A woman goes into labor and gives birth. The newborn is swaddled and placed to sleep in a nearby bassinet, or taken to the hospital nursery so that the mother can rest. Despite this common practice, research published in Biological Psychiatry provides new evidence that separating infants from their mothers is stressful to the baby.

The American Academy of Pediatrics recommends against co-sleeping with an infant, due to its association with Sudden Infant Death Syndrome, or SIDS. This notion has been debunked in the last couple of years, by the physician who first made a case for it. Safe co-sleeping has been shown to positively impact breastfeeding, infant and parent sleep.

Dr. James J. McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame says, “It is a curious fact that in Western societies the practice of mothers, fathers, and infants sleeping together came to be thought of as strange, unhealthy, and dangerous. Western parents are taught that cosleeping will make the infant too dependent on them or risk accidental suffocation. Such views are not supported by human experience worldwide.” Research has suggested that many mothers who have been diagnosed as having postpartum depression are actually suffering extreme fatigue from waking to go to their babies at night.

Having done research on sudden infant death syndrome (SIDS), Professor McKenna believes that low-level arousals, which did not actually awaken either parent, give the baby practice in arousing himself. This can lessen a baby’s susceptibility to some forms of SIDS, which are thought to be caused by failure to arouse from deep sleep to reestablish breathing patterns.

Professor McKenna says that millions of years of cosleeping and night feeing have not developmentally prepared young babies to “sleep through” in a solitary crib, involving, as this does, long periods of deep sleep. Videos taken show that cosleeping mothers, even in deep sleep, seem aware of their baby’s position and move when necessary to avoid overlying. Some of the lowest rates of SIDS are found among cultures where cosleeping is predominant.
It is standard practice in a hospital setting, particularly among Western cultures, to separate mothers and their newborns. Separation is also common for babies under medical distress or premature babies, who may be placed in an incubator.

Humans are the only mammals who practice such mother-infant separation, but its physiological impact on the baby has been unknown until now. Researchers measured heart rate variability in 2-day-old sleeping babies for one hour each during skin-to-skin contact with mother and alone in a cot next to mother’s bed. The neonatal autonomic activity was 176% higher and quiet sleep 86% lower during maternal separation compared to skin-to-skin contact.

Dr. John Krystal, Editor of Biological Psychiatry, commented on the study’s findings. “This paper highlights the profound impact of maternal separation on the infant. We knew that this was stressful, but the current study suggests that this is a major physiologic stressor for the infant.”

“Skin-to-skin contact with mother removes this contradiction, and our results are a first step towards understanding exactly why babies do better when nursed in skin-to-skin contact with mother, compared to incubator care,” explained study author Dr. Barak Morgan.

The research addresses a strange contradiction: In animal research, separation from mother is a common way of creating stress in order to study its damaging effects on the developing newborn brain. At the same time, separation of human newborns is common practice, particularly when specialized medical care is required (e.g. incubator care).

More research is necessary to further understand the newborn response to separation, including whether it is sustained response and whether it has any long-term neurodevelopmental effects.

Skin-to-skin contact has known benefits, and certainly, most would agree that unnecessarily stressing a newborn is unacceptable. As further evidence emerges, the challenge to doctors will be to incorporate skin-to-skin contact into routine treatment while still safely providing the other elements of newborn medical care.

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