Thursday, April 4, 2013

Evolution and Babies

"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!

(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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