Description of fetal and Neonatal Psychology

2. By Dr: Samir M Al-Minshawy
Lecturer of Neuropediatrics
Minia University

4. Psychology Vs Psychiatry
 Psychology is the study of people: how they think,
act, react and interact. Psychology is concerned with
all aspects of behavior, thoughts, feelings and
motivation underlying such behavior.
 Psychiatry is the study of mental disorders and their
diagnosis, management and prevention.

5. Dr: Emil Kraepelin(1856 – 1926): the founder of modern
psychiatry, who brought up the specialty of child psychiatry
starting with the neonatal period and extending through
adolescence.

6. 4000-years-old Luxor Temple!
The Abu el-Haggag Mosque

7.  Mental disorders have been recognised in Egypt for
millennia; 5000 years ago, they were considered to be
physical ailments of the heart or uterus, as described
in the Ebers and Kahun papyri. These disorders
carried no stigma, as there was no demarcation then
between psyche and soma.
 In the 14th century – 600 years before similar
institutions were founded in Europe – the first
psychiatric unit was established, in Kalaoon Hospital
in Cairo.

9. Interactive Children

14.  1- The right of having known and contracted (one) lineage:
 2- The right to have a healthy and chaste womb environment
 3- The right to have a strong genetic origin
 4- The right to have a true faith
 5- The right to get into heaven
 6- The right of equality with other fetuses
 7- The right to have a normal social life
 8- The right to maintain fetus life
 9- The right to enjoy health life within womb
 10- Maintaining fetus good and benefit
 11- Temporary hold of penalties for the pregnant
 12- Maintaining fetus's financial rights
 13-Honorable Islamic precedence

15.  Infanticide is explicitly prohibited by the Quran.
 Esposito, John L. (editor) (2004). NY: The Oxford Dictionary
of Islam, p. 138. ISBN 978-0-19-512559-7 .

16. http://galleryhip.com/egypt-children.html

17. Fetal Psychology

18. “Babies have been trying for centuries to convince us
they are like us : sensing, feeling, thinking. With new
windows to the womb studies uncovered previously
hidden talents of both prenates and newborns.
Basically, we should address and stress on:
 The roots of human behavior begin to develop early -
just weeks after conception, may before a woman
typically knows she is pregnant.
 Structural and functional brain development is highly
related to behavior and cognitive development as
supported by MRI studies and фффany significant
alterations in the vulnerable early fetal life may be
permanent and linked to childhood and adult
psychopathology.

19.  Magnetoencephalography (MEG) can be effectively
used to record fetal and neonatal cognitive
abilities/functions by recording completely non-
invasively the magnetic fields produced by the active
neurons in the brain.

20. Prenatal Development
Mixed Messages from Mom

22.  At 3-5 weeks, brain begins to develop.
 At 9 weeks, the brain allows fetus to bend its body,
hiccup, and react to loud sounds. At week 10, it moves
its arms, "breathes" amniotic fluid in and out, opens
its jaw, and stretches. Before the first trimester is
over, it yawns, sucks, and swallows, as well as feels and
smells. By the end of the second trimester, it can
hear; toward the end of pregnancy, it can see.

23. Factors affecting prenatal brain development:
 Genetic role
 Maternal health and nutrition
 Maternal age and weight
 Maternal immunity and infections
 Prenatal exposure to teratogens (drugs, chemicals and irradiation, etc..) and
psychoactive drugs
 Maternal emotional state and stress (working mother)
 Gonadal hormones
 Socioeconomic factors
 Others
Predisposing factors for early brain injury
 Prematurity
 Low birth weight (LBW) infants
 Small for gestational age (SGA) infants
 Adverse neonatal events

24.  Prenatal factors have long-lasting consequences on
later mental health. Maternal smoking is associated
with offspring ADHD and antisocial behavior. It
showed a dose-response relationship with persistent
criminal behavior in male offspring, after controlling
for demographic, parental, and perinatal risk factors.
 Lower birth weight and under nutrition linked to
wide range of psychopathology, including depression,
psychosis and ADHD. The mechanism may be
placental dysfunction, anoxia, maternal cortisol,
environmental toxins such as nicotine and carbon
monoxide that cross the placental barrier, and early
programming effects..
 Untreated maternal depression was associated with
slower fetal growth. preterm birth.

25. The Fetal Senses
Sensitivity to Touch
 Touch, the first sense, beginning in just before 8 weeks and completed by 32
weeks.
Tasting and Smelling
 Tasting begins at 14 weeks. Swallowing increases with sweet tastes and
decreases with bitter tastes. The nose develops between 11 and 15 weeks.
Amniotic fluid provides tastes and odors crossing the placenta by permitting
direct access to receptors of several chemosensory systems. So newborns are
drawn to the odor of breast milk.
Listening and Hearing
 Although amniotic fluid, embryonic membranes, uterus, and the maternal
abdomen—barriers, fetus receives sound. A mother's voice and music are
transmitted to the womb. "Reactive listening begins at 16 weeks, eight weeks
before the ear is structurally complete at about 24 weeks.

27. Development of Vision
 Although, eyelids remain closed until the 26th week, the
fetus responds to light with heart rate accelerations and
may use some aspect of "vision" to detect the location of
needles entering the womb, either shrinking away from
them or turning to attack the needle barrel with a fist. Also,
twins have no trouble locating each other and touching
faces or holding hands!
The Fetal Movement
 Begins with the first heartbeat at about 3 weeks after
conception. Between week 6 and 10, fetal bodies burst into
movements. Awake or asleep, it moves 50 times or more per
hour, serving as tactile stimulation for itself.
The Senses in Action
 skin and bones contribute to hearing, and vision seems
functional even with fused eyelids. Babies are dreaming as
early as 23 weeks g.a. when REM sleep is observed.

28. Fetal Learning
 Fetus can learn and remember by habituation. Within hours of
birth, a baby prefers its mother's voice to a stranger's, suggesting
it must have learned and remembered the voice. A newborn
prefers a story read to it repeatedly in the womb by responding to
the rhythm of voices and stories, not their words. the human
fetus is an active participant in its own development and is
collecting information for life after birth. Babies begin learning
language in the womb. This proved that by about 26 weeks of
gestation, this baby had already acquired certain features of its
"mother tongue."
Fetal Personality
 Babies are born with characterized differences. Just when and
how the behavioral traits originate in the womb is now the
subject of intense study, may due to mother's sleep/wake cycles,
eating patterns, movements and personality.

29. Fetal Emotions
 As in adults, external behavior is associated with
internal emotions like sadness, fear, pain, anger, rage
and pleasure . Audible crying is rare as it requires air
in trachea. However, it occurred in response to rupture
of a membrane, manual displacement of the head or
the attachment of electrodes for internal monitoring.
 Facial expressions, particularly smiling and other
facial expressions which occuring in REM sleep
indicating expressions of private pleasure.

30. Fetal Cry

31. Fetal Smile

32. Maternal fetal attachment
It is the extent to which women engage in behaviors
that represent an affiliation and interaction with their
unborn child, it begins prenatally.
Positively affected by many factors including the
mother’s emotional state, environment, social support
system, as well as negatively affected by factors, such as
substance abuse and anxiety.

33.  Emotionally disturbed women have infants who are
irritable, poor sleepers, with lower mental and motor
skills, ADHD, autism and psychosis.
 Increasing abortion and birth complications with fear,
anxiety, guilt, difficult acceptance and poor
attachment.
 Studies have also attributed that to
neuroendocrinological disturbances, particularly
catecholamines crossing the placenta, biochemically
provoke the physiological reaction to anxiety and fear
in the fetus.

34.  Steps to Bond with Your Unborn Baby
1. Understand what preborn babies may hear.
 Prenate are aware of and affected by what’s going on in the
outside world.
2. Know that sound may stimulate a six-month-old fetus.
 A six-month-old fetus can move his body to the rhythm of his
mother’s speech. Babies seem agitated by so loud sounds.
3. Understand what your preborn baby may sense.
 Fetus can perceive different tastes and sights.
4. Understand what your preborn baby may think.
 Mother’s thoughts affect the emotional life of her preborn baby.
5. Consider the long-term effects of your emotional life.
 Anxious mothers (not mild stress) produce anxious babies.
Mothers who felt no attachment to their babies were more likely
to have children who had emotional problems..
6. Grow a healthy baby.
 Guard against polluted thoughts! Relax! Take reasonable
measures to rid your life of tension, take time to rest and revel in
positive emotions . Talk to, sing to and share affectionate
thoughts with your baby.

35. Neonatal Psychology
How do infants experience the world?
 Infants are born with innate primary reflexes which are
unlearned responses to stimuli and disappear later.
 Indicate whether the newborn’s nervous system is working
properly.
How does love develop between mother and neonate?
 Harry Harlow evaluated whether feeding or contact was
more important.
 His research showed that the need for affection created a
stronger bond between mother and infant than did
physical needs (food) suggesting that the development of a
child’s love was emotional rather than physiological
 'kangaroo care‘ allows more attachment which may provide
additional physiological and neurodevelopmental benefits
in neonates

36.  Myths about Newborns
 1. Babies Don't Feel
 2. Very Poor Brains
 3. Assembly-Line Brain
 4. Babies Can't Think
 5. No Sense of Self
 6. Babies Don't Need Their Mothers
 7. The Age Myth

37. Attachment
 Maternal-Infant Interaction: is a strong, long-lasting
emotional connection that is “person-specific” and is
enduring across time
 Dynamic interactive process
 Represents the prototype for all other social
relationships.

38. Behavioral and Cognitive Activity of Newborns
 Within hours after birth, human -even premature-
neonates show significantly increased preferences for their
mothers voice , smell, and facial features over those of a
stranger. actively perceive, learn, and organize information.
 Holy Quran recitation can be considered a complementary
and supportive care for preterm newborns (Eskandari et al.,
2012).
Increased Sensitivity to Pain in Neonates
The traditional view that neonates were relatively insensitive
to pain was contradicted.
Maternal Separation
Prolonged maternal separation leads to the development of
exaggerated hormonal responses and altered
neurotransmitter release which may lead to long term effects.

39.  Adverse neonatal experiences (many of which are
preventable) may lead to early brain injury and
predispose to late abnormal behavior. The major
proposed mechanisms of brain injury are hypoxia-
ischemia and inflammation.
 Sedatives given in the absence of painful interventions
were noted to increase the risk for drug abuse.
 Invasive procedures in neonates cause marked
fluctuations in intracranial pressure leading to early
intraventricular hemorrhage or periventricular
leukomalacia and analgesia lessen that cascade.

40. Prematurity and low birth weight
 Giving high risk for brain injury, disturbances
in brain maturation and neurobehavioral sequale. Preterm birth
was significantly associated with increased risk of psychiatric
hospitalization in adulthood with nonaffective psychosis, bipolar
affective disorder, depressive disorder, eating disorder, drug
dependency, or alcohol dependency
 The developing brain, particularly the periventricular white
matter, is vulnerable to cytotoxic and hypoxic/ischemic injury,
which increase the risk for abnormal cognitive and motor
functioning. Ex-premature infants have more educational,
behavioral and emotional difficulties later as compared to their
ex-full term peers.
Early life stress:
 As mother separation, poor family functioning, low social
support, and caregiver psychological distress result in
abnormalities in brain structure and function which are
associated with deficits that may persist for years after the stress
is removed.

41. Breast feeding
 Benefits are as greater as longer the baby is
breastfed.
 Improving their children’s cognitive development of
preterm and term infants.
 Breast milk constituents promote healthy neural
growth and white matter development
 Breastfeeding may be associated with a lower risk
for psychopathology for mother and infants in later
life.
 Research points to the importance of breastfeeding
for promoting close mother infant contact and
social-emotional development.

43. Parenting is an Art

44. Very Early Parenting Starts Before Conception

45. For strong interpersonal bonds:
 Understanding the needs of the other
 Providing care and protection
 Preoccupation with the interests and wants of the other.
 parenting is a subset of caregiving or social behaviors and
thoughts that are conserved, and have a predictable time course
and characteristic content.
 Transition to parenthood involves a set of highly conserved
behaviors and mental states, reflecting both genetic role and
early life experience.
 Parenting behaviors play a critical role in the child's behavioral
development it shapes infants’ current and future behavior,
provides infants with their first social experiences, forms
templates of what they can expect from others and how to best
meet others’ expectations.
 Parenting of mothers and fathers may be independently and
interactively related to child outcomes. We are need for actual
wise fatherhood.

46.  Parenting is regulated by key hormones and neurotransmitters.

47. I need both of you
That is good for me and for you