Parents have long known that a cuddle can cure a multitude of ills. Research now proves just how powerful touch is in a baby’s development. Ellie Gwilliam reviews the science that matters so much to our every day.
Nothing compares to the feeling of holding your brand new baby for the first time. Their skin still waxy with vernix, their hair matted with evidence of their birth marathon. When your baby’s skin first comes in contact with your own skin, it’s like nothing else in the world matters. And, in fact, medical research now backs up this sentiment –nearly nothing else does matter in those first few moments of life outside the womb. The World Health Organisation emphasises the importance of tactile stimulation, recommending time for mother-infant skin-to-skin contact is given top priority at the moment of a baby’s birth, even in preterm births and situations requiring medical interventions.
For the most part, parents seem to intuitively know this, but now we are beginning to understand that while cuddling our babies is all-round delightful, vital and life-changing connections are happening inside a baby’s brain as we touch and care for them.
Sensory development, including touch, hearing, vision, smell and balance, is a complex process that starts in utero but matures rapidly in the first year of life. External experiences that stimulate a baby’s sensory system play a key role in the development of her brain. Dr Simon Rowley, a consultant paediatrician and neonatologist at Auckland Hospital puts it this way: “Newborn infants experience the world via their senses – they are born into a somatosensory bath. Our sensory systems not only play a key role in shaping the brain, they are essential in enabling human infants to experience anything. This may seem obvious, but without any sensory input, children simply do not develop”. As Dr Rowley states, most NICUs now use this knowledge of the importance of sensory systems in development within their intensive care for infants, for example ‘kangaroo cuddling’ to make the most of the benefits of skin-to-skin contact.
A review on multisensory stimulations and infant development recently published on researchreview.co.nz (an educational resource site for healthcare professionals) had some inspiring findings applicable for parents. While we generally understand that early life experiences are related to a child’s success in later life (due to the fact that a child’s brain is more responsive to stimulation during the first three years of life than at any other stage), it’s fascinating, empowering even, to consider that those significant early life experiences include some seemingly routine activities. Bath time, nappy changes, even bedtime – these are not mundane moments but powerful opportunities for vital stimulation of a baby’s sensory system, and consequential shaping of her brain development.
Ever noticed how much better you feel after a hug? The feel-good benefits of touch are far reaching with early mother-infant skin-to-skin contact contributing to a reduction in crying (in infants, but possibly mothers too!) and improved breastfeeding outcomes. Random trials comparing skin-to-skin contact with standard care also showed that touch contributed to greater cardio-respiratory stability in healthy newborns. In preterm infants, skin-to-skin contact via moderate pressure massage could reduce stress behaviours and facilitate weight gain.
The importance of tactile stimulation continues throughout infancy. For more on this. read Miriam McCaleb’s article in issue 30 of OHbaby! Magazine. And it’s not just the tactile sense making leaps and bounds in a baby. Hearing is a baby's most developed sense at birth and it is widely understood that talking, singing, even reading to your baby while she is still in the womb is well worth doing. Studies show maternal sounds, such as singing or speaking in a soothing voice, definitely have a calming effect on babies, especially preterm infants. Maternal sounds were also associated with improved feeding and bonding, therefore reducing parental stress often associated with preterm infant care.
Sight and smell also evoke powerful responses in babies. The WHO recommends parents engage direct eye contact with their baby, starting at birth, as this helps baby develop sensitivity to mutual gaze, supporting the development of social skills later in life. And while the development of smell has not been as well researched, general observations suggest babies prefer sweet odours. We also understand that babies recognise their mother’s scent, making smell an important part of the early bonding process. Evidence is accumulating that links our olfactory sense (smell) to emotional processing. Ever noticed a certain smell will take you straight back to a childhood memory or past experience? If you are a family who must have a ‘real’ Christmas tree, chances are that one of the reasons you overlook the endless pine needles in the carpet is that the smell of the tree makes it feel like Christmas. Studies now indicate that the memories we recall with an odour are more potent than those recalled by sight or sound. In neonates, learning is shown to be enhanced when sensory stimulation combines touch with smell.
Piles of evidence from a range of studies conclude that multisensory stimulation offers a broad range of benefits to babies: including improved social, emotional, cognitive and physical development. While science is impressive, it needn't be daunting – the easiest, and possibly most effective, ways to benefit from these research findings are found within a family’s daily routines.
While the ‘auditory-tactile-visual-vestibular (ATVV) intervention’ sounds a bit sci-fi, it is actually happening when you talk directly to your infant in a soothing voice (auditory stimulation) during a 10-minute massage (tactile stimulation), followed with five minutes of rocking (vestibular stimulation, the vestibular sense being balance and movement). Randomised controlled studies show the benefits of ATVV intervention form a long list, including better sleep, improved feeding, plus the reduction of maternal distress and infant stress. Stress, which can be measured in infants by testing cortisol levels in their saliva, is known to negatively affect brain development. It is hugely beneficial, therefore, to recognise practices that can so clearly reduce a baby's stress levels. Good news, and possibly not rocket science – close interaction, massage and cuddles are good for baby and mama! Very good indeed.
So often we rush through nappy changes and skip bath time due to the pressures of busy lives and demands of parenting. When we consider the benefits these simple routines are offering us, however, the motivation will likely be to slow down and make the most of these interactions with our babies.
Let’s look at the bedtime routine – better sleep being a worthy goal of course, but as we now understand, so much more growth and development is at play here.
A bath provides skin-to-skin contact, direct eye contact and auditory stimulation from a parent's voice. Add some suitable bath product and you’ve engaged the olfactory sense too – the familiar scents of the bathing experience, including their parent’s scent at this close proximity, are building memories of connection, and bonding is being nurtured.
Next, continue the sensory stimulation with some massage, adding to the long list of advantages for both baby and parent. Touch expert Alice Campbell, from the International Association of Infant Massage, says “all types of sensory stimulation are important for babies, but there appears to be something uniquely important about touch”. The sad fact that babies who don't receive adequate amounts of healthy touch can develop a medical condition known as failure-to-thrive is proof of this. "I see more pressures on parents today than there have ever been. For this reason, we tend to encourage parents to consider the simple, everyday ways in which they can integrate healthy, gentle touch into the normal activities and interactions they have with their baby each day. Touch and bonding should be something that brings a little of the joy back into parenting: rather than being another 'job' to tick off on the list of all the things that have to be done in order to be a 'good' parent” says Alice.
After a bath and massage, some quiet activities, such as cuddling, singing and gentle rocking, will do baby the world of good. Not only does this simple pre-bedtime routine encompass the multisensory stimulation we now know to be so beneficial, but it has also been shown to significantly improve sleep in infants, including the onset of sleep and a reduction in night waking. The findings are supported by a large multinational study involving 10,085 mothers from 14 countries. Worth a try, we think.
Dr Rowley notes that sensory over-stimulation is an issue as there are times in a day when a baby can’t cope with too much sensory input. Parents are often very familiar with the tell-tale signs that their baby is over-stimulated, and quite likely also over-tired. “The ability to recognise these times is one of the hallmarks of a ‘tuned in’ caregiver” concludes Dr Rowley.