“Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton,” B. Lester and J. Sparrow, Eds. (2010)

By Deborah Weatherston, PhD, IMH-E®

IMG_4001“Nurturing Children and Families: Building on the Legacy of T. Berry Brazelton,” edited by Barry M. Lester and Joshua D. Sparrow, invites readers to reflect on and celebrate the remarkable contributions that T. Berry Brazelton has made to the advance of science and the nurturing of infants, children and their families. The book introduces us to significant concepts that have changed how scientists and practitioners view babies and witness the relational nature of human development over the span of his 50 year career. Most important to mention here: individual differences in infancy and the dynamics of newborn behavior; the infant’s contributions to his or her own course of development; the power of the parent-child relationship to influence health, growth and change; and the importance of shared observation and meaning making in early work with families. Brazelton’s pioneering spirit has transformed practice, inviting pediatricians, nurses, psychologists, social workers, home visitors, early care and education professionals and many others to be open, curious, and thoughtful in their observations, interactions and affective responses to infants and families. Of great importance is Brazelton’s therapeutic stance that has guided generations of parents to feel confident and competent as they cared for their babies in the early years.

The book is laid out in three separate parts. Part I discusses Brazelton’s accomplishments in terms of behavioral and developmental research. Part II explores innovations in clinical intervention, including a section about infant mental health and the treatment of trauma. Part III discusses the implications of Brazelton’s work for professional development, systems of care, and policy. Chapter by chapter, the book is a masterful collection of writings from among the most respected scientists and clinical leaders in the infant and family field. Each contributor invites readers to think more deeply about early development, relational contexts, and touchpoints for optimal growth and change. What follows is a brief introduction to each part.

Part I introduces the reader to the transformations in research and practice that are attributed to T. Berry Brazelton. Barry Lester describes existing paradigms that Brazelton challenged and praised the “new lens through which we see and study children based on his scientific contributions.” p. 3. Joshua Sparrow follows with an illuminating chapter in which he examines Brazelton’s transformative ideas about infants and observation, individual differences, culture and development, and collaborative consultation. Part I continues with a focus on advances in fetal and newborn behavior, self-regulatory and relational processes, regression and reorganization in infancy, and neuroscience perspectives on developmental models. The range of topics is stunning, reflecting the depth and breadth of Brazelton’s thinking by colleagues and authors, Kathryn Barnard, Tiffany Field, Daniel Stern, Ed Tronick, Stanley Greenspan, Allan Shore, and Jerome Kagan, to name a few.

Part II includes discussions of innovative clinical interventions for infants and parents that are relationship based: Touchpoints®, Nurse Family Partnerships (NFP), the care of preterm infants (NIDCAP), the use of the Neonatal Behavioral Assessment Scale (NBAS) to encourage parent-infant interaction. Charles and Paula Zeanah, Joy and Howard Osofsky, Dante Cicchetti and Sheree Toth offer perspectives on infant mental health. They address core concepts that reflect Brazelton’s considerable contributions to our understanding of the field. It is clearly a multidisciplinary field that focuses on strengths; it is relational; it is observational, collaborative and insightful.

The discussion about “ghosts in the nursery” and angels in this section, written by Alicia Lieberman and William Harris, has particular meaning for the infant mental health community. They align the thinking and work of two important pioneers, T. Berry Brazelton and Selma Fraiberg:

“Brazelton observed, Fraiberg observed – and both intervened, each as a different segment of the health – pathology spectrum. Brazelton promoted awe, pleasure, and competence in parents who were often seeing the wondrous capacities of their babies for the first time. Through their babies’ responses to them, parents developed a reinforcing sense of self-efficacy. Fraiberg focused on parents whose capacity to connect to the unique individuality of their baby was thwarted by their negative attributions, rooted in their own childhood experiences of having felt unprotected and unloved. Brazelton was working through a lens of optimism, using the baby’s competence to help parents discover their own; Fraiberg was focusing on the mother’s psychopathology, using the baby’s potential to help the mother escape from entrapment in her own past. Together, they created a chiaroscuro that honors the complexity of what Daniel Stern calls ‘the first relationship.’” P. 243-44.

Their work led to the relationship as a focus for the promotion and practice of infant mental health, a significant shift in the delivery of developmental and clinical services for infants, toddlers and families. We are challenged by the authors in Part III to take the principles of relationship work, so central to Brazelton and Fraiberg, and apply them across disciplines, systems, and organizations to effect continued growth and change through collaboration in this rich and rapidly expanding field.

Part III contributors discuss the implications of Brazelton’s work across disciplines and systems of care. Libby Zimmerman offers observations about developing the infant mental health workforce; Jayne Singer and John Hornstein discuss Touchpoints® for early care and education providers; Constance Keefer examines early innovations in behavioral/developmental pediatric training. Change is the focus for the concluding chapters. Change in service delivery in a hospital environment is addressed by Myra Fox; improving healthcare service delivery with relationship-based nursing practices is presented by Ann Stadtler, Julie Novak, and Joshua Sparrow; Daniel Pederson and Jack Shonkoff translate the science of early childhood development into policy and practice.

I turned the last page of this extraordinary collection and drew a deep, reverent breath. What a remarkable man T. Berry Brazelton is. He has contributed so much to shared understanding of the importance of infancy and the power of nurturing relationships to growth, health, and change. Sarah Lawrence-Lightfoot’s concluding reflections are heartfelt:

“As we honor and learn from the luminous life and work of Berry Brazelton,we take his lessons and make them our own, hearing the echoes of his teachings and giving them our singular voice and commitment. Now is the time. Now is always.” P. 362

This remarkable collection will enrich every infant mental health professional’s understanding of the legacy of T. Berry Brazelton and his influence on the infant mental health field.


WAIMH Perspectives in Infant Mental Health, Vol. 21(2), June 2013. Reprinted here with permission.