http://www.numb.net.nz/research.html

More interesting reading on Kangaroo Mother Care.

An excerpt:

Premature births have reached epidemic proportions in Britain: around one in
eight babies are now born early - 80,000 a year. There are lots of reasons
for the rise: increasing numbers of older mothers, increasing numbers of
younger mothers, increasing numbers of multiple births (thanks to IVF) and
advances in antenatal medicine. People argue a lot about how far we should
go with all this - whether 22- or 23-week babies should be saved. What they
don't argue about is the core treatment that is doled out to these babies.

According to Rob Williams, chief executive of the premature baby charity
Bliss, of the British babies born early each year, around 18,000 receive the
full-on, hi-tech, alarm-heavy, floodlit incubator experience. Most of the
rest receive some sort of "special care" in a cot on a neo-natal ward. All
are separated from their mothers - that's the constant. Babies on one ward,
mothers on another, or even in a different hospital, as happened to Prince
Andrew's wife, Sophie. It's a separation that feels beyond awful for all
directly concerned. But parents are kept going by the knowledge that the
horror is unavoidable; that without it their child might die. In most units,
parents are encouraged to take their child out of its cot or incubator for
so-called kangaroo-care sessions - there's plenty of science showing that
such contact is good for both mother and baby - but it's very much an
add-on, and if the baby's not judged to be stable, the baby stays in its
box.

Bergman says this is topsy turvy. He thinks mothers and babies should only
ever be separated in extreme circumstances. "You want babies on their
mother's skin 24 hours, as the default setting," he says. Skin-to-skin
contact provides all the warmth a baby needs, and helps to regulate a baby's
breathing, he says; any extra help needed (such as oxygen, drips, monitors
or a feeding tube) shouldn't stop the baby being on the mother - just add
the technology to the mother-baby unit.

Only proximity to the mother can provide a baby with all the sensory
stimulation necessary for proper brain development, he goes on. When he
talks about "70% brain wiring", he is plucking figures from the air - he
does not mean to be taken literally. But if premature babies do only achieve
70% wiring, say, what sort of things are going to be wrong with them?
There's the obvious, measurable stuff, he says - IQ and so on - and then
there's the stuff that's hard to measure. Such as? "Ability to relate."

He says: "The brain is complex. Layers on layers. It depends on timing, on a
complex glue of nature and nurture and sequence ... if something happens at
this point, it could make an aggressive child; if it happens at that point,
it could make a passive child." But what about the really little babies, the
24-weekers the length of pencils? Bergman would argue that those babies need
their mothers more than most, if they're to have any chance of a good
outcome. Can a child ever recover, in his opinion, from the "insults", as he
calls them, of separation and incubator care? Does he think you can love it
out of them afterwards? "Yes I do," he says. "To an extent."


Very thought provoking. Especially when I think of the Cortisol Experience -
the effect of stress on the development of empathy centres in the brain -
from a session at the GOLD 10 conference by Robin Grille: utterly
fascinating. Did anyone else attend that session?

Juanita Jauer Steichen, MA, IBCLC, LLL
France

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