Thursday, October 31, 2013

What I Learned from Dr. Nils Bergman in Just Four Hours

If you have never heard Dr. Nils Bergman speak in person, you need to make every effort to do so.  This mild-mannered physician who was born in Sweden and raised in Zimbabwe works as a Senior Medical Superintendent of Mowbray Maternity Hospital in Cape Town – overseeing 18,000 births per year.

Dr. Bergman was in my community recently.  I did hear him speak.  And here is part of what I learned:

During pregnancy, a baby begins to get to know the mother.  Her voice, her smell.  And immediately after birth, putting a baby skin-to-skin….mother to baby with no interference from hats, blankets or
any other clothing…babies will begin to establish the external womb, a safe and inviting place in which to thrive.  Blood sugar, respirations, blood pressure, and neuromuscular control stabilizes because the baby knows that he is safe.  Skin to skin contact immediately between mother and baby allows the baby to be colonized by the same bacteria as the mother.

When other mammals are studied, those babies who are taken out of their natural habitat – the external womb – show all of the physiologic signs of being under significant stress.  Cortisol rises (a stress hormone) and thwarts the baby’s system, decreasing stabilization.  Additionally, normal baby behaviors such as rooting and searching the breast, breathing normally, staying warm…all of these behaviors take a tragic turn for the worse.

There is no reason why most babies cannot spend a significant amount of time in skin-to-skin contact with the mother – even cesarean born babies.  And what better to help the mother and father relax and establish this amazing environment that with the presence of a doula.

Unfortunately, Dr. Bergman’s highly praising comments regarding doulas were met with “crickets”.

This amazing and safe environment allows the baby to begin its life outside the womb with a feeling of calm and safety.  Yes, there is a lot of emphasis on safety.  Early experiences establish brain function and the loving mother is key for neurodevelopment.  Studies show that what happens in early life may facilitate a risk for developing severe psychopathologies at later states in life.  Therefore, separation of the mother/baby dyad by required stays in a nursery or the baby taken away for “tests” interrupts needed neural process and becomes opposite of skin-to-skin.  Basically, maternal absence to a baby is considered toxic stress.

For the mother, when oxytocin is released in the brain, its effects are to reduce fearfulness and initiate “mothering” behaviors but also enhances a tendency toward aggression and protective force toward anyone bothering the baby. 

These tremendous links between behavior and hormones are called neuro-endocrine behaviors.

Therefore, it truly matters how we are born and also how we are nurtured after the birth.  We are defined by our relationships early on.  And separation of mother and baby is a violation of an innate agenda.

To add to my notes and thoughts of hearing Dr. Bergman, the following is excerpted from Dr. Bergman’s website ~

One of the most basic abilities, and that appears early in development, is to determine whether a sensation (or even constellation of such) is safe, dangerous or life threatening. This is seen in early fetal life, and is fully competent from 28 weeks. All the sensations in the uterus tell the fetus it is SAFE. At birth the baby is highly stressed, and this birthing stress is necessary to activate the systems that make for breathing air and coping with “life outside”. But once outside, the need for being SAFE is primary, and essentially it is only mother’s presence providing familiar sensations that achieve this. The chest of the mother is to the newborn its PLACE of care. Care means the three basic biological needs are met: mother skin-to-skin contact ensures warmth, her breasts provide nutrition, and her arms cover baby for protection. The baby is wired to respond to this place in many different ways, the two we can easily see we call self-attachment and breastfeeding. After feeding, sleep cycling is essential to establish the pathways that were fired.
When mother is absent, the newborn brain feels unsafe, it perceives danger and threat to life, and its basic needs are not provided. The brain kicks in a powerful defence reaction, which first makes a short burst of crying before shutting that down and lowering heart rate and temperature, and then shuts down all activity, reverting to the immobilization defence, similar to that of frogs and reptiles. This looks like sleep! But it is not, and it is maintained by high levels of cortisol, which make the “wear and tear” which is the primary first cause of all subsequent problems preterm infants suffer from. This is not actually sleep, so the pathways are not established. Instead, when stress is prolonged, the cortisol disrupts brain architecture, unless there is “buffering protection of adult support”.

All of our routines that are just that….routines, and not evidence-based…do more harm to our society’s future than we realize.

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