Prenatal Programme Minding a Baby's MindTM
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The EPT Clinic’s
Minding a Baby’s Mind TM
Prenatal Programme
Handbook
An evidence-based parenting programme to help
parents foster physical and mental wellbeing in their
babies
By Lorraine O.B. Madden
Chartered Psychologist C. Psychol., Ps.S.I.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
About the Author:
Lorraine O.B. Madden C. Psychol., Ps.S.I. M6672 M.A. B. Ed. Psych. Ad.Dip.
is a Chartered Educational Psychologist and Clinical Director of the EPT
Clinic, Kilkenny, Ireland. She is also a published research author, lecturer
with University College Dublin, a wife and a mother of two small children.
In her work as a Psychologist, Lorraine specialises in the areas of child
development, infant mental health and early intervention. Lorraine and the
clinic’s highly qualified team of healthcare professionals believe in helping
all children reach their full potential in life. Lorraine begun her career
working as a home tutor with children who presented with Autism. She then
worked as a primary school teacher, before returning to university to
complete her M.A. in Educational Psychology. As a psychologist, she initially
worked with the HSE in both Early Intervention and School Aged Services.
After some time working with the HSE, Lorraine set up her own clinical practice, The EPT Clinic in
January 2019. The practice now comprises of over 12 team members, specialising in excellence in
paediatric healthcare. The team provide psychology, speech and language therapy, occupational
therapy, play therapy and psychotherapy to children and families within a family-systemic framework.
Trademark:
Minding a Baby’s Mind (TM) is a registered Trademark with intellectual property to Lorraine O.B.
Madden Under No: 262164 In respect of Goods and Services in Classes 9, 16, 41 and 42.
Copyright @2020 by Lorraine O.B. Madden. All rights reserved.
Published by The EPT Clinic Ltd.
The Education, Psychology and Therapy (EPT) Clinic,
Unit 6 Kilkenny Enterprise Centre,
Purcellsinch Business Park,
Dublin Road,
Kilkenny R95 YA07
www.eptclinic.ie
info@eptclinic.ie
00353-56-777-1383
No part of this production may be reproduced, stored in a retrieval system or transmitted in any form
or by any means, electrical, mechanical, photocopying, recording, scanning, or otherwise, without
prior written consent from the copyright holder, nor be otherwise circulated in any form, or to those
who have not purchased the course - except for as permitted under the Related Rights Act 2000,
whereby the author of this work is to be identified for her work.
The author and publishers have made every effort to trace and acknowledge the holders of copyright
for materials used in the book. In the event of a copyright holder having been omitted, the publishers
will come to a suitable agreement at the first opportunity.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
Forward written by Dr. Maeve Martin
We are at the beginning of a new and exciting era in which we are learning more about brain
functioning (neurology) and the mind (psychological functioning) and the integration of the
two. We now know that intense emotional experiences can produce lasting and detectable
physical changes in the brain, and that the early years from conception to birth are a critical
period for these changes. Of course this is not a new concept, many before us such as
Socrates, Winnicott and many more talked about the long lasting effect that experiences in
early childhood can have right into adolescence and adulthood, the difference is that we now
have the science that can demonstrate just how true that is.
This online prenatal programme Minding a Baby’s Mind, provides an exceptional integration
of current conceptual frameworks, practical advice and links to up to date research, in a most
accessible and user-friendly manner. I truly believe that this programme will provide parents,
potential parents and carers with the practical tools they need to develop the best possible
relationship with their child, and to make the most of the amazing, but often overwhelming
task of bringing a human being into the world. Congratulations on a fabulous piece of work,
it is a truly comprehensive yet highly accessible introduction to the world of parenting and
infant mental health.
Dr Maeve Martin
Clinical Director of Inform Psychological Services
Dr. Martin has worked as Principal Clinical Psychologist in the Irish Health Service, Project
Manager for the implementation of a major change programme in the Irish Mental
Health Service and as Assistant Inspector (Clinical Psychology) for the Mental Health
Commission. She was Chairperson of the National Child Health Information Service
Project (CHISP) and member of the national working party “Best Health for Children”.
Dr. Martin is the author of one of the largest research studies in Ireland into the mental
health needs of children and adolescents, “The Clonmel Project” and joint author of the
publication “Child Mental and Emotional Health”.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
Content
The EPT Clinic’s ................................................................................................................................................ 1
Programme Overview ...................................................................................................................................... 8
Introduction ....................................................................................................................................................... 8
Who is this programme for? .............................................................................................................................. 9
How to use this programme ............................................................................................................................. 10
Theoretical Underpinning ................................................................................................................................ 11
Module 1: Minding the Family and Baby during Pregnancy ........................................................................... 12
Module 1 – Lesson 1 (Primary Content) ...................................................................................................... 12
Video 1 (a): Minding the Family and Baby during Pregnancy .......................................................................... 12
Video 1 (b): Baby’s Development Starts in the Womb..................................................................................... 13
Video 1 (c): Diet and Exercise ........................................................................................................................... 14
Additional Reading for Module 1 ................................................................................................................... 15
Module 1 – Lesson 2 .................................................................................................................................... 15
Becoming a Parent ........................................................................................................................................... 15
Getting Started with Pelvic Floor Exercises ...................................................................................................... 16
Medicines during Pregnancy ............................................................................................................................ 16
Learning Activity 1 (M1) – Chat and Reflect ..................................................................................................... 17
Module 2: Developing a Parenting Identity and Style .................................................................................... 18
Module 2 – Lesson 1 .................................................................................................................................... 18
Video 2 (a): Advice for Expecting Parents ........................................................................................................ 18
Video 2 (b): Developing a Parenting Identity and Style ................................................................................... 19
Learning Activity 1 (M2): What kind of parent do you want to be?................................................................. 19
Learning Activity 2 (M2): Adapting to Change ................................................................................................. 21
What influences our parenting style? ............................................................................................................ 22
Learning Activity 3 (M2): Thinking about Your Childhood ............................................................................... 22
Learning Activity 4 (M2): Your Attachment History ......................................................................................... 24
Learning Activity 5 M2: What type of a parent might you be? ........................................................................ 25
Early Attachment.............................................................................................................................................. 26
Attachment and Parenting Theory ................................................................................................................... 27
Video 2 (c): Creating a Magical Attachment with Your Baby ........................................................................... 29
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
Additional Reading for Module 2 ................................................................................................................... 30
Module 2 – Lesson 2 .................................................................................................................................... 30
Psychological Preparation: ............................................................................................................................... 30
The Magic Bond................................................................................................................................................ 31
Learning Activity 6 (M2): Leaving some things in the past and bringing some things into the future............. 32
Learning Activity 7 (M2) – Chat and Reflect ..................................................................................................... 32
Module 3: Labour, Birth and Establishing Feeding ......................................................................................... 33
Module 3 – Lesson 1 .................................................................................................................................... 33
Video 3 (a): Approaching Birth with Midwife Anabela and Psychologist Lorraine........................................... 33
Video 3 (b): Labour and Birth ........................................................................................................................... 34
Packing your Maternity Hospital Bag ............................................................................................................... 35
Video 3 (c): Feeding in the Early Days with Midwife and Lactation Consultant Anabela and Psychologist
Lorraine ............................................................................................................................................................ 37
Additional Reading for Module 3 ................................................................................................................... 41
Module 3 – Lesson 2 .................................................................................................................................... 41
How to Know Birth is Approaching .................................................................................................................. 41
The following signs suggest that your labour may be approaching:............................................................ 41
The Water Breaking.......................................................................................................................................... 41
False Labour ..................................................................................................................................................... 42
So, how can you tell if your contractions are true labour? .............................................................................. 42
The Stages of labour – Script from the Video .................................................................................................. 42
First Stage .................................................................................................................................................... 42
Second stage ................................................................................................................................................ 43
Third Stage ................................................................................................................................................... 44
Learning Activity 1 (M3)– Chat and Reflect ...................................................................................................... 44
Module 4: Early Days at Home ....................................................................................................................... 45
Module 4 – Lesson 1 .................................................................................................................................... 45
Video 4 (a): Parent’s Roles in the Development of their Baby ......................................................................... 45
Video 4 (b): The First Few Days and Weeks with your Baby ............................................................................ 46
Early Communication with Your Baby .............................................................................................................. 47
The Basics of Newborn Communication ...................................................................................................... 47
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
A baby’s body language ............................................................................................................................... 47
A baby’s verbal communication style .......................................................................................................... 47
A baby’s facial expression ............................................................................................................................ 47
A baby’s behaviour as a form of communication ........................................................................................ 47
Serve and Return Interactions.......................................................................................................................... 48
What do Serve and Return Interactions Look Like? ..................................................................................... 48
Video 4 (c): Early Communication – Serve and Return Interactions at 9 weeks .............................................. 49
Additional Reading for Module 4 ................................................................................................................... 52
Module 4 – Lesson 2 .................................................................................................................................... 52
Learning Activity 1 (M4): Your Support Network ............................................................................................. 52
Learning Activity 2 (M4): A Support Person ..................................................................................................... 53
Problem Solving Together ................................................................................................................................ 53
Creating a Supportive Bubble........................................................................................................................... 54
Healthy Preoccupation ..................................................................................................................................... 55
Learning Activity 3 (M4) – Chat and Reflect ..................................................................................................... 56
Module 5: Early Developmental Milestones .................................................................................................. 57
Module 5 – Lesson 1 .................................................................................................................................... 57
Video 5 (a): The Developing Brain with Psychologist Lorraine ......................................................................... 57
Video 5 (b): Early Developmental Milestones with Occupational Therapist Maureen .................................... 58
Video 5 (c): Chatting and Connecting with your Baby – 3 months................................................................... 59
Additional Reading for Module 5 ................................................................................................................... 60
Module 5 – Lesson 2 .................................................................................................................................... 60
Understanding A Baby’s Mind .......................................................................................................................... 60
Mentalisation ............................................................................................................................................... 60
Mentalisation Case Study ............................................................................................................................ 61
Regulation .................................................................................................................................................... 61
Mentalisation task – Marked Mirroring ....................................................................................................... 61
Sowing Seeds for Social Competence and Emotional Wellbeing ..................................................................... 62
Why is social competence and well adjusted mental wellbeing in adults important for our children’s
development? .............................................................................................................................................. 63
How do we as parents improve our social competence? ............................................................................ 63
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
Seeing yourself in your Baby ............................................................................................................................ 64
Learning Activity 1 (M5): Passing on Traits to Your Child................................................................................. 64
Learning Activity 2 (M5)– Chat and Reflect ...................................................................................................... 65
Module 6: Adjusting to Family Life up to 6 Months After Birth ...................................................................... 66
Module 6 – Lesson 1 .................................................................................................................................... 66
Video 6 (a): Minding Your Baby At Home with Psychologist Lorraine ............................................................. 66
Video 6 (b): Touch, Sleep, Crying and Soothing ............................................................................................... 67
Video 6 (c): Playing wth your Baby................................................................................................................... 68
Additional Reading for Module 6 ................................................................................................................... 70
Module 6 – Lesson 2 .................................................................................................................................... 70
What is good enough in the early months? ..................................................................................................... 70
Here is an example of “good enough” attunement: ........................................................................................ 71
Laying the Foundations for Resilience.............................................................................................................. 72
Sleep Deprivation, Family Matters, and Adjustment ....................................................................................... 72
Coping with Sleep deprivation ..................................................................................................................... 72
Family Matters ................................................................................................................................................. 72
Learning Activity 1 (M6): .................................................................................................................................. 73
Planning for Positive Family Interactions:.................................................................................................... 73
Grieving the Life you Had ................................................................................................................................. 74
Difficulty adapting to your new parenting identity and the related responsibilities ....................................... 74
Reframing Life Changes .................................................................................................................................... 75
Learning Activity 2 (M6): Identifying Possible Negative Thoughts or Unrealistic Expectations – then Reframing
Them ................................................................................................................................................................ 76
Managing Mood and Anxieties ........................................................................................................................ 77
Learning Activity 3 (M6): Incorrect Interpretation of a Baby’s Behaviour ....................................................... 78
Seeking Appropriate Help ................................................................................................................................ 79
Learning Activity 4 (M6): Chat and Reflect ...................................................................................................... 79
Acknowledgements .......................................................................................................................................... 81
References ........................................................................................................................................................ 82
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
Programme Overview
Introduction
Becoming a parent is an incredible experience. This programme aims to help parents become the best
kind of parent that they can become. Scientific, evidence-based research from the field of paediatrics,
including research from physicians, developmental specialists and psychologists, explain that there
are certain things that enable babies and infants to flourish. Research which has tracked the
development of infants, children, teenagers and adults suggests that getting a good start in life
matters.
What is different about the Minding a Baby’s Mind ™ Parenting Programme?
There has been an explosion in ways to measure a babies development during the last decade,
including websites and apps which tell parents when to expect various skills to emerge, however,
reliable information regarding how to support a baby in reaching these milestones, especially social,
emotional and behavioural milestones is much harder to find.
Minding a Baby’s Mind ™ is written from a developmental and psychological perspective, prioritising
the development of social-emotional competence, physical and mental wellbeing because we know
from the research that a healthy social and emotional foundation provides the platform which we
launch all other skills from.
Our programme aims to helps parents sow seeds of social-emotional competence,
physical and mental wellbeing, giving babies a strong psychological platform
from which they can learn about the world.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
If parents support social-emotional competence, physical and mental wellbeing from the start, this in
turn supports the development of cognition (or IQ), speech and language skills, motor and sensory
skills and much more! The Minding a Baby’s Mind ™ programme has built upon the research findings,
creating a scientific framework to enable optimum development in all children.
We consistently reiterate that the aim of this programme is not to provide a set of
rules or strict guidelines to parents. Instead we aim to support parents in reaching
their full parenting potential.
Who is this programme for?
This programme is designed for expecting parents or anyone who thinks they might like to have a
baby. The course is also relevant to healthcare professionals who work with new or expecting parents,
or anyone who has an interest in attachment or positive infant mental health.
We use the word “couple” throughout the course, which we use to refer to two
people who are involved in the prenatal (before baby is born) and postnatal (after
baby is born) journey together. This may be a mom and dad, a mom and mom, a
dad and dad, a single parent and their birth partner, or parents who are not
together – they are still a couple in the sense that they are two people who are
sharing this experience – the creation of a new little person whom they will be
bringing into this world.
It is important that every expecting parent has someone who can support and
help them – no matter who they are!
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©
How to use this programme
Key information is summarised in this handbook and delivered through a set of expert videos, reading
materials and learning excercises. We suggest that you have the handbook with you as you progress
through the modules. There are six modules, so you can either do one a week for six weeks, or you
can work at your own pace.
• Module 1: Minding the Family and Baby during Pregnancy
• Module 2: Developing a Parenting Identity and Style
• Module 3: Labour, Birth and Establishing Feeding
• Module 4: Early Days at Home
• Module 5: Early Developmental Milestones
• Module 6: Adjusting to Family Life up to 6 Months After Birth
Through the videos and this handbook, we hope to provide evidence-based knowledge about what to
expect during pregnancy and early parenthood. Parents can use this information and integrate it with
their own values so that they can create their own approach to pregnancy, birth and parenting
thereafter.
Most importantly, the programme aims to empower parents to be the best type of parent they can
be. This is in the context of increased demands on parents – busy working lives, complex family
systems, significantly increased prevalence of developmental disorders, and mental health difficulties
in young children. We believe that parents and carers are the primary educators in all children’s lives,
and we therefore strive to provide families with the tools necessary to make the right decisions to
help their children thrive.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Theoretical Underpinning
The Minding a Baby’s Mind ™ programme is built upon a strong evidence – base. The integration of
scientific research from the field of infant mental health and attachment, paediatric child
development, developmental and attachment based cognitive behavioural psychology, genetics and
neuroscience combines to form the theoretical underpinning of the Minding a Baby’s Mind ™
programme – a holistic, flexible, evidence-based framework. By combining different areas of scientific
enquiry, the programme endeavours to enable parents to help their children develop social-emotional
competence, physical and mental wellbeing, and ultimately to thrive.
Particular inspiration was taken from works written by Donald Winnicott and Claudia Gold (full works
referenced in full at the end of the handbook). The programme offers a preventative, proactive, and
responsive paediatric metal health strategy which advocates a “scientific practitioner” approach
towards infant development and infant psychology.
Psychological Developmental
Frameworks Frameworks
Infant Mental Paediatric child
Health development
Developmental
Genetics
Psychology
Family Systems Neuroscience
Attachment
based Cognitive
Behavioural
Psychology
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Module 1: Minding the Family and Baby
during Pregnancy
Module 1 – Lesson 1 (Primary Content)
Video 1 (a): Minding the Family and Baby during Pregnancy
Please summarise what you learned from video 1 here, along with your own thoughts and feelings:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Video 1 (b): Baby’s Development Starts in the Womb
In this video you heard Maureen Ryan, Paediatric Occupational Therapist introduce some ideas
about wellbeing and development during pregnancy. Summarise what you learned here as well as
your own thoughts:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Video 1 (c): Diet and Exercise
Mom’s diet and exercise play an important role in your baby’s development in the womb. Please jot
in your notes and thoughts here:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Additional Reading for Module 1
Module 1 – Lesson 2
Becoming a Parent
Becoming a parent or care giver is a wonderful gift and a privilege. However, it is also a huge
responsibility and a challenge. Research suggests that there are a number of things that happen when
we become parents or care givers. So let’s explore what these involve….
Parents usually have an idea in their minds of what parenting should be like. Before having a baby,
parents often imagine that the connection to their baby will come easily, and that parenting will be
fun and intuitive. How much time and effort could a tiny baby really require… Parents rarely realise
the time and effort that parenting involves.
Prior to the birth of our first son, my own husband planned to re-do a section of the garden during his
two-week paternity leave and I had planned on attending mother and baby breast feeding meetings
on a weekly basis for the first few months. “We will have lots of free time”, we thought. I struggled to
understand why parents on maternity/paternity leave repeatedly told us that they had no free time.
Well, I am afraid both my own and my husband’s plans did not pan out as we had expected… and I am
now one of those people who is always run off their feet!
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Getting Started with Pelvic Floor Exercises
Exercising the mother’s pelvic floor muscles is very important during pregnancy. Ideally, you should
link in with a trained healthcare professional or physiotherapist who can guide you on how to do these
exercises safely. Pelvic floor exercises involve exercising the muscles which support the rectum,
vagina, and urethra in the pelvis. Toning these muscles with Kegel exercises will help expecting moms
push during delivery and recover from birth. It will also help control bladder leakage and lower your
chance of getting hemorrhoids. Pelvic muscles are the same ones used to stop the flow of urine. Still,
it can be hard to find the right muscles to squeeze. You can be sure you are exercising the right muscles
if, when you squeeze them you stop urinating. Or you can put a finger into the vagina and squeeze. If
you feel pressure around the finger, you've found the pelvic floor muscles. Try not to tighten your
stomach, legs, or other muscles.
Here is a little kegel exercise sequence to get you started:
1. Tighten the pelvic floor muscles for a count of three, then relax for a count of three.
2. Repeat 10 to 15 times, three times a day.
3. Start kegel exercises lying down. This is the easiest position. When your muscles get stronger,
you can do Kegel exercises sitting or standing as you like.
Medicines during Pregnancy
Probably the most important thing to remember during pregnancy is that the mom and the baby are
connected. The medicines you use, including over-the-counter, herbal, and prescription drugs or
supplements you take, might get into your baby's body, too.
Many medicines and herbs are known to cause problems during pregnancy, including birth defects.
For some medicines, we don't know that much about how they might affect pregnancy or the
developing baby. This is because medicines are rarely tested on pregnant women for fear of causing
harm.
Moms might wonder if it's safe to use medicines during pregnancy. There is no clear-cut answer to
this question. Your doctor can help you make the choice whether to use a medicine. Labels on
prescription and over-the-counter drugs have information to help you and your doctor make this
choice. Always speak with your doctor before you start or stop any medicine. Not using medicine that
you need may be more harmful to you and your baby than using the medicine.
Also, it’s good to note that some infections can be harmful during pregnancy, so it’s important to let
your baby’s healthcare team know if you think you may have an infection so they can give you the
right care as early as possible.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Okay, so that was a lot of information! But as they say, information is power. To finish up this module,
I just want to congratulate you on your pregnancy and wish you and your family every success with
the next module.
Learning Activity 1 (M1) – Chat and Reflect
What do you think are the key messages to remember from Module 1? Write them down here:
Things to remember:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Module 2: Developing a Parenting Identity
and Style
Module 2 – Lesson 1
Video 2 (a): Advice for Expecting Parents
Write down a few things that you think are important to talk about with your family before your
baby arrives.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Video 2 (b): Developing a Parenting Identity and Style
Learning Activity 1 (M2): What kind of parent do you want to be?
Draw or summarise what you think good parenting looks like here:
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Learning Activity 2 (M2): Adapting to Change
Write down 5 things in your life that will or have changed upon becoming a parent
1. _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
2. _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
3. _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
4. _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
5. _________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©What influences our parenting style?
Experts have consistently identified a tendency for new parents to think back to their own childhood
and their own experience of being parented when they become new parents themselves. This is a
normal and healthy process which enables new parents to think about what type of parent they want
to be themselves. It is important to come to terms with how we were parented and how it may impact
upon us as a future parent. We are all influenced by how we were parented!
Learning Activity 3 (M2): Thinking about Your Childhood
With your partner, think back to your own childhoods now:
Describe your childhoods using 3 key words:
What kind of a relationship did you have with your parents or caregivers during your childhood?
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©What techniques did your parents use to parent you?
Will you use any of these techniques with your children?
What will you do differently?
If you don’t want to parent in the same way as you were parented, you need to break the
cycle so that you can form your own parenting norms!
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Learning Activity 4 (M2): Your Attachment History
Name your early attachment relationships here – your parents or the people who cared for you as a
young child.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Learning Activity 5 M2: What type of a parent might you be?
A parent who will or already does provide a secure base
A parent who might have a tendency to get angry quick, and make threats
A parent who might experience difficulty being emotionally available to their child
At this stage, you can work on yourself to become whatever type of parent you want to be….
Write down one thing that you could do this week to become a more secure, emotionally
available and responsive parent:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Early Attachment
Edward Bowlby (1907 – 1990), a British psychologist, psychiatrist, and psychoanalyst is famously
known for the research he carried out on early parenting attachment. He worked with children of all
ages and backgrounds, dedicating his life to understanding why children develop certain social,
emotional and behavioural traits.
Bowlby was one of the first to teach us that there is a concrete,
measurable link between one generation and the next. In other words,
how we were parented is one of the biggest influencers of how we
parent.
While developing his theory of attachment, he suggested that babies
develop certain behaviours in order to survive, and that these
behaviours develop in the context of the relationship a baby has with
their carer.
The relationship we have with our parents or carer influences how we behave as a parent……..
and how we behave as a parent influences how our baby behaves.
Mary Ainsworth (1913 – 1999), an American-Canadian developmental psychologist was a colleague of
Bowlby’s. She took early parenting research a step further. She designed a test (The Strange Situation)
to illustrate that how a parent relates to, and interacts with, their baby affects how the baby behaves,
and subsequently how they relate to the world around them. In other words, if we experience an
extremely strict, cold type of up-bringing, we may find ourselves re-enacting some of these
experiences with our children, unless of course, we make a conscious decision not to. Similarly, if we
were generally responded to and encouraged as a child, we are more likely to naturally parent our
own children in the same way.
Mary Main (born in 1943) is another American psychologist who worked at the University of California.
She designed an interview called the Adult Attachment Interview (AAI: Main, 2000) which asks adults
to recall and describe their own relationship with those who cared for them.
During this task, Main assessed whether the parent was securely or insecurely attached to their own
parent or guardian (whether they were living or deceased).
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Similar to Bowlby, Main’s research demonstrates the long-lasting affect which our parents have on us.
However, this does not mean that we will turn into our own parents! (Although that is sometimes a
risk….). No, her research shows us that our experience of being parented can affect us for the good or
the bad… but it is up to us to decide!
The most important thing is to think about our experience of being parented – we
need to make sense of it and make peace with it.
When we do this, we protect the connection that we have with our family. This in
turn helps us to connect with the next generation – our own children.
This is how we leave unhelpful experiences in the past…. And take helpful ones
into the future with us!
Attachment and Parenting Theory
During Ainsworth’s career, she consistently found that parents and babies generally developed one of
three ways of interacting – they were either secure, insecure or avoidant.
Type 1: Secure Attachment
Parents of secure babies provide a safe base for their baby to seek comfort in. These babies explore
their environment from the safety of their parent, returning to them after explorations.
These babies
Parents who
typically develop
provide love and Typically have
into well adjusted
respond to their secure, well
children without
babies when they attached and
emotional-
seek protection and adjusted babies...
behavioural
comfort...
problems.
She also identified how difficulties in infanthood can develop. She found two types of unhealthy
attachment approaches in babies – insecure attachment or avoidant attachment. These babies are
insecurely attached to their parents.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Type 2: Insecure Attachment
Parents who were
inconsistent to These babies
Often had babies
their babies sometimes develop
who were clingy,
responses adjustment
anxious and
(sometimes fully problems as
oppositional.
present, sometimes children.
preoccupied)....
Parents of insecure babies often get angry more often and threaten their child with abandonment.
This means the infant is unsure whether their parents will be helpful or cross.
Type 3: Avoidant Attachment
These babies
Often had babies
Parents who sometimes develop
who who
provided minimal to adjustment
demonstrated rage
no comfort.... problems as
and aggression...
children.
Parents of babies who are avoidant are often emotionally unavailable, turning away from their child
when they need comfort.
In the next video you will learn how to foster a healthy, secure attachment between you and your
baby.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Video 2 (c): Creating a Magical Attachment with Your Baby
After watching this video, write out 3 things you can do to foster positive attachment with your
baby:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Additional Reading for Module 2
Module 2 – Lesson 2
Psychological Preparation:
Here are a few points to keep in mind to psychologically prepare for the arrival of your baby:
• Continue to mentalize – holding your baby’s existence in your mind – what they might look
like, smell like, sound like, feel like in your arms can really help you bond with them when they
arrive.
• Continue with BABE:
o Breath
o Accept what your partner is saying and listen
o Be honest about how you are feeling yourself
o Empathise with your partner
• Most women go into labour between 38 and 42 weeks of pregnancy, so rest up during this
time if possible so that your mind and body is ready for the birth.
• Your midwife or doctor should give you information about what to expect if your baby is
overdue.
• Call your doctor, hospital or midwife at any time if you have any worries about your baby,
including your baby’s movements.
• A range of strong emotions are normal during pregnancy, including feeling happy, sad and/or
anxious. Fear of the unknown can be scary. If you feel that your emotions are becoming a little
overwhelming, contact your GP or a member of your baby’s birth team.
• Do things that make you feel nurtured, good about yourself, loved, safe and relaxed.
• Talk to your baby and tell them about what is about to happen and what the world is like
• Learn about your rights and your hospital's protocols so that you can make informed
decisions. In Ireland, go to www.hse.ie for details.
Page 30 of 86
The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©The Magic Bond
Research has repeatedly demonstrated the power of developing a strong bond with your baby. In fact,
would you believe that scientific research has consistently linked a strong bond, or attachment with
your baby to the development of an array of impressive social and emotional skills in later life –
including social competence, positive mental wellbeing, learning and problem-solving skills. On the
other hand, poor bonding and attachment has been linked with an array of physical and emotional
problems in later life, such as mental illness, obesity, asthma and heart disease. So how can we achieve
this “magic bond”? It can be difficult finding time to spend bonding with your baby during their initial
24 months due to a range of challenges. Life is busy! Furthermore, lots of people aren’t sure exactly
what it means to spend time “bonding”, and wonder… what does it mean to develop a good
attachment with your baby, what does it look like? So let us try to explain:
Experts in the field of attachment, such as John Bowlby, Mary Ainsworth, Mary Main and more
recently, Dan Hughes and Daniel Siegal explain what healthy and unhealthy attachment looks.
Following a review of research, here is our own explanation.
Early attachment is the relationship that develops between a care giver and their
baby. This relationship begins the moment you learn about their existence. Both
the baby and their care giver go on a journey together getting to know one
another. Expectations develop and experiences follow.
Just like all relationships and experiences in our lives, attachment can be positive or negative, healthy
or unhealthy, and can change. It is a voyage.
Page 31 of 86
The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Learning Activity 6 (M2): Leaving some things in the past and bringing some things into the future
What parts of you do you want to pass onto your child
Example: A positive body image
I will talk positively about my own body, so that I model confidence and inner acceptance. That
way, my child will not criticise their body when they are older. Write your answer below:
Learning Activity 7 (M2) – Chat and Reflect
What do you think are the key messages to remember from this module? Write them down here:
Things to remember:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Module 3: Labour, Birth and Establishing
Feeding
Module 3 – Lesson 1
Video 3 (a): Approaching Birth with Midwife Anabela and Psychologist Lorraine
Write your video notes and any thoughts you had in this box:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Video 3 (b): Labour and Birth
Write your video notes and any thoughts you had in this box. You can also include your birth plan
here:
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Packing your Maternity Hospital Bag
As you reach the third trimester of your pregnancy, it is a good idea to start to think about packing
your maternity bag. The HSE (2019) suggest the following:
Files and medication Hair clips and bands
pregnancy records including birth plan hair clips and hair bands to keep
your hair off your face during labour
any prescribed medication
Clothes Towels and toiletries
2 comfortable maternity bras or support towel (choose dark colours to avoid
vests staining) for each day you're in
hospital
wide opening nightshirt pyjamas if
breastfeeding toiletries - lip balm, toothbrush,
hairbrush, face cloth, tissues
2 nursing bras if you're planning to
breastfeed breast pads and nipple cream
dressing gown 2 large packs of maternity sanitary
towels
3 to 4 nightgowns or pyjamas (light ones –
hospitals can be warm) small bottle of hand sanitiser
an old t-shirt or shirt for labour
consider a v-neck for breastfeeding
underwear – choose large cotton or
disposable
a pair of socks for labour (your feet can get
cold)
Footwear Snacks and water bottle
slippers healthy snacks (such as fruit and rice
cakes)
flip-flops or other waterproof sandals for
shower refillable water bottle
Birthing equipment Other items
any birthing equipment like a birthing ball or phone and phone charger
TENS machine if you plan on using one
camera
After the birth things to help you pass the time and
relax (books, magazines,
pen and paper (you may have to record newspapers or music and
baby’s feeds) earphones)
change for the car park your own pillow, if you want to bring
one. Use a pillowcase with a colour
loose-fitting clothes for the trip home
or pattern so it is not mistaken for a
(which fit you at 26 weeks pregnant)
hospital pillow
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©These are the items you need to pack for your baby:
Clothes Nappies
6 baby vests, 6 baby grows and 6 bibs - all 1 pack of 24 newborn or size 1
baby clothes should be washed before nappies
packing
1 roll of cotton wool or pack of
cardigan cotton wool balls
hat baby wipes
nappy cream
Towels and blankets Sheets and cloths
pre-washed baby towels 2 cot sheets (if your hospital doesn't
provide them)
2 cellular baby blankets
muslin cloths
Car seat
Write down your notes here for preparing your hospital bag:
Page 36 of 86
The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Non-medical pain relief options for childbirth
Research suggests that adequate preparation can help to reduce pain or at least modify the perception
of pain and reduce anxiety, which can help you to better cope with labour. There are several non-drug
pain relief options:
• Being in good physical condition is important. Exercise gently and regularly throughout your
pregnancy, avoid cigarettes and alcohol, and eat a healthy, balanced diet.
• Knowing what to expect during the various stages of labour can help reduce anxiety. Antenatal
classes are strongly recommended.
• Breathing techniques may help you to ‘ride the waves’ of each contraction.
• Constant, close support from your partner (or a trusted friend or loved one) for the duration
of labour can reduce anxiety.
• Using distractions like music can help to take your mind off the pain.
• Hot or cold packs, massage, a warm shower or immersion in a warm bath, and keeping active
may all be helpful.
• Hypnosis, acupuncture and acupressure are areas in which there has been little research but
these may be considered also.
Transcutaneous electrical nerve stimulation (TENS)
TENS is a technique in which nerves in the lower back are stimulated using a small hand-held device
controlled by the woman. It has no known side effects for mother or baby and many women find it
helpful either alone or in combination with other methods of pain relief.
Medical pain relief options for childbirth
The three main medical pain-relieving options for labour include:
• Nitrous oxide
• Pethidine
• Epidural anaesthesia
1. Nitrous oxide (Gas and Air)
Nitrous oxide, known as ‘laughing gas’, is mixed with oxygen and administered to the mother through
a face mask or a tube held in the mouth. The gas takes a few seconds to work, so it is important to
breathe from the mask as soon as a contraction starts. Nitrous oxide doesn’t stop the pain entirely,
but takes the ‘edge’ off the intensity of each contraction. Many women prefer nitrous oxide because
it allows them direct control – you can hold the mask yourself and take deep breaths whenever you
feel the need.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©Nitrous oxide doesn’t interfere with contractions and it doesn’t linger in either the woman’s or the
baby’s body.
Possible problems with using nitrous oxide include:
• Nausea and vomiting
• Confusion and disorientation
• Claustrophobic sensations from the face mask
• Lack of pain relief – in some cases, nitrous oxide does not offer any pain relief at all (this applies
to around one-third of women).
2. Pethidine
Pethidine is a strong pain reliever (related to morphine and heroin), usually injected directly into a
muscle in the buttock. It may also be administered intravenously (directly into a vein). Depending on
various factors, the effect of pethidine can last anywhere from two to four hours. Pethidine can make
you feel sick, so anti-nausea medications are usually administered at the same time.
Possible problems with pethidine for the mother include:
• Giddiness and nausea
• Disorientation and altered perception
• Respiratory depression (reduced breathing)
• Lack of pain relief, in some cases
Possible problems with pethidine for the baby include:
• The unborn baby is exposed to the drug via the umbilical cord and may experience respiratory
depression at birth, particularly if several doses are given or the baby delivers soon after a
pethidine injection. This effect can be reversed by an injection given to the baby.
• The baby’s sucking reflex may also be depressed, as well as other normal reflexes. Debate
persists over the effects of pethidine on newborns.
3. Epidural Injections
Epidural injections are the most effective pain relief available. They are used for vaginal births and
also for caesarean sections, because they allow the mother to stay awake and alert during the baby’s
birth. Anaesthetic is injected into the lining of the spinal cord through the back, which makes the
mother feel numb from the waist down. Your baby’s heart rate will be monitored continuously.
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The EPT Clinic - Lorraine O.B. Madden C. Psychol., Ps.S.I. 2020 ©You can also read
