What Newborns Need for a Healthy Psychological Start

When I was a new mom, there were plenty of books about how to physically care for a newborn: how to swaddle, how to change a diaper, and how to treat skin conditions.  But there was next to nothing on how to care for a newborn’s psychological well-being. What’s important for infant mental health? Erik Erikson, the famed psychoanalyst of the sixties, recommended eye contact for the foundation of newborn trust—so I spent a lot of time looking at my newborn baby girl.

1. Deep sleep: The baby sleeps quietly without moving, and breathing is regular

2. Light sleep: The baby might move, may have irregular breathing and even startle at noises, or may experience eye movements in the dreamy sleep of REM sleep (rapid eye movement). Babies can cycle between deep and light sleep, even within an hour. Sometimes, in the first few months of life, babies wake between the deep and light sleep cycles and have difficulty returning to sleep. (Newborns sleep about 16 hours a day, and about half of that is in REM sleep.

3. Drowsiness: In the transition between waking and sleeping (e.g., waking up, or conversely, going to sleep), the baby’s eyes may open and close, or even roll back. The baby might stretch, yawn, or doze.

4. Quiet alert: The baby’s face is bright, eyes are open wide, and the body remains quiet. This is time when the baby takes in her environment on her own terms. She might be looking, or staring, or simply quietly focusing on what she sees, hears, or senses. This is a good time to give babies their space, to let them get used to feeling comfortable settling alone.

5. Active alert: The eyes are open and scanning and alert, and both the facial expressions and body are medium-active. Babies are especially open to social interaction in this state, so this is a good time to gently engage with the baby, talking quietly, singing, touching.

6. Crying/fussy: A baby cries, screams perhaps, and the whole body and soul can become quite stressed and disorganized. Babies are born nearly helpless, so crying is the best signaling system to recruit outside help to regulate a need. With experience, parents soon anticipate the various needs—to eat, to be comforted, to be changed, to warm up or cool down, for more or less stimulation, to be eased into sleep.