1
Dr Nils Bergman
MB ChB, DCH, MPH, MD
(USA equiv: MD, MPH ,PhD)
Cape Town, RSA
www.skintoskincontact.com
THE SCIENCE BEHIND THE NEW
NEONATAL STANDARDS.
THE SCIENCE BEHIND THE NEW
NEONATAL STANDARDS.
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
MICRO-RNA
HISTONE MODIFICATION
DNA METHYLATION
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
“Phenotype” – specimen resulting from
gene – environment interaction
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
2
”Neurons that fire together wire together while those which don’t,won’t”
Hebb/Carla Shatz REMNR1NR2NR3NR4
ACQUISITION CONSOLIDATION MEMORYFORMATION
poly-sensory input transfer information P wavesshort-term memory “SNR” strong signals returns infostored cortex amygdala / to neocortex:
hippocampus organizedAwake and REM NREM stage 4 REM
BRAIN WIRING
Stanley Graven 2006
modulates state organisationelicits emotional behaviours
activates pre-feeding actionsanticipatory digestive physiologyregulates pace of ingestive behaviour
SMELL
Schaal 2004 9
The secretion of Areolar(Montgomery’s) Glands
“In early ontogeny the sleeping brain may thusremain sentient of an organism’s odor environment.”
Doucet 2009 10
Joseph 2014 Arch Dis Child Fetal Neonatal Ed. 2014 Sep 22. pii: fetalneonatal-2014-306104.
doi: 10.1136/archdischild-2014-306104. [Epub ahead of print]
Getting rhythm: how do babies do it?
Birth ~ /~ 8w 9w 10w 11w
dates averaged “between 6 and 18 weeks”
CORTISOLday-nightrhythm
MELATONINday-night rhythm
TEMPERATUREday-nightrhythm
H3f3b genedetected
Infant:sleep cycles
begin to block on diurnalrhythms
Mother-infant synchrony
… at 12 weeks
(circadian)
START at 3 months
Can be “adult-like”
at 6 months.
Thomas 2014
3
In child:will appear on its own 3 – 12 m
ONE SIZE DOES NOT
FIT ALL:
Equally *normal*at 6 months
to sleep 2hoursas 6 hours
3 12 m
Infant sleep cycling critical for brain
development,BUT is also determined by brain requirements:
TEMPERAMENTPERSONALITYOREXIN METABOLISM“MORE SLEEP MORE WIRING”
In adult:sleep pertains
to memory
In child:neurodevelopment
(brain wiring)1st 1000 days
BRAIN WIRING
Peirano 2003
Brain Architecture and Skills are Built in a Hierarchical “Bottom-Up”
Sequence• Neural circuits that process basic information
are wired earlier than those that process more
complex information.
Slide by: Jack P. Shonkoff, M.D.
Brain Architecture and Skills are Built in a Hierarchical “Bottom-Up”
Sequence• Neural circuits that process basic information
are wired earlier than those that process more
complex information.
• Higher circuits build on lower circuits, and
skill development at higher levels is more
difficult if lower level circuits are not wired
properly.
Slide by: Jack P. Shonkoff, M.D.
4
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
AT BIRTH,
the brain has TWO CRITICAL SENSORY NEEDS:
SMELL & CONTACT
APPROACH RESPONSE … learned prenatally, reinforced both during the birth process and
repeatedly throughout the postnatal period,
… supported by a unique neural framework … a system that ensures rapid and robust maternal odor learning
SMELL vanilla / colostrum / water (control)
read NIRS activity FRONTAL LOBE
• This was confirmed by
demonstration of a statistically
significant negative correlation
between changes in [Hb O2] and
postnatal age (r 520.64, p 5 0.001
with 95% confidence interval) (Fig.
4). Those babies showing the
greatest increase in [Hb O2] were
between 6 and 24 h old at testing
• In the 14 babies older than 24 h
there was no significant difference
between the changes in [Hb O2]
during control and colostrum
exposure
APPROACH RESPONSE
In the 14 babies
older than 24 h
there was
no significant
difference
between the
changes in [Hb
O2] during control
and colostrum
exposure
Those babies
showing the
greatest
increase in
[Hb O2] were
between 6 and
24 h old at
testing
The first hours after birth are a
CRITICAL PERIOD
5
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
“For species such as primates, the mother IS the environment.”
Sarah Blaffer Hrdy, Mother Nature (1999)
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
Nothing an infant can or
cannot do makes sense,
except in light of mother’s body
raises its own temperature,has a higher blood glucose,metabolic adaptation faster.
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
“The newbornmay appear
helpless, but
TRANSITION
Warming, feeding and
protection behaviours areintricately, inseparablylinked to the right place.
(Alberts 1994)
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BABY
BONDINGThe BOND is made up of the
sensory inputs from the parent to the infant
REGULATION
Bowlby 1969, 1973, 1980
6
Through “hidden maternal regulators” ...
warmth activity levelmilk heart rate
“ physiological set points “internal working modelsscripts – templates
a mother precisely controls everyelement of her infant’s physiology,
from its heart rate to its release of hormones
from its appetite to the intensity of its activity
(Gallagher 1992)
Through “hidden maternal regulators” ...
The BOND is made up of the
sensory inputs from the parent to the infant
REGULATION
Bowlby 1969, 1973, 1980
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BABY
BONDING
AT BIRTH,
the brain has TWO CRITICAL SENSORY NEEDS:
SMELL & CONTACTconnect direct to the amygdala
AMYGDALA:EmotionalProcessingUnit CPU
Prefrontal cortexExecutive function
SOCIAL and EMOTIONAL
INTELLIGENCE
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BABY
BONDING
Morphing emotion AMYGDALA FUSIFORMGYRUS
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BABY
BONDING
Smell
Skin contact
Simulation theory:EMPATHY is generated
by inner imitationof actions of others
In humans, oxytocin increases gaze to the
eye region of human faces and enhances
interpersonal trust and the ability to infer
the emotions of others from facial cues.
7
Smell
Skin contact
A primary visual areas,
B somatosensory motor cortex
C primary auditorycortex
D parietal cortex & cerebellum
E m l anterior pre-frontal cortex
Fransson 2007
Smell
Skin contact
EMOTIONCONTROL CENTRE
FACE RECOGNITIONCENTRE
OXYTOCIN
E prefrontal
A primary visual
B somatosensory
C primary auditory
D parietal& cerebellum
28 days old, 30 w PMA
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONBABY
BONDING Toxic stress
Garner 2011
8
The basic
science of
pediatrics.
Shonkoff J P et al.
Pediatrics 2012;
129:e232-e246
©2012 by American Academy of Pediatrics
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
Positive Stress
• Moderate, short-lived stress responses, such
as brief increases in heart rate or mild changes
in stress hormone levels.
Slide by: Jack P. Shonkoff, M.D.
Bad
Good
• An important and necessary
aspect of healthy development
that occurs in the context of
stable and supportive relationships.
High
StressLow
Stress
Tolerable Stress
• Stress responses that could disrupt brain
architecture, but are buffered by supportive
relationships that facilitate adaptive coping.
• Generally occurs within a time-limited period,
which gives the brain an opportunity to recover
from potentially damaging effects.
Slide by: Jack P. Shonkoff, M.D.
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONBABY
BONDING Toxic stress
• Strong and prolonged activation of the body’s
stress management systems in the
absence of the buffering
protection of adult support.
9
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONBABY
BONDING Toxic stress
•Disrupts brain architecture and leads to stress management systems that
respond at relatively lower thresholds, thereby
increasing the risk of stress-
related physical and mental illness.
SEPARATION DYSREGULATES
CORTISOL
CORTISOL
MICHAEL MEANEY epigenetics
CORTISOL
Unsafe environment activates HPAaxis (autonomic nervous system, ANS).
Psychobiology
and molecular
genetics of
resilience
Adriana Feder*, Eric
J. Nestler‡, and
Dennis S. Charney‡ Nat Rev Neurosci. 2009 June ; 10(6): 446–457. doi:10.1038/nrn2649
HG BABY HG BABYLOW Grooming care
HG - High Grooming Low Grooming LG
HG BABY LG BABY
MOTHER MOTHER
Healthy UNHEALTHYadult adult
HG – High Grooming Low Grooming - LG
Makes MOTHER Makes MOTHER
UNHEALTHYadult
LOW Grooming LG
Makes MOTHER
CORTISOL
10
HG - High Grooming Low Grooming LG
HG BABY LG BABY
MOTHER MOTHER
Healthy UNHEALTHYadult adult
HG – High Grooming Low Grooming - LG
Makes MOTHER Makes MOTHER
Early stress alters gene expression,with health impact across lifespan.
HG – High Grooming Low Grooming - LG
Makes MOTHER Makes MOTHER
HEALTHYadult
HIGH Grooming HG
Makes MOTHER
Earliest care at birth matters
Same gene switched
LG BABY LG BABYHIGH grooming care
OXYTOCIN
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONBABY
BONDING Toxic stress
OXYTOCIN CORTISOL
Primate separation studies
Maternal Separation Paradigm0w 1w 2w 3w 4w 5w 6w 12w
n 4 Mat MNSgroup reared no mothern 4 Mat MNS group as aboven 4 Mat (control)
Gene specific for the AMYGDALA( GUYC1A3)
Separated at 1 week:
LOW gene expression
Increased self soothing Anxiety
Decreased sociality Depression
Repeated shortseparations:
LOW gene expression
Correlate to human adult depression
11
2ND
KNOCK
Adults with depression, suicides:LOW gene expression
smalller hippocampal volumereduced expression frontal lobe
DOHAD
Developmental Origins of
Health and Adult Disease
… very early, once off, and forever.
Early stress alters gene expression,with health impact across lifespan.
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONBABY
BONDING Toxic stress
SKIN-TO-SKIN CONTACT
SEPARATION
BREAST- VAGALMOTHER FEEDING (PSNS) GROWTH
OTHER PROTEST- STRESS SURVIVAL orDESPAIR (SNS)
THE PLACE MODEL
12
Reference
RCT of skin-to-skin contact from birth versus conventional incubator care for physiological stabilisation in 1200- and 2199-gram newborns.
Bergman NJ, Linley LL, Fawcus SR.
Acta Paediatrica 2004 Vol 93(6); 779-785
“100% SCRIP STABILIY”
S S C C M C
1200g to
2200 g1 - 6h 56% 11%
@ 6h 100% 46%
1200g to
1800g1 - 6h 44% 0%
@ 6h 100% 25%
Stabilisation first 6 hours, average hourly SCRIP score
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
6
6.1
2nd 3rd 4th 5th 6th
KMC all
KMC <1800
CMC all
CMC <1800
Hourly average of SCRIP score, 2nd to 6th hour
Stabilization 1200g – 1800g
Skin-to-skin
Incubator
INCUBATORS DE-STABILISE
NEWBORNSStabilisation first 6 hours, average hourly SCRIP score
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
6
6.1
2nd 3rd 4th 5th 6th
KMC all
KMC <1800
CMC all
CMC <1800
Premature babies are not in incubators because they are unstable.
Premature babies are unstable because they are in incubators.
REGULATION vs STIMULATION
Expected vs UnexpectedEcologic salience vs Potential threatResource growth vs threat readiness
OXYTOCIN vs CORTISOL HOMEORHESIS vs HOMEOSTASIS
MOTHER vs OTHER
13
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
MOTHERBABY
BONDING Sensitization
SEPARATION
Toxic stress
Critical period concept :
“Windows of opportunity in early life when a child’s brain is exquisitely primed to receive sensory input in order to develop more advanced neural systems.”
a mother’s brain …
SENSITIZATION
Milk making NUTRITION
HypothalamusPituitary:PROLACTIN
Maternal ferocityPROTECTION
OXYTOCIN Gaze increase: BONDING
OXYTOCINCingulate Suppressed
REGULATION
Amygdala:CHOLECYSTOKININ Emotion / satiety
HypothalamusPituitary:
Cingulate
Amygdala
SENSITIZATION
0
5
10
15
20
25
-0.2 0 0.2 0.4 0.6 0.8 1
Maternal Behavior Q-Sort
Ho
urs
of
SS
C i
n I
nfa
nts
' F
irs
t 2
4 H
ou
rs
SENSITIZATION
Dose of SCC first 24 hours correlatesMaternal behaviour Q SortPredicts attachment security
0
5
10
15
20
25
-0.2 0 0.2 0.4 0.6 0.8 1
Maternal Behavior Q-Sort
Ho
urs
of
SS
C i
n I
nfa
nts
' Fir
st
24
Ho
urs
Dose of SCC first 24 hours correlatesMaternal behaviour Q SortPredicts attachment security
SENSITIZATION
0
5
10
15
20
25
25 27 29 31 33 35 37 39 41 43 45
Maternal Behavior Subscale of the NCATS
Ho
urs
of
SS
C i
n I
nfa
nts
' F
irs
t 2
4 H
ou
rs
Dose of SCC first 24 hours correlatesNCATS ( Nursing Child Assessment Teaching Scale )
Predicts cognitive outcome
14
Conclusion: Mother/infant SSC benefits mothers by reducing their depressive symptoms and physiological stress in the postpartum period.
JOGNN, 41, 369-382; 2012. DOI: 10.1111/j.1552-6909.2012.01350.x
EPDS (depression) score DECREASED significantly for first two visits.
JOGNN, 41, 369-382; 2012. DOI: 10.1111/j.1552-6909.2012.01350.x
Control
SSC
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONMOTHERBABY
BONDING Sensitization Toxic stress
Insensitiveparenting
… anxious parenting … mediated by stress-related mechanisms
and greater neural disorganization.
SEPARATION
Toxic stress
Insensitiveparenting
Well-adapted parenting … reward-related motivational mechanisms, temporal organization, and affiliation hormones
OXYTOCIN
may contribute to mental health risks & RESILIENCY in the mother–infant dyad.
Brain differences between VD & CSD mothers …
C/S
NVD
NVD
15
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONMOTHERBABY
BONDING Sensitization Toxic stress
Insensitiveparenting
There is a critical period for maternal neuroplasticity at birth.
BIDIRECTIONAL !!
Affect regulation
“Human brains are RELATIONAL”
… co-creating touch… signature unique to caregiver
PRATHIBA REEBYE
BONDING Sensitization
Secure attachment
Attuned parenting
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDING Feed Sleep Cycling
MOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
EMOTIONAL INTELLIGENCE
SOCIAL INTELLIGENCE
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
BABY
BONDING
Secure attachment
SEES
Mum’s eyes
Hand TOUCH
Mum’s skin
Skin-to-skin
CONTACT
SENSATIONS THAT WIRE BRAIN
Back FEELS
Mum’s arm
holding
TASTES
Mum’s milk
Ear HEARS
Mum’s voice
SMELLS
Mum’s milk
WARMED on
Mum’s front
MOVES
with Mum
Slide from JILL BERGMAN
a kind of invisible hothouse
BREAST - FEEDING=
BRAIN - WIRING
16
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
BABY
BONDING
Secure attachment
John Bowlbysecure attachment
“a safe base from which to explore the world”.
Safe HavenSecure baseProximity
maintenanceSeparation
distress
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Disordered attachment
Toxic stress
Insensitiveparenting
DISEASEHEALTH
FEARCONTROL
CENTRE
REWARDCONTROL
CENTRE
SOCIALCONTROL CENTRE
OXYTOCINDOPAMINE
CORTISOL
FEARCONTROL
CENTRE
REWARDCONTROL
CENTRE
SOCIALCONTROL CENTRE
OXYTOCINDOPAMINE
CORTISOL
EMOTIONCONTROL CENTRE
17
PR - Peer Reared
MR – Mother Reared
Plasma CORTISOL response to STRESS (2y)
RESILIENCE:“capacity to maintain
healthy emotional functioning in the after-
math of stressful experiences”
DISEASEHEALTH MR PR
OXYTOCIN DURING LABOUR
CHANGES MOTHER’S BRAIN !!
Same brain circuits …as RESILIENCE,
“highly conservedneuro-endocrine behavior”
FEARCONTROL
CENTRE
REWARDCONTROL
CENTRE
SOCIALCONTROL CENTRE
OXYTOCINDOPAMINE
CORTISOL
EMOTIONCONTROL CENTRE
DISEASEHEALTH
RESILIENCE VULNERABILITY
OXYTOCIN DURING LABOUR
CHANGES MOTHER’S BRAIN !!
This brain responds tobaby’s cry differently :
Amygdala –The emotional brain - to love her baby –relationship - to focus on care for baby
FEARCONTROL
CENTRE
REWARDCONTROL
CENTRE
SOCIALCONTROL CENTRE
OXYTOCINDOPAMINE
CORTISOL
EMOTIONCONTROL CENTRE
OXYTOCIN DURING LABOUR
Orbitofrontal cortex –activates approach
Nucleus accumbens –Reward and pleasure motivation- (dopamine)
Fusiform gyrus –(face coding unit of brain)
seeks her baby’s face
OXYTOCIN DURING LABOUR
Cingulate - (inhibition)switched off - makes ferocity for defence
Thalamus -activity coordinating centre of brain - to focus on care for baby
Hypothalamus –activates arousal response to respond
FEARCONTROL
CENTRE
REWARDCONTROL
CENTRE
SOCIALCONTROL CENTRE
OXYTOCINDOPAMINE
CORTISOL
EMOTIONCONTROL CENTRE
… there is considerable overlap in the brain structures associated with these neural mechanisms … functional interactions among the circuits.
18
FEARCONTROL
CENTRE
REWARDCONTROL
CENTRE
SOCIALCONTROL CENTRE
OXYTOCINDOPAMINE
CORTISOL
EMOTIONCONTROL CENTRE
An overly responsive fear circuit … may negatively influence functioning of the reward system.
… a properly functioning reward circuit may be necessary for …positive social behaviors.
Resilience Vulnerability
DISEASEHEALTH
RESILIENCE(= STRESS RESISTANCE)
“capacity to maintain healthy emotional functioning in the after-math of stressful experiences”
Resilience Vulnerability
DISEASEHEALTH
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience Vulnerability
DISEASEHEALTH
Disordered attachment
Toxic stress
Insensitiveparenting
OXYTOCIN
SEPARATION CORTISOL
SKIN-TO-SKINCONTACT
OPPOSITES
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience Vulnerability
DISEASEHEALTH
Disordered attachment
Toxic stress
Insensitiveparenting
OXYTOCIN
CORTISOL
OXYTOCIN
OXYTOCIN
OXYTOCIN OXYTOCIN
OXYTOCIN
CORTISOL
CORTISOL
CORTISOL
OXYTOCIN
OXYTOCIN
CORTISOL
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience Vulnerability
DISEASEHEALTH
Disordered attachment
Toxic stress
InsensitiveparentingPROLACTIN
CCK
VASOPRESSSINDOPAMINE
Prog / Estr
DHEA
19
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
intricately, inseparablylinked to the right place.
(Alberts 1994)
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
intricately, inseparablylinked to the right place.
(Alberts 1994)
MOTHER
is the key toneurodevelopment …… because she is the
RIGHT PLACE !!
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
- birth hormone- breastfeeding hormone- LOVE hormone- FRIENDSHIP hormone
OXYTOCIN
Protect my OXYTOCIN!
birthdoulasofpittsburgh.com
The DNA Behaviour
The Neuroscience of Birth & BreastfeedingThe Brain
BIRTHCOMPANION
FATHERAT BIRTH
ZEROSEPARATION
Best midwife + doula + father
cortisol oxytocin dopamine
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
“except in the light
of mother’s body.”
20
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
“needed neural
processes”
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
buffering protection
of adult support”
“Absence of the
buffering protection
of adult support”
“Absence of the
The Neuroscience of Birth & Breastfeeding
Do not measure how much skin-to-skin contact you are doing.Measure minutes of separation Your dose of TOXIC STRESS
“Non-pharmacological reduction of
hypercortisolaemia in preterm infants”(Modi & Glover 1998, Mooncey et al 1997)
Preterm infants experience prolonged severe stresswith tenfold increases in stress hormones.
Stress hormones at such levels are neurotoxic.
RCT on methods to reduce of stress (at one hour):
Cortisol EndorphinMassage slightly lower no change
Soft music no change no change
Skin-to-skin 66% lower 74% lower
CORTISOL
SEPARATION
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
ZERO
SEPARATION
BIRTH
BREASTFEEDINGFeed Sleep Cycling
MOTHERBABY
BONDING Sensitization
THE SCIENCE BEHIND THE NEW
NEONATAL STANDARDS.
21
… more like POETRY thanNeuroscience ??
close and loving relationship
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience Vulnerability
DISEASEHEALTH
Disordered attachment
Toxic stress
Insensitiveparenting
… more like POETRY thanNeuroscience ??
close and loving relationship
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience Vulnerability
DISEASEHEALTH
Disordered attachment
Toxic stress
Insensitiveparenting
… a definition of currentNeuroscience !!!
close and loving relationship
• “NINO approach to Birth”
• 1st 1000 seconds – Start skin-to-
skin contact on mum (later dad)
• 1st 1000 minutes first day/ night
• 1st 1000 hours- first 6 weeks
• 1st 1000 days – (started at
conception … to end of year 2.)
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
SEPARATIONMOTHERBABY
BONDING Sensitization Toxic stress
Insensitiveparenting
There is a critical period for maternal neuroplasticity at birth.
ZERO SEPARATIONfor first 1000 minutes
Support parents to have
22
ZERO SEPARATIONfor first 1000 minutes
Enable babies
THE SCIENCE BEHIND THE NEW
NEONATAL STANDARDS.
Does it apply MORE or LESS to PRETERMS ??
This science applies to FULLTERM BABIES
ZERO
SEPARATION
This science applies to PRETERM BABIES … immunity, microbiota,
enteromammary cycle …
Enable babies to receive
… developmentally ready ?? no longer preterm !(Evidence of harm !)
Promote cup-feeding !
23
THE SCIENCE BEHIND THE NEW
NEONATAL STANDARDS.
… actually, YOU are theirpartners in care …
The first hours after birth are a
CRITICAL PERIOD
mutual psycho-neuro-physiological
caregivers GC Anderson
“Human brains are RELATIONAL”
… co-creating touch… signature unique to caregiver
BONDING Sensitization
Secure attachment
Attuned parenting
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
MOTHERBABY
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDING Feed Sleep Cycling
MOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
EMOTIONAL INTELLIGENCE
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDING Feed Sleep Cycling
MOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
EMOTIONAL INTELLIGENCE
SOCIAL INTELLIGENCE
24
Proposed areas of INNOVATION!
Skin-to-skin by parents … others ?Role of father in continued BRF
Furniture to decrease separation dose Garments to decrease separation dose
Feeding frequency for best output?Synchronizing feeding and sleeping.
BIRTH BONDING Sensitization Toxic stress
IT MATTERS
HOW WE ARE BORN
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
SEPARATION
Vulnerability
DISEASE
Disordered attachment
Toxic stress
Insensitiveparenting
SEPARATION
VIOLATESthe innate agendaof mother and baby
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
MOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience
HEALTH
A mother and baby
DYADare asingle
psychoneurobiologicalorganism
NEURODEVELOPMENT
The DNA Behaviour
EVOLUTIONARY BIOLOGY
ENVIRONMENT EXPERIENCE REPRODUCTIVE FITNESSADAPTATION
The Neuroscience of Birth & BreastfeedingThe Brain
EPIGENETICS
BIRTH
BEYOND BREASTFEEDINGFeed Sleep Cycling
SEPARATIONMOTHERBABY
BONDING Sensitization
Secure attachment
Attuned parenting
Resilience Vulnerability
DISEASEHEALTH
Disordered attachment
Toxic stress
Insensitiveparenting
25
Nelson Mandela
… in describing themeasure of a nation,
he has argued that:
“There can be no keener revelation of a society’s soul than the way in which it treats its children.”
Top Related