving or carrying.
  • Soothing promotes visual alerting and visual exploration.
  • Nursing and feeding promotes a calm, awake-alert state afterwards.

Newborn Visual preferences:

  • Light – dark contrast, patterns
  • Black and white
  • Human face (mother’s own)
  • Cool colors – blue, green, purple
  • Picture or drawing of face
  • Warm colors – red, yellow, orange
  • Bull’s eye
  • Checkerboard
  • Variety of shapes, orientations, and colors

Newborn vision:

  • Myopic initially with visual acuity 7-12 inches
  • Organized visual perception present at birth, unlearned, innate.
  • Infant distressed by altered or scrambled maternal face (mask, glasses).
  • Newborn predisposition of response to faces.
  • Adaptive in giving social orientation to others.
  • Mutual visual regard = critical in maternal infant attachment.
  • Mother aligns herself en-face with infant.
  • Eye contact = love.
  • No eye contract = rejection.
  • Mother’s nodding, smiling face elicits social smile.

Visual perception:

  • Eye contact, fixing and following (tracking) present at birth.
  • Well developed at 1-2 months.
  • Recognizes parents at 2-3 months.
  • Visual imitative behavior = sticks out tongue, opens mouth, protrudes lips.
  • Expresses visual interest as baby becomes quiet and still, face brightens and eyes glisten, pupils dilate and HR decelerates.

Newborn Sound preferences:

  • Mother’s own voice.
  • Newborns can discriminate their mother’s voice & will work to produce it by sucking on nipple.
  • Female voice (higher pitch than male).
  • Voice inflections (over monotone).
  • Exaggerated variations and articulations in sentences and speech (“baby talk”).
  • Variety of sounds.
  • Music.

Newborn auditory competency:

  • Hearing fosters language acquisition.
  • Newborns must hear voices and speech (rhythm and style) in order to develop language.
  • Voices & speech convey security to newborn.
  • Newborns must hear themselves make sounds.
  • Variable infant sounds
  • Cooing, babbling, gurgling, slurping by 2 months.
  • Giggling, squealing, laughing by 4 months.
  • Cry is the primary modality of signaling.
  • Hunger, pain, discomfort, fatigue, loneliness.

Newborn cry:

Newborns have four audibly different and spectrographically different cries

  1. Hunger
  2. Anger
  3. Frustration
  4. Pain
  • Newborn cry engenders discomfort in mother and urge to “do something”.
  • Maternal response to cry is differential and selective.
  • Contingent behavior = mother rewarded by her success in diminishing crying.
  • Newborn cry = 100 dB intensity level, quite noxious to adults.

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