Nils Bergman discussed how modern newborn care has become highly technological, and is essentially based on the incubator. Yet, there is no evidence on the incubator’s safety. An alternative was first described in Columbia, and later formalized by WHO as Kangaroo Mother Care.
After birth, the most important decision a newborn must make is whether his or her world is safe or unsafe. If “safe,” a calm developmental state is expressed; if “unsafe,” a stress state focused on survival follows. A caregiver’s presence (or absence) & particularly skin contact (or its absence) are the primary and possibly sole determinants for an infant deciding he or she is safe or not. Autonomic nervous system activities dynamically chart this when infants are separated or in skin-to-skin contact. Separation produces an initial state of vigilance (that looks like sleep but is not), followed by freezing and dissociation. Skin-to-skin contact results in calm and regulated autonomic activity with sleep cycling, feeding preparedness and approach-oriented frontal lobe activity. It used to be thought that KMC was only appropriate for stable infants. However, a Randomized Controlled Trial, comparing low birth weight babies stabilized in incubators versus those without incubators in “skin-to-skin contact from birth,” provides clear evidence that skin-to-skin contact produces results far superior to those without incubators, and smaller babies actually become more unstable in incubators.
(a) Provide the scientific evidence base for or against the use of incubators.
(b) Explain the effects of maternal-infant separation on brain infrastructure and development of maternal-infant physical togetherness.
(c) Describe the essential functions of the newborn autonomic nervous system.
This talk was given at the conference “Brain Development and Learning 2010 Meeting” in Vancouver. It was an interdisciplinary conference devoted to improving children’s lives by making cutting-edge research in neuroscience, child psychology, & medicine. Further information available on http://www.interprofessional.ubc.ca/bdl.html