The neonate exists in a developmental stage in which many of the adaptations of the fetus are no longer relevant to the survival demands of postnatal life. Consequently, the neonate is presented at the moment of birth with a dramatically altered set of challenges, most particularly managing to maintain physiological homeostasis outside of the mother's uterus. The focus of this essay is on recent breakthroughs in the understanding of this amazing feat.
The limitations and capacities of the neonate in adjusting to life outside the womb suggest that this developmental period is truly unique, and that it is no surprise that important psychological processes become organized in the first 3 months of life. During the prenatal to postnatal transition, many systems are differentiating and emerging in form and function. For example, sensory systems, at various levels of maturation, are prepared to operate at birth with some efficiency, particularly the senses of touch, olfaction, and taste and the auditory system. Conversely, the visual system in the human neonate, as opposed to most primates, is relatively immature, requiring several months for complex functions such as acuity and accommodation to come on board. However, perceptual understanding of the environment is primitive.
Although there is much debate concerning the degree to which neonates appreciate object properties, there is evidence that infants exhibit preparedness to respond to certain cues with great competency. For example, in many cases, a few minutes after birth, infants are capable of responding rapidly to the cues for suckling. Using olfactory and touch cues, the neonate orients to the mother's breast, searches and attaches to the nipple, and suckles efficiently enough to feed. It is known from examining fetal behavior that the complex sequence of neonatal reflexes observed in the first feeding encounter has been carefully prepared in fetal life to ensure success. Further, infants are capable of associative learning under certain circumstances, particularly in relation to maternal exchanges.
Hence, as the neonate becomes experienced with feeding, competencies improve and reliance on neonatal reflexes such as rooting becomes integrated with the unique features of the maternal sensory environment. With regard to prenatal preparation and conditioning, the neonate soon after birth recognizes and responds to the unique features of the mother's voice. With the auditory cue only, neonates can select their own mother from other mothers who have just given birth, and even show a preference for the prenatal language of exposure.
Nonetheless, perception of the world around the neonate is limited by developmental immaturity in neurocognitive processes. With regard to brain development, the cortex is still extremely immature during the first 3 months, as indicated by neuroimaging, and this is reflected in the limitations of the newborn's cognitive understanding and memory function. Neuroplasticity as an experience-dependent process is in high gear during infancy. It has become increasingly clear that the nature of neonatal experiences is both necessary and directive in the processes of central nervous system plasticity and, in fact, sculpts the nervous system in profound ways.
Behavioral systems for regulating cardiorespiratory function, food intake, and thermoregulation become activated to maintain the health and well-being of the child. However, motor systems have poor differentiation of movements (with the exception of neonatal reflexes), relative weakness, and complex tone that is unique and different from earlier or later ages. Most of the time, the neonate is asleep (about 18-22 hours per day) and expresses a noncircadian distribution. Waking is brief and associated with feeding episodes, which vary in period based on mode (breast versus bottle) but average about 2 to 3 hours. Toward the end of the neonatal phase, alertness improves, as does the distribution of sleep to the nocturnal phase.
To communicate with caregivers, the neonate uses crying as the distress signal for any dysfunction in the capacity of his or her regulatory efforts. Social relationships that begin early in life with primary caregivers, such as with parents, are ideally characterized by continuity from this stage to the next. In the attachment process, it is the parent, rather than the infant, who is capable of maintaining proximity. Neonates are best soothed by skin-to-skin contact and being held frequently and for long periods. Social contact with primary caregivers at this age contributes to the development of attachment specificity by 4 to 8 months. The type and intensity of psychological stimulation required for rapidly growing motor, sensory, emotional, and cognitive domains is most supported by social contact. The unifying concept throughout this and later infancy stages is the dynamic interaction between maturational-genetic and environmental factors that influence both immediate and long-term trajectories of psychological growth.
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