The Sacred Hour

Uninterrupted Skin-to-Skin Contact Immediately After Birth

Raylene Phillips MD, IBCLC, FAAP

Disclosures

NAINR. 2013;13(2):67-72. 

In This Article

Skin-to-Skin Contact Supports Optimal Brain Development

The brains of newborn infants are not fully mature. The human brain of a newborn is only 25% the size it will be in adulthood. While all cells are present, myelination and synaptic development are not yet complete. Allan Schore, PhD, a neurobiologist from UCLA, and others have been exploring the roll of attachment and brain development for many years and explain that the amygdala is in a critical period of maturation in the first 2 months after birth. The amygdala is located deep in the center of the brain and is part of the limbic system involved in emotional learning, memory modulation, and activation of the sympathetic nervous system. Skin-to-skin contact activates the amygdala via the prefronto-orbital pathway and thus contributes to the maturation of this vital brain structure.[13]

Harry Harlow, PhD, in his famous research with Rhesus monkeys found that monkeys raised without their mothers preferred the touch of a fur-covered wire surrogate mother to one without fur but with milk in a bottle. Touch was more important than food to motherless monkeys![14] Drs. William Mason and Gerson Berkson demonstrated that touch and movement were both required for normal brain and social development by a novel experiment where baby monkeys were raised with a motionless fur-covered surrogate mother or an identical fur-covered surrogate that moved in a random back and forth and up and down motion. Only monkeys who were raised with both touch and motion had normal brain development, demonstrating the importance of maternal holding and carrying throughout infancy for ongoing brain development.[15]

Based on the work of Harlow, Mason and Berkson, James Prescott, PhD, a neuropsychologist and health scientist administrator at the National Institute of Child Health and Human Development (NICHD), one of the institutes of the United States National Institutes of Health (NIH) from 1966 to 1980, asserted that touch and motion were the most important senses for normal brain development. He was the first to identify that touch and motion were critical for normal neurointegration of the cerebellum–limbic–prefrontal cortex.[16]

In addition to his own research, Dr. Prescott examined the research of anthropologists who had provided detailed descriptions of primitive cultures. After evaluating the data about 49 primitive cultures, Dr. Prescott was able to predict which cultures were peaceful versus violent cultures with a simple observation. Cultures in which babies were carried on mothers' bodies throughout the first year after birth were more peaceful cultures and those that did not were more violent cultures. Interestingly, he also identified an association between longer duration of breastfeeding (greater than 2 1/2 years) and low or absent suicide rates in 26 primitive cultures. Dr. Prescott speculated that there is a sensitive period during infant brain development when pleasurable touch and movement are necessary and protective against depression and violence.[17] John Bowlby, the famous attachment psychologist, also claims that infant carrying and direct body contact are essential for normal infant development. Being skin-to-skin during the first hour after birth sets a pattern of behaviors between mothers and infants that supports continued body contact and carrying, and thus normal brain development of the infant.[18]

Mother–infant attachment is important in the development of the newborn's ability to self-regulate and maintain homeostasis. At first, the mother is the baby's regulator. The dyadic interaction between the mother and the newborn controls and modulates the newborn's exposure to environmental stimuli and by doing so serves as a regulator of the developing individual's internal homeostasis.[19] One-year old infants, who had spent the first 1–2 hours skin-to-skin with their mother, were found to have better self-regulation when evaluated in a research setting during a structured play session. They were less easily frustrated and better able to calm themselves.[21]

Dr. Schore asserts that the brain is designed to be sculpted into its final configuration by the effects of early experiences and that these experiences are embedded in the attachment relationship.[22] He and others who study attachment and brain development emphasize that early interpersonal events can positively and negatively impact the structural organization of the brain. Early experiences may shape brain structure and function in a manner that is designed to provide the individual with the type of brain best suited to the environment he or she is born into. A traumatic or hostile environment would require a brain designed for caution and defense, whereas a supportive environment would allow for a brain designed to grow and thrive. If the attachment relationship is, indeed, a major organizer of brain development, then attachment is far more important than simply providing a fundamental sense of safety or security.[23]

If the birth process did not go as planned and the baby's first impressions of life outside the womb are less than ideal, all is not lost. Bonding and attachment are so critical for survival that nature has made it possible for both to occur at any time during a lifetime. However, the longer after birth the process is begun, the more difficult it is and greater is the risk of incomplete bonding or insecure attachment. Fortunately, human beings are capable of recovering from most types of trauma with appropriate insight, support, and healing techniques. The bottom line is — whatever supports early mother–infant attachment, supports infant brain development!

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