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Written by Laura Maxson, LM   

Thank You Dr. Bergman 

 

 

When peeking in at a mama cat and her newborn kittens, every parent knows to say, (quietly, so as not to disturb the mother cat), “No, Honey, we can’ttouch the baby kittens. If we disturb them the mother might not take care of her kittens.” We humans are more developed then a cat, some might say, brushing off any possible correlation to kittens, but there is a consequence for all mammals in those first moments, hours and days after birth. Close undisturbed contact enhances interactions that in turn promote physical and hormonal responses that help with the physical and emotional transitions of birth.

 

Dr. Nils Bergman MD, MPH, PhD, made an astounding discovery in his work with premature babies that not only supports this caution of non-interference, but also should change the way all babies are cared for. This discovery shakes the foundation of infant care that has been a standard for decades. The question is not whether his discovery is valid, but instead whether it will be adopted by the medical system in general.

 

Kangaroo mother care – also known as skin-to-skin contact (SSC) – has long been known to be beneficial to babies born too early. But what was not known was the effect of routine separation on mothers and babies. Surprisingly, this had not really been studied.

 

Dr. Bergman took on the challenge and carefully designed a research project to evaluate babies experiencing SSC from birth in comparison to those cared for “normally” (babies removed to incubators for stabilization.) Because the study dealt with our most vulnerable population – premature newborns – great care was taken to protect them. A rating scale was devised based on the babies’ oxygen saturation, heart rate and temperature readings. This stabilization score (SCRIP) measured stability in both the incubator group and the SSC group. The idea was to be sure to be able to rush the SSC babies to an incubator if their SCRIP ratings dropped dangerously.

 

Reassuringly by six hours after birth, none of the babies in the SSC group needed to be rushed to an incubator for “better” care – because all 18 were stable. However, the big surprise was that less than half of the 13 incubator babies were stable and in fact eight of them had experienced hypothermia, meaning that the babies were not able to stay warm enough. Maintaining body temperature is one of the things that incubators are designed to do. If this research had been designed to study incubator use over SSC, the incubator babies would have been pulled from the study and placed with their mothers!

 

What Dr Bergman’s work shows us it that there is a biological imperative for babies and mothers to be together, skin to skin – touching each other, smelling each other tasting each other in nuzzles and kisses – just like those baby kittens. When babies experience SSC, their heart rates are stabilized, oxygen saturation rates rise, breathing is normalized and body temperature is more stable. In fact, the reaction of being in the incubator, away from their mothers reflects the panic and disconnect babies are feeling.

 

To quote the conclusion of Birth Kangaroo Mother Care Randomised Controlled Trial Abstract, Bergman NJ, Linley LL, Fawcus SR:

“Newborn care provided by skin-to-skin contact on the mother’s chest results in better physiological outcomes and stability than the same care provided in closed servo-controlled incubators. The cardio-respiratory instability seen in separated infants in the first six hours is consistent with mammalian “protest-despair” biology, and with “hyper-arousal and dissociation” response patterns described in human infants: newborns should not be separated from their mothers”

 

Dr. Bergman’s website shows us photos of hospitals that have implemented SSC in their neonatal units. With technology adapted for use in conjunction with SSC, babies are thriving and parents are parenting and bonding with their babies. The key piece of equipment is not expensive, it is a small parent-sized bed in every cubical. Sound and lights are controlled to be non-disruptive.

 

As more and more hospitals earn Baby-Friendly designation, routine separation of healthy babies from their mothers is becoming less common. However, the recommendation that ill or at-risk babies utilize SSC, as soon, and as much, as possible, to take advantage of its healing, nurturing qualities is often overlooked. This change is not going to come by itself. Parents and care providers will have to push for it to make it happen. The babies have spoken loud and clear through scientific research, the question is are we listening?

 

Laura Maxson, LM, CPM, the mother of three grown children, has been working with pregnant and breastfeeding women for over 20 years. Currently she is the executive director of Birth Network of Santa Cruz County and has a homebirth midwifery practice. Contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

 

kangaroomothercare.com

See how ill babies remain skin-to-skin with parents

Find studies to share with your doctor or neonatologist

Videos for hospitals & doctors to learn how to implement SSC

Special clothing and DVDs to help with kangaroo care

babyfriendlyusa.org

 
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