Friday, February 26, 2010

A Healing Touch?

Emi Arima 


Several weeks ago in our biology, Professor Grobstein mentioned that his college seminar class was holding a bake sale in our campus center. He approached his sales pitch by asking if we were stressed from the workload of the end of the semester. Inevitably we all nodded our heads in agreement that the homework had begun to take its toll. He urged us all to support his class's efforts and their somewhat atypical offer including an optional hug with the purchase of a brownie. After class I found myself thinking about his association with stress and the need for a hug.

I know from personal experience that a hug or even a pat on the back can cheer me up. I've also read that people who make appropriate physical contact in business transactions-a firm handshake or a hand on the shoulder-are more likely to land the deal than those who keep to themselves. However, the necessity of physical interaction goes beyond the role of a mere stress reliever or business etiquette; rather it is essential to the development of an infant-both socially and physically.

Among the most well known experiments on the subject were those of Harry Harlow in the 1950s and 1960s. Through his series of tests with infant monkeys and their application to humans, he brought a new understanding of child psychology and our own behavior (7). Until his experiments, most scientists assumed that the affection infants displayed for their mothers was an association between the mother and the quenching of primary needs-hunger, thirst, and pain (11).

Harlow ran a series of experiments in which he separated infant rhesus monkeys from their mothers six to twelve hours after birth (6). At first he raised the infant monkeys in a laboratory, isolated from others, where they received their nutrition from a bottle. In doing so he noticed that the laboratory-raised monkeys formed an attachment to the gauze used to cover the bottom of their cages. They grew so attached, in fact, that the removal of the cloth for sanitary purposes threw the infants into violent temper tantrums. As a follow up, he found that monkeys raised in a mesh cage with a bare floor had difficulty surviving their first five days. When he inserted a mesh cone the difficulty lessened, and when he covered the cone with terry cloth they developed into "happy babies" (11). According to Harlow himself in his essay, The Nature of Love, "We were impressed by the possibility that, above and beyond the bubbling fountain of breast or bottle, contact comfort might be a very important variable in the development of the infant's affection for the mother" (11).

From this point he embarked on his famed experiments that are now included in most psychology textbooks. He tested this infant-mother affection. In this series of studies he offered a "surrogate" mother to the isolated infants. He had two models of this mother substitute-one made of bare, heavy wire and the other made of wood covered with a soft terry cloth. In one such experiment both models were placed in the infant's cage, but only one had a nipple to provide milk. Regardless of which "mother" fed them, the monkeys spent a significantly greater amount of time with the terry-covered mother (6). Harlow summarized his findings by stating, "These data make it obvious that contact comfort is a variable of overwhelming importance in the development of affectional response, whereas lactation is a variable of negligible importance" (11).

An interesting twist to the story of Harlow's experiments became apparent in the later life of monkeys. Mary Carlson, a neuroscientist at Harvard medical school, says that the cloth mother was inadequate as a replacement for the actual mothers, and the monkeys had trouble both emotionally and behaviorally. "Even when raised in cages where they could see, smell and hear-but not touch-other monkeys, the infants developed what she called an 'autistic-like' syndrome, with grooming, self-clasping, social withdrawal and rocking" (2).

This condition has since been referred to as Maternal Deprivation Syndrome, and many other psychologists have continued on from the basic discoveries of Harlow. One such experiment, run by William Mason and Gershon Berkson, simulated Harlow's original set-up except that the surrogate mother was set in motion. Infants raised with this swinging mother did not develop the characteristic traits of the maternal deprivation syndrome (9). These results led Dr. James Prescott and several others to ask themselves why, and what they discovered is as surprising as Harlow's findings.

"More recent studies suggest that during formative periods of brain growth, certain kinds of sensory deprivation-such as lack of touching and rocking by the mother-result in incomplete or damaged development of the neuronal systems that control affection (for instance, a loss of the nerve-cell branches called dendrites)" (9). According to Prescott, the autistic-like rocking, hyper-reactivity to touch, and abnormal social behaviors characteristic of maternal deprivation syndrome are side effects of the brain damage caused by a lack of physical contact. He isolated these problems to the limbic-frontal-cerebellar brain system, from which, he claims, we develop the "Basic Trust," "Affection," and "Intimacy." These three elements combine to form the experiences of "Pleasure," "Bonding," and "Love." When the infant is deprived of the sensory stimulation necessary to develop the systems involved with these emotions, depression and violence can ensue (8). The infant, deprived of physical contact, does not learn how to form social bonds with others and becomes self-sufficient. Some suspect that the characteristic rocking and clutching simulate the sensory stimulation that the young monkeys did not receive from their mothers.

In December of 1989 Nicolae Ceasescu's dictatorship in Romania came to an end when he and his wife executed. Ceasecu's attempts to double the Romanian population in one generation left men and women fiscally unable to provide for their families and forced them to turn their children over to orphanages. By the time of his execution, more than 150,000 children occupied these ill-equipped facilities (12). Caretakers had as many as twenty infants in their care, which left little time for any personal care beyond changing diapers and administering bottles (1). When foreign doctors came in 1989 and examined the children, they found "grossly delayed" development of mental and motor skills, a significantly stunted growth-"the children were in the third to tenth percentile for physical growth"-and a tendency to rock and grasp themselves(2).

The deprivation of touch is no laughing matter, nor are its consequences restricted to the rhesus monkeys used in Harlow's experiments. Thousands of these Romanian orphans showed the same signs of social ineptness later in life-the damage is permanent. "Rock A Bye Baby" cites a case where an intense one-to-one physical relationship between a substitute mother and a six-month-old child significantly reduces the child's retardation (10). However, the cases of maternal deprivation syndrome still greatly outnumber stories such as this one. Approximately two-thirds of children under two years old who experience Failure to Thrive (stunted growth, inability to gain weight, and failure to accomplish the typical childhood milestones) are caused by neglect or ignorance on the part of the parents (5).

Mary Carlson, inspired by Harlow's findings on the effects of deprivation, directed her career toward its effects on the human race. She, along with many other scientists involved in this area, attempt to bring this issue beyond the scientific realm. According to Carlson, this is as much an issue of human rights as it is an avenue of scientific research. Romania has joined an allegiance of countries in ratifying the United Nation's Convention on the Rights of the Child -an allegiance that includes all countries in the world except Somalia and the United States.

Renee Spitz, who studied infants in foundling homes and along with the effects of long term hospitalization with John Bowlby in the 1930s (13), concluded from his research that we need strokes [denotes human contact] as much as the air we breath, the water we drink, and the food we eat (3). The concept of the need for human interaction is not difficult to comprehend and yet we seem to make it very complicated because the trend continues. It seems that if something as simple as a hug can be so vital for proper development-and also be such a cheerful sign of affection and encouragement-we would give and receive them freely. However, if such were the case, why would the idea of a complimentary hug with the purchase of a brownie be such a novel idea?

I found a children's story called A Warm Fuzzy Tale while I was doing my research. It tells the story of a long ago town, where all the people had bags of "warm fuzzies." The people gave these "warm fuzzies" to each other freely and it made them happy. Then one day a bad witch convinced someone that they had to conserve their stock because when they ran out they would never have any more. Soon the people stopped exchanging the "warm fuzzies" all together, and they became very unhappy. A stranger came to the town and begun to freely give hers away to the children. The children became happy and began to share again, but the parents-still wary of running out of their supply-disapproved (4). There is an extent to which our constraints on human contact and our concept of personal space make sense. Although children can freely give away hugs and kisses to anyone they encounter, such behavior is inappropriate in the work environment. And yet, I often think we sometimes hold back too much in attempts to be "correct."

There is no ending to The Warm Fuzzy Tale, nor is there one for the issue of the deprivation from the human touch. "The struggle spread all over the land and is probably going on right were you live. If you want to, and I hope you do, you can join by freely giving and asking for Warm Fuzzies and being as loving and healthy as you can" (4).

WWW Sources

1) No Laughing Matter , from The Science of Mother's Day 2) Not really a monkey..., from The Science of Mother's Day
3) Learning to Love
4) A Warm Fuzzy Tale
5) Maternal Deprivation Syndrome , from
6) The Experiment , from Chicken Wire Mother
7) Harry Harlow , from The Psi Café
8) Birth and the Origins of Violence
9) Alienation of Affection
10) Rock A Bye Baby , Time Life documentary and summary
11)The Nature of Love, from Classics in the History of Psychology
12) The Journey Home: A Romanian Adoption , from CBC
13)"Nature" And "Nurture" Interact In Sequential Stages , from Classrooms of the 21st Century
14) A Decisive Decade of Protection , from Unicef

Friday, February 5, 2010

Is Breast really Best?


To lactivists, and most people (even formula feeders) the answer is YES!

If you take a closer look and let your mind wander, actually breast is not best, breast is normal. Breastfed babies don't have a lower incidence of Otitis Media and other infections, it's that formula fed babies have a higher occurence of these infections. Breast milk is watered down a lot , and formula feeding is sugar coated too much for fear of offense. But trust me, you don't need to say something in a rude or disrespectful way and tone for people to take offense immediately. Too many HCPs are afraid of "pushing breastfeeding" too much. Too many HCPs are afraid of offending a mother who already chose to formula feed from before her baby's birth.

I'm not saying we must resort to scare tactics to get women to breastfeed, but we must be more straight forward and honest about the effects when it doesn't happen. When a pregnant woman (or any person for that matter) hears "Breastfed babies have higher I.Q.s , are sick a lot less, bond better and easier with the mother, it's just the best choice you can make" ... they then go on to think... "well... I can settle for an Ok baby, with ok , or (the ignorant) 'just fine' health"

No... mothers must hear the truth in a respectful tactful and informative manner. So instead of ;

"Breastfed babies have less ear infections"

"Formula fed babies have more ear infections"
"Formula is difficult to digest, especially with a premature digestive system"
"Formula is bland in taste and does not expose your child's palate to different tastes"

Too many women are in the dark about the real pitfalls to formula feeding, thinking it is a convenient and healthy ( but in the long run, not that convenient or healthy) alternative.

Let's take another biological norm, but this one no one dears question

Defecating (pooping for those who opened a new tab to check the meaning)

From Wikipedia ;

the final act of digestion by which organisms eliminate solid, semisolid or liquid waste material (feces) from the digestive tract via the anus.

 If I said, defecating through your anus is the best choice! You'd probably give me a weird look and quietly move away. Or you'd wonder "What the heck is she talking about, it's the biological norm, it's the way it should happen".  You'll never hear something like "Oh well, I can settle for a colostomy, it's an alternative after all..."

Again from Wikipedia;
 "A colostomy is a surgical procedure that involves connecting a part of the colon onto the anterior abdominal wall, leaving the patient with an opening on the abdomen called a stoma. In a colostomy, the stoma is formed from the end of the large intestine, which is drawn out through the incision and sutured to the skin. After a colostomy, feces leave the patient's body through the abdomen."

While this is a permanent or temporary necessity for some cancer patients, you wouldn't dare consider that normal bowel functions are "the best" way. It's the only way. Would you even question the efficacy of the G.I. tract in favor of a less-than-stellar man-made alternative? No.. but why do we do it with breastfeeding then?

We don't want to offend, but we do want to be truthful

They don't really care about us - AMA's Resolution 205

In light of recent news of AMA adopting an "indirect" stance against homebirth, this video came to mind right away. Below is Resolution 305. Below that is Michael Jackson's "They don't really care about us"



Introduced by:       American College of Obstetricians and Gynecologists

Subject:                 Home Deliveries

Referred to:           Reference Committee B
                              (Craig W. Anderson, MD, Chair)

Whereas, Twenty-one states currently license midwives to attend home births, all using the certified professional midwife (CPM) credential (CPM or "lay” midwives), not the certified midwives (CM) credential which both the American College of Obstetricians and Gynecologists (ACOG) and American College of Nurse Midwives (ACNM) recognize[1]; and

Whereas, There has been much attention in the media by celebrities having home deliveries, with recent Today Show headings such as “Ricki Lake takes on baby birthing industry: Actress and former talk show host shares her at-home delivery in new film” [2]; and

Whereas, An apparently uncomplicated pregnancy or delivery can quickly become very complicated in the setting of maternal hemorrhage, shoulder dystocia, eclampsia or other obstetric emergencies, necessitating the need for rigorous standards, appropriate oversight of obstetric providers, and the availability of emergency care, for the health of both the mother and the baby during a delivery; therefore be it

RESOLVED, That our American Medical Association support the recent American College of Obstetricians and Gynecologists (ACOG) statement that “the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the American Academy of Pediatrics (AAP) and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers” [3] (New HOD Policy); and be it further

RESOLVED, That our AMA develop model legislation in support of the concept that the safest setting for labor, delivery, and the immediate post-partum period is in the hospital, or a birthing center within a hospital complex, that meets standards jointly outlined by the AAP and ACOG, or in a freestanding birthing center that meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers.” (Directive to Take Action)

Fiscal Note:  Implement accordingly at estimated staff cost of $1,929.

Received:  04/28/08

[1], accessed March 18, 2008
[2], accessed March 18, 2008
[3] press_releases/nr02-06-06-2.cfm, accessed March 18,2008

Monday, February 1, 2010

Red Meat Monday

To oblige all of you, who like me, enjoy a bit of dry deadpan humor, I leave you now with Bug Eyed Earl

Click on it to read the whole strip