The superb memories and mental abilities of babies described in The Mind of Your Newborn Baby (3rd edition) push the limits of the current scientific frame of reference, requiring a shift to a larger paradigm of human nature and consciousness. Babies are comfortably at home in the larger paradigm. Looking back on a decade of debates and discoveries related to newborn life, I have been particularly interested in three important areas where skepticism persists, even as evidence continues to mount: skepticism about all human memory, especially early memory; skepticism about infant pain perception and the failure in medicine to grasp its significance; and skepticism about the life-changing power of early parent-infant communication and bonding.

Understanding Memory

Memory, although it accompanies us on our everyday rounds, and, for all practical purposes, functions marvelously, can still be personally vexing and puzzling to the scientists who try to understand it. Memory is hard to locate and explain: it is a mystery of perfection and imperfection combined. Memory is a balky human instrument, not an Absolute Machine. In this last decade, some of these facts were hammered home in emotional court challenges, were spread widely by news media, and led to considerable public confusion and disillusionment. Can any human memory be trusted, especially the long-buried memories of birth and infancy?

Out of the turbulent waters of debate between plaintiffs and defendants, between experts testifying on opposite sides, and the collision of clinicians and researchers in scientific associations came additional clarity about the fundamentals noted above. The pendulum lurched between extremes: Memories are sacred and automatically true, and memories are little more than fantasies and cannot be trusted. Professionals may now be prepared to grant that while memories cannot be guaranteed, they may be remarkably accurate. Psychotherapists, though they are not detectives or lawyers, have learned that validity of memory is a legitimate concern, and, that they have an obligation to help clients discriminate between fantasy and reality.

When personal memories are brought to court, they will be vigorously challenged and be met with more criticism than respect. Accusations of child abuse and murder, based solely on memory and not otherwise verified, are problems which courts are probably incapable of judging. Very young witnesses are especially problematic for courts. Unverified memories of children are vulnerable to distortion at the hands of adult investigators (including sympathetic, but unwary, counselors) who can become engulfed in a fantasy which they themselves have helped to create. Children are sometimes tempted to tell stories to make your eyes bulge out! However, this possibility should not mean turning a deaf ear to children. Child abuse is a shockingly common reality, often hidden or denied by adults to protect their own interests. For this reason, children must be heard, but with greater skill and understanding than in recent years.

A new appreciation has emerged for the special characteristics of trauma-based memories: These memories can be buried ("repressed") for long periods of time before being triggered by an event and admitted to consciousness. That they were submerged for a time is not proof they are false. Few persons have had continuous spontaneous recall of their birth (though I have known some), but, under various conditions, their long-lost memories can be recovered and verified. Children who have been severely traumatized may have no conscious memory they can offer, but, typically, they act out their memories in spontaneous play that is remarkably revealing and accurate. This form of memory is seen in war veterans who encountered unimaginable displays of violence and death. Some members of the same battle group will carry clear and specific memories, while others repress the experience totally - perhaps for decades - yet, like the children, these veterans act out their anxiety and shock in daily life. With therapeutic guidance, these subterranean memories can be raised and healed. In my experiences with a great variety of traumatized clients in hypnotherapy, I came to recognize that "hidden" memories were walking around disguised as fears. What seemed like lost memories were "hidden" in plain sight. In everyday life as we all struggle to recover parts of ourselves "lost" in the past, we can seldom meet the standards of "proof" required in court. Our personal search for truth calls for a mixture of curiosity and prudence, and as much objectivity as possible in judging what we have done and what others have done to us.

In academic circles, a long-standing prejudice against the reliability of early memory (intrauterine memory, birth memory, and infant memory) is slowly collapsing. The least-likely period for memory to function, the intrauterine period, is increasingly illuminated by ultrasound, making it possible for visionary experimental psychologists to show that memory and learning systems are already functioning. Babies still in the womb are signaling that they have become familiar with rhymes repeated to them daily over a four-week period. Likewise, immediately after birth, babies exposed to parents' voices, musical passages, soap opera themes, news program sounds, sounds of their native language, as well as tastes and smells introduced in utero -are all treated as familiar, that is, learned and remembered from weeks and months in the past.

Memory experts have continued to overlook the prima facie evidence provided by two- and three-year old children recalling specifics of their birth when they are first able to speak. This important evidence, published in magazines for childbirth educators and parents in 1981, and which I celebrated in this book, was never taken seriously in scientific circles. All this time, we have had memory experts denying birth memory while new waves of three-year-olds were continually proving them wrong! Psychologists have been enthralled with the theory of "infantile amnesia" since it was first stated by Sigmund Freud in 1916. The popular observation that people rarely remember anything that happened to them before their third or fourth birthday made the idea seem obvious. The belief was further justified by theories of noted Swiss psychologist Jean Piaget which have dominated developmental psychology for the last forty years. Piagetian ideas about the limitations of newborn intelligence and its development in discreet stages are only now crumbling under the increasing weight of experimental evidence. Tearing down the wall of illusion regarding infant memory was accomplished by a handful of experimental psychologists, completing over three dozen crucial experiments, over a decade of time. Now, at last, the theory of infantile amnesia is dead.

The principal idea in medicine and psychology which made it difficult to accept any sophisticated early use of the mind was the idea that the immature and unfinished brain could not support memory and learning. Added to that was the difficulty of testing true personal memory with infants who could not talk. For these reasons research was avoided and when evidence did appear, it was ignored or denied. Under heavy odds, experimental psychologists have managed to prove that children age three, age two, and age one are all capable of both immediate and long-term recall of events. Infants tested at two, four, and six months can recall details about hidden objects, their location, and their size. Infants can recall procedures involving a series of steps, even after long delays. And their ability to do so does not depend on their age, but on the same factors and conditions which improve recall in older children and adults, such as the nature of the events, the number of times they experience them, and the availability of cues or reminders. Those in the forefront of this research conclude that babies are constantly learning and remembering what they need to know at any given time: Their memories are not lost, but are continually updated as learning progresses.

The old belief that infants are mentally incompetent, still widespread today despite the evidence, has delayed acknowledgment of even elementary infant mental abilities. More importantly, this belief has blinded us to the evidence for the higher perception, telepathic communication, and subtle forms of knowing which are displayed by babies in this book.

For a century, babies have fought a losing battle to convince physicians they can experience pain and that their pain matters. Medical denial of infant pain has been blatant in the practice of infant surgery without using anesthetics, the pain-filled rituals of neonatal intensive care, the routine infliction of pain at birth, and the circumcision of newborn males. In the last decade, this battle reached a critical turning point for surgeons, but for obstetricians, the outcome is still in doubt. Parents could have a lot to do with how newborns are treated.

Against a background of scientific ignorance about what newborns could feel, experiments began in 1917 at Johns Hopkins University to observe their tears, reactions to having blood drawn, infections lanced, and their wrists pricked with pins during sleep. Results were unequivocal. When blood was taken from the big toe, the opposite foot came up at once to push the needle away. Lancing produced exaggerated crying, and pin-pricks, even in sleep, provoked a protective response. Even rough cleaning and wiping at birth inspired battling movements and frantic efforts to get away.

Pain experiments continued at Chicago's Lying-In Hospital in the 1920s and 1930s, at Columbia University and Babies' Hospital, New York in the 1940s, and yet again in the 1970s at Washington University School of Medicine in St. Louis. The results were all the same, but the evidence had little effect on doctors' beliefs. Handling of babies continued as usual. In the New York experiments, seventy-five infants were stimulated with a blunt safety pin at intervals from birth to age four. After 2,000 observations, researchers concluded that babies were born with an abnormally weak sense of pain, heat, cold, and touch. They had overlooked the fact that babies had been affected by the anesthesia given their mothers during labor and delivery!

Few people know that even after the discovery of ether anesthetic in 1846, surgeons continued to operate on babies without offering them any relief from pain. Although doctors feared that the babies might be harmed by anesthetics, they had no such fear that babies would be harmed by surgery without anesthetics. Physicians persisted in believing babies had poorly developed brains and would not know they were in pain. Believe it or not, this was still the case when I wrote this book ten years ago!

Two powerful forces converged to change the situation in 1986 to 1988: parent-power amplified by media power, and the power of brilliant research. Helen Harrison and Jill Lawson were mothers of children who were in neonatal intensive care who endured major surgeries without benefit of pain-killing anesthetic. Furthermore, the children were given a muscle paralyzer which prevented them from uttering a sound or lifting a finger in protest! One child went into a decline after surgery and died a few days later, while the other acquired a life long phobia of doctors, hospitals, and all medical procedures.

When these parents told their story, it was spread via radio, television, magazines, and journals attracting the attention of millions of people to the topic of infant surgery without anesthesia. Their stories broke a silence of 150 years. After an initial defense by medical authorities (using the traditional argument that babies didn't need anesthetics or might be harmed by them), the force of public opinion finally overwhelmed them.

At the same time, Mrs. Harrison and Mrs. Lawson were telling their stories, a series of decisive research studies were completed at Oxford University in England by anesthesiologist Kanwal Anand and his colleagues. Using advanced and comprehensive measurement techniques, they followed groups of infants in surgery - with and without anesthesia - and showed that infants both tolerated anesthesia well and had better surgical outcomes than did infants given no anesthesia. Their work brought to light previously hidden relationships between surgery without anesthesia and the physical shock that led to death a few days later. The practice of operating on babies without anesthetic had been hurting and killing babies! Facing the combined effect of parent power and research genius, official guilds of surgeons and anesthesiologists announced an abrupt reversal in policy: They promised to give the same consideration to infants as they did to all other patients in regard to adequate anesthesia for surgery, ending a century and a half of discrimination, suffering, and unnecessary death.

Sadly, in spite of this reform in infant surgery, the routine infliction of pain continues in neonatal intensive care, in hospital birth, and in the circumcision of males, leaving millions of babies still being subjected to needless pain. The problem seems most intractable in the case of neonatology which invented itself in the 1970s when babies were considered insensate, machines were thought of as saviors, and technology was becoming a cultural god. Babies became "cyborgs" (the product of machines) in the name of saving their lives. Medical care of the weakest and sickest babies, most of them born far ahead of time on the edge of viability, is a marvel of pain-inflicting engineering. The man-made womb assembled by technocrats bears no resemblance to the womanly womb, and, surprisingly, no special effort was made to achieve a real-womb analog. In the nation's approximately 700 intensive care nurseries, pain is a way of life for babies who must be tied or immobilized while breathing tubes, suction tubes, and feeding tubes are pushed down their throats. Tubes, needles, and wires are stuck into them, and their delicate skin is burned with alcohol prior to venipuncture or accidentally pulled off when monitor pads are removed. This is the everyday world of neonatology. Analysts describe life in this nursery as a "mixed blessing" because many babies die or are damaged for life, while all life-saving efforts are overshadowed by pain. Although survival prospects have improved in the last decade, especially for babies over three pounds in birth weight, no one can yet predict what the consequences to society will be for inflicting so much pain on so many premature babies. Massive pain typically makes people desperate and irrational, willing to fight and to take extreme risks. Pain feeds rage.

Currently, as many as 400,000 babies per year are entering life through man-made portals of pain. A new frontier of neonatology is fetal surgery-operating on babies inside the womb. In the beginning, surgeons gave no anesthesia because they thought these babies were surely too primitive to experience pain. However, in 1994, neonatologists measured the stress reactions of forty-six fetuses during intrauterine blood transfusions and found an increase of 590% of beta endorphins and 138% increase of cortisol after ten minutes of the invasive surgery-clearly reflecting pain. Even the youngest fetuses mounted a strong hormonal response to the procedure.

Ironically, since the majority of births moved from home to hospital in the United States back in the 1940s, normal babies born at term have been introduced to a new kind of pain: routine, medically-inflicted pain. This pain is inflicted with impunity because doctors continue to doubt both the reality of infant pain and its significance. Doctors are still assuming that pain passes quickly and is soon forgotten. I believe these doctors misunderstand memory and underestimate infants. The gauntlet of pain a baby must run in a hospital birth may start with the insertion of electrodes into the scalp for electronic monitoring, or with a wound to the scalp to obtain a blood sample - all this while the baby's head is still hidden in the birth canal and there is the chance of injury to an eye or an ear.

A medical delivery often begins with artificial induction of labor by rupture of the amniotic sac, which drains away the fluid which would have protected the baby's head during labor. The injection of pitocin, designed to amplify contractions, will increase the pain of contractions for the baby. When a mother receives epidural anesthesia, the efficiency of her labor is reduced so that steel forceps are frequently needed to pull out a baby's head. This insult to the head is quickly followed by a wrenching spinal insult as a baby is held in the air by the ankles, and by painful washing and wiping of sensitive skin to remove the waxy vernix caseosa. Inevitably, there will be an abrupt encounter with flat surfaces (another crude spinal adjustment) as an infant is weighed and measured. The environment of medical birth is a room about thirty degrees colder than what babies have known before; bright light is directed at the baby to help obstetricians see better, but such light is blinding to a baby and spoils first sight; a needle is inserted to supply Vitamin K. A deep lancing wound to the heel is used to obtain a generous blood sample needed for numerous tests. All through this process, the screams and cries of the newborn baby dramatically expresses their shock and discomfort-with no apparent effect on the obstetricians involved, who will treat the next baby exactly the same way.

This novel form of delivery offered by obstetricians in hospitals is a baptism of pain. Birth was not like this in the thousands of years of human evolution prior to the 1940s. Physicians believe it is "the best of care." Cultural anthropologist Robbie Davis-Floyd calls it a ritual of initiation into a technocratic society where machines are used to improve upon nature and all babies have become cyborgs.

Perhaps the most violent routine associated with hospital birth in America through the entire twentieth century is the practice of male circumcision, a surgery to remove the sensitive skin which covers the head of the penis. In the past, this surgery was always done without anesthetic; today, it is frequently done without anesthetic, although medical researchers working with the infants have been virtually unanimous in urging the use of local anesthetics. Polls indicate that the obstetricians and pediatricians who continue to do this excruciating surgery without adequate anesthesia still believe that babies don't need anesthesia and believe that injecting it might cause infection - an argument contradicted by research.

Sixty percent of American boys (down from a high of 90% in decades past) are still subjected to this painful cosmetic surgery which robs them of a functional and pleasurable part of their sexual anatomy. The assortment of "reasons" given by medical authorities for performing this surgery-that it would cure asthma, alcoholism, bedwetting, rheumatism, epilepsy, syphilis, mental illness, and would stop masturbation-have all been proved erroneous and absurd. However, in recent years, American doctors have continued the tradition of dire warnings based on flimsy evidence that an intact foreskin might contribute to sexual diseases, cancer, urinary infections, and even AIDS. There is no research that can possibly justify the mutilation of the majority of American boys born each year.

Even with the humane use of anesthetics to dull the immediate pain of surgery, this unnecessary operation involves shock and a long period of recovery, violates trust between babies and parents, provokes fears of genital injury, and inspires unconscious guarding of sexual parts from further danger. Because newborns are particularly good learners, it is an unconscionable risk to subject them to sexual assault at the very start of life when attitudes, patterns, and habits are being formed on a deep level of mind and body. In a society of increasing violence, especially the predominant violence of men against women, we should consider the possibility that a portion of it may be due to the systematic perpetration of sexual violence on American males on one of the first days of life outside the womb.

We have been so little concerned with the vulnerability of infants to violence that research on this subject has only recently begun, most of it designed to check up on the survivors of neonatal intensive care and very premature birth. Their ranks include many decimated by physical and mental disabilities and emotional illness. I know of no study yet made to explore the connection between pervasive early trauma and antisocial behavior in later life.

Headline stories about serial killers offer suggestive clues about the traumatic spawning grounds of our most brutal criminals, yet systematic research is sparse. An exception is the study by Adrian Raine and colleagues (1994) which revealed that birth complications, combined with severe maternal rejection, predispose to violent crime at eighteen years of age. In a cohort of over 4,200 males with both risk factors, 4% of the group accounted for 18% of the violent crime (murder, assault, rape, armed robbery, illegal possession of a weapon, and threats of violence).

Another rare piece of research throws new light on the possible long-term effect of circumcision trauma. A group at the Hospital for Sick Children in Toronto (1995) studying the reactions of children to vaccination shots four months after birth, discovered that circumcised boys were more strongly affected by the vaccinations. Observers rated them as suffering more and crying longer than boys who were left intact. Researchers suggested that the babies' pain threshold had been lowered by the earlier trauma of circumcision. While additional evidence is needed to illuminate the long-term consequences of circumcision, the new information from Toronto is consistent with the function of memory in sounding an alarm when there is danger of repeating a past trauma, and with new understandings of how neurobiological set points are changed as a result of violent experiences. The irony of this is that the battle which freed babies from major surgical pain a decade ago must be fought all over again to stop doctors from routinely inflicting pain on newborn babies.

The Power of the Infant-Parent Connection

When men took the place of women at birth and birth moved from home to hospital in the 1940s, Mother Nature was not invited to come along. In the 1950s prematurely born babies were starved for forty-eight hours for fear they might choke on "excess fluid." Men advocated cow's milk instead of mother's milk, advising women to feed their babies from bottles every four hours. Men coached mothers to let their babies cry unattended, and even opposed the use of rocking chairs! In hospitals, men promoted circumcision as if the excruciating pain and the robbery of sexual parts were matters of no importance to infants or parents, and men insisted on taking babies away from their mothers to house them in nurseries. In these days, fathers had no rights and were barred from attending their wives during labor and delivery; and mothers of pre-term babies were barred from attending them in the nursery.

Today - sixty years later - rocking chairs are back in vogue, babies are fed on demand rather than on schedule, mother's milk is more highly valued (though shared only for a short period of time with babies), fathers have gained access to delivery rooms, and both parents may visit their baby in the hospital nursery. These reforms were due in large measure to the persistence of Marshall Klaus and John Kennell, the pediatricians who first lifted the banner of "bonding" and have carried it for thirty years.

Ironically, in the decade since the publication of this book, bonding theory and research have been sorely tested. Critics attacked shortcomings in research methodology, said claims for bonding were unjustified, and pronounced the theory "a scientific fiction." Fortunately, these academic quarrels were not sufficient to undo the major reforms which bonding had brought about, but, like most counter-movements, they did bring about clarification in some of the more egregious interpretations of bonding. Bonding, it turns out, is not limited to one specific time when all benefits are gained or lost, but should be considered a continuum of opportunity from pre-conception onward. This fits with what mothers report, that their "moment" for falling in love with or "locking in" with a baby can come at all different times. Marshall Klaus tried to explain that bonding was not an epoxy or contact cement and that they never meant to suggest that mothers who could not be with a baby in the immediate period following birth would never be able to make up for this loss.

The original observations that led to bonding theory correctly noted that there was magic in the air between mothers and babies. They may have been too eager to believe that a period of minutes after birth could affect mothers and babies for years to come. Such things are hard to prove. How long was the "sensitive" period for bonding? At a meeting of the American Medical Association in the 1970s, authorities agreed that ten minutes was the precisely correct amount of time to set aside for "bonding" after delivery! This was epoxy theory at its worst, although even this was better than the medical protocol of snatching babies from their mothers and fathers as soon as they left the womb. What all parents need, and all parents had - until they came to hospitals for birth in the 1940s - was unlimited time for privacy and intimacy with their newborn baby.

Part of the real magic of connections at birth is that babies and parents are wide open to each other at this time. Parents frequently mention the riveting intensity of eye-to-eye contact, made possible by the fact that babies are in a special state of quiet attention immediately after birth. This state lasts only about forty minutes, and allows for profound and intimate communion while all parties are giving absolute attention to each other. It is as though both babies and parents are satisfying an immense curiosity about each other which they have nourished for many months. This timely state will all too quickly give way to a lot of sleeping, a little crying, and other preoccupied and distracted waking states. In a typical twenty-four hour period, a baby will be in the quiet alert state only about 10% of the time.

Other powerful forces are at work in this critical period just after birth. If the babies have not been drugged and are left undisturbed and warm on the mother's abdomen for about an hour after birth, babies will calm themselves, periodically look up at mother, begin to show signs of hunger, and will climb upward, find the breast, and begin suckling, with no assistance. Other provisions of Mother Nature are the exchange of friendly nasal flora, the natural ingestion of Vitamin K in the colostrum, the unique elements of mother's milk that coat the lining of the baby's intestine with an abundance of helpful antibodies which the mother has accumulated during her lifetime-a priceless legacy-and the psychological consolation of being safely in the mother's embrace which is reminiscent of the heart and body sounds that were the music of life inside the womb. The baby's cry sounds trigger the production of breast milk, and the baby's suckling triggers the mother's hormonal chemistry to assist with the expulsion of the placenta, providing further insurance against hemorrhage. This intimate and mutually beneficial start in life is ideal and can be fostered by privacy, rooming-in, and postponement of routine medical intrusions.

It could be worse, of course. There are always many ways to make things worse, but we should not routinely make things worse for mothers, fathers, and babies, especially when we have options to make things better. More than a half century ago medical anthropologist Ashley Montagu warned against separating mothers and babies at birth, advocated rooming-in, and sleeping with babies, and encouraged carrying babies rather than putting them in cribs and play pens. His was a prophetic, if largely unheeded, voice addressing fundamental human needs. Closer to the time the first edition of this book was published, psychiatrist John Bowlby, and pediatrician -turned-child-psychoanalyst, Donald Winnecott, in England, were sounding the alarm that mental health was built on a foundation of attachment between babies and parents. Others sought to measure attachment. Marshall Klaus and John Kennell, inspired by this earlier work, devoted themselves to finding valid measures of the bond they observed in parents who were given time for privacy and contact after birth compared to mothers and infants deprived of contact. They were pioneers exploring uncharted territory, and their discoveries about the extraordinary power of the parent-infant connection were both illuminating and profoundly important.

Further evidence is coming from unexpected sources. A cross-cultural experiment followed groups of 107 children in Greece and the United States whose conceptions were planned and unplanned. The researchers hypothesized that at the age of three months, babies who had been planned would show a higher differential vocal response to their mother (versus a stranger) than would the babies who were unplanned. Their prediction was correct: planned infants showed higher levels of cognitive capacity and attachment to their mothers than did the unplanned infants, as shown by vocal responses to mothers (versus a female stranger) (1993). Presumably, the planned babies enjoyed an earlier and stronger bond with their mothers. In another study of the subtle, but powerful, nature of the bonding connection, a large cohort of 8,000 women were divided into those whose pregnancies were wanted or unwanted. All women were in a privileged group who received early prenatal care under a comprehensive health care program. All were married and should have had a reduced risk of adverse pregnancy outcomes. The statistics for these 8,000 women revealed that babies of unwanted pregnancies had two and a half times the risk of death in the first twenty-eight days of life compared to the babies from wanted pregnancies.

Apparently, a mother's attitude toward pregnancy reached the babies and was translated into a life or death equation (1994). In a smaller experiment, using a hypnotic technique known as ideomotor signaling (described in Chapter Six), 25 out of 26 women correctly identified the gender of their baby before ultrasound examination or before birth. In the one case that was deemed incorrect according to ultrasound, the finger signal was correct, while the ultrasound reading was false! This remarkable finding again suggests a potent connection between mother and baby in the womb making it possible to know the gender before any physical indications are available. Similarly, this psychological bond between mother and baby in utero has been confirmed in a series of recent experiments with smoking and sham-smoking. Babies clearly increased their startle reactions to sham-smoking, a condition where no cigarette is lighted (1995). Since there was never any smoke to affect the baby chemically, the connection between mother and baby was purely psychological.

Ten years of additional evidence since the publication of the first edition of this book shows that babies are better equipped to relate to us than we previously supposed. As proof of human memory has been pushed back from age three to birth, the period previously thought to be clouded by amnesia, and from birth to life in the womb, we have reason to think more seriously about the birth memories our children are carrying. When we believed that no mind could be working at birth, we never had to consider the consequences of needless pain and suffering on our personal lives or on our social order. Now, we may be able to understand more fully the roots of violence in modern society and systematically set about replacing painful experiences with pleasant ones at times before, during, and after birth.