Table of Contents

 

Introduction: The surprising newborn

Newborns are not finished at birth. If a baby is a “bun in the oven,” as the saying goes, then newborns are not fully baked. They need to further develop during what pediatricians dub the “fourth trimester”—their initial three months outside the womb. And beyond that time, they spend the next nine months growing and developing the skills they will need to blossom into toddlers.

Few people, both lay and professional, recognize this fact, and Mysterious Baby will offer a unique exploration into the peculiar physiology of babies during their first year.

We open the book with the harrowing story of a one-week old baby who arrives in the ED with uncontrollable shaking. Suspecting the devastating diagnosis of neonatal seizures which signals brain damage or infection in the brain, the ED doctors transfer her to the Intensive Care Unit. A pediatrician ultimately diagnoses her with a condition common to many infants: “benign sleep myoclonus”, a condition no more dangerous than hiccups.

This section will use such examples to introduce readers to the unique nature of babies.

Section 1: What is a baby?

Babies are adorable. They have big eyes, soft skin, and they like to cuddle. However, as we watch a child grow, we all notice—usually quite abruptly—how much he has changed. Suddenly, he doesn’t look like a baby any more. He’s a kid! So, what makes a baby look uniquely like a baby?

For one thing, a baby’s body proportions, composition, and movements are uniquely distinctive during the first year of life, more so than at any other time. Most of these outward characteristics that we see are specific adaptations that help the baby to survive the ordeal of childbirth and adjust to the world outside the womb. In the first section of Mysterious Baby, we examine both these outwardly visible characteristics and the very unique inner workings of babies, and explain why babies behave in sometimes seemingly bizarre ways.

This section will offer fascinating insights for caregivers, and anyone interested in medicine or science, into how we as humans develop from these strange little creatures at birth into full-fledged adults. And, the section will help all caregivers understand how to interact with babies in a more meaningful, gratifying, and enjoyable way.

Chapter 1: Structure: Why does a baby look like a baby?

A baby cannot touch the top of her own head because her arms are so short and her head is so large. Imagine how odd adults would appear if their full-grown arms could not reach the top of their head! With that example as just one of many, it is obvious that a baby’s body is profoundly unlike that of an adult. In fact, baby parts can sometimes be so radically different in shape and structure that they fool even pediatricians into thinking something might be wrong as we will illustrate with the story of one of my colleagues. This young doctor referred babies to a neurosurgeon for enlarged head size, and only later realized these babies actually had congenitally large heads, which is a normal condition that runs in some families.

We all appreciate the adorable-ness of these naïve, cuddly beings. But we take for granted that the proportions and shape that make a baby’s body appear adorable are really brilliantly designed structural features.

This chapter explores the radical differences in shape and structure of baby parts; from the unique material that creates their baby soft skin to their pliable bones that have such effects as making baby’s ribcage move quite unlike adults’ when they breathe. This chapter also covers babies’ marble-sized stomach that overflows when they eat too much, their prolific drooling, weird fat, and why babies are really hairier than adults (but don’t look like Ewoks).

Chapter 2: Function: What’s going on in there?

Babies’ biological machinery can be flat-out weird. For example, since water makes up the vast majority of our tissues, it seems incredible that it can actually be dangerous to give a baby water to drink! The reason is that the nephrons in babies’ kidneys function differently than in older children so they are not able to dispose of water efficiently. Extra water in their diet can dilute a baby’s blood, which causes a relative low sodium concentration in their blood. Such lowered sodium can cause irritability, brain swelling, unresponsiveness, and seizures.

Babies can also change colors. They can be quite colorful billboards for all kinds of strange biological phenomena. For example, after nursing, their lips can take on a bluish hue, but not because they are deprived of oxygen. When babies nurse, the veins in their lips become engorged, producing a weird blue-white shade. And we will explain the neurologic reason for this phenomenon.

These little enigmas-in-diapers produce such physiological surprises in all their systems, from their skin to their blood circulation to their digestion. And most of the time, these startling phenomena are all perfectly normal. Besides kidney function and color changes, this chapter reveals the chemical processes and biological machinery that underlie such puzzles as babies’ erratic temperature regulation and breathing, their normally “malfunctioning” digestive plumbing, their idiosyncratic drug metabolism, surprising vitamin deficiencies and why it’s perfectly okay for a baby to exude Technicolor poop.

Chapter 3: The burgeoning baby

There is no other stage in human development that is so marked by such explosive physical growth as the first year. A baby doubles her weight in the first 6 months, and, at a minimum, triples her weight by a year. Imagine if an adult experienced such growth! He’d go from 170 pounds to 340 pounds in just six months—and would end up not in the emergency room, but in the laboratory, studied as a freak of nature.

But it’s not just growth in size that characterizes this stage of life. The first year of life could more accurately be described as “burgeoning,” which implies both growth and change. Besides tripling their birth weight in the first year, babies will also develop incredible new abilities and a variety of puzzling, entertaining, and sometimes unusual behaviors.

For example, not only does the brain grow physically in size, it also “grows” in complexity and interconnectedness. While a baby’s brain continues to grow after birth, she is also losing brain cells and connections, in a critical process called “pruning.” But unlike in adults, losing brain cells is perfectly normal in babies. Just as pruning shapes a tree’s growth, neural pruning shapes the pathways of a baby’s neural circuitry as he learns by playing, traveling, annoying the dog, etc.

This chapter explores how babies’ ultra-high-speed growth produces tumors, rashes, and all kinds of frightening “abnormalities” that the baby can easily overcome. But we also explain how their super-fast growth provides a critical window of opportunity for correcting such problems as clubfoot and lazy eye. We will examine the physiology underlying babies’ sudden “growth spurts,” as well as the disappearance of those puzzling, primitive reflexes. And we’ll explain the physiology behind those eccentric sleep patterns that can frustrate bleary-eyed parents.

Chapter 4: The “Mother Ship”

A mother’s effects on her baby continue long after the umbilical cord is cut. It’s an intimate, often little-understood physical and psychological relationship in which Mom not only provides her baby basic protection, caring, and sustenance, but also actually influences her offspring’s cognitive development and genetic and biological machinery.

This chapter explores the effects of mothers’ consumption of alcohol, cigarettes and other harmful drugs on the baby. But we also discover that the foods that pregnant moms eat influence their babies’ immune system, for example, the relationship between diet and allergies and asthma. Similarly, Mom passes on antibodies and hormones that have startling effects, on their babies.

This chapter explains the effects of cuddling—whether from Mom, Dad, or another caretaker—which actually switches on genes in the baby’s body that control growth.

We also uncover the complex biological communication between mother and child that occurs during breastfeeding. Besides breast milk’s well-known nutrients, it also has added ingredients for specialized tasks. For example, breast milk contains a drug that makes babies a teensy bit stoned. It’s a natural version of the chemical that gives marijuana its buzz. Called an endocannabinoid, it gives baby a healthy appetite, enhances food enjoyment, and aids in their sucking behavior.

The effects of the Mother Ship on a baby are by no means a one-way street. We discuss the research supporting the well-known positive effects of breastfeeding on mothers, and also the latest research demonstrating that having a baby makes moms’ brains grow. Even more astounding, there is evidence that before birth, the fetus is helping heal the mother’s heart! In studies with pregnant mice whose hearts had been injured, researchers have detected fetal stem cells derived from the placenta. Using clinical anecdotes, case studies, and research discoveries, this chapter will vividly portray the fascinating, intimate relationship between babies and their mothers.

Section 2: How does a baby become a kid?

In Section 1 we explained how babies arrive equipped with a stunning capacity to grow and develop from primitive beginnings. We continue this adventure in section 2, exploring how they are profoundly molded by exposure to the outside world. We’ll explain how they come prepared with sophisticated natural defenses to protect them from the world’s many assaults, as well as amazing sensory abilities to perceive and learn about the world around them.

Chapter 5: Bouncing baby: Resilient beyond belief!

We see babies as delicate, fragile creatures, but they literally are “built to bounce.” This chapter explores their near-superhuman resilience, alleviating parents’ sometimes profound anxieties about their inadequacy at keeping their babies safe from harm.

We open the chapter with the dramatic story of how more than a dozen infants survived for days in the wreckage of Mexico’s 1985 earthquake. We then explain many of the remarkable ways that such babies are stunningly resilient to injury; from the healing ability of their bones and skin— oftentimes without leaving the slightest scar—to how a baby’s brain can recover from even a severe stroke without any lasting effects.

We also explore their surprisingly powerful infection-battling immune system. And finally we discuss the surprising fragilities that babies do have.

This chapter will profoundly change the way you view babies: not as fragile, and helpless, but as resilient and well equipped for growth in this world.

Chapter 6: Perception: Seeing the world through baby-colored glasses

Babies are born with eyes, ears, and all the other apparatus they need to experience our world. But the world that their brain perceives is nothing like what we adults experience. For example, babies need about ten times as much illumination to see properly. While their baby eyes—about 65 percent the size of an adult’s eye—are still large enough to capture light, the photoreceptors in the back of the eye are insensitive to light as well as color. This means that parents who dim the nursery lights to help their baby sleep will only put themselves in a toe-stubbing situation, rather than helping their baby. Bright light won’t bother baby at all.

This chapter will draw on studies of infant perception to recommend the best way to foster babies’ visual development, as well as how to recognize vision problems.

Other sections of this chapter will use clinical anecdotes, case studies, and research discoveries to take the reader into the perceptual world of babies—including their senses of hearing, taste, smell, pain, and touch.

Chapter 7: Experience is the very best teacher

Even as your baby depends so totally on others for care, every experience she has teaches her lessons in life that you would not even imagine are occurring. For example, her exposure to bacteria “educates” her immune system. So, protecting your baby from germs may not be in her best interest.

Importantly, the chapter will discuss the growing body of evidence from neuroscience that is revealing the molecular effects of trauma on the developing brain. Recent research on “toxic stress” has shown that maltreatment during childhood affects the course of brain development and actually leads to differences in brain anatomy.

This chapter will offer a welter of surprising insights into how early factors such as obesity, allergies, and your baby’s learning environment can have profound effects throughout life. The chapter will also address parents’ “fever fear,” and explain that fever signals a healthy immune system; one that is developing in response to the child’s exposure and experience of different microbes. These immune system “training exercises” prepare babies to navigate the germ-infested world of playgrounds and pre-schools. And finally we explore what scientists know, and don’t know, about how a baby’s genetic predisposition interacts with experience at the basic physiological level.

Chapter 8: How babies learn

A major component of your baby’s experience, of course, is learning about this amazing new world she has been born into. So, we’ll devote this chapter to the stunning progress babies make in learning during their first year.

This chapter will cover how babies learn about the visual environment beyond their months as a newborn. It will include studies showing, surprisingly, that babies prefer a “Goldilocks” environment—ignoring scenes that are either too simple or too complex. And even though you think using “baby talk” is little more than a parental indulgence, it actually is specifically tuned by evolution to help develop her ability to understand and use language.

The chapter will also cover how babies learn such phenomena as gravity, and how to eat. For example, studies show that parents give up far too quickly in teaching their infants to like a new food. It typically takes ten tries, but most parents give up after only a few.

The chapter also will describe research that has yielded insights into how babies learn about emotions, numbers, language, and morality even during the first nine months of life.


Section 3: The continuing mysteries of babies

Even after centuries of scientific research, babies still present profound mysteries. The most experienced pediatricians sometimes still get the feeling that caring for babies is like treating cute little ETs! Despite the critical importance of understanding babies, far too little research has been done on their physiology, development, and effects of drugs. In many respects, babies are still little “black boxes.”

Such research is critically important because babies are so malleable, both physically and mentally, that early intervention can profoundly affect their entire lives. Such intervention could prevent problems ranging from psychiatric illness, to autism, to immune disorders.

This chapter will explore the deep mysteries of babies and how solving those mysteries could lead to better care for these delightful little enigmas. We will highlight the gaps in understanding infant physiology and development and will discuss how and why research funding and policy has led to a serious lack of research on infants.