The care of young children has taken extraordinary leaps forward in the last 50 years that I have been in practice. What used to be unusual is now commonplace.
The idea that separation is anathema to the human condition is a constant in the modern medical view of raising children. This idea is manifested in the proposal that the environment of the baby is the mother, the environment of the child is play, and the environment of the adolescent is the search for identity in a complicated world.
Children grow and develop in their mother’s arms, grow and develop around the family while at play, and grow and develop into adults with parental support as they search for identity.
Separation from the mother, from play, and from the search for one’s inner being leads to loneliness, anxiety, fear, an increase of harmful hormones in the blood of the child, and ultimately, illness of the body and of the mind. Like everything else, a solid foundation is critical for success.
It is in the field of neonatology, the second level of this foundation after conception and intrauterine life, that most progress has been made. Progress ranges from the dramatic change in the temperature of the birthing room to the idea that the best place for the newborn at birth is the mother’s body. The changes have been lifesaving.
When I started practising paediatrics, one had to fight to get nursing staff and surgeons to turn off the air conditioning in the delivery or birthing room. Many a baby came out of the mother’s womb, from a temperature of 37 degrees to an environment of 18 or 19 degrees, the equivalent, to an adult, of taking a plunge into Arctic waters.
It was common to see healthy infants come out, turn bluish, stop breathing, and have to be resuscitated—always a rather frightening experience. The old-time ways of having the mother lie flat on her back to give birth, preventing her from moving around, leaving her alone to labour, withholding food and fluids, sedating, setting up IV lines, and that continuous electronic foetal monitoring that is so anxiety-provoking and especially separating the mother and baby after birth are bad ideas and, fortunately, gone, one hopes forever.
Mothers should labour in comfort. Surrounded by love. At birth, babies were rushed away from their mothers to be weighed and measured, poked and prodded, given injections, and then wrapped up tightly so that they could not follow their wonderful need and instinct to stay where they could hear their mother’s heartbeat and voice, feel the velvety smoothness of her abdomen, and smell the scent of her breasts before crawling up her body and finding the milk. Babies should never be separated from their mothers unless the mother agrees to it.
Most of these advances in the birth process and afterwards did not come from technologically advanced countries but from countries like ours. “Kangaroo Care” originated in Colombia in the 70s when poor hospitals recognised that they did not need incubators to ensure survival of premature infants but that the mother’s body was better than an incubator at keeping the baby warm and healthy, hence “Kangaroo Care.”
“Skin to Skin” or the practice of handing the baby to the mother for her to hold the baby naked on her body immediately after birth, was a natural evolution of Kangaroo Care. Early skin-to-skin contact promotes bonding, maintains warmth, and lowers infection and mortality. Newborn babies need to stay in contact with the mother’s body, her voice, and smell as their bodies adjust to life outside the womb.
The exquisite necessity for the baby to remain in contact with the mother’s skin not only keeps the baby warm but also regulates the heart rate, breathing, and brain wave activity and prevents infection. In turn, the presence of the baby stimulates the release of hormones that cause the womb to contract, prevent bleeding, and prepare the breast to secrete milk. Much of the impetus for these forward-thinking practices has come from the breastfeeding movement.
They are all outshoots of traditional thinking on breastfeeding. The need for the mother to feel comfortable, to feel cared for, and above all, to feel loved, is necessary for a mother to breastfeed.
Years ago, developmental anthropologist Dr Ashley Montagu expressed biology in this way: “The basic plan of the mother-infant relationship, from conception to birth and onward, is that the loving behaviour of the mother and child for one another confers survival and growth benefits upon each other.
“In this beautiful mother-and-child interconnectedness and interaction, the basic pattern is laid out for humanity to follow towards the achievement of healthy growth and development, that is, to live as if to live and love were one.”