[ Music ] [Narrator:] The first four mothers belong to type 1. All are highly empathic and are in control throughout the feeding. Their movements are appropriate and economical. They never delay or interrupt the feeding without consideration of the baby's state. For all mothers and infants in this type, feeding is a source of gratification. This young mother has chosen this seat thatpermits her to maintain physical closeness to the baby without confining him. Her gentle tact does not disturb his sucking and she sustains a good-humored communication with him. She is free to turn her attention to others, although her main visual regard is for the baby. It is near the end of the feeding. Here another young mother gazes at her babyintently. They approach each other smoothly, as he needs help in spitting up. The joint maneuver makes for no loss ofcomposure on either side. In spite of his upset, the baby is still eager to look at his audience. After another interval of feeding, the mother burps with zeal. The baby has freedom to discover his cheek, as he waits contentedly for his bottle, and his mother enjoys watching him. This experienced mother is engrossed in the baby's activity. She is relaxed and her little girl is held snug. The mother plays gently with the baby's fingers and she allows the baby's outstretched fingers to touch her breast. Sucking is rhythmic and peaceful. The mother regards the baby with quiet admiration. Then lifts her adeptly to burp her in an erectposition, A kiss, gentle rocking, visual contact, nosetouching, a smile and one more kiss. At the beginning of this feeding, the mother offers mashed banana, but when the baby squirms, she switches to the bottle he's been waiting for and beams at his ready response to it. Even her burping is tender as she lays her cheek against his and listens for his burp. At the end, she makes sure that they have a good look at each other. A tired baby has time to stretch and yawn. The next two mothers, who are in type 2, are also empathic. They greatly enjoy their own role in the feeding and accelerate the pace of it according to their own needs. Their control is often excessive, but never unkind. They act overeagerly, anticipating real andimaginary needs of their infants. They interrupt the feeding too often to carry out unnecessary procedures and their efficiency is lowered or uneven. This eager beaver mother, so occupied with her own task, almost loses sight of her baby's need to be fed. Play comes before food, while the baby's appetite grows. She has several styles of burping. She takes time to study his yawn and then makes sure that the milk flows freely. She's aware of the baby's hunger, but still fusses. Still testing, testing, but the baby does not abandon hope of getting his bottle; more burping, more patting, more ironing. More touching, more examining. As a reward for her earnestness, she gets a baleful glance. The second mother in type 2 enjoys apostponement after feeding cereal, playfully admonishing her little girl to stop crying before she can have her bottle. After a brief offering of the bottle, she undresses the baby competently and quickly. Evidently, she feels closer physical contact with the baby when her dress is off. Burping continues and the mother shows us that burping can be fun. Playfully again, she pauses to make an inquiry of the baby. She squeezes, pats, again squeezes, palpates generously. Blows and kisses. The baby, drunk with sleepiness, is no longer hungry. The mother shifts her to a position in which the baby cannot fall asleep and can be forced to take a few more swallows. The infant squirms and flails in protest before the mother surrenders her authority. Mothers in type 3, of which five are to be seen, lack empathy for the needs of their infants. They are so overconfident that they are unaware that even a tiny infant needs to be encouraged to take an active role in his own feeding. Although they have a capacity for tenderness in responding to their infants, they disparage qualities of affection or tolerance. They are determined to get food into their babies, and quite overlook the rapport offered by the feeding experience. In the first five minutes, this mother has interrupted the bottle feeding many times to feed more cereal against the baby's wish. To accomplish her aim, she pushes the food in rapidly. The little girl is obviously frustrated, preferring to keep sucking, as most infants of her age do. Occasionally, the mother responds to the baby's need for physical security, but does not maintain her tactile support. She says explicitly, that she dislikes feeding the baby. The burping is inventive, automatic, and oftenrough. After she has alternated the feeding of milk and cereal 23 times and burped 600 times, her painful smile reflects her general tension. The feeding is about to begin and the mother has placed the baby in a position that enables them to look at each other, but as the mother fusses over the infant, the infant cries. Her crying does not disconcert the mother. This mother loves activity and excitement and has her feeding strategy planned to keep command of the little girl and to maintain her own comfort. Despite the appearance of intimacy in this part of the feeding, only the baby's back is touched by the mother. For most of the 40 minutes that this feeding lasted, the little girl fidgeted and the mother remained cheerful. Mothers in type 3 often choose to place their babies in an infant seat even in the baby's first weeks. They say this gives them better control of the baby. This baby's body is poorly supported. The back of his legs are pressed stiffly against the hard edge of the seat and he has no freedom to move. The mother, to feed without interruption, pins down both of his arms. She hardly gives him time to swallow. After the vegetables, there have been 14 episodes of bottle feeding. The baby has no more appetite and he spends his energy in pushing the bottle away, but the mother urges it upon him again. Among mothers in type 3, it is common that the mode of feeding agitates the baby even though it satisfies his hunger, and thus, the mother's impatience with feeding becomes fixed. Gradually, the mother avoids distressing scenes by leaving him to feed alone. Here the baby enlists his whole body in the fight against the bottle. This feeding ends in an angry struggle on thebaby's part and with an air of sulky defeat, on the part of the mother. This mother, describing how she loves to hold her baby, stimulates him to take more milk. She stimulates him by twirling the nipple in his mouth, which she did several hundred times during this feeding. The mother stares at him without expression. His gaze at the ceiling seems equally affectless. She holds her activity with the bottle only to clean his eyes. After this very long feeding, the baby has fallen asleep, but the mother is eager to awaken him. She doesn't realize she can do this by holding him erect or by talking to him. Instead, she brushes his lips seductively with the nipple. She seems avid to demonstrate her skill in getting him to suck again. When he does awaken, she's indifferent to hisprotests. This last mother in type 3 adjusts a bib on her baby calmly while he cries because of hunger. Abruptly, she shifts him to a feeding position. She's determined to feed carrots first and have him wait for the bottle. Spoonful after spoonful increases his crankiness. He looks at his mother expressively and bursts into tears. The bottle comes into view only to be snatched away. Now it comes even closer, but again is held off. At last he gets it, and immediately loses it in favor of a face cleaning. He can suck peacefully for a few moments, until the mother decides he's calm enough to be given more carrots and then he's cleaned and burped again. Suddenly, he's thrust forward and held precariously on his mother's knee. He looks about in bewilderment. She smiles self-consciously and suddenly thrusts him back to resume sucking. Although he looks at her with intensity, her face remains impassive. Another few spoonfuls of carrots are poorlyreceived. When finally he gets the bottle, he cannot relax. For almost at once it is pulled away and he'sroughly pushed onto the edge of her lap. In the end, he has recourse only to tears. Babies of type 3 mothers share certainsymptomatic behavior at one year. For example, restlessness, poor appetite, anderratic social responsiveness. The next four mothers in type 4 are even lessempathic and more controlling than mothers in type 3. They may delay feeding until the babies show acute distress. They may feed as though the babies were alien to them or they may overwhelm the babies with food or with feeding procedures. In spite of general praise of their babies, theyfrequently scold and ridicule them for their feeding behavior. They consider feeding a burden and resent it. At no time do they feel free to foster intimacy with their babies. At first glance this feeding looks restful, but the mother is tense, holds her infant rigidly and is unsure how to proceed. She waits for a cue from the baby unaware that she can take the initiative. Both wait. The baby gets restless, the mother more uneasy. The relationship between them is frozen. The baby stares into space and the mother stares at the baby. His body is clutched tightly. Without any overt distress, the mother withholds the nipple while the baby's tension mounts. The feeding episode is joyless for both. At one year of age, this very well-endowed little boy was hyperactive and enjoyed no play. He made no sounds and he rarely smiled. Here the mother dons a hospital gown expecting that the baby will spit up his cereal and soil her dress. It is characteristic of the mothers in type 4 to be concerned with their own appearance. This hefty boy has taken a large portion of cereal, but the mother continues to ply him with it as if her task were to get the full amount into him whatever his emotional state. She's accomplished in prying his mouth open. Sometime later, she kisses him impulsively,removes the bottle without reason, examines it admiringly, cleans him, and involves herself in a busy burping session. In the midst of his feeding, the baby is suddenly folded in half and thumped resoundingly. Again suddenly, he is set back in feeding position, only to be groomed at his mother's pleasure. Like many mothers who declare themselves to be more secure about infant care than they feel, this third mother in type 4 began to train her little girl to take semisolids in the second week of life. When the baby cries, resisting the cereal, themother takes advantage of the baby's open mouth to pour in the food. She ignores the baby's flailing limbs andparoxysmal crying. At her breast, she holds the infant cozily and tries to show that she's relaxed. However, ambivalent attitudes about her maternal role produce contradictory behavior. Although she breastfeeds, she pokes at the baby's ear, looks bored, yawns. As her tension increases, she strokes the baby's hair in a perfunctory way, tweaks her ear and yawns again. This vigorous infant at one year was apathetic and grossly inhibited. During the feeding, the mother wards off allcommunication with the baby. All of her life, this mother has been undergoing great familial stress and has tried bravely to manage. Her willingness to participate in the research stems from her earnest wish not to repeat the actions of own mother who beat her. Nevertheless, her problems defeat her intention to act in harmony with the baby. The baby has been fed semisolids since two weeks of age. The mother has said that his agitation duringfeeding is caused by his opening his mouth so wide that he swallows great amounts of air. Her rule of forcing solids and then withholding the bottle until the baby has burped, adds to his misery. After three episodes of feeding cereal and three burping periods, she believes it may not be bad for him to have some milk. Hardly has he settled down to the bottle with relief, when her fear that he will become colicky causes her again to take the bottle away and to resume burping. She keeps telling him to calm down and not be bad. She warns him that he will get no food until hebrings the bubble up. A hasty tidying creates more delay. Again, she starts to feed. She supports the baby's head tentatively as ifanticipating another interruption. The baby is again thrown into disequilibrium and grabs at the mother's tie in an attempt to right himself. She disengages his fingers and shifts him into a better position to burp. With a kiss to remind him of her feelings for him, she says, as she continues to burp him, that he should be ashamed of himself. She says she will give him the milk, but warns him that he will get sick if she does. All of this is expressed as a matter of fact. For this mother is proud of her ability to remain at ease. The kind of interaction that is now seen occurred repeatedly throughout the feeding, which lasted an hour-and-a-half. Very short feedings were alternated with... Now the baby looks extremely fatigued. The mother does not restore the bottle until he is almost in a state of panic, and even then, she restores it only to quiet him temporarily... much increase, and she has to dominate more forcefully. Her handling becomes rougher. Her capacity for sympathy decreases. Giving him the pacifier, she tells him that if he isn't quiet he can't bring up the gas. She adds, that there is no sense in his crying and chides him for being all bound up. "Come on sweetie," she says to him. "I know that my finger is hurting you, but we must bring up the gas." Five minutes later after he has once burped, she continues to pat and rub his back, supporting his chin in a taut position. Several times as he falls asleep, her activitystartles him into fretful waking. She tries to comfort him with a kiss, but the baby is limp with exhaustion. He has fallen asleep with the pacifier which has been given to 15 times so far. The mother tries to burp more effectively bydrawing circles upon his abdomen and poking with her finger. Her conviction that her efforts are correct, enable her to regard with a detachment the startles that dramatize his disturbed state. In a last try to bring up the... she abruptly places him in prone position, lets him sleep briefly, and then again briefly in a sitting position. The mother said that this feeding was typical. In another context, she stated that the happiest time of his day was when he was being fed. Mothers in type 5 are unable to offer adequateemotional stimulation to their babies. As a result, their empathy is restricted. Their control is faulty and their efficiency uneven. When the baby's needs are obvious, the mothers do respond. Otherwise, they are withdrawn. In spite of their love for their infants, these mothers are detached. They feel protected by routine and prefer to beuncurious about infant care. The play they engage in is rarely spontaneous and the relationship to their infants is impoverished. The baby, held away from the mother's body,gropes with her open fingers for something totouch. The mother, though appearing to see the baby's uneasiness, offers no warmth or reassurance. She remains silent and distant. She scrutinizes the infant, evidently without any realization that the little girl might be comforted by a gesture of love. The mother believes that the baby's hiccupping requires no particular attention. She responds only to those needs of the baby that become obvious by crying. The only time she smiles is at the observer, self- consciously. Mothers in type 5 frequently explain that they believe an uncomplaining baby is a satisfied baby. This inexperienced mother seems to feel it's safer to have a pillow under the baby's head than to support him with her own arm. Her remoteness from him is emphasized by the tension visible in her face. New mothers often judge the baby's state by the amount of milk left in the bottle and worry about the adjustment of the nipple, if the baby pauses in his sucking. When she burps him, she holds him stiffly, pats him hurriedly, and regards him anxiously. She has a worried look, and searches his face for a cue that will help her decide what to do next...and finds none. For the ninth time she tries to elicit a burp. Only after an hour-long feeding, can she relax. As he is no longer crying, she loses her severity and smiles affectionately. The third mother in type 5 feeds and cleans with dispatch. She merely glances at the little girl and likes to chat with the observer, although she is given no encouragement. Please note that the baby is dressed for theoccasion. The mother's movements are rapid, mechanical, and rough. Her brusque activity upsets the baby, who vomits and cries. Incidentally, at one year of age, this was a beautiful baby. The mother resumes the feeding without any sign of pleasure. The fourth mother in type 5 pauses betweenfeeding episodes, but her regard of the baby is rigid. Her procedures are mechanical. She provides body contact mainly with the flat of her hand. The baby's fretfulness may be caused bydiscomfort or by the disappearance of the bottle. His torso rests across her knees, but his lower limbs are unsupported. The mother tries to create rapport by visual contact, yet the distance between them creates tension. This fifth mother in type 5 seems unable to make herself or her baby comfortable. To feed him more quickly, she snatches his hand away from the spoon. His body has fallen between her legs and hisrestlessness has increased by rapid spoon-feeding. The baby has already taken five ounces of milk ,and clutching his mother's fingers, he struggles against the bottle. He has been gulping rapidly and now he wants to pause. The mother uses the pause to rearrange the sleepy baby's position. The burp she waits for doesn't come. She prods him to wakefulness by playing with him in an elaborate manner. Slapping his hand gently, talking to him, jiggling his head, tickling and touching him. She doesn't know that it would help if she merely allowed him a quiet pause in the feeding. She offers the bottle again. As he is still notinterested, she resumes the burping ineffectually. Peering at him, she tries again to arouse hisinterest in the bottle, engaging in another series of maneuvers. She brushes the nipple against his lips over and over again, talks to him, smiles wistfully, and keeps dabbing at his face with the nipple. At last she succeeds in giving the bottle, but to an even more tense and squirming baby. Limp with fatigue, he is thrust forward to burp again. His jaw is held between his mother's stiff fingers. Producing no burp, she again urges the bottle, for the fourteenth time. After an hour-and-a-quarter of feeding, the baby cannot be persuaded to take any more food. Admitting her defeat, the mother looks to theobserver almost apologetically. In spite of herself, she is compelled to make a last attempt to burp him. Her caresses are bestowed upon a sleepy,unresponsive infant. At no time during this long feeding, is emotional communication between the two established. The last mother in type 5 is doing her duty at what she considers a safe distance. Her sober involvement with the procedure of getting food into the baby's mouth seems to prevent her from relieving his crooked position. She carries out all aspects of the feeding quickly and with relentless detachment. The baby seems easy to feed, but the mother still does not relax enough to allow for any loving contact. Even the burping is performed in such a way that they cannot look at each other, but the baby does quietly and speedily oblige. Type 6 mothers, three of whom are shown, aim to be highly efficient. Their activity is well-organized and they havecomplete confidence in their feeding methods. They interrupt the baby's sucking only when they consider it necessary, for example, to clean or to burp. They rarely touch or speak to the baby and the business-like way in which they conduct feeding, almost precludes any responsiveness from the baby. This mother feels it proper to sit silently and to hold the infant in this stiff position. Typically, her feedings last about 30 minutes, and it is her practice not to interrupt more than once or twice during that time except for the formality of burping. This mother's concern is to feed with efficiency, but her manner is stark and sterile. In 30 minutes, there has been no physical contact. The mother eventually puts him on her lap to burp him. She glues her eyes on him, but does not react to his distress. Finally, she permits him to rest comfortably in her arms and restores the bottle to him. Later she returns him to the infant seat for the sole purpose of cleaning him. At some point during the bottle feeding, this mother placed the baby in the crib to change his diaper. Her devotion to mopping up allows her to regard the baby's discomfort as a matter of secondary importance. At one year, this little boy was hyperactive and never initiated any social contact. He rarely smiled. The third mother in type 6 feels and is truly efficient. She wastes no time in being sociable with the baby, adjusts her in the feeding position adeptly, and settles herself down to her well-planned job of nursing. As soon at the baby is sucking securely, the mother consults her watch several times to make certain that the infant remains at each breast for the number of minutes she believes necessary. Babies of type 6 mothers seen at one year of age, are often excellently developed physically and mentally, but are almost too independent of their mothers. Their early self-sufficiency suggests that they have too soon relinquished babyhood. Mothers in type 7, five of whom are shown, work hard to understand their babies. Most of them have had little or no previousexperience with infants. They waiver between controlling the baby too much and being fearful of exerting the necessary controls. Their empathy is uneven. There are indications, especially clear in this type, that the way a mother behaves toward her baby is a reflection of the way she remembers thather mother behaved toward her. Mothers in type 7 are uneasy about feedingprocedures and often express an almost desperate wish for guidance. One of them, aware of her awkwardness saidtimidly, "Maybe feeding the baby will be more fun later on." This beautiful red-haired little boy has alreadylearned that he must swallow fast to keep up with his mother. Her intense look shows her interest in his feeding activity. Aware of his extreme hunger, she offered the bottle but removed it too soon in order to feed cereal, believing that she must also accustom him to semi-solids. This is in accord with her belief that breastfeeding would make him dependent upon her alone. Although his eagerness for his bottle is apparent to her, she cannot let him complete one aspect of the feeding at a time, but switches from bottle to cereal, to clean him or change his position. Her busyness seems to give her a feeling ofcompetence at the expense of the baby'scontentment. Now the baby seems more relaxed, but the mother does not. It is as if she regards being quiet a withdrawal from him. In response to his opening his mouth in search of the bottle, the mother comes to life. The baby gulps the milk in spite of his awkward position. Mothers in type 7 often describe their babies at one year of age as being alert, active and sociable, but also restless and easily frustrated. This patient mother, whose tension is at once obvious, has been sitting in this position for 10 minutes. From the baby's first days, she had difficulty in learning to hold him to her breast even with the skillful assistance of a hospital nurse. Her attempt to make herself more comfortable without disturbing his sucking, results in a more rigid posture for her and for the baby. In this scene, the bottle is given for the third time after eight episodes of breastfeeding. The mother's manner of holding the baby during bottle-feeding is also awkward and inert. She reports that his feedings often last three hours because she has to make sure that his hunger is completely satisfied. During this two-hour feeding, she patted and rubbed his back more than 5000 times. For all her devotion, six feedings a day are carried out in this lusterless fashion. The third mother in type 7 reports that the baby cries when the bottle is removed for burping. Nevertheless, she does remove it so often that her little girl is rarely allowed to suck for as long as two minutes. The same tense kicking of one leg seen mainly during this kind of burping at six weeks hampered the baby's crawling movements at six months. At one year, the baby stiffened her whole body, unobliged to tolerate any passivity, and fought with all her might until she was permitted to stand and run. The mother now listens for the burp, although this means that she must disregard the baby's acute distress due to continuous deprivation of the bottle. In this feeding, the baby got three-and-a-half ounces of milk in 45 minutes, because half the time was given to burping. This young mother is delighted with the idea of feeding her baby, but she says that as he always falls asleep while sucking, she must try to keep him awake to maintain his schedule. Notwithstanding her exuberant efforts to arouse him, he remains sleepy. His fingers open and close helplessly as he grasps at the air in his attempt to gain equilibrium. Ten minutes later, her enthusiastic burping is still of no avail. He sleeps. She tries harder to wake him. She rubs his chest, tugs at his right arm, shakes his left arm, tickles each of his feet and rubs his entire back energetically. Now she concentrates excitedly on squeezinghis cheeks, pressing down upon his chin so that she shakes his head with exceeding rapidity, and finally rubbing his hand. This was a quiet baby, and his responses to stimuli were slow, but his development was entirely normal. Later in the afternoon as he awoke from a nap in the crib, he was observed to turn his head from side-to-side six or eight times, in just the same way that his mother shook his head during her attempts to awaken him. Eventually, she tries to rouse him by forcing the nipple into his mouth and even by using it an instrument to shake his head. This device also fails, but undaunted, she resorts to her former methods, which by now appear to have made him stuporous. Thus, the mother instead of waking her baby by speaking softly or by altering his position, overwhelms him with more stimuli that he can manage. The baby's drowsiness during feeding may be partially explained by his having been habituated to falling asleep with the help of a pacifier, so that for him, a nipple has become a signal for going to sleep. At one year, this baby's gross motor development was a little advanced, but he was continuously active, impatient and easily angered. This last mother in type 7 is at ease for brief intervals of the breastfeeding. However, she nervously pulls the baby to her breast so that the little girl is held too high and too tight. She has explained that she is often at a loss to know what to do with the baby, but she does love to hold the baby's bare body close to her own. She interrupts the sucking to burp the baby, who is disturbed, and startles. The jerky clutching and sudden releases of the baby's body punctuated the 30-minute feeding. Among the 7 types of of mothers, the qualities of empathy, control, and efficiency are observable in various degrees. One or more of these attributes are often missing, because few mothers, unfortunately, have the necessary emotional maturity and knowledge of infant development to respond to the needs of their infants sensitively and consistently. The study of over 100 mothers and infants during the infant's first year of life has shown that the babies of mothers in types 3, 4, 5, and many in type 7 show a high frequency of developmental lags at one year of age. Many of them are also prone to be irritable and passive, and to have temper tantrums, stereotypic behavior, low frustration tolerance, fears, low function pleasure, and disturbed object relations. In contrast, babies of mothers in types 1 and 2, and many in type 6, are at one year of age the most uniformly well-developed in all areas. All of their mothers have at least adequate degrees of two of the three criteria of satisfactory feeding: empathy, control, and efficiency. This means that these infants begin their second year of life with the capacity to make optimal use of their endowment. This is the last mother to be seen. She belongs to the second type. She is empathic, adequately efficient, and dominating though not unkindly. Here she engages her baby in her own style of burping, which though enthusiastic, is brief and appropriately enough a minor aspect of the feeding. The remarkable leaps in the development of this little boy in less than a year, provide a glimpse of the sturdy relationshipbetween this mother and infant. Here is this lively fellow at six months. He is thoroughly alert and accepts any solids begrudgingly. The mother holds him securely on her lap and in no way constricts him. Such pleasant ease and close physical contact with babies of six months is not often seen. Although she follows him about with the spoon, she gives him the privilege of rejecting his fruit. She explains that his appetite for it at midday is often small, and she is ready to give him his bottle. This little boy can drink from his bottle by himself, but cannot quite manage to grasp the nipple because of his present position in her lap. Rather than place him in the crib summarily, the mother chooses to go on holding him and encourages his efforts by guiding the nipple to his mouth. At one year, this boy shows that his mother's thoughtful training has its rewards. He can hold the bottle easily with one hand, but she still is glad to sit by protectively and lovingly. Now her tendency to dominate recedes, and she gives him the greater control of his own feeding. When he is in his highchair for solid foods, she can come and go within his range of vision, and feels free to clean up while he munches. For this baby, eating has become a happy game with mother. For very many other babies of this age, feeding is a routine that invariably generates conflict. Since this little boy has to wait for his mother's company, she provides a substitute on whom he practices the game. Helpfully, she shows him where the baby's mouth is and now everybody has been happily fed. [Music]