Positive Relationships: Touch - That loving feeling

It is a sad fact that changes in childrearing practices in the western world have reduced the opportunities for natural and instinctive physical closeness at birth and in the early years of childhood.

According to a long-established body of research, the importance of early tactile experience cannot be underestimated. For while the baby feels safe and physically secure in the womb, once it is born it needs to be held, cuddled, rocked and kept warm in order to develop healthily.

Sylvia Baddeley, who is a bonding and attachment specialist midwife and child development consultant working in Stoke, fears that an understanding of the importance of touch is being lost.

She believes that educating new parents about their baby's need for skin-to-skin and eye-to-eye contact should be high on the list for midwives, family support workers and early years practitioners.

'Research highlights that the pre-verbal years are a critical period for tactile learning,' she says. 'Even eye-to-eye contact is "touching at a distance" and is very important for babies. They have the ability to read facial expressions soon after birth, and a "flat expression" will be noticed very quickly and cause distress.'

She emphasises that mothers who have had experience of supportive touch in labour will use their own hands more effectively when touching and exploring their infants. 'This has profound implications for professionals who provide antenatal care,' she says. 'This care should reinforce messages about touch - that sensory input via the skin informs baby about the world around him and sends messages about the carer who is holding him.'

SENDING THE RIGHT MESSAGES

Ms Baddeley currently delivers bonding and attachment training for student midwives at North Staffordshire Hospital. The two-day courses are linked to Stoke Speaks Out and blend theory and practice on the importance of encouraging physical and emotional, parental engagement.

'A baby needs to be held - and not just when it cries,' she says. 'Culturally, we seem to think this is the only justification for such attention. We need to dispel the myth that you can spoil a baby by picking it up all the time.'

She believes that problems to do with warm interactions are compounded by young women being isolated during pregnancy. 'When I was a practising midwife in the 1970s, most women finished working at 28 weeks and this gave them plenty of time to attend excellent parenting classes. Today we see women working for much longer up to the birth and opting to take time off afterwards. Parenting classes now tend to concentrate on pain relief, labour and breastfeeding, rather than parenting itself.'

According to Ms Baddeley, embedding the right messages can form part of routine antenatal care and it does not have to carry big funding implications. 'Routine checks can be an opportunity to drip-feed important information,' she says. 'At 24 weeks, the foetal ear is formed and the baby can hear and recognise its mother's voice, which is something that practitioners can talk about in a positive way.

'For many women, the first baby they have ever touched is the one they have just pushed out, and it is vital that midwives have the expertise to encourage touch and familiarity. There also needs to be continuity in these messages while babies grow and develop, supported by the approach of health visitors and early years practitioners.'

She adds, 'It's all about putting parenting on a high platform and viewing it with the importance it deserves. Parents who enjoy touching and holding their babies in the first 12 months lay the right foundation for the rest of the child's life.'

THE NEED FOR TOUCH

The skin is the earliest sensory organ to develop and is considered an exposed part of our nervous system. The developing foetus acquires a sense of touch at five to six weeks gestation and at five months will even suck its thumb.

In the womb, the foetus is continually touched and caressed by both itself and its mother's body. The sensations received by the skin during labour and contractions send signals to the foetus that a big change is about to occur and tells its organs to prepare. After the birth, it is the skin-to-skin contact with the parent that reduces the trauma of the birth experience.

Once the baby has safely arrived, this skin-to-skin contact gives continuous feedback on body temperature and the mother's skin cools down or warms up depending on the baby's needs. Cuddling the infant at birth also helps to stimulate regular respiration and deep breathing.

Loving touch and stimulation from birth are absolutely necessary for physical and mental wellbeing. Deprivation of touch is akin to not feeding and can have the same devastating consequences.

Studies of touch-deprived, institutionalised infants - such as those raised in Romanian orphanages in the 1980s - have shown that weight and growth hormones are affected, and in severe cases of neglect, brain size may be reduced.

BABY MASSAGE - BUSY BEARS DAY NURSERY

At Busy Bears Nursery in Durham, baby massage is used as a comfort strategy for children aged from birth to 15 months who are responsive to it. The nursery has a qualified baby massage practitioner who has given other staff members basic training in the techniques.

Owner and manager Emma Graham says, 'Louise is passionate about baby massage, having used it on her own children and having seen its positive effects. However, in the nursery we do not use it to imitate the bond between mother and baby, but rather as a way of getting children to relax and settle.'

Practitioners have access to a hessian baby massage bag which contains a practice guide, towels, massage oil, and relaxing CDs to listen to.

'Massage is used at times of the day when the mood of the baby room suits it,' says Ms Graham. 'It is very good for making staff think more deeply about meeting the individual babies' needs. After messy play, for example, babies often liked to be softly dried and have a little lotion rubbed into them. This has a very calming effect.

'When other children in the baby room are asleep this can provide a good opportunity to give the awake babies a massage and make it a special time. While messy play and other activities are often regarded as a focus for the day, the time spent drying and relaxing afterwards is every bit as important. In this way, massage can provide a shift in emphasis in the way that staff think about their baby practice.'

Ms Graham says parents sign a consent form for their baby to receive massage when they register. 'It suits some children more than others, and for staff it is important to gauge which babies like it. Our parents are very positive about it and they often copy our techniques to use at home.'

FURTHER INFORMATION

• Touching: Human Significance of the Skin, by Ashley Montagu, Harper Perennial (available through Amazon), £7.95
• Nursery World Learning and Development series: 'Physical Development' by Anne O'Connor and Anna Daly (2009), www.nurseryworld.co.uk/go/physicaldevelopment
• 'Child Development: Your guide to the first five years' by Maria Robinson (2008), www.nurseryworld.co.uk/go/childdevelopment.