I’ve been a devoted admirer of Dr. Nils Bergman’s work for years. To celebrate Kangaroo Care Day, I interviewed him. As you know, there are literally hundreds of studies and other resources that show the efficacy of kangaroo mother care (KMC), but Dr. Bergman expanded on KMC and discussed “zero separation,” or what he calls the “nurturescience” of the newborn.
I’ve listened to this interview several times, because there were a few points I hadn’t fully grasped in years past.
Mothers need to “recalibrate” their brain
Dr. Bergman pointed out that mothers come to the birth experience with previous psychological “baggage.” To recalibrate her brain, the mother should have uninterrupted contact with the newborn for at least 1000 minutes. (You’ve heard of nutrition for the first 1000 days, right?) That’s more than 16 hours; 20 hours if you round up. When all of the senses are in motion, an “orchestra” is created within the mother’s limbic system. Then, when all of the “instruments” (the five senses and the hormones) are in tune, the mother’s brain is recalibrated for optimal mothering behaviors.
Skin-to-skin contact is paramount
After birth first became hospital-based, skin-to-skin care was assumed to be optional, irrelevant, or unimportant. Nothing could be further from the truth. Contact between the newborn, the mother and — yes, the father— is a critical component of the transition to extrauterine life for the baby, and the transformation of individuals into family units.
Together with his wife, Jill Bergman, Dr. Bergman asserts that we need to pay attention to what’s best for the baby in an ecobiodevelopmental model. He reminds us that the United Nations Convention on Rights of the Child emphasizes that the best interests of the child are paramount. In short, the healthcare professional who feels compelled to carry out tasks and do documentation should remember that such responsibilities, while important, do not supersede the need for continuous skin-to-skin contact of the mother and baby.
Skin-to-skin contact: not just the first hour
Nowadays, parents and professionals seem to understand that skin-to-skin contact is desirable or even ideal during the first hour after birth. Yet, in many hospitals, this first “hour” is often truncated after several minutes.
Further, when the baby has difficulty attaching any time thereafter, many staff nurses do not suggest skin-to-skin contact as the first strategy to overcome those difficulties. (I’m saying “some” and I’m hoping that the staff at your hospital are more enlightened!) Yes, the first hour of skin-to-skin contact is necessary, but it’s not sufficient. We need to embrace the “zero-separation” of the nurturescience long after that first hour.
Having continuous contact is the opposite of toxic stress
The term “skin-to-skin contact” is often used synonymously with kangaroo mother care. And, some early studies made no distinction between skin-to-skin contact and suckling. Now, there is yet another dimension to consider.
It seemed to me that Dr. Bergman was suggesting continuous skin-to skin contact as a preventive measure for Early Childhood Adversity and Toxic Stress as described by the American Academy of Pediatrics (AAP). You might be thinking that the statement from the AAP is “old.” Okay, point taken. But have you read it? And if you and everyone else on your staff has read it, has it changed your hospital birth practices?
Hospital birth practices and nurturescience
We need to stop thinking that there is some “reason” to whisk the baby away after an hour, or even after several hours. But we also need to re-think how birth practices can enhance or detract from the newborn’s experience.
If we focus on trying to implement zero separation, we will look more critically at practices that can interfere with the newborn’s early experience (e.g., an oxytocin induction, which Dr. Bergman discussed) and practices that enhance the newborn’s experience e.g., the “kangaroula”.
Continuous contact for 20 hours has a lifelong effect
It’s not just about “now.” Dr. Bergman insists that implementing what we know about the nurturescience has a lifelong impact. Conversely, the lack of contact has a lifelong effect.
We need neuroscience, as well as nurturescience. And, we need more than science. We need action to create the optimal environment for our newborns.
Does your hospital stress the importance of skin-to-skin contact and kangaroo mother care beyond the first hour? Share this post with other healthcare professionals to help spread awareness of the positive impacts of nuturescience.