BIOLOGICAL NURTURINGBIOLOGICAL NURTURING

Jean Meadows April 2010Jean Meadows April 2010

Step 4 UNICEF Baby Friendly InitiativeStep 4 UNICEF Baby Friendly Initiative

All mothers should be given their All mothers should be given their babies to hold with skin to skin babies to hold with skin to skin contact in an unhurried environment contact in an unhurried environment for an unlimited period as soon as for an unlimited period as soon as possible after delivery possible after delivery

Four Basic Needs Four Basic Needs

OxygenOxygen

WarmthWarmth

NutritionNutrition

protection protection

Biological NurturingBiological Nurturing

BN is defined as any mother/baby BN is defined as any mother/baby behaviour at the breast where baby behaviour at the breast where baby is in close contact with the mother’s is in close contact with the mother’s body contours. (SD Colson et body contours. (SD Colson et al.2008)al.2008)

Biological NurturingBiological Nurturing

BN is an extension of skin to skin.BN is an extension of skin to skin.

It builds on the effects on the body of the It builds on the effects on the body of the close contact between mum and baby.close contact between mum and baby.

It doesn’t negate the need to know about It doesn’t negate the need to know about the more traditional approaches to the more traditional approaches to breastfeeding. Rather, it enhances our breastfeeding. Rather, it enhances our knowledge of why babies search for the knowledge of why babies search for the breast.breast.

Remember the effects of BN are important Remember the effects of BN are important for bottle feeding babies too. for bottle feeding babies too.

BN position for babyBN position for baby

BN positions build on the Tummy to BN positions build on the Tummy to Mummy position.Mummy position.

Full BN position entails the baby lying on Full BN position entails the baby lying on top of the mother:top of the mother:

FacingFacing Close Close TouchingTouchingMother does not have to hold the baby.Mother does not have to hold the baby.Gravity maintains baby position.Gravity maintains baby position.

Mother’s Position in BNMother’s Position in BN

The mother should be sacral The mother should be sacral dependant but not flat. dependant but not flat.

1515o – o – 6464o o appears to be optimal to appears to be optimal to initiate breast feeding.initiate breast feeding.

Every part of the mother’s body Every part of the mother’s body should be supported.should be supported.

The mother’s body opens up. The mother’s body opens up.

Full Biological Nurturing Full Biological Nurturing PositionPosition

Baby’s chestBaby’s chestis in closeis in closecontact withcontact withmum’s bodymum’s bodyContour.Contour.

UnrestrictedUnrestrictedaccess toaccess tobreastbreast

Behavioural StatesBehavioural States

When physical contact between When physical contact between mother and baby is unrestricted mother and baby is unrestricted following birth concentrations of following birth concentrations of oxytocin in maternal blood seems to oxytocin in maternal blood seems to be higher than just before the birth be higher than just before the birth (Nissen et al.1996)(Nissen et al.1996)

Why is that important?Why is that important?

OxytocinOxytocin

Oxytocin is produced in the same Oxytocin is produced in the same area of the brain as the hormone area of the brain as the hormone Vasopressin.Vasopressin.

Vasopressin is needed to produce the Vasopressin is needed to produce the fight or flight hormone Adrenalin.fight or flight hormone Adrenalin.

Research shows that when oxytocin is Research shows that when oxytocin is stimulated it pours into the brain and stimulated it pours into the brain and dampens the effect of Vasopressin.dampens the effect of Vasopressin.

Why is that significant?Why is that significant? Adrenaline rapidly prepares the body Adrenaline rapidly prepares the body

for action in emergency situations.for action in emergency situations.

It increases the heart and respiratory It increases the heart and respiratory rate.rate.

As a side effect high levels increase As a side effect high levels increase anxiety.anxiety.

The effects of The effects of adrenalineadrenaline

Not exactly the Not exactly the state we want state we want our mums in our mums in when they when they feed!feed!

But how many But how many of us have of us have seen this!!seen this!!

The effects of The effects of OxytocinOxytocin

CalmCalm Lower heart rateLower heart rate Higher pain Higher pain

thresholdthreshold Higher social Higher social

interactioninteraction Less anxiousLess anxious SoporificSoporific

Innate behavioursInnate behaviours

Primitive Neurological Behaviours Primitive Neurological Behaviours Identified as Feeding Reflexes by SD Identified as Feeding Reflexes by SD Colson et al (2008)Colson et al (2008)

Endogenous (cues)Endogenous (cues)

Hand to Mouth Tongue DartHand to Mouth Tongue Dart

Mouth Gape RootMouth Gape Root

Arm Cycle Leg CycleArm Cycle Leg Cycle

Innate BehavioursInnate Behaviours

Motor (finding and latching)Motor (finding and latching) Palmer grasp Palmer grasp Plantar stepPlantar step Plantar grasp Plantar grasp CrawlingCrawling Babinski (big toe curling/toe fanning)Babinski (big toe curling/toe fanning)

Innate BehavioursInnate Behaviours

RhythmicRhythmic

SuckSuck

SwallowSwallow

Innate BehavioursInnate Behaviours

Anti-Gravity (finding/latching)Anti-Gravity (finding/latching)

Head rightingHead righting

Head liftingHead lifting

Head bobbingHead bobbing

So what does all this mean for So what does all this mean for our practice?our practice?

We should all be allowing our mothers We should all be allowing our mothers to have unlimited, unrestricted skin to to have unlimited, unrestricted skin to skin contact with their babies, as soon skin contact with their babies, as soon after birth as possibleafter birth as possible

This is especially important when This is especially important when labour may inhibit the mum’s own labour may inhibit the mum’s own production of oxytocin i.e.: production of oxytocin i.e.:

The use of epidural.The use of epidural. The use of oxytocin.The use of oxytocin. Instrumental or operative delivery.Instrumental or operative delivery.

………………………………………….Continued.Continued

We should be encouraging BN on the We should be encouraging BN on the Post Natal Ward.Post Natal Ward.

It should be our first defence when It should be our first defence when babies are not interested in the breast.babies are not interested in the breast.

The mother’s should be allowed time to The mother’s should be allowed time to listen to their own maternal instincts.listen to their own maternal instincts.

Just think a method of helping mums and Just think a method of helping mums and babies to feed that actually works better babies to feed that actually works better if we are not there!!!if we are not there!!!

Finally.Finally.BN works for every other mammal on BN works for every other mammal on

the planet. Why should we be any the planet. Why should we be any different?different?

There’s moreThere’s more

Thank YouThank You