One of the first questions Prof. Gomes-Pedro asked me was: “What does a Speech Therapist do with a newborn baby? Do you play with the baby? Talk to the baby? My answer was: “I help newly born babies with feeding difficulties”. Thanks to assistance and knowledge passed on by Prof. Gomes-Pedro, I later realised that we were talking about one of the first touchpoints in the life of a baby, and that this stage offers an excellent opportunity to develop communication.

In the Paediatric Unit, this is how my work as a Speech Therapist with newborn babies at risk and their parents starts. At that point, I attend one of Prof. Gomes-Pedro’s classes and observe how he establishes with mastery a relationship based on trust with those parents and baby. He starts by asking them “What is the name of your baby?” Parents reply: “This is Tomás”. Further on, with a large smile, he asks them: “would you like to embark on a journey of discovery of Tomas?” It is in this sensitive and affective way, as exemplified by Prof. Gomes-Pedro, that I became directly more involved with the touchpoints methodology, which I want to discover and know more about.

I then pose the question to myself: what is this thing of helping to feed a newborn baby at risk? What are we talking about and what does it mean for the lives of these parents and babies? At what point in life does “bath water”, which Prof. Gomes-Pedro talks about in such an engrossing and passionate way, enter the feeding process?

I do realise that feeding their babies is a “sacred mission” for all parents. Accordingly, parents have doubts and ask: Will my baby have enough strength to be able breastfeed? Won’t he become tired? Should we insist? When should we stop? Is it safe?

It is important that parents know and learn to carefully observe the feeding of their child. A more fragile baby needs time to get himself organized, and never feels totally prepared when he is given the bottle or the breast. The baby needs to have a taste of the milk on his lips, so that he can look for and taste the food that is on its way.

For this reason, it is important to help him suck, swallow, and breathe, so that he can demonstrate signs of pleasure and comfort while feeding. The whole process takes time and it is necessary to learn how to recognise the signs the baby gives us, to ensure that feeding is done safely. Accordingly, it is important that parents meet a professional, a specialist in feeding who can help them in this task, enabling weight gain, the development of sucking ability, and release from hospital.

Prof. Gomes-Pedro also told me: “As a speech therapist, the most important in a special newly born unit, is to be able to transmit passion, wherever it may be found, to parents and professionals! Only then can we establish a relationship based on trust, believing that the true feeding specialists are the parents, and that our role is to help them understand their strengths and discover the baby as a human being.” I then start looking at the baby as a unique and individual human being, with his own will and preferences.

And from now on, how to establish this communication passion that Prof. Gomes-Pedro refers to? I observe him in his classes, once more, and I begin to discover what babies’ own language means, and what sharing behaviours and feelings about babies implies. At this point, the alliance and partnership with parents is established.

Another frequent question parents ask me is: Will our baby ever succeed to breastfeed? He looses interest, becomes very tired, the bottle is easier…what we want is for the baby to put on weight so that we can take him home…but I would like so much to be able to breastfeed him.”

Breastfeeding a baby can be a major challenge for parents, and is not an easy task. However, at the end of the day, it can be very rewarding both for the mother and the baby. When the mother puts the baby to her breast for the first time, he starts to smell, feel the temperature and the heart beat of the mother. It is an environment he is familiar with, and, at this point, feeling confident, he licks and looks for the source of food. Bonding thus begins, the mother learns how to touch and hold the baby, to rock him, talk to him and be in harmony with the baby. This is a very special occasion in terms of communication, interaction, knowledge of each other’s rhythms, and mutual adaptation. Often, these babies are still learning how to coordinate sucking with swallowing and breathing. However, the most important point is to create several opportunities, give the baby and the mother enough time. Breastfeeding enables the baby’s growth and development, preparing him to later eat with a spoon, chew and, at a later stage, talk.

In order to be able to know the baby’s rhythm and suction pattern, first one needs to know who is this baby and his parents, Therefore, following an invitation of Prof. Gomes-Pedro, I ventured into the Neonatal Behavioral Assessment Scale (NBAS) to better understand babies, their answers, their timings and personalities. I am thankful to Prof. Gomes-Pedro for showing me, in a true and passionate way, how the touchpoints methodology is vital for our work with parents and children. This methodology has become a core part of my personal and professional approach.

Joana de Sousa Rombert
Child and Health Department of Santa Maria Hospital
Developmental Unit
joanarombert@gmail.com

Bibliography:

1. Brazelton TB, Sparrow J. A criança e a alimentação. Lisbon: Editorial Presença 2004
2. Fucile S, Gisel EG, Lau C. Effect of an oral stimulation program on sucking skill maturation of preterm infants. Dev Med Child Neurol 2005; 47:158-162.
3. Lester, B, Sparrow J. Nurturing Children and Families: Building on the legacy of T. Berry Brazelton. New Jersey: John Wiley & Sons 2010
4. Nugent JK, Petrauskas B, Brazelton TB. The Newborn as a Person: Enabling Healthy Infant Development Worldwide. New Jersey: John Wiley & Sons 2009