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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Monday, August 13, 2012

Nursing Babies and Eye Contact: Who Said It? And What Did He Mean?

Readers of this and other blogs have gone around in circles about the claim that nursing babies gaze into their mothers’ eyes. This assertion turns up in many an Internet site and many a book, and those who make the claim often add the suggestion that the mutual gaze causes attachment and/or bonding. However, experienced nursing mothers usually say, “Sure, sometimes they do--  but sometimes they don’t.” They also note that babies younger than about 6 weeks don’t reliably make eye contact at all, much less allow themselves to be distracted from voracious feeding in order to socialize.

I’ve been looking for a source for this claim about eye contact, and I think I’ve found one in the work of Rene’ Spitz  (sorry, I don’t know how to make that acute accent properly on my keyboard). Spitz was a psychoanalytically-trained physician who suggested the term “anaclitic depression” to describe the distress of infants and toddlers abruptly separated from familiar caregivers and cared for in institutions. In the 1940s and later, he used careful observations and  filming techniques to demonstrate the young child’s response to separation. Spitz spent some time at the University of Colorado Medical Center and was the mentor of the eminent infancy researcher Robert Emde.

Spitz’s 1965 book, The first year of life, focuses on the shaping of personality by very early experiences--  and I should point out that, interestingly, the word “attachment” does not appear in the index at all. I should also point out that Spitz emphasizes the interaction of experiences with biological characteristics and notes that personality developments may emerge from previously existing forms as a result of maturation, just as limbs grow spontaneously from  primitive forms during embryonic life, without being triggered by experience.

Here’s what Spitz says about the gaze of nursing infants: “We have observed that in the majority of cases the breast-fed baby stares at the face of his mother unswervingly throughout the act of nursing without turning his eyes away until he falls asleep at the breast…; in bottle-fed babies this phenomenon is neither consistent nor reliable”. Overleaf (p. 52), Spitz shows a photograph of a nursing baby and mother who appear to be making eye contact. The caption reads “During Nursing the Breast-Fed Baby Stares Unwaveringly at His Mother’s Face.”

Now I ask you, are those two statements the same?   “In the majority of cases the breast-fed baby stares at the face of his mother unswervingly” and “During nursing the breast-fed baby stares unwaveringly at his mother’s face”? No, the first one says that sometimes, in at least 51 % of cases, the baby stares at his mother’s face. The second one appears to be saying that all breast-fed babies stare all the time, but in fact it may have been intended to say that in this particular picture, the baby was looking at his mother at the time the picture was taken. It’s not exactly clear what the photo caption means, but in either case it’s different from the text statement.

Let’s see what else Spitz says in The first year of life. Maybe that will help figure out what he meant to say about nursing babies and their mutual gazes with their mothers. Here are some relevant statements: “The infant’s inability to perceive his surround lasts for a number of weeks. Toward the beginning of the second month an approaching human being begins to acquire a unique place among the ‘things’ in the baby’s surround… If you approach the hungry, crying baby at the hour of feeding, he will become quiet, open his mouth or make sucking movements…. In this second month, the infant reacts to the external stimulus only when it coincides tith the baby’s interoceptive perception of hunger… Two or three weeks later, we note a further progress; when the infant perceives a human face, he follows its movements with concentrated attention.”

In other words, it would appear that Spitz would not have expected infants of less than 6 weeks to pay attention to faces at all. So his claim about an unwavering mutual gaze would seem to apply only to babies older than perhaps 6 or 8 weeks.  Were the “majority of cases” all among babies who were older than that? Or did Spitz count the younger babies in the group that was less than the majority? He doesn’t say, but it does seem pretty clear that he did not expect neonates to gaze into anyone’s eyes.

More recent research, like that of Melzack and Moore, does indicate that even newborns can pay attention to people’s faces and show us they do by imitating facial expressions. Like other researchers of his period, Spitz believed that many developments appeared at later ages than we now have seen demonstrated. But  imitating a person sticking out his tongue is quite a different matter from sustaining a mutual gaze, and we can’t reason from one to the other; to conclude that one ability is related to the other, we would have to have evidence of nursing infants involved in mutual gaze at a very early age, and we don’t have that.  

The idea that the gaze has a power to influence others people is quite an old one, and it’s not surprising that young mothers can easily be unnerved by claims that their babies must look into their eyes, especially now that everyone is terrified of autism. But the fact is that even babies who are old enough to make eye contact only do this about half the time while nursing, even according to Spitz, and this does not indicate any problem about their development. And, by the way--   nursing mothers are not always deeply engaged with gazing at their babies. They may find this time an excellent one for cutting the baby’s fingernails or cleaning out the ears without protest, or they may talk on the phone, eat a sandwich, have a cup of tea, or read to an older child while the baby does his thing. Breast-feeding only takes one of your hands--  that’s one of its great advantages.

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