"Many Western doctors hold the belief that we can improve
everything, even natural childbirth in a healthy woman. This philosophy is the
philosophy of people who think it deplorable that they were not consulted at
the creation of Eve, because they would have done a better job." ~ Dr. Kloosterman, Chief of OB/GYN, University of Amsterdam,
Holland
Dr. Ala Alwan, World Health Organization (WHO) Assistant
Director General for Non-communicable Diseases and Mental Health said in April,
2009, "It is a deep concern that the global burden of disease attributed
to mental disorders continues to grow, particularly
in developing countries. It is essential to prioritize, implement and fund
projects on autism spectrum disorders and other mental disorders in children in
developing countries."
Guess what? The U.S. is also the 46th in
the world in order of infant mortality. 45 other countries have healthier
babies at birth than we do: Singapore, Hong Kong, Malta, Slovenia, Czech
Republic, Portugal, Gibraltar, Cuba, Taiwan, and Macau, to name just a few. Our
mothers’ chances of surviving childbirth fare just as poorly here as well: 38
other countries are ahead of us in that too.
But as I write we are being told that now, since 2011,
women have surpassed men in the Western World in holding more post-graduate
degrees than ever before. Finally, we (women) are smarter, more advanced, more
intelligent, and more insightful on all levels in mathematics, engineering,
medicine, the sciences, and in all other areas than ever before in history.
Aren’t we clever? Yet we have more problems with our infants and young children
than many/most other places in the world. What is wrong? How did this happen? I
believe we have somehow, quite falsely, assumed that our offspring would or
could evolve along with us in direct ratio to the fast forward we have
plummeted ourselves into in the race toward the 21st century. We
must stop here and take a few things into account before considering such
assumptions.
Have
you ever wondered why we as humans have such large brains? This one is obvious:
we are smarter than any other animal. But our babies are more helpless than other mammals at birth. Have you ever wondered
why? Part of the reason is that, yes, we are the most intelligent species, but
our babies are born unprepared for survival. Our brains grow so fast before we
are born, and into the first year, however, that if they kept growing until the
rest of the body caught up and was as mature as, say, a calf is at birth, their
heads would be far too large for the birth canal they must pass through. Since
our brains are so advanced, they grow faster in the first year than the brains
of any other species. If we waited another 3 months to deliver our babies,
their heads would be too big to fit our frames. So Mother Nature had a toss-up:
make mothers’ hips even bigger than what we have now (Horrors!) or have babies
born sooner than they are in reality ready for. So, this makes it clear that
they are not as mature as other little mammals and do need us constantly, even
more than the offspring of other species. Nature knows this. Babies know this.
Do we? We don’t act like we know it.
"Natural childbirth has evolved to suit the species, and if mankind
chooses to ignore her advice and interfere with her workings we must not
complain about the consequences. We have only ourselves to blame." Margaret
Jowitt
It is actually an illusion to imagine that our man-
or woman-made time machine should likewise affect our babies, but we in fact do
believe this. The truth is, our babies are just about as immature at birth as
our fore-mother Lucy’s were 3.18 million years ago. Consider Lucy (who
currently resides at the Ethiopian National Museum in Addis Ababa, Ethiopia),
whose babies had to be carried and in constant contact with her, 24 hours a
day, day and night, for at least 2 years or until they could walk. He (I am
just guessing it was a firstborn son) had constant skin-to-skin contact;
was in constant proximity for eye contact with his mother or whatever member of
the clan his mother was interacting with throughout the day – at an adult’s eye
level, incidentally, and not lower as in a crib or stroller where faces
suddenly appear to loom above his and just as quickly disappear. He nursed on demand. He had no need to cry. A grunt or his reaching
for a breast would be enough of a sign. His mother had enough time connected to
him that she could already easily ‘read’ any signals coming from him. He
listened to his mother interacting with others all day long. We don’t know when
she began speaking directly to him, though. Perhaps it began when he spoke
first, having listened to adult speech and figured out how it worked.
We now
know that bonding is reciprocal. Even
into the 21st century, however, we can read from some authors who
are still considering bonding a mother-led phenomenon, whereas it is actually
reciprocal. When a baby searches his
mother’s face, he is seeking her gaze in return. If her gaze is not there more
times than it is, she has also given him a clear message: this is not how we humans interact, though she
gives him no alternative solution. When he reaches out to touch her, he expects
his hand will be held or caressed. When he first coos, a rewarding sound from
his mother will encourage more early speech. If parents are engaged elsewhere
either mentally or literally, while interacting with a cell phone or texting, for
example, and those overtures from your baby are ignored, that, too, is a
message: he isn’t being answered. Perhaps his voice may not be the best way to
communicate after all. He’ll have another try at it first: cry louder, perhaps,
to get the needed response. Or do something, anything, to get your attention.
Sounds familiar? But back to Lucy. Bonding was the way to survival. Had she put her
babies down, they would have been mauled or eaten. And we would not be here
today.
The most basic factors that influence bonding are
touch or skin contact, smell, eye contact, attention, and sound or hearing. We
don’t know yet which factors in what
order affect an infant’s earliest development, i.e., whether touch is
primary, or if language comes on the bottom of the ladder, though one study of
deaf mothers of hearing children regarding a lack of vocal speech did not
appear to negatively influence their babies’ overall well-being during the first
year or later on. We don’t know if 100,000 words in a given time frame are
required to ensure normal, adequate development, or if only 5,000 will do,
though a recent 2010 study has shown that more educated mothers do directly
address their children more than poor or less educated mothers, and the long
term outcomes are notably better. We don’t know if 40 hours of skin-to-skin
contact in the first month is enough to guarantee a proper level of bonding or
if 400 hours of some form of touch is required. Breastfeeding already offers skin-to-skin
contact every time your baby feeds, but mothers who choose or need to bottle
feed their babies can supply the same skin-to-skin contact, too. We don’t know
what the exact formulae is in combining these factors that are necessary for
successful bonding, but what I have been observing is that somewhere between
the high levels of all factors in one of the refugee communities I was able to
observe over a ten year period, and the present poor connection on all levels
of all the factors* that I have been observing more recently in a second
refugee population, there is a threshold that is being left far behind.
Another analogy would be to consider how little food a person needs to survive. We can guess that X amount of calories represent the barest minimum and less than that is simply not sufficient to sustain life. The same is true in the realm of child development. If we could only know how much of each factor is needed at minimum, or what combination of what levels of all the factors as we know them, is necessary, then, I believe, we would know the mystery behind all child development problems. But we cannot measure hugs and kisses, caresses and bedtime stories, nor do I believe we should ever have the technology to do so. What I do believe, though, is that we should be intelligent enough to grasp the simple fact that as technology has advanced, and as we have moved forward in intelligence and knowledge, our newborns have remained immature, helpless little mammals who need to bond with us, need us to bond with them, and that the rules of Nature really have not changed in a very, very long time. We are giving birth to Stone Age babies in a space age world. And we must rethink our present responses, and our often gross lack of appropriate responses to their Stone Age needs. Until recent, western historic periods, no human parents ever asked: Where will my baby sleep and how will I feed my baby? Most human parents still wonder!
Another analogy would be to consider how little food a person needs to survive. We can guess that X amount of calories represent the barest minimum and less than that is simply not sufficient to sustain life. The same is true in the realm of child development. If we could only know how much of each factor is needed at minimum, or what combination of what levels of all the factors as we know them, is necessary, then, I believe, we would know the mystery behind all child development problems. But we cannot measure hugs and kisses, caresses and bedtime stories, nor do I believe we should ever have the technology to do so. What I do believe, though, is that we should be intelligent enough to grasp the simple fact that as technology has advanced, and as we have moved forward in intelligence and knowledge, our newborns have remained immature, helpless little mammals who need to bond with us, need us to bond with them, and that the rules of Nature really have not changed in a very, very long time. We are giving birth to Stone Age babies in a space age world. And we must rethink our present responses, and our often gross lack of appropriate responses to their Stone Age needs. Until recent, western historic periods, no human parents ever asked: Where will my baby sleep and how will I feed my baby? Most human parents still wonder!
(See also This Emotional Life, DVD, and the work of Dr. Seth Pollak at the University of Wisconsin, Madison, on bonding.)
* I am currently writing an assessment
tool for rating bonding, similar to Apgar or Latch scoring to help chart this
and be able to identify at-risk mother-baby couples sooner. See the Bonding Grid
in Appendix I in the upcoming book, Stone
Age Babies in a Space Age World: Babies and Bonding in the 21st Century,©
pending by Stephanie Sorensen Stay tuned....
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