National Geographic

“Kangaroo Mothers” and the Power of Touch

In the early 1980s, two pediatricians in Bogota, Colombia, made waves around the world for a new method of caring for premature babies. The method, called Kangaroo Care, was so named because of how it resembles marsupial caregiving: A mother snuggles her baby, upright, against her bare chest for long periods of time.

The doctors developed the program in 1979 at the Instituto Materno Infantil at San Juan de Dios Hospital in Bogota. This large maternity hospital was overcrowded and understaffed and underfunded: In the special baby care unit, several babies would often share the same incubator. Infection rates were sky-high, as were abandonment rates and death rates.

To improve this dire situation, doctors Edgar Rey and Hector Martinez launched a program to get babies out of the hospital — and its germs — as soon as they were physically stable, even if they were still very small. They advised mothers to keep their baby on their chest for warmth, and to exclusively breast feed.

Rey and Martinez reported mortality rates of the 539 babies who went through this home care between 1979 and 1981. The smallest babies — those weighing between 501 and 1,000 grams — showed 72 percent survival rates, compared with 0 percent survival with the hospital’s conventional care. Nearly 90 percent of babies between 1,001 and 1,500 grams survived at home, compared with 27 percent in the hospital. And the number of babies abandoned dropped by two-thirds.

These results never appeared in a medical journal, and they are somewhat inflated because they didn’t include deaths of babies who died in the first few days of life. Nevertheless, this very appealing idea — that a mother’s touch could save her child’s life — made headlines all over the world, and UNICEF endorsed the program whole-heartedly.

People in developed countries were eager to try the new method, too, even though they didn’t have any of the problems of a strapped hospital in Colombia. Many doctors were skeptical that Kangarooing would provide much benefit in rich countries, beyond making moms and dads feel better about the experience. As two British doctors wrote in a Lancet paper — titled “Myth of the Marsupial Mother” — in 1985: “Colombia has nothing to teach developed countries about improving survival of [premature] babies but may yet help us to heal some of the psychological problems incurred by modern neonatal care.”

PAHO/WHO, via Flickr

PAHO/WHO, via Flickr

In the three decades since, those Colombian researchers and many other groups have published randomized, rigorous studies of Kangaroo Care, and experts continue to debate whether, and under what circumstances, it does any good. In 2011, the prestigious Cochrane Collaboration published a comprehensive review of all of the major studies to date, and seemed to confirm what Rey and Martinez had originally claimed: In resource-limited settings, Kangaroo Care significantly lowers the risk of infection, hypothermia, and death. It also increases a baby’s weight and head circumference, and the strength of the maternal bond. It’s unclear, though, whether the method’s positive effects last through a baby’s adolescence, nor whether it offers much for premature babies in developed countries.

I write this protracted introduction as a caveat to two new papers reporting that, in Colombia and Israel, respectively, the positive effects of Kangaroo Care can last for more than a decade after a baby’s birth. The studies are fascinating to me because they’re suggesting that a mother’s touch can exert a powerful influence on her child’s brain development (wow! how?). But it’s also possible, given the spotty data, that the positive effects aren’t coming from her touch, per se. So, with caveat said, on to the new studies.

The first was done by a group of Colombian and Canadian researchers who have been advocating for Kangaroo Care since the beginning. They measured brain activity of 48 teenagers in Colombia: 39 born very prematurely and 9 born at term. Of the premature group, 21 had received Kangaroo Care and 18 had received standard hospital care.

The researchers used transcranial magnetic stimulation, or TMS, in which researchers place a wand on the participant’s head. The wand contains a magnetic coil, which produces an electromagnetic pulse that passes through the person’s skull and tickles the neurons underneath. The neurons respond to that pulse, and the researchers then measure that neuronal response via EEG electrodes placed all over the scalp.

In this case, the researchers placed the wand over participants’ motor cortex, on the center of the top of the head, which is involved in motor planning. Teenagers who were born prematurely and received Kangaroo Care showed brain-wave patterns that were similar to the kids born to term, according to the study, published last year in Acta Paediatrica. In contrast, the kids born prematurely who had had standard hospital care showed a slower synchronization of brain activity.

The second study, based at a hospital in Israel, also looked at adolescents who had been born too early: 73 who had received Kangaroo Care and 73 who had been given standard incubator care. As published last week in Biological Psychiatry, the researchers found that by 10 years old, the Kangaroo babies had better responses to stress, more regular sleeping patterns, and scored higher on tests of cognitive development compared with the kids who had received standard preemie treatment.

If we assume (and, again, see caveat above) that these benefits are the direct result of skin-to-skin contact between a baby and her mother, then what could explain that?

Nobody knows for sure, but scientists have learned a lot by studying the interactions between baby rodents and their mothers. For example, early physical contact with mom affects the expression of genes related to stress hormones and social behavior in the baby animal’s brain. Conversely, depriving an infant rodent (or infant human, for that matter) of its mother leads to all sorts of behavioral and medical problems for the rest of the animal’s life. “Being a mammal therefore implies that the brain is not fully formed at birth, and maturation of systems that enable adaptive functioning in the world are gradually acquired through close contact with an alert, responsive mother,” write the authors of the new Biological Psychiatry study.

These studies of mother-baby interactions — and the descriptions of these studies in the popular press — tend to focus on these chemical mechanisms of how a mother’s touch and attention help her baby thrive. (There’s this thing called oxytocin…) What sometimes gets overlooked, though, is that this is not a one-way phenomenon. As a mother touches and influences her baby, so too does the baby touch and influence her mother. It’s the constant, back-and-forth interaction that creates the bond, and the bond that keeps a mother invested in her child’s success for many years to come.

There are 10 Comments. Add Yours.

  1. Anarcissie
    October 10, 2013

    It’s kind of interesting that Big Science is just figuring this stuff out. What’s been holding them back for so long?

  2. Katrina Remphrey
    October 11, 2013

    this is so akward…but the baby is so cute at the veryyy toppp

  3. Virginia
    October 11, 2013

    Did the last two studies look at the influence of breast feeding? It might be a bias, as you very well pointed out the influence of oxytocin on the mother-baby relationship, besides which there might be nutrients/vitamins absent in formula that could have an impact on the development of the brain.

  4. El Gabilon
    October 11, 2013

    Of course there is a bond between mother and child which begins as soon as the mother holds the child. The one thing missing in this study is: Would a bond occur between a child and a woman who was not the childs mother. Science is behind the times, for there is a bond not only between mother and child, but between all humans although it is not as intensive as a mother-child bond, as well as all life forms. The saying “that the flutter of a butterflies wings affects the entire universe” is not just a saying, it refers to the fact that the Universe is ONE, not a hodge podge of galaxies and planets. There is a “veil” drawn between the mind of all life forms and the MIND of the universe. Necessary because the life forms could not absorbe, but would like a 12 volt bulb plugged into 200 volt line blow out. Telepathy is NOT someone sending out a message to someone else, rather it is a intensifying of the bond relationship between the two. Lets think of it as a “mind meld”. Predjudice against investigatging such phenomena is holding the human race back. Ever experience the phenomena of “KNOWING” for certainty that someone you know has just died, or is going to call on the phone? Oh ye of little faith!

  5. Bijutoha
    October 12, 2013

    Kangaroo Mothers : Really nice thought .. It touched me so much even I am in the Father’s zone .

  6. Holly
    October 14, 2013

    I second Anarcissie’s, “what’s been holding them back!”

    And to answer El Gabilons initial question before the tangent, as to whether a bond would occur between infant and woman if the woman was not the biological mother the answer is, “yes”, BUT!
    Yes, a bond would ver likely occur, however, the bond between a mother and her child does not begin the moment the mother holds her child, as you stated, the bond actually begins while baby is in the womb! The baby knows it’s mothers voice, her smell, the way she moves…as a result, if the baby is abandoned at birth or loses its mother, the infant will grieve that loss. So if another woman steps in to provided the “Kangaroo” form or nurturing, the baby will initially reflect this stand in “mommy” as a result of the grief the infant is going through. The infant will literally avoid eye contact with the new mother as well as do everything within its power to physically separate from the mother. As a result, the production of the oxytocin by the mother will be reduced (compared to the oxytocin output of a biological mother. However, when the non biological women who is providing kangaroo care for the infant continues to talk, caress, smile at and push through the initial rejection by the infant, the infant will eventually come around and a “cautious and guarded” bond will begin. Once this occurs, the levels of oxytocin omitted by the women will increase, resulting in an increase of trust and willingness to bond to the woman.
    The bottom line is this; Affective Attunement! When the infant is in the incubator, it’s not getting a whole lot if attention! When it’s attached to a women, the moment the infant has a need, it’s hungry, gassy, dirty diaper, it cries (asking for its need to be met). When loving care giver responds to the baby, by mirroring its feelings with her words and facial expressions, then meets the babies need, the child learns to trust resulting in a bond!
    So much our country doesn’t understand! See articles on “Attachment Disorder” because the author of the article was essentially writing about attachment disorder and why it occurs or doesn’t occur.

  7. Irzan
    October 21, 2013

    Discovered now! Islam taught this 14 centuries ago. Welcome modern science.

  8. Julie Eliason
    November 17, 2013

    I am doing my Bat Mitzvah in 2016 and some large paintings on optimum infant care such as natural childbirth, Kangaroo Mother Care, breast feeding, etc. I have done many years of primal regression therapy in which I experienced my infancy. In every stage of my infancy my needs were grossly neglected: the womb experience, which was a toxic soup, my birth, which was brutal and abusive, my entrance into the world, which was cold and rejecting, and from birth to five months I was abandoned and starved (my mother had severe postpartum depression). That is why I am highly motivated to promote this cause. Fortunately, for me, I have done a lot of healing using Primal Therapy. I want to be part of the revolution to make optimum infant care the standard all over the world.

  9. Alaa Craddock
    November 18, 2013

    When you say “Wow, how?”… geez, how about epigenetics? The effect of early nurture on epigenetic tags and subsequent hormonal cascades (and thus behavior) is old news… could similar mechanisms influence early brain development? Maybe I am too much of an “early adopter” of the whole “epigenetics explains _______” thing, but it certainly seems like a good area for research.

  10. Liliana
    December 6, 2013

    I was born in 1984 in Bogota Colombia at only 5.5 months and with less than 1.5kg. My mom as a nurse from the “Instituto Materno Infantil” had been deeply involved in this method and had no doubts that it would work and I would survive. After I was able to breathe by myself she took me home and with the assistance of the program my mom and dad kept me on their chest at all time.
    I have no doubt that it worked and that my chances of life would have been completely different in other circumstances. Trying not to sound “smart a s s” I was always a bright and independent kid, getting the best marks at every place I went and holding up my University degree at 19 years old (something odd in my family).
    I cannot tell from a scientific point of view whether this works, but from my experience it totally did.
    Yet, 30 years later, there is no better comfort than my mom’s hugs!

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