Separation and stress

The opposite of skin-to-skin contact or KMC is SEPARATION. Skin-to-skin is the right place for baby, anywhere else causes stress. Details of how to avoid stress can be seen under Developmental Care and Staff Training. The baby is able to respond in a healthy way to short periods of stress. His mother’s presence makes it possible for him to quickly find his balance again. The brain actually needs mild and short stress, so this is called “positive stress”. The stress can be quite severe, but if mother is there all the time to comfort and soothe, then there is no harm to the baby’s brain. This is called “tolerable stress”. Then there is “toxic stress”. High levels of stress hormones for long periods of time are toxic to the neurons that make the brain work. The stress hormone cortisol makes more neurons die off at a faster rate. This disrupts and disturbs developing pathways and circuits. With prolonged stress after birth, the brain is measurably smaller one year later. Prolonged stress is toxic to the brain. The only difference between toxic and tolerable stress is the absence or presence of mother or father.
  SEPARATION This is an excerpt from the book “Hold Your Prem”. Separation causes stress, the baby feels it as a state of emergency! When the baby is stressed, his heart rate, and blood pressure will increase and he will wave his arms and legs and cry to get mum’s attention. This uses a lot of energy which the baby should be using to grow. But more ominous is that the baby feels abandoned, and feels that he must learn to fend for himself.  The baby’s brain wires the “avoid” pathways as no one is meeting his needs. The stress hormones circulating in the blood can take up to an hour to wash out of his system, but only if the baby feels safe – in other words when in skin-to-skin contact. These stress hormones make the body balance systems run on overdrive, which causes “wear and tear” over time, damaging cells and organs. Babies separated even by only one metre from mother in a crib at the bottom of mum’s bed show double the levels of the stress hormone cortisol. Hard crying also forces open a valve between the two parts of the heart, so that blood without oxygen is sent to the brain instead of the lung. It is even more stressful  for the brain to be without oxygen. Many people speak about “sleep training” or “controlled crying”. There is no research done as to the safety of sleep training. Lee Salk ( child psychologist ) said: There’s no harm in a child crying: the harm is done only if his cries aren’t answered. If you ignore a baby’s signal for help, you don’t teach him independence … what you teach him is that no other human being will take care of his needs.” Stress will be seen in the baby’s body as it makes her back arch and her legs and arms move a lot. This uses up a lot of energy which the baby should be using to grow. Stress will release the hormone somatostatin which inhibits growth hormone and stops the stomach from absorbing food effectively. Stress will affect the emotions and mind of the baby; as she will think that “nobody hears me crying or cares that I am alone and frightened”. In the brain, there is “hyper arousal” or vigilance. A tiny baby has not yet developed a separate sense of self. Her very being is tied up with her mother for the first months of life. When a tiny baby is separated from her mother she goes through what psychologists call “annihilation anxiety”, she fears that she does not exist, or that she will die (9). This is why a baby reacts so strongly to being separated from her mother.
  These are some of the signs of a baby who is stressed and disorganized: Protest
  • She cries.
  • She holds her breath – apnoea.
  • Her heart rate increases.
  • Her blood pressure increases.
  • Her skin colour becomes red, darkens or becomes blotchy.
  • She extends or stretches her arms and legs out sideways.
  • She arches her back stiffly.
  • She spreads her arms out wide and holds them stiffly,
  • She splays her fingers and toes.
  • She puts her hands in front of her face with a ‘stop sign’.
  • Her movements are jerky and there are twitches or tremors.
  • She ”sits on air” with her legs up in the air at right angles to her body.
  • She fusses and squirms.
  • She sneezes, hiccups and spits up.
  • Her breathing is irregular.
  • Her heart rate decreases.
  • Her oxygen saturation decreases
  • She looks away from you.
  • She becomes limp.
  • She yawns
  • She frowns
  • Small twitches of face muscles and fingers
If your baby is doing any of these things she is in distress and needs you! Ideally, she wants to be picked up and held in skin-to-skin contact. For ANY baby you can gently place your hand over her body and hold your hand still. You can also cup one hand around her head and one around her feet to contain her. Flex her legs and bring her hand or fist next to her mouth. This will give her security. Help your baby to find ways to keep herself calm. This is called “self-soothing” or “self-regulating”. Do not rock her or shake or jig her up and down or pat her back. Hold her still. Baby massage should be left for after the first month.


Stress signals of newborns separated from mum:
  • Baby cries in protest
  • Extends and jerks arms and legs
  • Arches Back
  • Spreads fingers and toes
  • Heart rate and blood pressure unstable
  • Breathing irregular
  • Oxygen saturation decreases

  More science on this can be found on our sister site, Skin-to-skin Contact, which details how separation harms.


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