Physical Connection Throughout the Lifespan

Become a cuddler and get volunteer hours at the same time. Cuddle and care for babies--which can help you too and be a comfort if you are feeling down or need emotional connection. Every pre-med student needs volunteer hours and many women are looking to women's health as an outlet. A variety of  hospitals in New York have an option for this as a way to give infants in the NICU the touch they need. 

Premature births happen for a variety of reasons and some are completely out of the control of the mother, much less preventable in the short period of time during pregnancy.  A preterm baby is one born before 37 weeks gestation, with very preterm before 32 weeks and extreme preterm before 28 weeks. In the United States, preterm births happen every 1 in 10 births. Infections, chronic high blood pressure, or conditions relating to the uterus, cervix, or placenta are common causes of preterm births.  Not all preterm births lead to immediate health complications, but there are often substantial effects on the general long-term health of the baby. Premature babies are much more likely to have some serious conditions in the first weeks of life including heart problems (such as Patent ductus arteriosus and low blood pressure), blood problems (like anemia and newborn jaundice), temperature control issues (hypothermia), underdeveloped digestive systems, metabolism processing conditions, and immune system conditions.  Of all premature births, 1 in 10 newborns have a permanent condition like lung disease or cerebral palsy.  But with the help of better postnatal care and continuing close physical contact, these babies can be saved and the relationship between parents and baby will thrive.
Kangaroo care, or skin-to-skin contact, is when a premature baby receives a lot of contact with people as part of their growth and healing process. It is a way for the infant and parent to connect through touch and smell. Kangaroo Care has begun to receive an endorsement from journals. The premise behind it is having the mother or father help regulate the newborn's body temperature and nervous system through physical touch. Kangaroo Care is a specific form of close skin-to-skin contact where caregivers hold their newborn to their chest in an upright position with nothing between the caregiver's chest and the baby’s skin.  Put simply, think of the way that kangaroo moms hold their offspring in the front pouch. In Kangaroo care,  arms and body heat a newborn for a short period of time, replacing a temperature-controlled incubator. In the United States, with vulnerable newborns, Kangaroo Care treatments are usually done in the NICU (neonatal intensive care unit) until physicians are confident that babies are stable enough to be supported at home.   

NICUs weren’t always like this.  In fact, only a hundred years ago, they did not even exist at all.  Doctors didn’t know that it was possible to help premature babies survive when they were too young to keep their bodies warm. Pierre-Constant Budin was the founding researcher who improved infant mortality when he worked with other obstetricians to develop a wooden box with a hot water bottle that helped contribute to a 28% decrease in the mortality rate by the beginning of the twentieth century. 

Throughout most of the last century, medical researchers focused on developing machines that would help at-risk preemies gain the ability to breathe for themselves.  Human contact was often secondary to technology.  Although in recent decades Kangaroo Care has become typical, parents weren’t always allowed into the room with the newborns who needed extra care to survive. In the 1970s, familial participation and involvement became more standardized, and bonding between parents and infant was encouraged. Allowing parents to spend the night in the hospital room was firmly established in the 1980s, which drastically changed the connections made in the first weeks following birth. As the century came to a close, more advanced technology also became more available and accessible to be used in addition to a caregivers touch. 

Though the technology to keep struggling babies stable has improved a great deal in the past fifty years, it was only recently that true skin-to-skin contact was learned to be greatly beneficial for both caregivers and infants in the short and long term. In countries with more resources, skin-to-skin contact is a supplemental source of care to typical incubators. However, this is not the case everywhere. 

Some of the highest rates of premature births around the globe are in low-income communities in Southern Asia and Africa where there is also a significantly higher rate of mortality in the weeks after birth.  Upwards of 90% of very premature babies (less than 28 weeks) who are born in low-income areas die in their first days of life, while less than 10% of premature babies die in higher income settings.

In low-income settings, kangaroo or skin-to-skin care can reduce infant mortality.  In some cases, Kangaroo care can replace an expensive incubator. Human touch is much cheaper than the technology required to regulate the oxygen and temperature 24/7 in countries that lack these resources. 

The science behind skin-to-skin contact can be boiled down to: hormones, temperature, and connection. Even for full-term babies, it is now typical in many US hospitals for newborns to be placed on the mothers’ chest moments after the cord is cut. This wasn’t always the case; infants use to be rushed away to be cleaned and measured. This is now understood after longitudinal research observing correlations between skin-to-skin contact and hormonal balances and positive physical health outcomes. One study conducted by Ruth Feldman and her team at Yale University and in Israel, followed a number of first-time mothers with either full term(FT: minimum 34 weeks) or premature infants who were followed from birth to adulthood. They observed and compared the effects of Kangaroo Care to standard NICU care and to  full-term infant care. For each stage, infancy (3mo), preschool (3yr), adolescence (12yr) and young adulthood (20yr), synchrony between the child and mother was tested. This study examined social synchrony between mothers and infants, emphasizing the significance of nonverbal signals and interactive rhythms. Synchrony, crucial for mature social and emotional development, was initially tested at 3 months, revealing that skin-to-skin contact enhanced synchrony compared to standard care, with kangaroo care falling in between. Despite not fully replicating full-term conditions, kangaroo care displayed long-term effects, as there were no significant differences in social synchrony between full-term and kangaroo care groups in their twenties.

This skin contact releases a hormone called oxytocin. This hormone not only  initiates birth and the mother’s contractions, but can also dictate many of the emotional and physical changes before and after birth. As such, oxytocin synchronizes mother and baby, inducing breastfeeding and allowing each to recognize the other’s scent. All of these factors contribute to how easily a baby and mother can relax right after birth. 

In addition to social synchrony, another large part of that study was brain scans of the adults when the child was a young adult. They specifically looked at the social network system that includes the prefrontal cortex(PFC), insula, amygdala and the temporal pole(TP). The second prediction was that the increased physical touch and connection between mother and infant would increase the capacity for understanding others emotions and connecting with them. The ventromedial prefrontal cortex shows great affinity for social processing and is crucial for understanding others emotions in theory of mind tasks. The amygdala is our central point for fear and empathy regarding emotional distress and insula for more physical pain. They assessed the neural basis through an fMRI scan and compared it to a control cohort to see if there was a significant difference in the expression during the presentation of certain emotions. They analyzed the correlation between the synchrony score and the dissimilarity in the brain scan activity between the cohort and control group showing clearly a higher connection lead to a more dissimilar brain activity. There is a correlation inferred that the empathic understanding is connected to the dissimilarity in the insula and amygdala. The STS contact enhanced the empathy representation in the infants and early childhood and increased the capacity for learning and understanding. In a border context this study showed that being able to understand developmental continuity and change in humans emotionally is important to detecting the social factors that push infants toward a resilient positive trajectory. While kangaroo care is a demonstration of how physical touch can improve a relationship between a preterm infant and mother, the idea of touch and connection resonates in relationships across the board.