PART I
by John A. Speyrer
Acclaimed for its remarkable clinical effects, Kangaroo Mother Care means skin-to-skin contact between the mother and her newborn baby. A major teaching of KMC is that from birth onward the infant should never be separated from its mother.
Dr. Nils Bergman, Medical Superintendent of Mowbray Maternity Hospital in Cape Town, South Africa, has been researching KMC for twelve years. He believes restoring the original model of the infant/mother early care rather than our present incubator, bottle and feeding formula model can result in happier and healthier babies.
Inferring from mammalian animal behavior, Dr. Bergman believes that there is much wrong with our present way of treating the newborn. He bases this on recent findings in neuro-endocrinology. Bergman explains that it is the newborn infant itself which begins and directs the attachment process that is aided by skin contact with the mother. The mother responds to her infant's "attachment program" and mother and infant set up a mutually stimulating system to which both respond by altering hormonal outputs. As an example, Bergman says that if the newborn is placed on the mother's chest, within one hour, the baby will pull itself to the breast, find the nipple and begin nursing.
One of the problems with our present attitude of unnecessarily separating mother from infant is that the newborn exhibits the protest-despair response as soon as it is removed from her. This sorrowful and despairing wailing is the survival mechanism of an infant in pain trying to bring its mother back. Sadly, if this doesn't work, and the mother doesn't appear, the baby becomes too tired to cry any more. It gives up in despair, and to conserve energy for survival. I believe that it is not only an automated reflex as the baby consciously wants to be with its mother. Many of us in primal therapy have discovered this truth.
The skin-to-skin contact of the mother and child allows for a needed emotional closeness of both as well as allowing the production of essential bonding hormones. I wonder if the bonding which occurs between mother and child is the result of being loved or because of hormones? Perhaps one cannot exist without the other!
The author presents a vivid description of the breathing patterns of newborns both in the incubator and on their mother's chest. Both the heart rate and the breathing pattern soon stabilize when the baby is taken from the incubator and placed with the mother. On the mother's chest the baby's temperature is controlled in a very narrow range unlike the range in the incubator. Levels of cortisol (a stress hormone) in the baby doubles after it is separated from its mother.
Studies have shown the advantages of Kangaroo Baby Care with its axiom of never separating the new-born from its mother. Since its inception, there have been about two hundred studies on aspects of KMC; none of them report any adverse effects.
An interesting portion of the tape is about the evolutionary significance of KMC. The shift of the early mammals from walking on four legs to bi-pedalism meant that the pelvis had to undergo significant physical changes. Because of gravity and In order to be able to contain the viscera, the pelvic outlet had to become more narrow. Another factor was a change in the pelvic structure required to support the entire body on two legs.
The shift to bi-pedalism and thus necessarily to an upright position, also allowed our early ancestors to perfect the use of hand tools. Tool use had survival value and also meant that the human brain would increase in size. The newer smaller pelvic birth opening combined with a larger brain, meant that the fetus had to be born before it was fully developed. The gestation which for other mammals could be completed in utero, now had to be completed after birth with the infant needing more and more care.
This evolutionary development also had significant implications for human birth becoming more difficult, but that's another story! Most importantly it meant that human babies were being born more and more premature and helpless, and needed constant skin-to-skin holding and access to the breast, in order to complete their gestation period, in arms, after birth.
Skin-to-skin contact also stimulates the vagal nerve which prepares the baby to receive and digest its mother's milk. Surprisingly, much of the content of human milk is unrelated to nutrition but nonetheless is very important to the baby's well being, as is supplies among other things, protection against disease. The composition of the mother's milk continuously changes, in response to the needs of the developing infant. Even apart from the attachment issues, babies fed with a formula of cow's milk do not get all of the benefits they need. Bottle feeding causes hypoxia because it requires a sucking motion which interferes with breathing, rather than a suckling movement which occurs in more natural breastfeeding and allows the infant to feed and breathe at the same time.
Cow's milk is for a precocial mammal which is born mature, while human milk is based on a type of milk for a mammal which is altricial, born very immature and needing to be carried and having unrestricted access to the breast for many months. Apart from that fact, the mother's milk actually changes in response to the baby's changing needs. It is adjusted to the exact needs of that particular infant, at differing times in its development, and includes protection against disease. "Collostrum is absolutely necessary for the development of the newborn," Dr. Bergman says. No bottle formula could ever achieve what is needed for the optimal growth of the developing baby.
When the present model of new-born infant care evolved we were members of a hunter/gatherer culture. The baby was kept strapped to the mother while she
worked and the baby was able to feed whenever it needed to. For untold thousands of generations this was how new-borns were nurtured. Evolution requires time to adapt to changes in the environment. Yet, in only three generations much of the industrialized world has changed from "breast to bottle”, and from the baby’s natural habitat - the mother’s body, to a foreign habitat – a crib or incubator. This is especially traumatic to the baby. Dr. Bergman quotes Pediatrician Betsy Lozoff who has written that these recent changes in how newborns are treated, may be beyond the limits of adaptability for the baby, and for the mother-baby relationship (creating short term and long term problems).
The original paradigm or model which evolved was the skin-to-skin approach in nurturing. In our culture, with two family members employed, unfortunately, the present model is leaning more to the use of the incubator, the bottle and formula.
This is why such an educational approach which Bergman is emphasizing with KMC may be imperatively and critically necessary at this time. It is much better to prevent neurosis than treat it.
Dr. Bergman ends the video with these words: "If I could say it as simply as possible, from a child's point of view, I can define Kangaroo Baby Care as:
Perhaps it is not coincidental that many of our regressive re-livings of infancy contain those exact petitions to our mothers. These always tearful and desperate pleadings for what we needed are familiar to those in primal therapy. When added to our birth and intrauterine traumas, this trio of unmet needs, contains the kernel of the origin of humankind's discontents.
PART II
by Pat Törngren
This is the tape I have been waiting for years! Like so many other people in Primal Therapy, I have spent years recovering from my traumatic birth; followed by many hours of "routine" separation from my mother (abandonment trauma). On top of that I was made to lie alone in a crib, night and day, except for "five minutes on each side" breastfeeding every four hours during the day, for the first months of life. A friend of mine, also working through similar baby trauma, described it as his "Heaven or Hell Syndrome." (I am alone and in hell. Mommy comes and holds and feeds me and I am in heaven. Mommy goes away again and I am in hell once more.)
In the 1970s when many of us began reliving these traumas in Primal Therapy, we were dismissed as cranks. We were told that there was no way that babies could have those kind of feelings, and that a baby's place was in the newborn nursery, while a new mother needed to be alone to get her sleep after the hard work of labour. Yet those of us who were spending hours curled up in the foetal position, crying like newborns, and feeling that if someone didn't come and love us soon, we wanted to die; knew that this belief was wrong.
It always puzzled me as to how we were going to convince people that what we were experiencing was real. Arthur Janov was studying patients undergoing these primals, while connected to monitors measuring vital signs. He found huge changes in heart- rate, blood pressure, core-body temperature, and brainwave patterns before, during and after these primals.
It struck me then, that if we went through these measurable changes decades after undergoing the traumas, surely babies must show some measurable signs of stress to indicate the trauma that they were undergoing. But what were they, and how were they to be measured in such a way that health-care professionals could be convinced of the need to change the way babies were being treated?
Now, at last we have the tape to hopefully convince the professionals! Dr. Bergman, who previously worked at a mission hospital in Zimbabwe, where there were no incubators or other technical apparatus, has been studying Kangaroo Mother Care (KMC) for more than 12 years. The only resources that they had in the mission hospital were mothers, and here they found that placed on their mother's chest, premature babies who would have died in our modern hospital incubators, survived and even thrived.
On the tape Dr Bergman brings together not only his own observations and theory, but also a summary of much of the related research that has been done in this respect over the last decade or more.
The tape has impact in two areas - live filming of mothers and babies; and charts and diagrams showing the adverse effects on heart-rate, breathing, oxygenation and body temperature when separating babies from their rightful habitat - skin to skin on the mother's chest. Dr. Bergman also cites studies that have found that when a mother and baby are separated, the baby experiences an outpouring of stress hormones that can reach dangerous levels - sufficient to cause brain damage in some cases.
Seeing the live footage is moving. I was entranced to watch a newborn baby placed on its mother's body; arching it's back, pushing with its feet and finally finding it's own way to the mother's breast using smell, and successfully latching on and nursing. Of great interest was the fact that the baby grasped the nipple in its hand, and put it into its own mouth! (So that's what the "grasp reflex" is for!)
It was disturbing to watch a baby that had been lying contentedly on its mother's chest, taken away and put in a crib. The baby began crying desperately, in an attempt to regain its mother. Dr. Bergman describes this as the "protest/despair" response (the despair part feels very familiar from my own baby primals!) The purpose of this crying is to bring the mother back, but when that fails, the baby will stop crying out of exhaustion. If it is not reunited with its mother, the baby's body then begins to "shut down". The core body temperature drops, the heart-rate and breathing slow down and become unstable, and digestion stops. The purpose of these body changes are to conserve energy and thus survive until the baby is reunited with its "life support" (mother). This is of interest, as in Primal Therapy, we refer to a person who has a lot of repressed pain, as being "shut down."
Dr. Bergman refers to the place where the baby is, as its "habitat." In whatever habitat it is, it will show habitat-specific behaviour. He says that there are only two possible habitats - "Mother" and "Other." When the baby is skin-to-skin with the mother, it is in the growth mode and will feed and thrive. When it is away from her it will show the protest/despair reaction, crying at first, and then giving up. At the same time it releases large amounts of stress hormones and the body (including the digestive tract) shuts down as the baby tries to survive.
Babies, he says, can be in only one of these two modes at a time - thriving, or barely surviving. For those of us who have been through Primal Therapy, we know subjectively what the latter feels like to the baby. Separation anxiety, loneliness, depression and suicidal feelings are some of the ways this is carried over into adulthood. All this can be avoided if we come to understand and meet the needs of the newborn and young babies (premature and full term), which is Kangaroo Mother Care for the first months of life.
Why is this particular tape so important? Well, for me, as a childbirth educator, I discovered that over the years, and in spite of teaching and lecturing endlessly about my own experience, I found it very hard, if not impossible, to get hospitals to change their procedures. I think there is a reason for this. Most people go into deep denial when it comes to this subject.
If they are parents or professionals, to acknowledge these facts they will have to face the possibility that they may have unknowingly traumatized their own children or patients. Even more threatening than that, they will be faced with opening up the repressed trauma of their own infancy, and for most people, this is simply too painful to contemplate. It's easier to say that the old way of doing things was fine - and to go on doing them.
By contrast, the KMC tape is non-condemning and the research is shown in an unemotional way. The fact that mother/baby separation may cause life-long problems is acknowledged, but mentioned only once at the end. On the other hand there are pictures of mothers with contented newborns nursing at their breasts, with big smiles on the mother's faces (and those of the staff too). The tone of the tape is enthusiastic and encouraging, and it makes it possible for professionals to see this as a new and better way of doing things, rather than an opening up of old wounds, and a laying of guilt and blame for what was done in the past.
The experience that we are having here is that professionals who have seen the tape are eager to share it with others, and even to use it to motivate for change in the policy in their hospitals.
So if you want to really do something to make the world a better place, I think buying a copy of this tape as a gift for your local maternity hospital is a very good way to start!
Note: Copies of the second video, Kangaroo Mother Care - Rediscover the Natural Way to Care for Your Newborn Baby is available for purchase from Kittie Frantz. The second video gives the same information, but for parents rather than professionals; and makes a good gift for any couple expecting a new baby. The video reviewed on this page is the first video which goes into greater detail about the scientific aspects of KMC. Unfortunately it is not available in the USA at this time. Please contact the link above for information concerning its future availability.
In the meanwhile it can be ordered direct from Dr Bergman in South Africa - contact bergman@xsinet.co.za for ordering details.
You can also visit Dr. Bergman's Kangaroo Mother Care website at
http://www.kangaroomothercare.com- You will find beautiful pictures illustrating KMC there.
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The kangaroo analogy is perfect for KMC because the mother kangaroo's pouch contains all the baby kangaroo's essentials for life. The pouch environment works well even though the baby kangaroo is born in an even more undeveloped state than the human infant. The kangaroo newborn has no resemblance to a kangaroo and is only about an inch in length. It is a still developing embryo! The embryo is furnished with a specialized claw which helps it to reach the pouch (through a sense of smell) after a journey of a few minutes. In the mother kangaroo's pouch there are four nipples each which draw upon milk needed for a particular stage of development. The baby kangaroo remains in its mother's pouch for about nine months. This material was not in the video, but I wanted to include it because it has an interesting parallel to Dr. Bergman's two videos.
-- John A. Speyrer, Webmeister, The Primal Psychotherapy Page
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Check out Yahoo Group Kangaroo Mother Care
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