You may not realize it, but as you navigated through this morning’s hospital rounds and your busy office schedule, some of what you did and how you did it was the result of the pioneering work of Boston-based pediatrician T. Berry Brazelton, MD, who died March 13, 2018, at the age of 99.
You probably found the newborn you needed to examine in his mother’s hospital room. The 3-year-old in the croup tent was sharing his room with his father, who was sleeping on a cot at his crib side, and three out of the first four patients you saw in your office had been breastfed. These scenarios would have been unheard of 50 years ago. But Dr. Brazelton’s voice was the most widely heard, yet gentlest and persuasive in support of rooming-in and breastfeeding.
Although I was fortunate to have had dinner with Benjamin Spock’s widow, I never met Dr. Spock himself. However, I did interact on several occasions with the man who inherited his mantle as the most well-recognized pediatrician in America. Dr. T. Berry Brazelton and his fellows played an active role in the pediatric training of those of us who rotated through Boston Children’s Hospital as medical students and house officers.
Watching Dr. Brazelton examine a newborn for the first time was a unique experience and a critical turning point in my training. My fellow house officers and I had been accustomed to picking up infants to assess their tone. However, when Dr. Brazelton picked up a newborn, it was more like a conversation, an interview, and in a sense, it was a meeting of the minds.
It wasn’t that we had been rejecting the notion that a newborn could have a personality. It is just that we hadn’t been taught to look for it or to take it seriously. Dr. Brazelton taught us how to examine the person inside that little body and understand the importance of her temperament. By sharing what we learned from doing a Brazelton-style exam, we hoped to encourage the child’s parents to adopt more realistic expectations, and as a consequence, make parenting less mysterious and stressful.
When I first met Dr. Brazelton, he was in his mid-40s and just beginning on his trajectory toward national prominence. When we were assigned to take care of his hospitalized patients, it was obvious that his patient skills with sick children had taken a back seat to his interest in newborn temperament. He was more than willing to let us make the management decisions. In retrospect, that experience was a warning that I, like many other pediatricians, would face the similar challenge of maintaining my clinical skills in the face of a patient mix that was steadily acquiring a more behavioral and developmental flavor.
It is impossible to quantify the degree to which Dr. Brazelton’s ubiquity contributed to the popularity of a more child-centered parenting style. However, I think it would be unfair to blame him for the unfortunate phenomenon known as “helicopter parenting.”
He has been quoted as saying, “I would like to look at what can be done to get parents to relax and not to take [parenthood] too seriously.” ( “T. Berry Brazelton, doctor who challenged parents to read babies’ cues, dies,” Washington Post, March 14, 2018 ). And for the most part with his calm and gentle demeanor, he achieved his goal. Unfortunately, not every parent who tried to follow Dr. Brazelton’s advice about reading their baby’s cues was successful. With his passing, it is up to us as pediatricians to continue comforting those parents who are struggling and echo his reassuring message.
Dr. Wilkoff practiced primary care pediatrics in Brunswick, Maine for nearly 40 years. He has authored several books on behavioral pediatrics, including “How to Say No to Your Toddler.” Email him at pdnews@frontlinemedcom.com .
