I was rather shocked by the perspective of the young mother referred by my colleague, Gale. "Gale thought you could help me out," the young woman explains.
Eli was Samantha's second baby. He was a planned child, born healthy and full term. Labor and delivery had gone well, breastfeeding was successful, and Mom had two months of maternity leave. What could be that wrong? I wonder.
"He fusses all the time!" Samantha explains as she lays the baby on the exam table. "See, like now! Hear him making all those grumpy sounds!"
Eli is a robust, wide-eyed six-week-old. He is very busy in his movements as he wiggles and squirms on the exam table. His level of activity is a wonder to behold. He seems to wind up a second, then one arm shoots out to the side, both legs kick upward, and he arches his back. He is also very busy with his vocalizing—a grunt here, a groan there, or was that a coo? The activity and sounds coming from his cute little body are normal and even entertaining to me. But his activity level and his vocalizing seem to be off-putting to his mother who thinks Eli is fussing all the time.
"See Sarah there," Samantha says as she points to her four-year-old daughter coloring peacefully on the floor at our feet. "She is so calm and easy to be around. Both my husband and I had alcoholic parents, and we promised each other that we would have a peaceful household. But Eli just keeps on fussing," the new mother remarks as she hands me her baby.
What an opportunity and a challenge this moment is! Can I help this mother see her son through a different lens? As usual, when I feel challenged by a patient encounter, I simply report to the parent on the behavior of the baby (a technique well described by Dr. T. Berry Brazelton). I demonstrate Eli's normal reflexes and get excited when he brings his hand to his mouth and begins to calm down. I pick up the end of my red stethoscope and engage the baby in a little game of following its movement with his eyes. Of course, I finish with the grand finale of having the mother call out the baby's name. Eli hesitates only a moment before he turns toward his mother and—I believe he actually gives her a wink!
Samantha giggles and scoops up the baby from my arms as I discuss this high, but normal, level of activity and vocalizing. We talk about how each baby has a special temperament and style, right from birth. "His body activity and enjoyment of vocalizing are part of Eli's inborn personality," I explain. Mom smiles as she gives him a hug. “I guess he’s just a real go-getter,” she responds.
Eli is three years old now. Every time he and his family come to the clinic to see Gale, they stop by and say hello to me. "Eli's not really fussy anymore," Samantha explains. "But he's still a busy and noisy little guy!" Eli runs down the hall ahead of his mom who laughs out loud as his sister squeals in his pursuit!