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.



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