How Your Newborn Baby Communicates with You

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Connecting with your baby before and after birth can set the stage for your relationship with your child over the entire course of your lives together. But how much can a parent connect with a newborn, who seems to have almost no ability to communicate aside from crying? Lots, says UH Rainbow pediatrician Ganga Srinivas, MD. Babies often are trying to tell you something, whether turning their face away from you when overstimulated, gazing in the direction of your voice or smacking their lips when hungry. Dr. Srinivas describes the many subtle ways in which your newborn is constantly communicating with you – and how you can communicate back.

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Transcript

Pete Kenworthy
My oldest child is 19, but I still remember that first moment of her life. You know, the day we brought her home and all the fear that came along with both those things, her being born, and then going home with her. Seriously, what are we supposed to do with a baby? You know, we never had one before and now here’s this living person. Does she know who we are? Does she love us like we love her? So many questions in those first few days.

Macie Jepson
And that drive home, Pete, from the hospital, it was scary, wasn’t it? You know, the world suddenly seemed bigger, and our world, which was just my husband, our newborn daughter and me seemed very small and vulnerable. She was oblivious, of course, but in those first few days at home, the facial expressions were really endless. What did they mean? The grimace when she looks at us. What does she think? And that smile? Is it love? Or is it gas? Hi, everybody. I’m Macie Jepson…

Pete Kenworthy
…and I’m Pete Kenworthy and this is Healthy@UH. And today we’re going help you overcome some of those fears about having a newborn and hopefully teach you some things about connecting with and understanding your new baby.

Macie Jepson
Now, if you’re a new parent, listen up; this conversation will surely be helpful. Dr. Ganga Srinivas, UH Rainbow pediatrician, joins us now for tips and some things we wish we had known. Dr. Srinivas, thank you for joining us today.

Dr. Ganga Srinivas
Thank you so much for having me. I’m really happy to be here.

Macie Jepson
Absolutely. Now, first up, we’ve all heard about Baby Bach and reading to our babies in utero. Is there anything that we should do before our baby is born to better connect with them after they’re born, like ways to prepare?

Dr. Ganga Srinivas
There’s a lot of things that you can do to help yourself connect with the baby before baby is born. Just the talking that we normally do is something that babies are hearing in the womb. They can hear Mom’s voice really clearly because it’s right up above them. But they can also hear Dad. They can hear any siblings that are around, the family pet. So, they are hearing all of these things. They’re also tasting what Mom eats. So, if you are eating a nice well-balanced diet with good fruits and vegetables, those flavors are getting into the amniotic fluid and baby’s tasting those. And there’s a little bit of research that shows that babies that are exposed to that wide variety of healthy foods actually do better when they’re introduced to fruits and vegetables later on in life. So, they are getting acculturated to what the family normally eats. And that, you know, going back to the sound piece of things, they’re also hearing what you’re hearing.

You mentioned Baby Bach. It doesn’t have to be that specific. It can be any nice music that you enjoy. Now, hard rock, I don’t know. But if you’re talking other forms of classical music, lullabies, things that you enjoy are things that the baby’s going to be hearing, and another small study showed that babies that are hearing nursery rhymes or stories that Mom reads when they’re in the womb, they tune to that a little bit better once they’re born. And this was done within the first three months of life. So, they’re listening to all this stuff. They’re learning language. They’re learning food. They’re learning the entire family before.

The other thing that they’re learning before they’re born is touch. So, when that little baby starts kicking, a response from the parent where they touch the foot, touch the baby, massage, earns more activity from the baby. So, there’s some give and take going on even before the baby’s born. And so these are really cool ways that you can develop that bond and sense for yourself along with helping your baby recognize you and recognize the family.

Pete Kenworthy
The devil’s advocate in me wants to ask you about how do we know that, right? How do we know that the baby does well? Is this is this through studies that have been on people who do and people who don’t?

Dr. Ganga Srinivas
Some of these are very small studies. And yes, these have some controls, meaning, especially the one about foods and the one that I mentioned that looked at babies recognizing stories that the mother read to them. There are ways of looking for attention that the baby’s paying to what’s going on as well as heart rate and respiratory rate that tells the researcher what state of wakefulness and attention that baby’s in. And so, infants that heard the story oriented to that story much more than they did to random stories. And so, yes, it was very cool.

Pete Kenworthy
Yeah. It’s very fascinating. And based on science and research. Really cool. Okay. So, the baby’s home now, right? Now we have this tiny little human, right? That mostly wants to sleep, but also gets hungry. He goes to the bathroom, of course. Now, we connect with our eyes, but are we really connecting with this three day old baby? Right? So, let’s start around that 50,000 foot level. What do we really need to know in those first days after bringing our baby home?

Dr. Ganga Srinivas
So, the first thing is to remember that your baby’s a person. They’re not inert. As we just talked about, they’re responding when they’re in the womb. A lot of it is instinctive, but they are programmed to respond to their parent, and they are developing methods of responding to you and developing their emotions, developing communication skills. Because their brains are still developing in many, many different ways, their responses are much further behind than their ability to take in sensory input. So, while it may look like a blank stare, that infant is learning your face. That infant is hearing your voice and connecting it to what they’ve heard before. That infant is honing in on the language that you use, learning to calm themselves from you being calm and loving. So, there’s a lot of sensory input that’s going on that’s helping your baby integrate into the family. Their responses, though, lag far behind. And that goes on for several weeks to months. I mean, it’s a long time before a newborn gets to the point of coordination that you expect of even an adolescent.

Macie Jepson
So, they’re taking a lot in, in utero. They recognize our voices, you’ve said. They recognize even the stories that we read to them. But how soon do they actually recognize us?

Dr. Ganga Srinivas
Fairly quickly. I’ve not been able to locate that video, but there is a video on the internet somewhere that shows…T. Berry Brazelton is a very famous child and newborn behavioral physician…and there’s a video of him holding a baby that’s under a day old. He’s got the baby facing him, and he’s talking to the baby. And then he has the father speak from the side. And in slow motion, you can see the baby gently turn and then fix on the father’s face because that’s the familiar voice. So yes, they are recognizing you. And the reason we don’t realize that they are recognizing and responding is because their responses are in slow motion. Their nervous system is not yet myelinated. That’s a way for the nerves to function rapidly so that when someone throws a ball, you’re able to catch it even if they threw it with just a second to spare. Whereas you throw a ball at a baby, it’s just going to bump the baby because they don’t have that speed of response. So, they’re still waiting for myelination to happen. Their response may have a 2, 3, 4 second time lag, by which time the adult has moved onto something else, thinking that the baby’s not responding. So, they are responding. It’s just subtle. And you need to give them a chance to show you what they can do.

Macie Jepson
But let’s get a little more specific about our voice, our faces, a sense of smell. What do we know about that?

Dr. Ganga Srinivas
What we know is that within two to three days, babies will preferentially look for Mom’s face. Babies already are born knowing Mom’s voice and Dad’s voice. And as I just mentioned, they will preferentially look for Dad or Mom over a stranger. They will have a different cry in response to a stranger within three to four days. And they are born smelling pheromone-like substances and amniotic fluid that is also produced by Mom’s axilla and the area around her breast. And they are born knowing those smells. So, when a baby goes skin to skin, they are smelling Mother, learning again that smell and honing towards feeding at the breast. And both from the point of view of a baby’s skin sensitivity and from this natural honing in towards the mother’s smell, it’s important for parents to not use fragrances and, you know, heavy fragrances and perfumes and so forth in the first few days of life, because babies actually have very sensitive sense of smell and very acute hearing. They just can’t see very far.

So, in terms of recognizing a parent’s face, the best distance for them is when they’re held at about that 8 to 10 inches, which is what happens when you hold a baby in your arms. So, at that distance, your face is clear. Beyond that, things get start getting blurry. And that’s true for, you know, TVs and stuff. They will focus on something that’s far away and bright and shiny, but they’re not actually seeing very much. But that 8 to 10 inch distance, when you hold a baby in your arms, they know, they can see you and very quickly begin to recognize you.

Macie Jepson
Before we move on, there are certainly circumstances where babies aren’t able to be with their parents immediately, maybe NICU, maybe adoptive parents coming into the situation. I wouldn’t want them to be discouraged.

Dr. Ganga Srinivas
They should not be discouraged. Babies connect with people, and the more they are with the person, the more connection happens. And while being separated from your newborn because the baby’s sick and they have to go to the NICU or the birth parent is sick and is not able to be with the baby. Or as you said, in a situation of adoption, holding that infant, being with them, going skin to skin, talking, singing, cuddling, all of those are important. And as you do those actions, and we’ll talk a little bit more about ways to connect with your baby in a minute. But as you do those things, you’ll also start seeing a response from your baby. As I mentioned earlier, they’re not inert. They’re just subtle. And so the more you hold and slow yourself down to watch for what they do, you are going to see that they alert to your face when you use a particular tone. Or they calm down when you use that little singsong baby voice that we all instinctively use when we are talking to a baby. And they then will give if you feedback that things are going right, or they don’t like something that you’re doing.

You’re also going to start recognizing that they have personalities. They are all not the same. And like I mentioned earlier, they’re little people. They are different in that they are still developing and developing very rapidly, but they have a lot of capabilities at the moment that they’re born. And this goes for the very pre-term infant as well, like the 24-, 28-weeker, not just for the term infants. So, all is not lost because you didn’t have those first few precious moments. There’s a variety of reasons when that initial bonding cannot happen. And it’s going to happen over time. It’s a question of spending that time with the baby.

Macie Jepson
Mmm-hmm. Very good point. Thank you, Doctor.

Pete Kenworthy
You mentioned the connection that we are going to talk about, and I feel like this is maybe the most important part for the new parent, right? How do we connect with our baby? We love that little boy or girl immediately, right? Like as soon as we put our eyes on him or her. But is there anything we can do to help that early connection, right? Feel like we’re developing something going both directions.

Dr. Ganga Srinivas
Sure. It is both directions. And like I said, it’s important to take a moment and think about it. That initial bond, that loving that at babies sometimes doesn’t happen right away. There’s a variety of things that can happen. Mom is sick. There’s, labor is exhausting. There’s other reasons where this was not the most happy of events for the family. But parents typically want that connection with their infant, and you can make this happen like you can with any human relationship. It’s just that when we are faced with a baby that doesn’t talk back and cannot show love by hugs and so forth, we don’t know how to make that connection. And like all of us, babies respond to hugs; only we call it cuddling. They don’t hug you back. They respond to our voices, the tone of our voice, the words, not so much…the words matter because they’re learning language…but the tone of your voice being kind and loving and just engaging with that baby, either with your eyes or your smile, it doesn’t matter what you’re doing; what matters is that you’re doing it in a loving manner.

So, that engagement sometimes happens easier when you have a script. And so reading to the baby can help where you’re holding the baby in your arms. It is important when you are dealing with an infant that’s less than four months old for them to be able to see you as well. When they’re that young, they connect with people more than the outside world. So, yes, they should see the book because it’s a point of focus, but they should also be able to look at whoever’s holding them that’s reading the book so that they have a human being to connect with. Nursery rhymes are a great way, if you like to sing. It doesn’t matter how good your voice is, or whether you’ve been trained as a singer; they love your voice. And so singing gives you the sound and it also helps parents who are stressed, who are having a hard time. It helps to calm them down as well. So that’s another piece in this whole thing of connection is that babies’ emotional ability to emote, their ability to regulate themselves is still developing. So, they’re a mini little storm in this very small body. And they’re learning how to regulate their emotions from all these things that you’re doing for them.

Macie Jepson
I agree that connection is super important, but I thought of another thing that must be significant, and that is our ability to calm our baby. I mean, listen, if we had a secret for this, we’d be for rich. That’s just all there is to it. Our first was colicky. So, need I say more. Any advice on what to do?

Dr. Ganga Srinivas
The hardest thing to do and the easiest thing to say is that the parent needs to stay calm themselves, or whoever is with the baby needs to figure out a way to calm themselves. And so the hugging, the holding, the walking, the rocking, the singing, they’re all just different ways for the adult in the room to be the adult in the room and be the calm in the storm and for them to calm themselves as they’re trying to get baby eat to soothe. Babies do pick up on your emotions. You don’t, you can use a happy voice, and if you are upset and angry, they’re probably going to pick up on it. So, it is important to take those 5, 10, 15 seconds to truly center yourself and calm yourself when you have a frantic infant. That said, there’s going to be times that you’re not going to get through.

You mentioned a colicky baby. That is probably one of the worst experiences in a parent’s life where you cannot help them. They are not hungry. They don’t need to be changed. All the other tricks that you’ve had and used are not working. And that is when also reaching for help is important. But in that arsenal of things that we can do to help baby, first, calm yourself. Second, there’s different things that babies, different babies will respond to. Not every baby’s going to respond to the same thing. Things that you can try include swaddling the infant. You do want to swaddle with the arms tight and allow some movement of the legs most of the time. You can try shushing the baby. That’s a fairly natural thing that parents will do, which is, shhh, shhh, shhh. And in some cultures, actually, they will make the noise louder than the baby crying. It’s sounds counterproductive, but they actually do calm down to someone that’s being louder than them.

You can try swaying with a baby, holding them in a variety of different ways, either face up, over your arm, like a football. You just have to figure out what position your baby likes. The old saw about putting a baby in a carrier and putting them on the dryer works. That vibration helps them. And all of those different ways of moving: throwing them in the back seat of the car…not throwing them…but put them in a car seat, strap them safely and take them for a ride. That, all that vibration noise can sometimes help babies calm down. And the final thing is a swing that a lot of parents use. And I would caution that you don’t want your baby in a swing for a very long time when they’re very young, because their neck muscles are not strong enough to keep the airway open if they’re in it for more than a half hour to an hour. So, really, they shouldn’t be falling asleep in the swing. You can use it briefly to calm them and, you know, get them in a place where you can pick them up and then deal with what’s going on.

It’s also important for the parent to take that minute…it may be 5 or 10…to calm themselves down before they handle that crying infant, because we know that babies can really disturb your emotions so much that sometimes they get shaken to get them to calm down. And that’s something that we want to avoid. And that is where the 5 or 10 minutes it takes for you to center yourself and calm down is really, really important. A crying baby is a breathing baby. So, they’re actually okay if you need to set them down for five minutes and just walk away.

Macie Jepson
If you need to.

Dr. Ganga Srinivas
Yeah.

Pete Kenworthy
So, before we let you go, anything else that new parents could benefit from knowing?

Dr. Ganga Srinivas
So, we talked so much about engaging with a baby that’s, you know, in communication and so forth. These are all things that stimulate an infant. And it’s sometimes important to recognize when a baby’s overstimulated and stressed out. So, just like you’re taught feeding cues that a baby going to lick smack their lips, push their tongue out, suck on things. An overstimulated infant will actually move their gaze away from you. They look away and up, like they’re rolling their eyes at you as a newborn.

Macie Jepson
It starts that early, huh?

Dr. Ganga Srinivas
It starts that early.

Macie Jepson
Wow.

Dr. Ganga Srinivas
And you know, they turn their head away from you. They may arch their back. Their little hands and arms will stiffen and turn backward and fall away. And so looking for those cues that they’re stressed and they need calming rather than stimulation; the talking, the singing, the engagement, is also a good way to head off an over-stimulated baby that’s not able to calm down. And part of understanding that, and as things go along, it’s understanding when your baby’s hungry and tired and so forth, is also part of preventing meltdowns in your toddler is that you understand when they are ready to be stimulated and when they need downtime and calm time to get back to an even keel.

Pete Kenworthy
So, I lied. That wasn’t the last question. A question about, I’m just imagining picking up my daughter every time she cried. First kid, for sure, right? You’re so worried about everything that’s going on. Is that okay though to do what we…people worry about spoiling their baby, right? Picking it up every time it cries or every time it fusses a little bit. Is that okay?

Dr. Ganga Srinivas
In a sense, yes. You’re spoiling your baby if you hand them candy, but not if you are teaching them to connect with you, to understand your voice, and you’re helping them calm down. So, they don’t yet have the ability to calm themselves down. And they’re trying to tell you something when they’re crying. And as you pay attention, you’re going to be able to tell the difference between I’m hungry. I’m really hungry. I am starving and you have taken too long to feed me. And that’s a difference from that from I’m tired. I’ve got a wet diaper. I need to be rocked. Or I’m just bored, and I don’t know what to do with myself. And you will develop a differentiated response to each of those things. And especially in the early days, if you pick up and attend to your baby’s needs, even if it’s just a cuddle and I don’t know what’s going on, but let’s talk through this thing.

As time goes on, they are going to be responsive to your voice. And they’re going to, you should be able to talk to your baby across the room and hold a little conversation. It’s going to be grumpy and whiny on their part, and you’re going to be talking them through it, but there will come a point when you don’t have to pick them up every time.

So, to get to that relationship, to get to that point where they have connected enough with you, you need to put in the work initially of building that connection. And that connection will stand you in good stead when they’re toddlers and are having a meltdown and when they’re teenagers and they become incomprehensible, that there is still that connection that you are able to talk to them and at least come to some kind of understanding of what’s going on between the teenager and yourself.

Macie Jepson
Pete, when we started, you said it was love at first sight with your daughter. The same for me, but I think we’d be remiss if we didn’t talk about the fact that that is not always the case. And that’s okay, right, Doctor?

Dr. Ganga Srinivas
That’s totally okay. It can be difficult as I said, for a variety of different scenarios, especially when baby and Mother are not together from the beginning. It can also be very difficult when the mother is depressed or any other caregiver that’s closely present with the baby is depressed. And that’s one of the reasons why we talk a lot to new families about recognizing depression in both the mother and the other parent, because it happens. And it happens very frequently, especially if there are other life stressors in that family’s situation. Since baby is depending on the adult for emotional regulation, a parent that is having a hard time dealing with their own emotions will also have difficulty with the baby dealing with their own emotions.

And so that’s one of the reasons it’s really important for that family to seek help for any signs of depression. This can be sadness. This can be no joy in the normal ordinary things that give us joy. No joy in your baby. This can also show up in new mothers as hypervigilance. They are unable to relax their attention enough to even take a nap or 15 minutes to themselves. They are, every little thing seems to be an outsize problem. So, there are very many ways. It can show up as anger, especially in male caregivers. And fathers can be prone to postpartum depression, just much less than mothers, but it can happen. So, it’s important for the family to look out for each other, not just for themselves. And so this is a key point to where they’re going to be screened many times, but it’s also important to recognize it within oneself.

Macie Jepson
This has been so helpful. You know, back when our kids were little, Pete, I wish we’d had podcasts because I know we didn’t have time to read all those books that were sitting around. That’s for sure. So, this is a great service to new parents who are very short on time and energy is to be able to listen to this and get advice from you. So, thank you for joining us today.

Dr. Ganga Srinivas
It’s been great to have this conversation. Thank you.

Macie Jepson
Dr. Ganga Srinivas, UH Rainbow pediatrician in Cleveland. Remember, you can find and subscribe to this podcast on iTunes, Google Places, Stitcher or wherever you get your podcasts. Search University Hospitals, or Healthy@UH depending on where you subscribe.

Pete Kenworthy
For more health news, advice from medical experts and Healthy@UH podcasts, go to UHHospitals.org/blog.