Warm, responsive mothering was assumed vital for infant health.
The What Happened To Mothering? Series
- Part 1: Mother Love Used to Matter
- Part 2: What Is “Good Enough Mothering” of a Baby?
- Part 3: Why Provide Empathic Care for Infants?
- Part 4: Disbelieving the Importance of Mothering
In the 20th century, after the fad of focusing only on the physical needs of infants and the rash of infant deaths as a result, doctors and therapists concluded that impersonal nursing care was to blame. Mother love was key to keeping infants alive and growing well. Here is a description about what that looks like from a physician who did studies with hundreds of infants and mothers.
Dr. Margaret Ribble, M.D., summarized her findings in her book, The Rights of Infants. She discussed how modern medicine had focused on baby nutrition and hygiene even to the extent of assuming a nurse could replace a mother’s care. Institution after institution had provided nurse-type care to infants (patients or orphans) and a wave of marasmus (wasting away) took the health and even lives of many.
Medical and social agencies found that to develop a “bouncing baby” the best (impersonal) care in institutions was no match for a poor family with a loving mother. So hospital and related authorities started to involve “Pharaoh’s daughters” (women who would nurture babies who were not their own, as happened with the Biblical Moses) in infant care.
“The infant who is treated impersonally, however well nourished and clean he may be, is actually thwarted in his mental development and may suffer more cruelly than an adult locked up in solitary confinement. The experiences of infancy determine in no small way the evolution of individual personality.” (Ribble, 1943, p. 3)
The “hunger for mothering experiences” affects infant physical as well as mental health (ibid, p. 4). As Bowlby (1982) also documented after Ribble’s publication, young children who experience a prolonged absence of their primary caregiver enter a state similar to depression.
What does “mother love” look like?
“It is really a continuance of the closeness of the prenatal state, and the more clearly it imitates certain of the conditions before birth the more successful it is in the first weeks. The newborn baby still needs to be carried about at regular intervals until he can move and coordinate his own body. This helps to strengthen his sense of equilibrium and to give him a feeling of security. Also he must have frequent periods of actual contact with the mother because the warmth and the holding give him reassurance … we mean all of the small evidences of tender feeling—fondling, caressing, rocking, and singing or speaking to the baby. These activities have deep significance.” (Ribble, 1943, p. 9)
Ribble writes that infants have three biological needs or hungers that mothers (or primary caregivers) help organize: for oxygen, to eat, and to feel. The infant needs assistance in using and strengthening the organs and muscles that meet these needs by their frequent use.
Breathing.
Babies need help learning to breathe. After nine months or so in the womb, receiving oxygen through the placenta, baby has to learn to breathe with his own immature lungs.
“They breathe quite insecurely, and even after respiration has been well started it continues to be rapid, shallow, and often irregular during the first weeks of life and is easily disturbed by any adjustment the child has to make.” (Ribble, 1943, p. 11)
Crying in the first weeks is often “emergency crying” to assuage oxygen hunger when that need is not being assuaged through other means.
“After birth the muscle of the diaphragm is learning to reverse itself, to suck downward and draw in air, after months of upward suction [of getting oxygen from the liver which received it from the placenta in fetal life].”
This takes practice and requires the caregiver’s touch as well. Touch increases the baby’s respiration.
“From being held, fondled, allowed to suck freely and frequently, the child receives reflex stimulation which primes his breathing mechanisms into action and which finally enables the whole respiratory process to become organized under the control of his own nervous system.” (Ribble, 1943, p. 18)
At nighttime, the baby needs to be near the mother so she can touch him in case he stops breathing. See also more recent research.
Although at first the baby can still access the oxygen stored in the liver during gestation, this source becomes depleted and the infant must learn to breathe in the air. The brain needs lots of oxygen to grow well, as it affects the quality of blood vessels and brain metabolism as well as myelin sheaths (which cover neurons—brain nerves—for protection and communication).
Babbling (and smiling) is a sign that breathing capacities have developed and stabilized. In well-nurtured babies, babbling shows up at two months. Babies who have been left too much alone may be delayed in this capacity until five months or later, affecting the onset of talking. Ribble notes a close relationship between breathing, sucking, and speech.
Sucking.
“More than 5 percent of newborn babies cannot suck vigorously enough to get their own nourishment until they have been repeatedly prompted and assisted.” (Ribble, 1943, p. 11)
Sucking is highly gratifying for a child in the first months, providing access to nutrition, but also a first grasp on the world and a sense of how secure the world is. Making sucking or suckling easy and pleasurable helps ensure a good start to relationships, speech and mental health. Understanding that sucking is an emotional experience for babies may make parents more generous in providing the experience (e.g., providing the breast whenever the need to suckle arises).
Winnicott (1987) pointed out the “tremendous richness” of the feeding experience for the baby in relation to the caregiver, whether or not it is through breastfeeding: “the baby is awake and alive and the whole of the emerging personality is engaged. A great deal of the baby’s waking life at first has to do with feeding.” (p. 29)
Once the baby is able to vocalize, bite and grasp, sucking diminishes, showing a relationship among such capacities.
The mouth is an organ of the skin with a nerve supply from five different cranial nerves. The tongue muscle, critical for suckling and later speaking, is first close to the heart muscle in the womb. Normally developing babies should suck at least two hours a day, according to Ribble, because it satisfies a ‘stimulus hunger.’ Children who thumb suck are showing either early suckling frustration or lack of stimulation to relieve bodily tension.
Thus, suckling in infancy is not always related to nourishment but relieves tension, brings blood flow to the face and head and shapes the face muscles (jaw and palate). Social and emotional feelings are connected to the pleasure and ease of suckling. Babies who have trouble establishing suckling usually show a disorganization in breathing, circulation and muscle tone. In contrast, breastfed babies often show more trust in their mothers and more cooperativeness.
Feeling.
Ribble notes that infant psychological needs are to feel secure, feel pleasure in bodily functions (e.g., suckling), and feel that one is of interest to the community.
“The infant is peculiarly helpless, and it is not until after the faculties of speech and locomotion have developed that he can cope with any separation from the mother without danger. Mother and child after birth are psychologically still a unity, and close relationship is as important for early mental development as was the more primitive connection with the foetus for physiological development … The infant appears, then, to have at birth a peculiarly human faculty for registering and associating sensory impressions from personal contact with the mother.” (Ribble, 1943, p. 12)
“Social impulses are part of our primary equipment; emotional hunger is an urge as definite and compelling as the need for food. When we deny an infant fulfillment of these needs, we stifle his emotional and social life.” (Ribble, 1943, p. 13)
What are the outcomes of mother love?
“The art as well as the science of mothering is to initiate and give momentum to the first functions of the child as they develop in sequence … Fundamental right adjustment is reflected in the feeling of security, which leads the infant onward to a glowing self-reliance.” (Ribble, 1943, p. 104)
At the conclusion of National Breastfeeding Month (August), we can point out that the three hungers Ribble says a baby has are met by breastfeeding or suckling on request. But non-breastfeeding mothers can still provide the stimulation and support needed with skin-to-skin and other forms of regular holding, responsive, emotionally present care. As Winnicott (1987) noted, “Holding and handling are more vitally important as indications of management than is the actual fact of a breast-feeding experience” (p. 25). The key is to meet the infant’s needs to exercise their mouth and lungs and feel seen and loved through physical affectionate care.
The What Happened To Mothering? Series
- Part 1: Mother Love Used to Matter
- Part 2: What Is “Good Enough Mothering” of a Baby?
- Part 3: Why Provide Empathic Care for Infants?
- Part 4: Disbelieving the Importance of Mothering
References
Bowlby, J. (1982). Attachment and loss: Vol. 1. Attachment (2nd ed.). New York: Basic Books.
Ribble, Margaret (1943). The rights of infants. NY: Columbia University Press.
Winnicott, D.W. (1987). Babies and their mothers. Reading, MA: Addison-Wesley.