Ep. 1: Week 1 Newborn Baby with Dr. Lisa Durette – Developing Mighty Minds

Episode 1: Developing Mighty Minds’ WEEK 1 BABY interview with child and adolescent psychiatrist, Dr. Lisa Durette, and parents Susan (aka The Tyrant) and Aaron von Frank.

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Watch the video discussion about Week 1 newborn babies:

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Here’s what parents Aaron and Susan von Frank covered during the Week 1 Baby video interview with child and adolescent psychiatrist, Dr. Lisa Durette: 

1. Question: What is going on in your newborn baby’s brain development during Week 1?

Your baby is undergoing rapid brain development. Millions of new neurons (which act like the brain’s electrical wiring) and glial cells (which act like insulation around the wiring) are forming per minute.

During the first two years of life, there’s an overproduction of synapses (connections – the conduit via which brain messages are transmitted) forming; then the connections are pruned if they’re not used. The brain is incredibly moldable and pliable at this point.

Example of synapse pruning: having two languages spoken by parents/primary care givers during the first year, then only one language used later on. The brain would then prune out the synapses that had been used for the lost language.

Synapse development slows slightly around age 2/pre-school. Newborn baby brain size is about 25% the size of an adult brain. By 2 years old, it’s about 75% the size of an adult brain. That’s an amazing growth rate!

Brain growth/development is NOT just about size; human brains are very complex. Human brain development happens via layers and regions in the brain over time as they come online, develop, and interconnect. Right now (newborn), very primitive areas of the brain are the ones undergoing rapid development.

2. Question: For the sake of clarity and establishing definitions, what is the difference between a mind and a brain? What is theory of mind? When does it arrive? How would you know?

A brain is a thing; a physical structure. A mind is an existential construct – the self. The mind is an emergent property of the brain. You can have a brain without a mind, but you can not have a mind without a brain.

Example of these distinctions in action in psychology/psychiatry – “theory of mind.” Theory of mind is recognizing that other people and animals have different emotional and mental states and experiences than you do. That’s a result of one mind recognizing the distinct individual mind of another — and it’s impossible for newborns to have theory of mind because their brains haven’t developed to have that ability yet.

For instance, Lisa’s daughter first showed empathy (an example of theory of mind) at age two when she recognized that their pet cat might be scared by what she was doing, and she tried to comfort the cat accordingly.

This understanding about baby brain development and lack of ability to have theory of mind can be helpful for parents experiencing postpartum/peripartum anxiety, depression, and psychosis, conditions which can affect both fathers and mothers. These conditions are often caused by massive hormonal swings. Symptoms may include:

• the perception that your baby is evil and is out to get you, and
• thoughts of suicide, infanticide, and persistent negative thoughts which lead to parental withdrawal.

It’s important for new parents who are understandably feeling overwhelmed to realize that your baby is not out to get you! A baby doesn’t have the capacity to understand that they may be causing you pain or making you tired (they can’t connect causes and effects yet or understand that you’re having a different emotional experience than they are).

What should you do if you’re experiencing postpartum depression? Think of it as no different than a physical injury – get help! Don’t be ashamed. Contact your pediatrician, call 911, or call your local mental health agency. Don’t assume it’s going to go away on its own or ignore it. 

Postpartum depression does NOT mean you’re a bad parent or bad person. It does require help and treatment, both for your sake and your baby’s sake (your baby needs primary attachment, physical touch, etc).

3.A. Question: How does your Week 1 baby see the world right now, both visually and otherwise? What general capacities do their brains have at this stage in development?

Newborns have terrible eyesight. They see in black and white, not color vision, until ~4 months old. They may only have 20/600 vision. Newborns are also unable to focus their eyes on objects beyond 1 foot in front of their face.

Repeatedly hearing your voice, feeling your touch, and smelling you are very important in helping them establish who their primary caregivers are.

3B. How can you test your newborn baby’s reflexes and what do those reflexes tell you about their brains?

Newborn reflexes are different than adult reflexes. You can test your newborn’s reflexes at home! (See below.)

These differences are due to how their brains are currently developed — only the more primitive brain regions are functioning in newborns. Their higher level brain regions are not connected yet.

A few examples of newborn reflex tests you can do at home:

1. The “Babinski reflex” – Rub your fingernail along the bottom of your baby’s foot. Their toes should splay up and out. (An adult’s toes will scrunch down under the same reflex test.)
2. The “Moro reflex” – A sudden move (such as dipping really quickly while holding your baby) or a loud noise (hand clap) causes the baby to startle and throw out their arms and legs, then pull them towards their body.
3. Rooting – Stroke their cheek or side of mouth. The baby should turns towards the source, open mouth, and suck (aka rooting).

Newborn reflexes change over to more adult-like reflexes after about 3 months (there’s a lot of variability). New parents: don’t be too nervous or concerned if your newborn’s startle reflexes aren’t robust or exactly like other babies! If your newborn has no startle reflexes, ask your pediatrician to conduct an evaluation.

4. Question: As new parents, what stage- and developmentally-appropriate actions should you take starting in Week 1 to help your baby develop their Mighty Mind? Diet? Physical touch? Other things?

The biggest thing you can do to develop your newborn baby’s brain/mind: provide baby with consistent love and nurturing to promote attachment. Also:

• skin-to-skin touch and feeding,
• snuggling and cuddling,
• responding to their needs and cries.

It’s also VERY important for primary attachment figure(s)/parent(s) to talk to their baby. The more language that babies hear from their parents, the better.

Primary attachment figure (the individual or individuals who provide the most caregiving to your baby) voices are the ones that cause the most impact — not television or radio or other people’s voices. Primary attachment figures are the people who are consistently there raising the baby, which may or may not be their biological parents.

Overstimulating objects, toys, noises, etc are NOT effective in developing a newborn’s brain at this stage of development.

5. Should you read to a newborn baby?

Talking to a newborn baby is what matters if you’re a primary caregiver. Reading a book allows the baby to hear your voice, but they can’t see the book or focus on it visually, so new parents don’t need to read to their newborns so long as they’re constantly talking to them and providing them with consistent love and nurturing.

6. Question: What is the most important mental health advice that new parents should keep in mind for themselves during the first weeks postpartum? After all, they’re going to be transitioning into the extraordinary challenge of parenthood while being totally exhausted by lack of sleep, recovering from the physical strains of childbirth, and possibly even experiencing postpartum anxiety, psychosis, and depression.

The first few weeks/months postpartum are often the most psychologically challenging for parents.
Measures to take to keep yourself (as a parent of primary care giver) mentally healthy:

• sleep when your baby is napping to try to stay as well-rested as possible;
• maintain good nutrition and hydration (healthy foods and lots of water);
• lean on your partner and/or support network to help with cleaning, meals, and other needs.

It’s not abnormal to have “baby blues” in the weeks after birth due to massive hormonal changes and sleep deprivation. What’s abnormal or concerning? What are possible symptoms of postpartum depression or psychosis?

Symptoms may include:

• Perception that your baby is evil or trying to harm you.
• The desire to withdraw or not interact with your baby.
• Starting to think that the world would be ok without you (suicidal ideations).
• Thoughts about killing your spouse or baby.

Don’t ignore these symptoms! Contact your pediatrician or local mental health experts. Or if it’s an emergency, call 911. Remember not to feel shame or that you’re a bad person if you’re experiencing postpartum depression, just as you shouldn’t feel shame if you have a broken arm. Both medical conditions are treatable, so get help.

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More in Developing Mighty Minds:

• Introduction to Developing Mighty Minds 
• Week 2 Baby (coming soon!) 

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