Inside The Womb

Such images of life stirring in the womb - in this case, of a 17-week-old fetus no bigger than a newborn kitten - are at the forefront of a biomedical revolution that is rapidly transforming the way we think about the prenatal world.

For although it takes 9 months to make a baby, we now know that the most important developmental steps - including laying the foundation for such major organs as the heart, lungs & brain - occur before the end of the first 3.

We also know that long before a child is born its genes engage the environment of the womb in an elaborate conversation, a 2-way dialogue that involves not only the air its mother breathes & the water she drinks but also what drugs she takes, what diseases she contracts & what hardships she suffers.

One reason we know this is a series of remarkable advances in mri's, sonograms & other imaging technologies that allow us to peer into the developmental process at virtually every stage - from the fusion of sperm & egg to the emergence, some 40 weeks later, of a miniature human being.

The extraordinary pictures on these pages come from a new book that captures some of the color & excitement of this research: From Conception to Birth: A Life Unfolds (Doubleday), by photographer Alexander Tsiaras & writer Barry Werth.

Their computer-enhanced images are reminiscent of the remarkable fetal portraits taken by medical photographer Lennart Nilsson, which appeared in Life magazine in 1965. Like Nilsson's work, these images will probably spark controversy.

Antiabortion activists may interpret them as evidence that a fetus is a viable human being earlier than generally believed, while pro-choice advocates may argue that the new technology allows doctors to detect serious fetal defects at a stage when abortion is a reasonable option.

We also know that long before a child is born its genes engage the environment of the womb in an elaborate conversation, a 2-way dialogue that involves not only the air its mother breathes & the water she drinks but also what drugs she takes, what diseases she contracts & what hardships she suffers.

One reason we know this is a series of remarkable advances in mri's, sonograms & other imaging technologies that allow us to peer into the developmental process at virtually every stage - from the fusion of sperm & egg to the emergence, some 40 weeks later, of a miniature human being.

The extraordinary pictures on these pages come from a new book that captures some of the color & excitement of this research: From Conception to Birth: A Life Unfolds (Doubleday), by photographer Alexander Tsiaras & writer Barry Werth.

Their computer-enhanced images are reminiscent of the remarkable fetal portraits taken by medical photographer Lennart Nilsson, which appeared in Life magazine in 1965. Like Nilsson's work, these images will probably spark controversy.

Antiabortion activists may interpret them as evidence that a fetus is a viable human being earlier than generally believed, while pro-choice advocates may argue that the new technology allows doctors to detect serious fetal defects at a stage when abortion is a reasonable option.

The other reason we know so much about what goes on inside the womb is the remarkable progress researchers have made in teasing apart the sequence of chemical signals & switches that drive fetal development.

Scientists can now describe at the level of individual genes & molecules many of the steps involved in building a human, from the establishment of a head-to-tail growth axis & the budding of limbs to the sculpting of a 4-chambered heart & the weaving together of trillions of neural connections.

Scientists are beginning to unroll the genetic blueprint of life & identify the precise molecular tools required for assembly. Human development no longer seems impossibly complex, says Stanford Univ. biologist Matthew Scott. "It just seems marvelous."

How is it, we are invited to wonder, that a fertilized egg - a mere speck of protoplasm & DNA encased in a spherical shell - can generate such complexity?

The answers, while elusive & incomplete, are beginning to come into focus.

Only 20 years ago, most developmental biologists thought that different organisms grew according to different sets of rules, so that understanding how a fly or a worm develops - or even a vertebrate like a chicken or a fish - would do little to illuminate the process in humans.

Then, in the 1980's, researchers found remarkable similarities in the molecular tool kit used by organisms that span the breadth of the animal kingdom & those similarities have proved serendipitous beyond imagining. No matter what the species, nature uses virtually the same nails & screws, the same hammers & power tools to put an embryo together.

Among the by-products of the torrent of information pouring out of the laboratory are new prospects for treating a broad range of late-in-life diseases.

Just last month, i.e., 3 biologists won the Nobel Prize for Medicine for their work on the nematode Caenorhabditis elegans, which has a few more than 1,000 cells, compared with a human's 50 trillion.

The 3 winners helped establish that a fundamental mechanism that C. elegans embryos employ to get rid of redundant or abnormal cells also exists in humans & may play a role in AIDS, heart disease & cancer.

Even more exciting, if considerably more controversial, is the understanding that embryonic cells harbor untapped therapeutic potential. These cells, of course, are stem cells & they're the progenitors of more specialized cells that make up organs & tissues.

By harnessing their generative powers, medical researchers believe, it may one day be possible to repair the damage wrought by injury & disease. (That prospect suffered a political setback last week when a federal advisory committee recommended that embryos be considered the same as human subjects in clinical trials.)

To be sure, the marvel of an embryo transcends the collection of genes & cells that compose it. For unlike strands of DNA floating in a test tube or stem cells dividing in a Petri dish, an embryo is capable of building not just a protein or a patch of tissue but a living entity in which every cell functions as an integrated part of the whole.

"Imagine yourself as the world's tallest skyscraper, built in 9 months & germinating from a single brick," suggest Tsiaras & Werth in the opening of their book. "As that brick divides, it gives rise to every other type of material needed to construct & operate the finished tower - a million tons of steel, concrete, mortar, insulation, tile, wood, granite, solvents, carpet, cable, pipe & glass as well as all furniture, phone systems, heating and cooling units, plumbing, electrical wiring, artwork & computer networks, including software."

Given the number of steps in the process, it'll perhaps forever seem miraculous that life ever comes into being without a major hitch. "Whenever you look from one embryo to another," observes Columbia Univ. developmental neurobiologist Thomas Jessell, "what strikes you is the fidelity of the process."

Sometimes, though, that fidelity is compromised & the reasons why this happens are coming under intense scrutiny. In laboratory organisms, birth defects occur for purely genetic reasons when scientists purposely mutate or knock out specific sequences of DNA to establish their function.

But when development goes off track in real life, the cause can often be traced to a lengthening list of external factors that disrupt some aspect of the genetic program.

For an embryo doesn't develop in a vacuum but depends on the environment that surrounds it. When a human embryo is deprived of essential nutrients or exposed to a toxin, such as alcohol, tobacco or crack cocaine, the consequences can range from readily apparent abnormalities - spina bifida, fetal alcohol syndrome - to subtler metabolic defects that may not become apparent until much later.

Ironically, even as society at large continues to worry almost obsessively about the genetic origins of disease, the biologists & medical researchers who study development are mounting an impressive case for the role played by the prenatal environment.

A growing body of evidence suggests that a number of serious maladies - among them, atherosclerosis, hypertension & diabetes - trace their origins to detrimental prenatal conditions.

As New York Univ. Medical School's Dr. Peter Nathanielsz puts it, "What goes on in the womb before you're born is just as important to who you are as your genes."

Most adults, not to mention most teenagers, are by now thoroughly familiar with the mechanics of how the sperm in a man's semen & the egg in a woman's oviduct connect & it's at this point that the story of development begins.

For the sperm & the egg each contain only 23 chromosomes, half the amount of DNA needed to make a human. Only when the sperm & the egg fuse their chromosomes does the tiny zygote, as a fertilized egg is called, receive its instructions to grow. And grow it does, replicating its DNA each time it divides - into two cells, then four, then eight and so on.

If cell division continued in this fashion, then 9 months later the hapless mother would give birth to a tumorous ball of literally astronomical proportions.

But instead of endlessly dividing, the zygote's cells progressively take form. The first striking change is apparent 4 days after conception, when a 32-cell clump called the morula (which means "mulberry" in Latin) gives rise to 2 distinct layers wrapped around a fluid-filled core.

Now known as a blastocyst, this spherical mass will proceed to burrow into the wall of the uterus. A short time later, the outer layer of cells will begin turning into the placenta & amniotic sac, while the inner layer will become the embryo.

The formation of the blastocyst signals the start of a sequence of changes that are as precisely choreographed as a ballet. At the end of Week One, the inner cell layer of the blastocyst balloons into 2 more layers.

From the first layer, known as the endoderm, will come the cells that line the gastrointestinal tract. From the second, the ectoderm, will arise the neurons that make up the brain & spinal cord along with the epithelial cells that make up the skin.

At the end of Week Two, the ectoderm spins off a thin line of cells known as the primitive streak, which forms a new cell layer called the mesoderm. From it will come the cells destined to make the heart, the lungs & all the other internal organs.

At this point, the embryo resembles a stack of Lilliputian pancakes - circular, flat & horizontal. But as the mesoderm forms, it interacts with cells in the ectoderm to trigger yet another transformation. Very soon these cells will roll up to become the neural tube, a rudimentary precursor of the spinal cord & brain.

Already the embryo has a distinct cluster of cells at each end, one destined to become the mouth & the other the anus. The embryo, no larger at this point than a grain of rice, has determined the head-to-tail axis along which all its body parts will be arrayed.

How on earth does this little, barely animate cluster of cells "know" what to do? The answer is as simple as it is startling. A human embryo knows how to lay out its body axis in the same way that fruit-fly embryos know & C. elegans embryos & the embryos of myriad other creatures large & small know.

In all cases, scientists have found, in charge of establishing this axis is a special set of genes, especially the so-called homeotic homeobox, or HOX, genes.

HOX genes were first discovered in fruit flies in the early 1980's when scientists noticed that their absence caused striking mutations. Heads, i.e., grew feet instead of antennae & thoraxes grew an extra pair of wings.

HOX genes have been found in virtually every type of animal & while their number varies - fruit flies have 9, humans have 39 - they're invariably arrayed along chromosomes in the order along the body in which they're supposed to turn on.

Many other genes interact with the HOX system, including the aptly named Hedgehog & Tinman genes, without which fruit flies grow a dense covering of bristles or fail to make a heart. And scientists are learning in exquisite detail what each does at various stages of the developmental process.

Thus 1 of the 3 Hedgehog genes - Sonic Hedgehog, named in honor of the cartoon & video-game character - has been shown to play a role in making at least half a dozen types of spinal-cord neurons. As it happens, cells in different places in the neural tube are exposed to different levels of the protein encoded by this gene; cells drenched in significant quantities of protein mature into one type of neuron & those that receive the barest sprinkling mature into another.

Indeed, it was by using a particular concentration of Sonic Hedgehog that neurobiologist Jessell & his research team at Columbia recently coaxed stem cells from a mouse embryo to mature into seemingly functional motor neurons.

At the Univ. of California, San Francisco, a team led by biologist Didier Stainier is working on genes important in cardiovascular formation. Removing one of them, called Miles Apart, from zebra-fish embryos results in a mutant with two nonviable hearts. Why?

In all vertebrate embryos, including humans, the heart forms as twin buds. In order to function, these buds must join. The way the Miles Apart gene appears to work, says Stainier, is by detecting a chemical attractant that, like the smell of dinner cooking in the kitchen, entices the pieces to move toward each other.

The crafting of a human from a single fertilized egg is a vastly complicated affair & at any step, something can go wrong. When the heart fails to develop properly, a baby can be born with a hole in the heart or even missing valves & chambers. When the neural tube fails to develop properly, a baby can be born with a brain not fully developed (anencephaly) or with an incompletely formed spine (spina bifida).

Neural-tube defects, it has been firmly established, are often due to insufficient levels of the water-soluble B vitamin folic acid. Reason: folic acid is essential to a dividing cell's ability to replicate its DNA.

Vitamin A, which a developing embryo turns into retinoids, is another nutrient that is critical to the nervous system. But watch out, because too much vitamin A can be toxic.

In another newly released book, Before Your Pregnancy (Ballantine Books), nutritionist Amy Ogle & obstetrician Dr. Lisa Mazzullo caution would-be mothers to limit foods that are overly rich in vitamin A, especially liver & food products that contain lots of it, like foie gras & cod-liver oil.

An excess of vitamin A, they note, can cause damage to the skull, eyes, brain & spinal cord of a developing fetus, probably because retinoids directly interact with DNA, affecting the activity of critical genes.

Folic acid, vitamin A & other nutrients reach developing embryos & fetuses by crossing the placenta, the remarkable temporary organ produced by the blastocyst that develops from the fertilized egg.

The outer ring of cells that compose the placenta are extremely aggressive, behaving very much like tumor cells as they invade the uterine wall & tap into the pregnant woman's blood vessels. In fact, these cells actually go in & replace the maternal cells that form the lining of the uterine arteries, says Susan Fisher, a developmental biologist at the Univ. of California, San Francisco.

They trick the pregnant woman's immune system into tolerating the embryo's presence rather than rejecting it like the lump of foreign tissue it is.

In essence, says Fisher, "the placenta is a traffic cop," & its main job is to let good things in & keep bad things out. To this end, the placenta marshals platoons of natural killer cells to patrol its perimeters & engages millions of tiny molecular pumps that expel poisons before they can damage the vulnerable embryo.

Alas, the placenta's defenses are sometimes breached - by microbes like rubella & cytomegalovirus, by drugs like thalidomide & alcohol, by heavy metals like lead & mercury & by organic pollutants like dioxin & PCBs.

Pathogens & poisons contained in certain foods are also able to cross the placenta, which may explain why placental tissues secrete a nausea-inducing hormone that has been tentatively linked to morning sickness.

One provocative if unproved hypothesis says morning sickness may simply be nature's crude way of making sure that potentially harmful substances don't reach the womb, particularly during the critical first trimester of development.

Timing is decisive where toxins are concerned. Air pollutants like carbon monoxide & ozone, i.e., have been linked to heart defects when exposure coincided with the 2nd month of pregnancy, the window of time during which the heart forms.

Similarly, the nervous system is particularly vulnerable to damage while neurons are migrating from the part of the brain where they're made to the area where they will ultimately reside. "A tiny, tiny exposure at a key moment when a certain process is beginning to unfold can have an effect that is not only quantitatively larger but qualitatively different than it would be on an adult whose body has finished forming," observes Sandra Steingraber, an ecologist at Cornell Univy.

Among the substances Steingraber is most worried about are environmentally persistent neurotoxins like mercury & lead (which directly interfere with the migration of neurons formed during the first trimester) & PCB's (which, some evidence suggests, block the activity of thyroid hormone).

"Thyroid hormone plays a noble role in the fetus," says Steingraber. "It actually goes into the fetal brain & serves as kind of a conductor of the orchestra."

PCB's are no longer manufactured in the U.S., but other chemicals potentially harmful to developing embryos & fetuses are. Theo Colborn, director of the World Wildlife Fund's contaminants program, says at least 150 chemicals pose possible risks for fetal development & some of them can interfere with the naturally occurring sex hormones critical to the development of a fetus.

Antiandrogens, i.e., are widely found in fungicides & plastics. One in particular - DDE, a breakdown product of ddt - has been shown to cause hypospadias in laboratory mice, a birth defect in which the urethra fails to extend to the end of the penis.

In humans, however, notes Dr. Allen Wilcox, editor of the journal Epidemiology, the link between hormone-like chemicals & birth defects remains elusive.

The list of potential threats to embryonic life is long. It includes not only what the mother eats, drinks or inhales, explains N.Y.U.'s Nathanielsz, but also the hormones that surge thru her body. Pregnant rats with high blood-glucose levels (chemically induced by wiping out their insulin) give birth to female offspring that are unusually susceptible to developing gestational diabetes.

These daughter rats are able to produce enough insulin to keep their blood glucose in check, says Nathanielsz, but only until they become pregnant. At that point, their glucose level soars, because their pancreases were damaged by prenatal exposure to their mother's sugar-spiked blood.

The next generation of daughters is, in turn, more susceptible to gestational diabetes & the transgenerational chain goes on.

In similar fashion, atherosclerosis may sometimes develop because of prenatal exposure to chronically high cholesterol levels. According to Dr. Wulf Palinski, an endocrinologist at the Univ. of California at San Diego, there appears to be a kind of metabolic memory of prenatal life that's permanently retained.

In genetically similar groups of rabbits & kittens, at least, those born to mothers on fatty diets were far more likely to develop arterial plaques than those whose mothers ate lean.

But of all the long-term health threats, maternal undernourishment -which stunts growth even when babies are born full term - may top the list.

"People who are small at birth have, for life, fewer kidney cells & so they're more likely to go into renal failure when they get sick," observes Dr. David Barker, director of the environmental epidemiology unit at England's Univ. of Southampton.

The same is true of insulin-producing cells in the pancreas, so that low-birth-weight babies stand a higher chance of developing diabetes later in life because their pancreases - where insulin is produced - have to work that much harder.

Barker, whose research has linked low birth weight to heart disease, points out that undernourishment can trigger lifelong metabolic changes. In adulthood, i.e., obesity may become a problem because food scarcity in prenatal life causes the body to shift the rate at which calories are turned into glucose for immediate use or stored as reservoirs of fat.

But just how does undernourishment reprogram metabolism?

Does it perhaps prevent certain genes from turning on, or does it turn on those that should stay silent?

Scientists are racing to answer those questions, along with a host of others. If they succeed, many more infants will find safe passage thru the critical first months of prenatal development.

Indeed, our expanding knowledge about the interplay between genes & the prenatal environment is cause for both concern & hope. Concern because maternal & prenatal health care often ranks last on the political agenda.

Hope because by changing our priorities, we might be able to reduce the incidence of both birth defects & serious adult diseases.

With reporting by David Bjerklie & Alice Park / New York & Dan Cray / Los Angeles

How They Did It

These are no ordinary baby pictures. What Tsiaras & his colleagues are manipulating are layers of data gathered by CT scans, micro magnetic resonance imaging (MRI) & other visualization techniques.

When Lennart Nilsson took his groundbreaking photographs in the 1960's, he was limited to what he could innovatively capture with a flash camera. Since then, says Tsiaras, "there's been a revolution in imaging."

What's changed is that development can now be viewed thru a wide variety of prisms, using different forms of energy to illuminate different aspects of the fetus.

CT scans, i.e., are especially good at showing bone & MRI is excellent for soft tissue. These two-dimensional layers of information are assembled, using sophisticated computer software, into a three-dimensional whole.

The results are painstakingly accurate & aesthetically stunning. Tsiaras, who trained as a painter & sculptor, used medical specimens from the Carnegie Human Embryology Collection at the National Museum of Health & Medicine in Washington as models for all but a few images.

The specimens came from a variety of sources, according to museum director Adrianne Noe, including miscarriages & medically necessary procedures. None were acquired from elective abortions. - By David Bjerklie

Intentions

Baldwin's previous research suggests that infants as young as 12-18 months are able to understand something about the intentions that underlie people's behavior. Infant's abilities in this respect are remarkable given that human behavior tends to occur in a complex, rapid & continuous stream. Baldwin is now investigating the origins of these impressive abilities.

Baldwin wondered if infants, even younger than one year of age, might have the capacity to identify structure within complex activity. Would infants recognize the "units of action" in the behavior of the person they're observing?

Would the infants recognize these units even when the units aren't demarcated, in any simple way, by pauses in the flow of behavior?

"i.e.," she says, "many of our behaviors fall into a similar pattern: we fix our gaze on an object, touch it or otherwise manipulate it, release it & move our gaze & body-orientation elsewhere, then repeat the process with another object.

If infants can identify each goal-directed action as a discrete unit, they would have a leg up on discovering the intentions motivating such activities."

By running a series of experiments with infants, Baldwin & colleagues collected evidence that infants indeed segment continuously flowing behavior into units that coincide with the initiation & completion of intention.

The scientists used a series of videotapes of adults performing simple actions, such as grasping a towel. Sometimes, the tapes were freeze-framed at the completion of the action; other times, the tapes were freeze-framed in the middle.

The infants showed only moderate interest in the tapes that showed the complete action. But they were transfixed by tapes that interrupted the expected sequence in mid-stream. That, says Baldwin, appears to be "the first evidence out there that infants this young are sensitive to the structure inherent in intentional action."

Taken as a whole, Baldwin's research contributes significantly to our understanding of how social cognition, language & knowledge acquisition are linked in the developing brain.

Newborn Life: Key Controversies in the Last Decade
by David Chamberlain, Ph.D.

In 1988, when Babies Remember Birth was first published, scientists weren't ready to acknowledge that a newborn infant could possibly have a working mind, while parents, blessed by close encounters with their own babies, were open to the idea.

This notable difference in attitude between "experts" & parents still prevails, although the study of babies & their abilities became more popular in psychology & medicine over the last decade.

The bulging bank of prenatal & perinatal information now provides ever-expanding support for the unexpected abilities of babies in the womb, as well as at their births.

Yet, this book in its documentation of the advanced qualities of newborn memory & the far ranges of infant consciousness is still unique - & still remains controversial.

The superb memories & 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 & consciousness.

Babies are comfortably at home in the larger paradigm. Looking back on a decade of debates & discoveries related to newborn life, I have been particularly interested in 3 important areas where skepticism persists, even as evidence continues to mount:

• skepticism about all human memory, especially early memory
• skepticism about infant pain perception & the failure in medicine to grasp its significance
• skepticism about the life-changing power of early parent-infant communication & bonding

Understanding Memory

Memory, although it accompanies us on our everyday rounds & for all practical purposes, functions marvelously, can still be personally vexing & puzzling to the scientists who try to understand it.

Memory is hard to locate & explain: it's a mystery of perfection & 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 & led to considerable public confusion & disillusionment.

Can any human memory be trusted, especially the long-buried memories of birth & infancy?

Out of the turbulent waters of debate between plaintiffs & defendants, between experts testifying on opposite sides & the collision of clinicians & researchers in scientific associations came additional clarity about the fundamentals noted above.

The pendulum lurched between extremes: Memories are sacred & automatically true & memories are little more than fantasies & can't be trusted. Professionals may now be prepared to grant that while memories can't be guaranteed, they may be remarkably accurate.

Psychotherapists, though they aren't detectives or lawyers, have learned that validity of memory is a legitimate concern & that they have an obligation to help clients discriminate between fantasy & reality.

When personal memories are brought to court, they'll be vigorously challenged & be met with more criticism than respect. Accusations of child abuse & murder, based solely on memory & 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 shouldn't 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 & 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 & admitted to consciousness.

That they were submerged for a time isn't proof they're 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 & 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 & accurate.

This form of memory is seen in war veterans who encountered unimaginable displays of violence & death. Some members of the same battle group will carry clear & specific memories, while others repress the experience totally - perhaps for decades - yet, like the children, these veterans act out their anxiety & shock in daily life.

With therapeutic guidance, these subterranean memories can be raised & 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 & prudence & as much objectivity as possible in judging what we've done & what others have done to us.

In academic circles, a long-standing prejudice against the reliability of early memory (intrauterine memory, birth memory & 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 & 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 4 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 & smells introduced in utero - are all treated as familiar, that is, learned & remembered from weeks & months in the past.

Memory experts have continued to overlook the prima facie evidence provided by 2 & 3 year old children recalling specifics of their birth when they're first able to speak.

This important evidence, published in magazines for childbirth educators & parents in 1981 & which I celebrated in this book, was never taken seriously in scientific circles. All this time, we've had memory experts denying birth memory while new waves of 3 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 3rd or 4th 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 40 years. Piagetian ideas about the limitations of newborn intelligence & 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 3 dozen crucial experiments, over a decade of time. Now, at last, the theory of infantile amnesia is dead.

The principal idea in medicine & psychology which made it difficult to accept any sophisticated early use of the mind was the idea that the immature & unfinished brain couldn't support memory & learning.

Added to that was the difficulty of testing true personal memory with infants who couldn't talk. For these reasons research was avoided & when evidence did appear, it was ignored or denied.

Under heavy odds, experimental psychologists have managed to prove that children age 3, age 2 & age 1 are all capable of both immediate & long-term recall of events. Infants tested at 2, 4 & 6 months can recall details about hidden objects, their location & their size.

Infants can recall procedures involving a series of steps, even after long delays. And their ability to do so doesn't depend on their age, but on the same factors & conditions which improve recall in older children & adults, such as the nature of the events, the number of times they experience them & the availability of cues or reminders.

Those in the forefront of this research conclude that babies are constantly learning & remembering what they need to know at any given time: Their memories aren't 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 & subtle forms of knowing which are displayed by babies in this book.

Understanding Infant Pain

For a century, babies have fought a losing battle to convince physicians they can experience pain & 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 & 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 Univ. to observe their tears, reactions to having blood drawn, infections lanced & 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 & pin-pricks, even in sleep, provoked a protective response. Even rough cleaning & wiping at birth inspired battling movements & frantic efforts to get away.

Pain experiments continued at Chicago's Lying-In Hospital in the 1920's & 1930's, at Columbia Univ. & Babies' Hospital, New York in the 1940's & yet again in the 1970's at Washington Univ. 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, 75 infants were stimulated with a blunt safety pin at intervals from birth to age 4.

After 2,000 observations, researchers concluded that babies were born with an abnormally weak sense of pain, heat, cold & touch. They had overlooked the fact that babies had been affected by the anesthesia given their mothers during labor & 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 & wouldn't know they were in pain. Believe it or not, this was still the case when I wrote this book 10 years ago!

Two powerful forces converged to change the situation in 1986 to 1988: parent-power amplified by media power & the power of brilliant research.

Helen Harrison & 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 & died a few days later, while the other acquired a life long phobia of doctors, hospitals & all medical procedures.

When these parents told their story, it was spread via radio, television, magazines & 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 & Mrs. Lawson were telling their stories, a series of decisive research studies were completed at Oxford Univ. in England by anesthesiologist Kanwal Anand & his colleagues.

Using advanced & comprehensive measurement techniques, they followed groups of infants in surgery - with & without anesthesia - & showed that infants both tolerated anesthesia well & had better surgical outcomes than did infants given no anesthesia.

Their work brought to light previously hidden relationships between surgery without anesthesia & the physical shock that led to death a few days later. The practice of operating on babies without anesthetic had been hurting & killing babies!

Facing the combined effect of parent power & research genius, official guilds of surgeons & 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 & unnecessary death.

Sadly, in spite of this reform in infant surgery, the routine infliction of pain continues in neonatal intensive care, in hospital birth & 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 1970's when babies were considered insensate, machines were thought of as saviors & 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 & 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 & 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 & feeding tubes are pushed down their throats.

Tubes, needles & wires are stuck into them & 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 3 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 & irrational, willing to fight & to take extreme risks. Pain feeds rage.

Currently, as many as 400,000 babies per year are entering life thru 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 46 fetuses during intrauterine blood transfusions & found an increase of 590% of beta endorphins & 138% increase of cortisol after 10 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 US back in the 1940's, 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 & its significance. Doctors are still assuming that pain passes quickly & is soon forgotten. I believe these doctors misunderstand memory & 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 & there's 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 & by painful washing & 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 & measured. The environment of medical birth is a room about 30 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 & 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 thru this process, the screams & cries of the newborn baby dramatically expresses their shock & 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 wasn't like this in the thousands of years of human evolution prior to the 1940's. 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 & all babies have become cyborgs.

Perhaps the most violent routine associated with hospital birth in America thru the entire 20th 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's 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 & pediatricians who continue to do this excruciating surgery without adequate anesthesia still believe that babies don't need anesthesia & believe that injecting it might cause infection - an argument contradicted by research.

60% 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 & 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 & would stop masturbation-have all been proved erroneous & 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 & even AIDS. There's 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 & a long period of recovery, violates trust between babies & parents, provokes fears of genital injury & inspires unconscious guarding of sexual parts from further danger.

Because newborns are particularly good learners, it's an unconscionable risk to subject them to sexual assault at the very start of life when attitudes, patterns, & habits are being formed on a deep level of mind & 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've 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 & very premature birth. Their ranks include many decimated by physical & mental disabilities & emotional illness. I know of no study yet made to explore the connection between pervasive early trauma & 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 & colleagues (1994) which revealed that birth complications, combined with severe maternal rejection, predispose to violent crime at 18 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 & 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 4 months after birth, discovered that circumcised boys were more strongly affected by the vaccinations. Observers rated them as suffering more & 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's danger of repeating a past trauma & 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 & birth moved from home to hospital in the 1940's, Mother Nature wasn't invited to come along. In the 1950's prematurely born babies were starved for 48 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 4 hours. Men coached mothers to let their babies cry unattended & even opposed the use of rocking chairs!

In hospitals, men promoted circumcision as if the excruciating pain & the robbery of sexual parts were matters of no importance to infants or parents & men insisted on taking babies away from their mothers to house them in nurseries.

In these days, fathers had no rights & were barred from attending their wives during labor and delivery & mothers of pre-term babies were barred from attending them in the nursery.

Today - 60 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 & both parents may visit their baby in the hospital nursery.

These reforms were due in large measure to the persistence of Marshall Klaus & John Kennell, the pediatricians who first lifted the banner of "bonding" & have carried it for 30 years.

Ironically, in the decade since the publication of this book, bonding theory & research have been sorely tested. Critics attacked shortcomings in research methodology, said claims for bonding were unjustified & pronounced the theory "a scientific fiction."

Fortunately, these academic quarrels weren't 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, isn't 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 & that they never meant to suggest that mothers who couldn't 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 & babies. They may have been too eager to believe that a period of minutes after birth could affect mothers & 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 1970's, authorities agreed that 10 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 & fathers as soon as they left the womb. What all parents need & all parents had - until they came to hospitals for birth in the 1940s - was unlimited time for privacy & intimacy with their newborn baby.

Part of the real magic of connections at birth is that babies & 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 40 minutes & allows for profound & intimate communion while all parties are giving absolute attention to each other.

It's as though both babies & parents are satisfying an immense curiosity about each other which they've nourished for many months. This timely state will all too quickly give way to a lot of sleeping, a little crying & other preoccupied & distracted waking states. In a typical 24 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 haven't been drugged & are left undisturbed & 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 & will climb upward, find the breast & 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 - & the psychological consolation of being safely in the mother's embrace which is reminiscent of the heart & body sounds that were the music of life inside the womb.

The baby's cry sounds trigger the production of breast milk & 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 & mutually beneficial start in life is ideal & can be fostered by privacy, rooming-in & postponement of routine medical intrusions.

It could be worse, of course. There are always many ways to make things worse, but we shouldn't routinely make things worse for mothers, fathers & babies, especially when we have options to make things better.

More than a half century ago medical anthropologist Ashley Montagu warned against separating mothers & babies at birth, advocated rooming-in & sleeping with babies & encouraged carrying babies rather than putting them in cribs & 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 & pediatrician -turned-child-psychoanalyst, Donald Winnecott, in England, were sounding the alarm that mental health was built on a foundation of attachment between babies & parents.

Others sought to measure attachment. Marshall Klaus & 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 & contact after birth compared to mothers & infants deprived of contact.

They were pioneers exploring uncharted territory & their discoveries about the extraordinary power of the parent-infant connection were both illuminating & profoundly important.

Further evidence is coming from unexpected sources. A cross-cultural experiment followed groups of 107 children in Greece & the US whose conceptions were planned & unplanned.

The researchers hypothesized that at the age of 3 months, babies who had been planned would show a higher differential vocal response to their mother (vs a stranger) than would the babies who were unplanned.

Their prediction was correct: planned infants showed higher levels of cognitive capacity & attachment to their mothers than did the unplanned infants, as shown by vocal responses to mothers (vs a female stranger) (1993).

Presumably, the planned babies enjoyed an earlier & 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 & should have had a reduced risk of adverse pregnancy outcomes.

The statistics for these 8,000 women revealed that babies of unwanted pregnancies had 2 1/2 times the risk of death in the first 28 days of life compared to the babies from wanted pregnancies.

Apparently, a mother's attitude toward pregnancy reached the babies & 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 & baby in the womb making it possible to know the gender before any physical indications are available. Similarly, this psychological bond between mother & baby in utero has been confirmed in a series of recent experiments with smoking & 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 & baby was purely psychological.

10 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 3 to birth, the period previously thought to be clouded by amnesia & 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 & 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 & systematically set about replacing painful experiences with pleasant ones at times before, during & after birth.

The extension of memory & learning into the natal & prenatal period of our development awakens us to previously unthinkable possibilities for prenatal communication, stimulation, modeling & bonding.

Formal research on prenatal stimulation already confirms the important rewards that are available when the minds of babies & the minds of parents meet before birth or even before conception. I'll be writing about these experiments & about the mind before birth in my next book.

This article is a chapter from the new book, The Mind of Your Newborn Baby (North Atlantic Books, Berkeley, CA, 1998). It is reprinted here by permission of the author, David B. Chamberlain, Ph.D.

Dr. Chamberlain is a psychologist, independent scholar, President (1991-1999) of the Association for Pre & Perinatal Psychology and Health (APPPAH) & Editor of the Birth Psychology web site.

The Infant's Questions
From The Parables of Kryon by Lee Carroll (1996).
Carlsbad, CA: Hay House, Inc.
Reprinted with permission of Lee Carroll and Hay House.

The human mother was startled indeed when the large male angel appeared in her laundry room. "What are you doing here?"

"You expected me in the kitchen?" asked the angel.

"No, I didn't expect you at all!" the mother answered. "Why are you here?"

"To grant your request," said the angel, as if it were a common thing to appear in a human's home.

"I don't remember any request!" exclaimed the mother. "I hope I asked for something good and that you didn't just overhear me swearing. I say things all the time when I'm mad."

"No, no," replied the angel. "Remember when you were looking into the eyes of your son and murmured, 'If only we could talk to each other'? Well, I'm here to arrange that. Tomorrow night when you go into your son's nursery, I will be there to allow you to speak to him, and he to you. You will have a brief time where he can speak to you with the intellect of an adult and the language of an adult. I'll tell you more when I see you then." And with that, the angel disappeared-slightly to the left of the dryer-and up a vent.

The mother was not frightened. After all, she believed in angels and had been to the local angel shop many times. She had no way of knowing that real angels don't like angel shops. All the popularity had taken the fun out of appearing before people. Some mothers even wanted to know where the angel got its costume-very insulting to a real live angel.

The mother didn't sleep much that night, and when she put her six-month-old infant to bed early in the evening, she looked deep into his eyes and said, "Tomorrow, you and I will actually get to speak to each other!" She was excited indeed. He drooled in response.

She carefully crafted what she would say to him. Where does one begin? How long would she have? Would she be able to communicate the difficult things of life? She started by thinking of all the things she wanted to tell a child just starting out in life-about how a stove is hot, and a pretty fire can hurt-but wait! The angel said the child would speak with an adult's mind. That would change everything! She would need to tell him how to handle girls, and how to treat a broken heart, and how not to trust everyone, and how not to drive too fast. Oh my! There is so much to tell him about being human, she thought.

The next evening, the time for the magic discussion slowly approached. She waited with her infant son at her side in the nursery until the appointed hour, when the angel appeared again.

"Nice to see both of you," the angel quickly said. "Here are the rules of the conversation. Mom, you can only answer. Son, you can only ask three questions. Then it's over." And with that, the angel again disappeared-this time down the furnace grate.

This changes everything, thought the mother in silence while looking at her son. Perhaps I am hallucinating. I'll bet my son simply goes to sleep now. Instead, the infant stood up!

"Mother," said the infant. "it's a magical day indeed that brings us together like this. What a joy to be able to speak to you at this point in my life!"

The mother stood up at attention-with her mouth dropping in amazement. She even drooled a bit.

"Only three questions can I ask," the boy continued from the crib. "I want to know so much!" The boy was thinking about his first question as his mother was taking it all in. This is real, she thought. My son is talking to me as if he were all grown up! What a miracle. What a gift. She could hardly contain herself waiting for her son's first question. Would it be about philosophy or religion? Perhaps he would want to know the best advice to guide him into a good career, or maybe he wanted to know how he should choose the best mate-one who would stick around longer than hers did. The boy looked into his mother's eyes and asked the first question.

"Mother, I have laid outside this house on my back and was amazed at the sky. Why is it blue?"

It was all the mother could do not to shout: "You wasted the first question! Who cares why the sky is blue!" But the mother was so in love with her son that she patiently answered the question according to the rules. She explained how the atmosphere and oxygen molecules refract the light of the sun and turn it blue-at least that's what she believed. It sounded good, anyway. She anxiously waited for the next question. The next one has to be better, she thought. Perhaps he would like to know what he should do with his life in order not to end up homeless or with delinquent friends.

"Mother, my second question is this. Although I have been here only six months, I notice that sometimes it is hot outside, and sometimes it is cold. Why is that?"

The mother was appalled. Another question wasted on dumb stuff! How could this be, she wondered. Her son was innocent and alert. His question was important to him, and she treasured this magic time they could have together. Slowly, she tried to tell him about the Earth and the sun, and how the Earth tilts slightly as it orbits the sun, causing winter and summer, cold and hot. Finally, it was time for the last question. They had been at it for almost thirty minutes, and so little had actually been communicated.

"Mother, I love you!" exclaimed the son. "But how do I know you are really my mother? Do you have some kind of proof?"

What kind of a question was this? Where did that come from? Who else would be his mother? Hadn't she cared for him every day of his life? What a disappointment this session had been. She almost wanted to walk away and go back to the laundry room where this had all started. She thought of how she was going to shove the angel in the dryer the next time she saw him. Her son, his innocent eyes wide open and alert, was waiting for a reply.

She started crying, but held out her hands and said, "Look at my fingers; they are just like yours. My feet and my face look like yours. My expressions of joy and love are just like yours. I am truly your mother. We have the same eyes and mouth-look!" With that, the child was satisfied, and he slowly laid himself down on his mat and went to sleep.

That was it? This miracle of communication had come and gone, and the mother had not had a meaningful conversation with her beautiful son. What happened? What went wrong? She spent a great deal of time thinking about it all, and she mourned the passing of such an event without anything substantive being transferred.

Then the angel appeared again-up through the bathroom drain.

"Go away," the mother said before the angel could say anything. "What a disappointment you turned out to be."

"I gave you the time," the angel said kindly. "I did not design the questions."

"What good was it? Why didn't my son ask anything important? You told me he would have the mind of an adult, but he asked the questions of a child. You have tricked me with your so-called miracle."

"Dear one," the angel replied, "although your son was given the language and the intellect of an adult, he had only the wisdom and experience of the six months he had been on Earth. His questions were therefore the most meaningful ones he could think of, and you answered them all. Even the last one, which was postured in fear, you answered correctly. In addition, you transmitted your love to him while you were together, and you were not impatient with him. He did his best and was honest. What more could you ask?"

The mother sat down. She hadn't thought of that. Her son had mustered up the best questions he could come up with. How could he know what to ask if he didn't have the wisdom she had? And if he had somehow been given that wisdom, he would not have had to ask anything! Without any more communication, the angel left for the final time-this time out the window.

The mother returned to the crib and spent a long time looking at her precious son. "You did your best, my son," she said in a quiet voice. "It was good that we had time for a talk."

The Mind of a Newborn
Excerpt from The Mind of Your Newborn Baby
by David B. Chamberlain, Ph.D.
North Atlantic Books: Berkeley, CA 1998
10th Anniversary edition of "Babies Remember Birth" (1988).
(1999)

What do you see when you look at a newborn baby, bright-eyed, gazing straight at you?

Is there really a person there?

Silently frowning or beet-red with rage, can this baby think & feel? For its small size, a newborn makes a powerful, compelling noise, but is it actually saying anything?

Until recently, there were many theories about newborns but few known facts. For uncounted centuries, infants have been separated from the rest of us by a veil of ignorance.

As close as we've been to them, we didn't know how amazing they are. Common wisdom about babies was based on the obvious limitations of their size, weight & muscle power.

Consequently, babies were described as sometimes adorable but incapable, subhuman, pre-human, dull & senseless & treated as such.

Twentieth-century science has held that infant cries were only "random" sounds, their smiles only "gas" & their expressions of pain simply "reflexes."

Misinformation about the newborn has made parenthood more difficult & infancy more miserable.

A brighter future has been dawning for infants. In the last 25 years, research on the newborn has flourished. An unprecedented combination of interest in infants, investment of large sums of public & private money & innovative methods of study has resulted in new information, much of it surprising.

Contributions to our widening knowledge of the newborn come from diverse fields of science from embryology to psychology. This book gathers the most important facts from this wide literature for a general audience, especially new or prospective parents.

Leading researchers now sing the praises of infants. Harvard's Berry Brazelton calls them "talented"; Hanus Papousek, a German pioneer in infant studies, calls them "precocious"; famed pediatrician, Marshall Klaus calls them "amazing." Professor T.G.R. Bower, one of the most innovative of all infant researchers, declares that newborns are "extremely competent" in perception, learning & communication.

Babes have come of age in our century. Because so much has been discovered & momentum is still building, I think this will prove to be the century of the newborn, the time when we finally reach a full & factual knowledge of who they are.

At the beginning of this century, only a handful of scientific papers about infants could be counted worldwide. By mid-century, almost 500 could be cited. In the 1960's & 1970's, serious reviews of this literature suddenly had to cover at least 2,000 books & papers.

This information explosion continues. Infants have been measured inside & out, filmed with cameras permitting analysis down to microseconds, watched for hours on end & tested in clever experiments.

Results show that they pick up information constantly & learn from their experience much as we do.

One of the exciting aspects of this new knowledge is the verification of infant abilities at earlier & earlier ages. Timetables estimating the ages at which particular talents are expected to appear have had to be revised again & again, bringing them closer to birth.

Many abilities are innate & adult-like, surprising investigators & ruining theories. A fundamental rule of developmental psychology -that all complex behaviors must start as simple behaviors & develop gradually-has become obsolete.

Surprisingly, many behaviors start out complex. The truth is, much of what we've traditionally believed about babies is false. We've misunderstood & underestimated their abilities. They aren't simple beings but complex & ageless, small creatures with unexpectedly large thoughts.

Babies know more than they were supposed to know. After only minutes of repeated exposure to its mother's face after birth, a baby can pick her out from a gallery of photos. Babies recognize the gender of other babies, even when cross-dressed, provided they're moving-something adults can't do.

They're mentally curious & eager to learn. Consider how smoothly the senses are coordinated at birth: eyes turn with the head in the direction of a sound; hands go up to protect eyes from bright light; the first time at the breast, the baby knows how to suckle & breathe in perfect synchrony; they shriek & pull away from a heel lance.

The territory of life before birth has also been charted as never before. Thru the wizardry of the scanning electron microscope, fiber optics & special lenses, ultrasound imaging & other measuring devices & laboratory techniques, we now have a comprehensive picture of development of all parts of the physical system before birth.

These discoveries have added to our understanding of the baby's many talents.

Neuroscientists have discovered the timetable for development of the entire nervous system, For example, studies show that the sense of taste begins functioning around 14 weeks after conception & the sense of hearing around 20 weeks.

After only 8 weeks of gestation, stroking the baby's cheeks with a fine hair produces consistent reactions indicating that tactile sensitivity has already been established.

During gestation, all the structures are set in place that will enable the newborn to use the sense of smell as well as any adult. Similar preparations are made for use of a wide range of visual talents. Learning before birth has even been demonstrated in many experiments.

A host of scientific discoveries provides formal verification of what many parents & grandparents have known all along: newborns are real persons. Parental enthusiasm about newborn abilities used to be dismissed as vanity, bias, or hallucination.

Now science confirms that infants are social beings who can form close relationships, express themselves forcefully, exhibit preferences & begin influencing people from the start.

They're capable of integrating complex information from many sources & with a little help from their friends, begin regulating themselves & their environment.

Infantile "Amnesia" is Dead!
by David B. Chamberlain, Ph.D.

In academic circles, a long-standing prejudice against the reliability of all early and very early memory is collapsing. The least-likely period for memory to function, the intrauterine period, increasingly illuminated by ultrasound, has made it possible for visionary experimental psychologists to show that memory and learning systems are 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 evidence, published in magazines for childbirth educators and parents in 1981, was never taken seriously in scientific circles. Ironically, for the last 16 years, we have had memory experts denying birth memory while new waves of three-year-olds were proving them wrong!

Psychologists have been enthralled with the theory of infantile amnesia since it was stated by Sigmund Freud in 1916. The popular observation that people rarely remember anything that happened to them before their third or fourth birthday turned an idea into dogma. It was further justified by theories of noted Swiss psychologist Jean Piaget, about the limitations of newborn intelligence and its development in discreet stages. After 40 years, these ideas are now crumbling under the weight of experimental evidence. Tearing down the wall of illusion regarding infant memory has taken a handful of brilliant experimental psychologists, completing over three dozen crucial experiments, and a full decade of time. As a result, infantile amnesia is dead.

A key 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. A further prejudice was that true episodic memory could not be tested with preverbal infants. These notions made it easy to avoid research and to dispute the evidence as it appeared. What the experimental psychologists have managed (against heavy odds) to prove is that children age three, age two, and age one are all capable of both immediate and long-term recall of specific events in their lives. Infants tested at two, four, and six months can recall details about hidden objects, their location, and size.

Ability to recall procedures involving a series of steps, after long delays, depends not on 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. Experts now conclude that babies are constantly remembering and learning what they need to know at the time; their memories are not lost, they are continually updated as learning progresses.

The old belief that infants are mentally incompetent has isolated them and delayed discovery of their elementary abilities. More importantly, this belief has obscured the evidence for higher perception, telepathic communication, and subtle forms of knowing which we have discovered in various forms of psychotherapy. With another big barrier down, perhaps parents and professionals will be able to meet real babies more often.

The first three years of life are a period of incredible growth in all areas of a baby's development. A newborn's brain is about 25 percent of its approximate adult weight. But by age 3, it has grown dramatically by producing billions of cells and hundreds of trillions of connections, or synapses, between these cells. While we know that the development of a young child's brain takes years to complete, we also know there are many things parents and caregivers can do to help children get off to a good start and establish healthy patterns for life-long learning.

Frequently Asked Questions

The human brain begins forming very early in prenatal life (just three weeks after conception), but in many ways, brain development is a lifelong project. That is because the same events that shape the brain during development are also responsible for storing information—new skills and memories—throughout life. The major difference between brain development in a child versus learning an adult is a matter of degree: the brain is far more impressionable (neuroscientists use the term plastic) in early life than in maturity. This plasticity has both a positive and a negative side. On the positive side, it means that young children's brains are more open to learning and enriching influences. On the negative side, it also means that young children's brains are more vulnerable to developmental problems should their environment prove especially impoverished or un-nurturing.

Which plays a more important role in brain development, nature (genes) or nurture (environment)?

Genes and environment interact at every step of brain development, but they play very different roles. Generally speaking, genes are responsible for the basic wiring plan—for forming all of the cells (neurons) and general connections between different brain regions--while experience is responsible for fine-tuning those connections, helping each child adapt to the particular environment (geographical, cultural, family, school, peer-group) to which he belongs. An analogy that is often used is wiring a phone network: genes would specify the number of phones and the major trunk lines that connect one relay station to the next. Experience would specify the finer branches of this network-the connections between the relay station and each person's home or office.

For example, each of us is born with the potential to learn language. Our brains are programmed to recognize human speech, to discriminate subtle differences between individual speech sounds, to put words and meaning together, and to pick up the grammatical rules for ordering words in sentences. However, the particular language each child masters, the size of his vocabulary, and the exact dialect and accent with which he speaks are determined by the social environment in which he is raised--that is, the thousands of hours he has spent (beginning even before birth) listening and speaking to others. Genetic potential is necessary, but DNA alone cannot teach a child to talk.

Does experience change the actual structure of the brain?

Yes. Brain development is "activity-dependent," meaning that the electrical activity in every circuit—sensory, motor, emotional, cognitive--shapes the way that circuit gets put together. Like computer circuits, neural circuits process information through the flow of electricity. Unlike computer circuits, however, the circuits in our brains are not fixed structures. Every experience--whether it is seeing one's first rainbow, riding a bicycle, reading a book, sharing a joke--excites certain neural circuits and leaves others inactive. Those that are consistently turned on over time will be strengthened, while those that are rarely excited may be dropped away. Or, as neuroscientists sometimes say, "Cells that fire together, wire together." The elimination of unused neural circuits, also referred to as "pruning," may sound harsh, but it is generally a good thing. It streamlines children's neural processing, making the remaining circuits work more quickly and efficiently. Without synaptic pruning, children wouldn't be able to walk, talk, or even see properly.

What is a "critical period" in brain development?

Pruning or selection of active neural circuits takes place throughout life, but is far more common in early childhood. Animal studies have shown that there are certain windows of time during which the young are especially sensitive to their environment: newborn mice must experience normal whisker sensation in the first few days of life or they will develop abnormal tactile sensitivity in the face region; cats must be allowed normal visual input during the first three months or their vision will be permanently impaired; and monkeys need consistent social contact during the first six months or they will end up extremely emotionally disturbed. Many of the same critical periods appear to hold for human development, although we are less certain about their exact length. Thus, babies also require normal visual input or they may suffer permanent impairment; children born with crossed or "lazy" eyes will fail to develop full acuity and depth perception if the problem is not promptly corrected. Language skills depend critically on verbal input (or sign language, for babies with hearing impairments) in the first few years or certain skills, particularly grammar and pronunciation, may be permanently impacted. The critical period for language-learning begins to close around five years of age and ends around puberty. This is why individuals who learn a new language after puberty almost always speak it with a foreign accent.

Are there critical periods in the development of every brain function?

Probably not. In the case of visual development, certain abilities are more at-risk than others when a young child's vision is impaired by eye-crossing or other visual problems (such as congenital cataracts). Thus, two visual abilities--acuity (the perception of fine detail) and binocularity (the coordinated use of both eyes), which is especially important for depth perception--do depend on normal visual experience as a child, whereas two other visual abilities--color and peripheral vision--are not impaired by visual problems in early life. A similar distinction holds for language development: certain skills (including grammar and phonology--the ability to perceive and produce individual speech sounds) are more sensitive than others (such as vocabulary size) to a child's experience with language in the first few years of life.

We know much less about the development of other mental skills, such as emotional functioning, mathematical ability, or musical skill. If their development is comparable to vision and language, we may expect that some features will be subject to a critical period while others are not. One musical skill known as "perfect pitch"--the ability to identify a musical note without reference to a tuning note--seems to develop only in musicians who began their training before the age of seven (and then, not in all professional musicians). Similarly, a child's social-emotional development depends on a positive, nurturing attachment to a primary caregiver, based on the higher frequency of serious behavioral problems among children who were severely neglected during the first year or more of life, (such as the thousands of Romanian children reared in state-run orphanages). Comparable problems emerge among monkeys who are reared in isolation, and neuroscientists are beginning to understand how the lack of attachment in infancy alters development of emotional areas of the primate brain.

Why does the developing brain undergo these critical periods in its development?

Neuroscientists do not yet fully understand the biological basis of these critical periods. One theory is that they correspond to a period of synaptic excess in the brain: between infancy and the early grade school years, the brain actually over-produces connections--some 50 percent more than will be preserved in adulthood. During the critical period, a child's experience--sensory, motor, emotional, and intellectual--determines which of these synapses will be preserved, through pruning of the least useful connections. In this way, each child's brain becomes better tuned to meet the challenges of his or her particular environment.

A related theory holds that learning itself creates critical periods in a child's brain. That is, the longer a child has been exposed to one type of experience or environment, the less likely he or she will be able to reverse the synaptic learning that has already taken place. Animal studies provide some support for this theory. For example, kittens that are deprived of all vision (as opposed to the vision in just one eye) in the first few months of life show a delayed critical period for visual experience, beginning from the time their deprivation ends. Similarly, songbirds normally learn their species-typical songs early in life, by listening to adults of the same species. However, when newly hatched birds of certain species are isolated, permitting them no song exposure during early life, their critical period for song learning is delayed, even as late as adulthood.

When is the brain fully developed?

In some way, never. Our brains are continually re-shaping themselves to meet the demands of everyday life, even throughout adulthood. However, there are certain aspects of brain structure and function that do level off during development. For example, the number of neurons peaks even before birth; some 100 billion are formed during just the first five months of gestation. (Recent evidence suggests that new neurons are produced throughout life, though far less rapidly, and probably in numbers sufficient only to replace those that gradually die off.)

In spite of the great number of neurons present at birth, brain size itself increases more gradually: a newborn's brain is only about one-quarter the size of an adult's. It grows to about 80 percent of adult size by three years of age and 90 percent by age five. This growth is largely due to changes in individual neurons, which are structured much like trees. Thus, each brain cell begins as a tiny sapling and only gradually sprouts its hundreds of long, branching dendrites. Brain growth (measured as either weight or volume) is largely due to the growth of these dendrites, which serve as the receiving point for synaptic input from other neurons.

Another way of measuring brain development is to look at the speed of neural processing. A newborn's brain works considerably more slowly than an adult's, transmitting information some sixteen times less efficiently. The speed of neural processing increases dramatically during infancy and childhood, reaching its maximum at about age fifteen. Most of this increase is due to the gradual myelination of nerve cell axons (the long "wires" that connect one neuron to another neuron's dendrites.) Myelin is a very dense, fatty substance that insulates axons much like the plastic sheath on a power cable, increasing the speed of electrical transmission and preventing cross-talk between adjacent nerve fibers. Myelination (the coating or covering of axons with myelin) begins around birth and is most rapid in the first two years but continues perhaps as late as 30 years of age.

Synaptic development is a more complicated issue. Synapses are the connecting points between the axon of one neuron and the dendrite of another. While information travels down the length of a single neuron as an electrical signal, it is transmitted across the synapse through the release of tiny packets of chemicals or, neurotransmitters. On the receiving (post-synaptic) side, special receptors for neurotransmitters change the chemical signal into an electrical signal, repeating the process in this next neuron in the chain. The number of synapses in the cerebral cortex peaks within the first few years of life, but then declines by about one third between early childhood and adolescence.

How does nutrition affect the developing brain?

Brain development is most sensitive to a baby's nutrition between mid-gestation & 2 years of age. Children who are malnourished - not just fussy eaters but truly deprived of adequate calories & protein in their diet - throughout this period don't adequately grow, either physically or mentally.

Their brains are smaller than normal, because of reduced dendritic growth, reduced myelination & the production of fewer glia (supporting cells in the brain which continue to form after birth & are responsible for producing myelin).

Inadequate brain growth explains why children who were malnourished as fetuses & infants suffer often lasting behavioral & cognitive deficits, including:

• slower language & fine motor development
• lower IQ 
• poorer school performance

A baby's birth weight - & brain size - do depend on the quality of his or her mother's nutrition during pregnancy.

Pregnant women should gain about 20% of their ideal pre-pregnancy weight (e.g., 26 pounds for a 130-lb woman) to insure adequate fetal growth. This requires consuming an extra 300 calories per day, including 10-12 extra grams of protein.

After birth, brain growth depends critically on the quality of a child's nutrition. Breast milk offers the best mix of nutrients for promoting brain growth, provided that breast-fed infants receive some form of iron supplementation beginning around 6 months of age.

(Most infant cereals are fortified with iron & breast-fed babies require this supplementation at 6 months whether or not their mothers are iron-deficient.)

Iron deficiency has been clearly linked to cognitive deficits in young children. Iron is critical for maintaining an adequate number of oxygen-carrying red blood cells, which in turn are necessary to fuel brain growth.

Bottle-fed babies should receive formula that contains iron.

Because of the rapid pace of myelination in early life, children need a high level of fat in their diets - some 50% of their total calories - until about 2 years of age. Babies should receive most of this fat from breast milk or formula in the first year of life & breastmilk remains an excellent source of liquid nutrition into the toddler years.

However, whole cow's milk can be introduced after the first birthday & provides an excellent source of both fat & protein for toddlers in the 2nd year. After 2 years of age, children should begin transitioning to a more heart-healthy level of dietary fat (no more than 30% of total calories), including lower-fat cow's milk (1 or 2%).