When Dr. John H. Kennell was a hospital pediatrician in the 1950s, newborns were typically whisked away within minutes of delivery, washed, weighed, blood-tested and plunked into bassinets under the nursery's fluorescent lights. Their mothers would not be permitted to hold them for 12 hours, sometimes longer.
At University Hospital in Cleveland, where Dr. Kennell was the staff neonatologist, nurses bottle-fed infants every four hours. Mothers could visit, but not for very long.
Dr. Kennell, who died on Aug. 27 at 91, liked to say that it was the full-throated complaints about this state of affairs by his patients that led him to undertake a research project in the 1960s that helped change the world on which most newborns now open their eyes.
His findings, published in "Maternal-Infant Bonding," a 1976 book written with Dr. Marshall H. Klaus, a fellow professor of pediatric medicine at Case Western Reserve University in Cleveland, were considered a prime catalyst for changes in hospital procedures that gave new mothers more private time with their infants, let fathers into the delivery room and allowed young children to visit new siblings in the hospital.
The book's central claim was that infants and their mothers were hormonally primed in the first hours after birth to form crucial bonds, but that under hospital rules then commonly observed, that process was not allowed to happen.
"Babies were ready to eat right away after being born, but they didn't get to their mothers for 12 hours," Dr. Kennell said. "No one was paying attention to what the baby wanted."
The doctors' ideas were well received by developmental psychologists who ascribed to attachment theory, which links the relations newborns have with their first caregivers to their ability to have healthy relationships in adulthood. Relatively quickly, "bonding" became widely adopted as part of maternity ward routines.
But "Maternal-Infant Bonding" came under severe criticism. Fellow researchers said its conclusions were based on too small a case sample and put too much stock in the mother-child interactions in the first hours. Adoptive parents complained that the theory left them out of the picture. Some feminists saw it as just another way to place child-rearing responsibilities solely on women and to blame the mother if a child grew up troubled.
Dr. Kennell and Dr. Klaus acknowledged mistakes in their findings and published a revised version of their book in 1982, "Parent-Infant Bonding." Though it stuck to the original premise, the new edition was less specific about a bonding timetable. The book has been updated several times since. In an introduction to the 1996 edition, the noted pediatrician-author Dr. T. Berry Brazelton defended the authors.
"Despite criticism by some that 'proof' of a sensitive period for bonding between parent and baby has not been shown, the authors have continued to fight for a more humane atmosphere in hospitals at the time of delivery," Dr. Brazelton wrote, "including time for early attachment behavior between a new parent and baby. We now realize how important it is to create this atmosphere."
The sea change in hospital childbirth practices drew on many social currents of the 1960s and '70s, including the natural childbirth movement, the women's movement and an anti-authoritarian climate, said J. Kevin Nugent, the director of the Brazelton Institute, a child and family research center founded by Dr. Brazelton at Boston Children's Hospital.
"Maternal-Infant Bonding," he said, struck a chord with a broad cross section of women, many of them nurses and hospital administrators who were also mothers and were receptive to the changes it proposed.
"Hospital procedures were geared to the efficient running of hospitals rather than to the needs of mothers and babies," Dr. Nugent added. "John helped change that."
John Hawks Kennell was born on Jan. 9, 1922, in Reading, Pa., to Doris Hawks and Carlyle Kennell and grew up in Buffalo. His mother was a high school English teacher, and his father an insurance salesman.
After medical school at the University of Rochester and two years in the Navy, Dr. Kennell did his residency at Harvard Medical School. He was the chief resident at Boston Children's Hospital before he moved to Cleveland in 1952 to teach at Case Western Reserve and serve as the attending pediatrician in the neonatal unit of the university hospital.
Dr. Kennell, who died in Cleveland, is survived by his wife, Margaret Lloyd Kennell; a daughter, Susan; two sons, David and John, who confirmed his death; and five grandchildren.
Dr. Kennell went on to study the bonding process from another perspective, looking at parents of infants who die in delivery or soon after being born. He was one of the first neonatal experts to recommend that the grieving parents hold their newborns, and his insights about the emotional benefits such physical contact can provide parents have been incorporated in the standard procedures of most neonatal intensive care units.
Dr. Kennell also became an advocate of doulas, trained nonmedical professionals who help women during pregnancy, labor and postpartum. With Phyllis H. Klaus and Dr. Klaus, he wrote "The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier and Healthier Birth," published in 2003 and now in its third printing.
The great question of his work, however, was the mystery of the chemistry between children and parents.
"What is the process by which a father and mother become attached to an infant?" he asked in "Bonding," a 1996 book he also wrote with the Klauses. "We have developed ever-greater respect for the complexities of the process. It is our continuing quest."
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