Skin-to-skin contact is 
                 FOR ALL NEWBORNS

 Skin-to-skin contact for healthy newborns therefore means ZERO SEPARATION from birth.

The first reports of this method were from Bogota, Colombia, where Dr Rey and Dr Martinez called it the Kangaroo Mother Method. The “kangaroo” they likened to the way marsupials care for premature offspring, and Kangaroo Care and Kangaroo Mother Care (as described earlier) imply that this is all about preterm, or premature and low birth weight infants.

Skin-to-skin contact is however for ALL NEWBORNS. In a biological sense, human newborns are born immature, and therefore completely dependent on maternal care for a prolonged period. In the first days and weeks of life, this happened through continued physical contact with mother, in skin-to-skin contact. The DNA and the brain of the full term is prepared and ready for the maternal environment at birth. Evidence of this has been confirmed for the first hour of life, as is required for Baby Friendly Hospital status, Step 4.   After that first hour, our culture tends still to separate babies from mothers. There is no clinical evidence from randomised controlled trials that this is right, and no evidence from randomised controlled trials that this is wrong, there are in fact no randomised controlled trials at all.  Separation is done for cultural reasons. There is however “scientific evidence” in a broader sense than RCTs provide, from mammalian neuroscience. No one has yet understood this deeply enough, and been rich enough to do the detailed RCTs, to show that maternal infant separation does cause harm. It is firmly established that it is so in all primates, it would not be difficult to show in humans.

In mammalian neuroscience, one can describe SEPARATION TOLERANCE. For many species, some separation is in fact part of their life history. Rabbits and deer for example are called “cache” species, they hide their offspring, and feed them seldom with very rich milk. The cow is a cache species, its milk is made to stay in the stomach for a long time and keep the calf sedated. Almost the opposite are the “follow” species, which are born able to run after their mothers. Such mammals have milk that is low in protein and fat, as the offspring can top up frequently. “Nesting” animals are somewhere between, mother feeds them as often as she can, but she has to hunt and feed herself in between, during which time the nest keeps them warm and protected. The fourth category are called “carry” species, and this includes all primates. While cache and nesting species have separation tolerance built in to their reproductive strategy, follow species much less so, and carry species not at all. This is true in broad terms, within carry species there are variations, with some species having absolutely zero separation tolerance (e.g. the baboon), and others having some.

Note however that it is separation that is being measured, not contact. Octodon degus (a small rodent) is used as an animal model for testing anti-depressant drugs before they are used in humans. To create this model, an 8 day old  pup  is separated from its mother for 6 minutes in the morning and again in the afternoon, repeated three days in a row. These 36 minutes of separation are enough to produce a brain with profound depression, and the brain structures and neurotransmitters can be studied. In piglets, 2 hours of separation during the first week of life produces a similar depression model and greatly increases stress receptors in the brain, permanently. Just two examples of many.

In human research, the concept that there might be something called “SEPARATION TOLERANCE” does not seem to have been considered. It is our standard practice. But because the results of this care is “normal” as in common and the only result we know, we do not recognize that it comes at great cost, both to short term wellbeing and long-term health.

 

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