The Effects of the Newborn Behavioral Observations (NBO) System on Sensitivity in Mother–Infant Interactions

Abstract

The Newborn Behavioral Observations (NBO) system is a neurobehavioral observation tool designed to sensitize parents to infants' capacities and individuality and to enhance the parent–infant relationship by strengthening parents' confidence and practical skills in caring for their children. The NBO's focus on relationship building is intended for infant mental health professionals who strive for a relational, family-centered model of care versus a pathology-based model. This study assessed the impact of the NBO on the sensitivity of mother–infant interaction in the first 4 months of life. Primiparous mothers and their full-term infants were randomized into experimental and control groups. The intervention group participated in the NBO in the hospital within 2 days of birth and again at home at 1 month postpartum. At 4 months, dyads (n = 35) were videotaped during semistructured play episodes, which were coded to assess parent–child sensitivity in interactions with one another. Intervention infants were 2.8 times more likely to be classified as “cooperative” (sensitive) than control group infants. Intervention mothers were 2.5 times more likely to be classified as sensitive than control mothers. These findings highlight the potential of the NBO to promote positive maternal–infant relations by influencing newborn behavior and suggest that the NBO is an effective, time-limited intervention for strengthening relationships between parents and infants.

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: Results from the Northern Babies Longitudinal Study (NorBaby).

“…The results from the mother-infant relationship domain did not support our hypothesis that the NBO would be associated with higher levels of maternal bonding, re ective functioning and con dence. Thus, our results were not in line with earlier research indicating that the NBO can signi cantly increase maternal engagement (40), con dence (43) and maternal sensitivity (41). However, the present study did not include any observational measures of actual mother-infant interaction, which could possibly have shed additional light on this issue.…”

“…There is a possibility that the high functioning of this sample did not give much room for signi cant enhancement by receiving the NBO, neither on the depressive symptoms/parental stress domain nor on the mother infant relationship domain. Two previous studies of NBO conducted in the US with a more limited sample size have indicated that the intervention may have bene cial effect by reducing the odds of depression in rst-time mothers (42) and increasing sensitivity in mother-infant interactions (41). Contrary to this, our results suggest that the bene ts of the NBO on depressive symptoms, parenting stress and measures related to the mother-infant relationship may be limited within a general population sample with particularly well-functioning participants.…”

“…By increasing parental competence and con dence the intervention may contribute to more sensitive parenting and a positive parent-infant relationship. Previous studies have included rst time mothers of healthy infants in the US (40,41,42) and Norway (qualitative study; 43), as well as mothers in risk of depression (Norwegian feasibility study; 44). The NBO has been delivered between 1 and 3 times in hospital and/or home settings.…”

“…This includes observations of responsivity to visual and auditory stimulation, capacity for habituation or sleep protection, amount of crying and ease of consoling, stress responses, re exes, muscle tone and motor activity. Based on the observations, care giving strategies such as handling, sleep protection, comforting and regulation of social interaction are discussed (41). The NBO takes 15 to 40 minutes to administer and can be used from birth until the infant is three months old.…”

Newborn Behavioral Observation, maternal stress, depressive symptoms and the mother-infant relationship: Results from the Northern Babies Longitudinal Study (NorBaby).

“…This includes observations of responsivity to visual and auditory stimulation, capacity for habituation or sleep protection, amount of crying and ease of consoling, stress responses, reflexes, muscle tone and motor activity. Based on the observations, care giving strategies such as handling, sleep protection, comforting and regulation of social interaction are discussed (41). The NBO takes 15 to 40 minutes to administer and can be used from birth until the infant is three months old.…”