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P&S Journal

P&S Journal: Spring 1996, Vol.16, No.2
Alumni Profile - T. Berry Brazelton: Babies' Best Friend

By Peter Wortsman

Grown up now, many with children of their own, they still ask after the horse, the antique carousel charger that instantly kindled their trust. A non-descript sign outside says "Doctor's Office," but the twitter of canaries, the toys scattered round the waiting room-everything about the place bespeaks the charmed precinct of childhood. Here in this cozy yellow house on a quiet street in Cambridge, Mass., generations of tykes and toddlers have commanded care and respect, and generations of parents have learned how to listen.

This is home base and headquarters for T. Berry Brazelton'43D, America's most celebrated and influential baby doctor since Benjamin Spock'29. It is here that Dr. Brazelton wrote his 26 books on pediatrics and child development, including the classic "Infants and Mothers," and here that he hosts and tapes "What Every Baby Knows," the longest running show on cable TV.

"The Tallest 2-Year-Old"

Asked if a pediatrician needs to be in touch with the child in himself, Dr. Brazelton grins: "A friend of mine says I'm the tallest 2-year-old he's ever known!" At 77, with smile lines deep as rivers and eyes squinting with unabashed glee, he'd be a dead ringer for Rex Harrison's Dr. Doolittle but for his down-home Texas drawl.
T. Berry Brazelton'43

And while the fabled Dr. Doolittle chatted up the birds and the beasts, the very real Dr. Brazelton opened the lines of communication to the most beloved and least understood being on the planet, that strange visitor from Inner Space, the newborn baby. The Neonatal Behavioral Assessment Scale he developed in 1973 (known as "the Brazelton") is now used worldwide as an evaluation tool to assess the physical and neurological responses of newborns as well as their emotional well-being. His lifelong research in early child development has helped doctors and parents realize that individuality is there right from the start and that if we listen carefully, newborns can tell us what they need and want. "That's something that I've spent my whole life aware of," says Dr. Brazelton. "I can look at a child, a newborn, and tell you just what he is trying to say without words!"

Watching T. Berry Brazelton in action, on TV or in person, one is struck by his uncanny ability to mimic and in a sense "become" whomever, big or little, he happens to be communing with at the moment. His face takes on their expressions, mirroring all the nuances of an infant's fascination and fear and a parent's hope and worry. Even his hands, like finger puppets infused with a life of their own, can't help but offer a second opinion. Eschewing formality, Dr. Brazelton is not above "getting down" with his little patients-in some cases, quite literally getting down on his hands and knees to make contact. It should come as no surprise, then, to learn that as an undergraduate member of Princeton's Triangle Players, he was so evocative on stage as to attract the attention of fellow Princetonians, actor Jimmy Stewart and producer Josh Logan, who offered him the juvenile lead in a Broadway production opposite Ethel Merman.

Acting, however, was most definitely not what the folks back home in Waco, Texas, had in mind, persuading young Berry to abandon any thespian aspirations and pursue his first love, medicine.

"I was 9 years old, maybe younger, when I knew I wanted to do something with babies," he recalls. As the oldest child in an extended family (with 80 cousins still living back in Texas today), he took to heart a beloved grandmother's praise for his way with the little ones.

His mother, a dynamic woman well ahead of her time (the first woman elder in the Presbyterian Church and founder in 1940 of the first abortion clinic in Texas), was somewhat overpowering when it came to child rearing, pushing hard and all but smothering Dr. Brazelton's younger brother. "She was so intense," Dr. Brazelton recalls with a shake of the head and a hint of sadness clouding his smile. "Gosh, how can passion turn so sour! I knew back then that I wanted to be the kind of person who could help change that passion into something more positive, to help parents pull back and realize that they didn't have to control their kids."

At P&S, he credits Robert Loeb with teaching the art of observation. "He made us stand at the end of the bed and watch the patient for 15 minutes, after which we had to tell him all kinds of details-real Agatha Christie stuff!"

After medical school, Dr. Brazelton interned in medicine at Roosevelt Hospital. Following a stint in the Navy, he pursued a medical residency at Massachusetts General Hospital before undertaking pediatric training at Children's Hospital in Boston. Back then, however, pediatrics was largely mired in the pathological model, he recalls. And though he received a solid grounding in the diagnosis of disease and physical disorders, the normal path of child development was largely ignored. He was, moreover, allergic to what he perceived as a certain hostility to parents, the unspoken sense that "they were the reason why kids got sick and were disordered." To broaden his base of knowledge, he pursued another five years of training in child psychiatry at Mass General and the James Jackson Putnam Children's Center.

Dr. Brazelton has never been afraid to cross the lines of academic disciplines, a readiness that has led to many rich collaborations, including his later work with the Swiss child psychiatrist Dr. Bertrand Cramer, with whom he co-authored "The Earliest Relationship: Parents, Infants, and the Drama of Early Attachment" in 1990.

Eager to understand the stages of healthy child development, he undertook a fellowship with experimental psychologist Jerome Bruner at Harvard's Center for Cognitive Studies. In his foreword to the first edition of Dr. Brazelton's best known book, "Infants and Mothers: Individual Differences in Development" (1969), Bruner subsequently praised him as "a physician who has made us better aware of the care of health in infancy and childhood, but also of the importance of opportunities for growing." Encouraged by Bruner to pursue his own path of research, Dr. Brazelton crystallized a keen appreciation of the infant as an active participant, an individual able to express himself in and through his behavior, to be affected by, and in turn to affect his environment. Dr. Brazelton also formulated one of his fundamental theses, elaborated in "Infants and Mothers," that there are three types of normal newborns: the average baby, the quiet baby, and the active baby-a notion that has helped ease the anxiety and bolster the confidence of countless new parents. In 1972, he co-founded (with Dr. Edward Tronick) the Child Development Unit, a pediatric training and research center at Children's Hospital, a facility that would become the workshop and crucible for his revolutionary studies on communication in the newborn. It was here that he developed the Neonatal Behavioral Assessment Scale in 1973 and did subsequent work, including cross-cultural studies, on the rich and varied interaction between the child and his environment. More than 60 pediatricians trained here have spread his insights to academic medical centers and private practices around the country.

Other foci of his research, detailed in more than 180 scientific papers and chapters, include the development of attachment between parent and infant, cross-cultural comparative studies of infant behavior and parenting practices, the importance of early intervention to at-risk infants and their parents, and the opportunities presented in early infancy for strengthening families.

A Friend of Families

Among his many insights regarding the care of children is his basic realization, expressed most succinctly in "The Earliest Relationship," that "the parent-infant pair must be cared for as a unit . . . A baby cannot exist alone, but is essentially part of a relationship."

This insight has fueled his concern at the overwhelming pressures and stresses faced by families today. His harrowing report, "Why Is America Failing Its Children?" published in The New York Times Magazine in 1990, documented a nationwide crisis of failure and neglect. "Needy children are in double jeopardy," he wrote. "They have the most health problems and the least access to care." Challenging politicians who tout "family values" but favor draconian cuts in federally funded social and medical programs, Dr. Brazelton insists, "We are the least family-oriented society in the civilized world."

Co-founder of Parent Action, a grass roots advocacy group on behalf of parents, he has made frequent appearances before Congress to support parental and medical leave bills. Appointed by Congress in 1989 to the National Commission on Children, he continues to speak out in support of constructive aid to disadvantaged children and families.

A further insight that "the vulnerable times in a child's development are vulnerable for families too," led him to create The Touchpoints Center at Children's Hospital. Its goal is to formulate curricula and train residents to reach out to underserved populations, to help parents foster a constructive response to stress.

The Brazelton Center for Infants and Parents, another unit he founded at Harvard, trains health care professionals worldwide in the effective use of Dr. Brazelton's Neonatal Behavioral Assessment Scale. To date, eight pilot centers exist in this country, two in South America, nine in Europe, and three in Asia.

As clinical professor of pediatrics emeritus at Harvard Medical School and professor of psychiatry and human development at Brown, Dr. Brazelton keeps up a tireless schedule of teaching and research.

In December 1995, Harvard recognized his outstanding achievement with the creation of the T. Berry Brazelton Professorship in Pediatrics. "Not bad for a Texas boy!" he beams. Other laurels include Princeton University's Woodrow Wilson Award for Public Service and a host of honorary degrees from universities in the United States and around the world.

With A Nose for What Every Baby Knows

Since 1984, he has been a friendly fixture in America's living rooms, dishing out practical advice to parents as host of a popular television series for the Lifetime channel, "What Every Baby Knows," the longest running program on cable TV. Aglow before the camera, Dr. Brazelton intersperses videotaped close-ups of infants demonstrating a particular developmental concern with interviews with their parents. A master of the media, capturing an Emmy award in 1994, Dr. Brazelton soothes, comforts, and teaches as he entertains.

He is also a weekly syndicated columnist for The New York Times and a regular contributor on child care-related issues to Family Circle magazine.

Back home in Cambridge, a typical day begins with a jog around the block. From 8:30 to 9:30, he personally takes telephone calls from parents around the country and the world. By 10, he's off to the Child Development Unit at Children's Hospital to pursue his research and teaching, which may take up much of the rest of the day.

"I've been very lucky," he reflects upon his success. "I just hit it right at the right time and got a lot of credit for whatever I did. I married the right lady [the former Christina Lowell] . . . been married 46 years and my kids are OK!"

An avowed workaholic-though in his case, "playaholic" might be more apt-the smile that seldom leaves his lips is proof that T. Berry Brazelton is still busy having the time of his life.

copyright ©, Columbia-Presbyterian Medical Center

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