Using the Brazelton Neonatal Assessment Scale to facilitate the parent-infant relationship in a primary care setting.

This article describes use of the Brazelton Neonatal Assessment Scale (BNAS) as an effective parent-teaching tool and demonstrates how this tool can be successfully integrated into a primary care setting. Research indicates that the BNAS can be used to enhance parent-infant bonding, to promote parents' confidence, and to intervene in potentially dysfunctional parent-infant interactions before poor parenting patterns become well established. Case studies exemplify how a clinician can use the BNAS to evaluate 37 newborn behaviors and 18 neurological reflexes, identifying the newborn's individual strengths, elucidating coping behaviors (as he or she strives to maintain control over the autonomic nervous system), illuminating his or her individual stress responses, and demonstrating which comforting techniques are most effective for that child. Further case studies illustrate how the tool can enable a clinician to identify the positive characteristics of a difficult baby, and emphasize the importance of noticing and responding appropriately to a baby's state of consciousness. The BNAS is an effective interactional exam because the clinician captures the patients' attention by interacting with their newborn. During this interaction the clinician assesses and describes the newborn's strengths and needs, and at the same time models effective interaction with the infant. Samples of the BNAS scoring protocol and a helpful parent-education handout are included.