Maternity leave and infant brain development

It is not until about eight weeks of age that an infant has a fully developed capacity for mutual gaze.

Then a baby looks directly into his mother’s eyes, while she, in turn, reflects back this loving gaze, cooing softly in response to her baby’s earliest communication. When a mother looks at a baby in a way that communicates with him, not with words but with feelings, “I understand you,” he begins to recognize himself, both physically and psychologically. He begins to be able to regulate his feelings. This mutual gaze, literally and figuratively being “seen,” actually facilitates the development of the baby’s brain.

The Massachusetts Supreme Judicial Court now has proposed to interrupt this newly emerging dance of co-regulation by ruling this week that woman workers are entitled to only eight weeks of maternity leave. This ruling applies only to women whose maternity falls under state law, and differs from the wiser federal Family and Medical Leave Act of 1993 which provides up to 12 weeks of unpaid leave and job protection.

Research at the interface of neuroscience and infant development is offering great insight into how mutual gaze actually grows the brain. Our knowledge about early brain development is derived from a combination of detailed video observations of mother-infant interaction and studies of the brain known as functional MRI. These imaging studies can actually see which parts of the brain are responsible for what behaviors. This research has shown that healthy wiring of the brain is contingent on attuned responses of caregivers. This attunement is not only in gaze but in touch, sound of voice and facial expressiveness.

When baby is born, the amygdala, the lower center of the brain that responds to fear and stress, is fully formed. The amygdala connects directly to the hypothalamus, which in turn connects directly with the parts of the body, like the adrenals, responsible for the release of hormones that lead us to experience the physical sensations of stress.

At about 2 months of age, another part of the brain known as the medial prefrontal cortex(MPC) begins to develop. It serves to regulate and control the smoke alarm. When a mother engages in this dance of co-regulation with her baby, she is wiring his brain, helping the fibers of the MPC to grow. The MPC continues to develop well into a person’s twenties. An infant’s brain, however, doubles in weight in the first year of life. A lot of wiring goes on in the third month.

When these connections are not well developed, intense emotions are not regulated. In the face of difficult feelings a person may be flooded with stress hormones. He may become overwhelmed by feelings of rage, anxiety or sadness.

Interesting research by Dr. Hilary Blumberg at Yale offers food for thought. Using MRI, she has found that adolescents with bipolar disorder have structural abnormalities in the amygdala and underdeveloped prefrontal cortex. She points to hopeful research using medication to rewire the brain to treat the emotional dysregulation characteristic of the disorder.

This is not to say that stressed early relationships inevitably lead to psychopathology. But doesn’t it make sense to do all that we can to insure that brains are wired well in the first place?

Important changes happen not only in an infant’s brain but also in a mother’s brain in her baby’s third month of life. When a mother sees her loving gaze reflected back at her from her baby, she develops a sense of competence. This trust in herself is critical in helping her face the many challenges ahead in her role as parent.

Certainly a mother who works full time is well able to facilitate her child’s healthy development if she is receiving appropriate support. But even under the best of circumstances, returning to work means that a mother will be stressed. Offering her the option for a full three months of what D.W. Winnicott, pediatrician turned psychoanalyst, referred to as “primary maternal preoccupation” seems an important and wise investment in the next generation.

Claudia M. Gold is a pediatrician who blogs at Child in Mind and is the author of Keeping Your Child in Mind.

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  • michelle

    Great another article to make working mom’s feel like dirt for going back to work. Reducing maternity leave to 8 weeks is bad, but when many working moms can’t even afford to take the full 12 as an option because those weeks are UNPAID (unless the mom has saved up enough vacation time) most must go back to work as soon as they can due to finances.
    Personally as somebody who has the “option” to go unpaid for 12 weeks I would rather have the federal law changed to 8 weeks if it was all 100% paid. I have to go back to work after 6 weeks if I want to pay the bills (I am not a single mom either). Sad thing is I work at a hospital where pediatricians like these in the article know it is important to be at home, yet you don’t see the MDs in administration jumping to change the poilcy to help invest in the next generation.
    .

    • pat

      This may sound harsh but…

      You should live within your means. If you know you’re having a baby then that means lowering your expenses to the point where your family can live on your spouses income until you have to go back to work.

      Does it suck? Yes. Should you do it anyways? Yes. You owe your children the best opportunity for success that you can provide. Guilt has nothing to do with it.

  • Celeste

    Interesting, considering that most states only give 6 weeks of paid leave for a vaginal birth, 8 weeks for a c-section. Sounds like the human race is pretty doomed, what with those mothers rushing back to work at 6 weeks and leaving the babies all alone until they come home. Or is it that they actually use a caregiver, but the gaze of anybody other than the mother fails to give them crucial assistance with their development?

  • http://doctorsintraining.com Erin

    If you have a flexible job where you could conceivably work remotely either full or part time, ASK for the ability to do so after you return from leave. I have done this for both of my pregnancies, and approached my boss early (like 8 weeks preg–family didn’t even know yet) with a plan containing several options and let them choose what would work for the department. Both times I have been allowed a flexible schedule for up to 6 mos after returning from leave. This isn’t possible at every workplace, but don’t assume 6 weeks is all you can have. Ask for the moon and stars, and maybe you’ll get the moon.

  • http://www.fancyscrubs.com FancyScrubs

    It’s sad we don’t have more time off with babies in this country. Other countries do offer paid leave up to a year and some more. Many places will not hold your job if you do not return on the designated time. Many businesses are not flexible as Erin suggests. Been there, done that. Had to return on the day or they would have been no job to return to.

  • Nancy

    I don’t think it’s meant to make anyone feel like dirt. There’s research there and I’d rather know about it than bury my head in the sand. The article clearly states that these babies/children aren’t doomed, but that there seems to be important development going on in the third month. Clearly, not everyone can stay home with their child or chooses to stay home for a full 12 weeks, but it’s informative, nonetheless. And what’s to say that this research can’t help to better train our future/current child care providers?

  • http://notwithstandingblog.wordpress.com The Notwithstanding Blog

    “But doesn’t it make sense to do all that we can to insure that brains are wired well in the first place?”

    While I’ll remain agnostic for now on the merits of the underlying topic, this approach of health-seeking absolutism strikes me as the wrong one. There will be opportunity costs to any course of action, especially at the policy level. It is rare that it will ever make sense for us to “do all that we can” in the pursuit of any goal, regardless of how noble.

  • http://carolynandersonmd.com Dr. Carolyn Anderson

    This research is just one of the reasons it’s important for new mothers to be able to stay at home with their children for at least the first few months. It also makes it easier for moms to maintain breastfeeding .

    Here in Canada, mothers are allowed 50 weeks at 55% pay. It’s a bit different for doctors like me but I was lucky to be able to take off 15 months to care for my son. I was missing out on a significant source of income but figured I could never get his childhood back. Obviously it isn’t feasible for all women but it was the right decision for me.

  • Mollie

    a mom that needs to work shouldn’t be feeling like dirt, they should be voicing the need for change.

    I was blessed to be able to stay home with my child but as a day care provider I understand that its just not possible for some. still, you can not gloss over articles like this. we should not blame the mother but we need to blame to social system here which gives woman no choice to stay home if they want to.