Skin-to-skin contact is evidence-based

Our culture separates mothers and babies ONLY because it is seen as normal. There is evidence that separation produces HARM.

I make the claim that skin-to-skin contact is evidence based. “Evidence” in medical minds means systematic reviews and meta-analyses of randomized controlled trials, as exemplified by Cochrane reviews. The review on “Kangaroo Mother Care” – when updated in 2011 – concludes that KMC does have a positive impact on survival, and reduces morbidity. The review on “early skin-to-skin contact for healthy newborns” does not look for mortality (as healthy newborns should not be expected to die) but shows benefits for breastfeeding, and in the 2007 update has 64 different outcomes, all of which outcomes that “favour treatment” (SSC), of which 46/64 (72%) do so with statistical significance. Based on biological normality of SSC, our cultural way of providing care by separation  is inferior, and worse.

But does our current way of care do HARM?

“Primum non nocere” is Latin, and translates to: “First do no harm”. This is the primary ethical axiom of the medical profession. A legitimate and immediate response to the above statement “separation produces harm” is to counter this with “What harm? We were all separated at birth, and there is nothing wrong with us.”

There is a saying  “Every system is perfect to produce what it produces”. Our culture is the way it is, and the way our culture manages birth and subsequent parenting actually is the determining factor in how our culture is the way it is. It is a bit of a circular argument. The way our culture is and does things perfectly maintains the way our culture will be. So how “perfect” is our culture? The system is perfect at producing what it is producing, but is the product it produces perfect? It is NORMAL … because there is no other product to compare with. Is our culture perfect? We don’t usually ask ourselves the question. A quick look at a newspaper, a slightly slower look at an medical emergency unit, and deeper look at any school … I would suggest our culture is far from perfect. “Normal” yes, the same problems are everywhere.

As a result, we do not recognize or even allow that HARM may be taking place.

I am proposing that the way we are born, and our earliest experiences, and our early parenting, profoundly shape the way we are as individuals, and particularly our relationships, and our society. Our DNA survived for millions of years because we are a social species. Even as adults our survival depended on other individuals, and as newborn and children, absolutely so. Our social and emotional development was key to species survival. The wellbeing of the specimens of the species was both shaped to make this so, and dependent on being so. Seemingly this is no longer so. But this discord between the “social DNA” and our “individualistic culture” comes at a high price if measured in terms of public health. There are direct costs of “allostatic overload” to physical well-being and the health budget(LINK), but also indirect costs of psycho-social problems that pervade society.

A key concept to factor in here is RESILIENCE. There are many factors, gene variants, timing differences, circumstances and social contexts that help an individual cope with stress, and cope entirely successfully even with severe stress. But these are all evenly spread through the population, so as many as may be resilient, as many may be SENSITIVE. So while resilient individuals do well in our culture, sensitive ones do not. And the more stressful our early parenting culture is perceived by the DNA and the brain, the more allostatic load and overload will be experienced. But even those who seemingly do well, may pay the price of ill-health and early death from vascular heart disease.

Back to the question “What harm?” We need to understand the neuro-developmental mechanisms involved, and then look at these more carefully to see the harm. And we need a long view; the harm is often only evident many decades later, but some decades earlier than should be!

NEXT: SSC is for all newborns