The difficult baby is born that way

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ONE out of 10 babies is born difficult. The difficult babies are the red‐faced infants whose howling wakes the other newborns in the hospital nursery. They're the babies who twist and scream when their faces are washed. Who spit out new foods. Who'd rather cry than sleep—or so it seems to their harassed parents, who are often not only be wildered by these cantankerous infants but deeply anxious, even guilty. What are they doing wrong? Could there be something wrong with the child?

The answer is nothing is wrong with them or with the baby. But if they don't come to understand their baby's temperament, they will almost inevitably start handling him wrong, and their difficult baby will grow up to be a difficult adult who may bully his wife and children or be angrily dismayed that the world does not revolve around him, or simply be an irritable, uncooperative person.

Fortunately, researchers have discovered how to bring up these rambunctious babies happily and healthily.

Early in the course of their long‐term study on personality, known as the New York Lon gitudinal Study (now in its fifteenth year), Dr. Stella Chess, professor of child psychiatry at New York University School of Medicine; Dr. Alexander Thomas, professor of psychi atry at the same institution, and Dr. Herbert G. Birch, professor of pediatrics at Albert Einstein College of Medicine, found that most babies fall into three temperamental cate gories. (Many, of course, cannot be neatly pigeonholed; they are a little this and a little that.) These temperamental categories are simply a description of the child's style of reacting to the stresses and strains—and joys —of life. They have nothing to do with intel ligence, ability, character or even charm.

The majority of infants are born with positive, sunny dispositions. They are “easy babies.”

“Slow‐to‐warm‐up babies” form the second largest group. Wary of new situations and people, they tend to withdraw. Once parents understand this rather cautious temperament, they usually find it easy to allow the child to adapt to change at his own rate while gently encouraging him to try new experi ences.

Then there are the “difficult babies.” Dif ficult babies manage to get mother and father on the run very early. In extreme cases, baby becomes a ruthless household tyrant whose whims cannot be anticipated soon enough and whose rages are so violent that his par ents will do anything for a little peace.

“These children are often irregular in feed ing and sleeping,” report Drs. Chess, Thomas and Birch. “They are slow to accept new foods, take a long time to adjust to new routines or activities and tend to cry a great deal. Their crying and their laughter are characteristically loud. Frustration usually sends them into a violent tantrum.

“They are a trial to their parents,” the re searchers sympathize, “and require a high degree of consistency and tolerance in their upbringing.”

Barbara W. Wyden is a member of the staff of this Magazine.

THE authoritarian versus permissive argu ment has gone on for generations now, but in the case of the difficult baby, there can be no argument. The findings of the New York Longitudinal Study indicate that he will thrive and become easier under a kindly consistent and firm regime (and turn into holy terror if his parents try to use the per missive methods that work so well with some children).

Since the beginning, the N.Y.L.S. team has been helping the parents of the difficult children among the 231 youngsters in the study to understand their offspring and bring them up happily and effectively. Dr. Thomas, whom I interviewed in his roomy, old‐fashioned corner office at Bellevue, pulled out a sam pling of case histories from his files and reviewed some of the advice the research team had given parents.

“Here's a boy we've followed since 1956,” he said. “We'll call him Bob. Bob was very difficult. When he was eight weeks old, he would not sleep more than half an hour at time. He would wake up and shriek and scream for long periods.

“His mother could not stand the screaming for long. She would give in, give him a bottle. He would take it. Afterwards he would vomit. She really struggled to keep some kind of feeding schedule, but she just couldn't take the screaming. And she was distressed be cause he seldom smiled.

“Both parents feared he might be abnormal. We were able to reassure them. The physical and neurological exams showed that he was normal—simply very difficult.

“We advised them to handle Bob very gently and smoothly when he had to be fed and changed This would help minimize his intense reactions. And to leave him alone the rest of the time. This was hard for them. But we told the mother that she just could not continue the pattern she was establishing. In just two weeks—of course, that's a long time in baby's short life—she told us that Bob had become much easier to handle. And he had started to smile more often, which delighted her.”

DIFFICULT babies are often thought to be colicky and vice versa. “It is easy enough to distinguish between them,” Dr. Thomas says. “The colicky baby has intense negative reactions about food and feed ing times. His troubles are centered around the gastro intestinal tract, and we simply have to wait for him to out grow them. The difficult baby, on the other hand, has intense negative reactions to almost everything. And he will not outgrow them. He has to be taught to control them.”

NTENSITY is the key char acteristic of the difficult baby. His every reaction is intense. Fortunately, not all are nega tive. And when he responds positively, this intensity is de lightful.

“Annette is a good exam ple,” Dr. Thomas said, pick ing up another folder. “She had an intensely negative re sponse to her paternal grand mother. So negative that her mother was embarrassed when her mother‐in‐law visited. An nette would scream when her grandmother picked her up. Wouldn't smile. Refused to be cuddled.

“But she had an immediate spontaneous positive reaction to children. When she saw another baby, she would laugh. And she loved it when her mother held her up in front of a mirror. Annette would smile at herself and hold out her arms.”

This intensity throws many parents off. The N.Y.L.S. team stresses that parents must simply accept it. It's there. It can't be changed. And there's nothing “wrong” about it.

“Here's a case,” Dr. Thomas said. “Lewis fought every new experience. He screamed dur ing his first bath. It took days before his mother was able to complete a face washing. When she started him on Pab lum, he screamed and twisted and spat it out. When she first gave him strained squash, he got so upset it took 10 min utes to quiet him. ‘It was ab solute chaos,’ his mother re ported. ‘It took two of us to calm him and hold him after that first spoonful of squash.’

“We advised Lewis's parents to handle him as calmly as possible, to be consistent, to keep introducing and re‐intro ducing foods until he accepted them.

“They managed very well after that. By the time Lewis was 18 months old, his parents took great delight in him and his exploits. They enjoyed his intense reactions. The father told us he was proud of hav ing ‘such a lusty kid.’

“When Lewis went to nurs ery school, things got rough again. He screamed and acted up and refused to stay. But, his mother told us, he eventu ally adapted and got to like it.

“Eventually,” he repeated. “Eventually. That's the word parents of difficult babies must remember. The baby will eventually adapt if the parents are consistent, firm and lov ing.

“They must learn to grit their teeth and sweat it out. They must learn it is wrong to do something, anything, to stop the crying. This only teaches baby he can get any thing he wants by howling.

“Parents must also learn,” he continued earnestly, “to stop feeling guilty. They are not to blame for the child's difficult temperament. It's just the way he was born.”

NOBODY knows the origin of temperament, be it easy or difficult. It has nothing to do with birth order. Difficult babies can be first‐, last‐ or middle‐born. It has nothing to do with sex. Girls and boys are about equally represented in the three temperamental categories. It seems to be unconnected with emotional stress during pregnancy. It may be hereditary. And again it may not. It will take time and study to determine whether or not the difficult child is the offspring of difficult parents.

“It is more difficult to de termine temperamental char acter in an adult than in child,” Dr. Thomas points out. “The adult has been formed by his inborn temperament and by his environment. It is hard to distinguish which char acteristics he was born with and which he acquired through the impact of people and events.

“I hope that if we can keep this study going until our present children get married, we can learn about the role of the parent's temperament by observing the babies of this group that we have come to know so well.”

It may be more important— and more helpful—for mothers of difficult babies to under stand the origin of mother love than the origin of tem perament. Many women feel no love for their newborn in fants—especially the mothers of difficult babies. This over whelrns the mother with guilt. She feels there must be some thing wrong with then Other wise, why doesn't she love the baby she so eagerly awaited?

It turns out that mother love is not an instant emo tion. A pioneering study on the beginnings of mother love carried out by Dr. Kenneth S. Robson, assistant professor of psychiatry at Tufts Medical School, and Dr. Howard A. Moss, a psychologist at the National Institute of Mental Health, destroyed the cliché fantasy that normal women love their babies at first sight. Not so. No more than most women fell in love with their husbands at first sight.

The two researchers studied 54 bright young women and their first babies and discov ered that 34 per cent of the mothers had no feelings at all for their babies when they first set eyes on them. Seven per cent reported negative feelings— “I couldn't look at her.” “I wanted them to take him away.” About half said they had positive feelings, but only seven women described these feelings as love.

It took most of them from six to nine weeks to feel love, and the emotion was triggered by very specific happenings. Mother after mother reported that when baby began smiling at them, looking into their eyes and watching them as they cared for him, that they felt more and more deeply at tached and loving.

These findings are particu larly meaningful for the moth ers of difficult babies. The re searchers tell of one young mother “whose baby had cried and fussed inconsolably for the first ten weeks. She be came angry and exhausted and felt unable to love or care for a baby who gave little cause for pleasure.” And of another woman who told them, “I felt she was completely un connected to me in any way. She was just a little thing that had come into my life and brought all this trouble.” Both mothers eventually came to love their babies very much. It just took them a little long er than the mothers of easy babies probably because it took a little longer for their difficult babies to respond positively to them.

IT may be possible to cut down this response time. The New York Longitudinal Study has inspired other research ers to examine temperament with an eye to pinpointing it as early as possible. The soon er parents can recognize their baby's temperament, the soon er they can apply the most appropriate child‐rearing meth od. And the sooner baby feels comfortable in his world, the sooner he will respond posi tively.

In Philadelphia, Dr. William B. Carey, a pediatrician with the Children's Hospital, re cently completed a project with the cooperation of 210 mothers and their infants that showed it was possible to es tablish a baby's temperament as early as four to eight months. He designed a simple 70‐point questionnaire that can be filled out by the mother in about 20 minutes and analyzed by the doctor in ten. Even the most harried pediatrician can use it to give a mother an objective view of

66Evenfualiy. That's the word parents of difficult babies must remember. The baby will eventually adapt if the parents are consistent, firm and loving.” the type of baby she has, the kinds of problems she may face and how to handle them.

Another researcher, Dr. Ar nold J. Sameroff, a psychol ogist at the University of Rochester, thinks it may be possible to spot clues to a baby's temperament even ear lier— between the first and third day of life. In a pilot project with 30 newborns that will be completed this spring, he is trying to measure such characteristics as intensity, ac tivity, and adaptability. He then hopes to go on to apply these measures to a larger sample of some 100 infants.

Dr. Sameroff has already succeeded in determining learn ing ability. By means of special feeder, he has discov ered that a baby, not even 24 hours old, can learn to suck at a certain pressure to get the maximum amount of form ula. By varying the degree of pressure necessary to get the most food, the researcher can find out how quickly an in fant learns to adapt to the new situation. The difficult baby, of course, is slower to adapt.

It may be that in a few years, when a mother goes home from the hospital with her baby, she will have some indication of his temperament, just as she knows his sex and weight. And with this aware ness, the battle is half won.

The N.Y.L.S. team has found that “most middle‐class par ents, once they have been ex posed to the idea of tem perament, are sophisticated enough so that they can work patiently and persistently to help their child adapt.”

F the difficult child is handled correctly,” says Dr. Thomas, “he finally adapts to the routines of living. After all, as you get older, there aren't so many new things that happen in life. Most sit uations, even if they are new, tend to have some familiar element about them. The child also develops self‐awareness. He knows how he reacts to things.

“We'll know in a very few years whether the difficult children in our study have de veloped in a healthy way,” he said. “We do know that more of the difficult children have behavioral disorders than other children. This is under standable. It's simply because their adaptation is harder and more of a demand on parents. What also seems to be true is that they respond to treat ment as well as other children. There is no difference here.”

Dr. Thomas has great ad miration for the positive qual ities and potential of these difficult children. He refuses, quite correctly, to speculate about the final conclusions of the study, but he says, “I'll tell you what we will know. In six years or so, we'll know whether this will be the kind of kid who can battle harder and be a leader. We'll be able to forecast how he will react to serious adult stress—flunk ing out of college, losing a job, divorce.” It is evident that he thinks they will be able to handle future stresses competently.

There's one thing he is positive of, even now. “By helping parents understand and handle their difficult child,” he concludes in gentle triumph, “we're taking a lot of business away from child psychiatrists.”