Newborn Behavioural Observations

The Newborn Behavioural Observations (NBO) system is a tool designed to help parents and practitioners share together the fascinating uniqueness of a baby, though observing their behaviour, which is their language. We offer training and certification for practitioners, giving them enhanced knowledge, skills and confidence in supporting parent-baby relationships.



**NEW** NBO Refresher Course: Read More and Book your place

NBO Course for High Risk Infants: Read More & Book Now

Free NBO Support Sessions: Read More and Sign Up


The NBO Tool

The NBO is a set of shared observations designed to help you as the practitioner and the parents together observe the baby’s behaviour. Since we know a newborn baby’s method of communicating is their behaviour, taking time to observe and understand these signs, movements and responses, means understanding what that baby is saying, who they are, what they like and what they dislike.

Key assumptions the NBO are based on:

  • Infants are social beings ready to communicate
  • Babies communicate through their behaviour
  • Infants’ communication is not random

The NBO can be used with babies from birth to 3 months old. There are 18 items in total that can be observed on the NBO.  Each session is individual, because you and the parents will be guided by the baby, but it will typically cover:

  • Capacity to habituate to light and sound (sleep protection)
  • Motor tone and activity level
  • Capacity for self-regulation (including crying and consoling)
  • Response to stress (indices of the infant’s threshold for stimulation)
  • Visual, auditory and social-interactive capacities.

“Every baby is different and has many ways to tell us what they would like us to do. The NBO provides the baby with a ‘voice’”

Dr. T. Berry Brazelton

Observing these behaviours will show the baby’s strengths and also identify the kind of support the baby needs. The observations can provide you with individualised guidance to offer parents.

Results from parents after having an NBO show:

  • They feel they know their baby better and have enhanced parent-baby engagement
  • They feel more trust in the practitioner enhancing the parent-practitioner relationship

The NBO provides the infant with a "voice", a "signature".

Dr. Kevin Nugent, Author of the NBO

Using the NBO

The NBO is designed to be a user-friendly, flexible tool so it can be used by any individual working with newborn babies and their parents. It can be integrated into any practice and adds a strength-based individualised form of care.

Some examples include:

  • A neonatal nurse in a NICU with a baby and parents before discharge
  • A health visitor on a home visit to carry out the new birth visit
  • A midwife or maternity support worker as part of postnatal care.

The NBO is recommended in the National Health Visiting Core Service Specification (2015/16, NHS England) and Specialist Health Visitors in Perinatal and Infant Mental Health (2016, NHS Health Education England).

In clinical settings:

  • Give professionals in depth knowledge of infant development and behaviour
  • Add a strength-based perspective alongside other care and assessments
  • Offer fascinating insights and guidance to new parents thus helping rapport with parents

The NBO Course and Certification

We will give you thorough teaching and support to guide you

to feel confident and ready to use the NBO tool.

Please note that an NBO certificate does not entitle the person to train others in the NBO.  The NBO can only be taught by trainers who have been approved and trained by the Brazelton Centre.

✔ Step 1

Before arriving on the course please read chapter 3 of the NBO manual.

✔ Step 2.

2 day training course (content remains the same for in-person and online courses)

We offer our NBO Course Online: Read More

This covers the background and content of the NBO through presentations, interactive exercises and a live demonstration with a newborn baby and their parents*.

*Please note, the trainer demonstration of the NBO with a parent and baby has been suspended for the time being. A selection of videos showing the NBO will be played instead. 

By the end of this training course practitioners will:

  • Understand how newborn babies communicate
  • Know about different behavioural states of infants
  • Understand infants’ self-regulatory behaviours
  • Know the signs of overstimulation or need for a break
  • Learn soothing techniques to console the baby
  • Understand how to support parents in a strength-based way, taking into consideration the parents’ needs

Please note that participants will need to bring (have to hand for online courses) a doll to work with, such as the dolls used for infant massage.

View Course Programme

You will receive your CPD certificate and points after attending the course.

✔ Step 3.

Practice Phase and Support

Carry out 5 practice NBO sessions with full-term babies and their parents. Document each session on the recording forms.  There is the opportunity for two follow-up mentoring conference calls and unlimited support by email during this practice phase.

✔ Step 4.


Send in the recording forms from your 5 practice NBO sessions to our Neonatal Evaluation Officer who will study your forms to check you have demonstrated understanding of the tool. You may be asked to do some more practice sessions.  Once approved you will receive your certified practitioner pack including your certificate. Your CPD points will also be topped up to the full 30 hours through our partnership with the Infant Mental Health Recognition Register.

Training Fee

£465 (£233.00 if previously taken NBAS training in the UK)

Fee includes

  • 2 day course (with lunch and refreshments provided at in-person courses only)
  • NBO kit, NBO book and hand-outs (all provided at the training or posted to you if an online course)
  • Post-training support supervision calls

*A cancellation charge (up to 100% of the booking fee) may apply if a training place is cancelled less than two months from the date on which the training is scheduled to take place.

If there are 16 or more people interested in training, we can come to you. Learn about Group Bookings using the button below.