Touch is essential not only to healthy human development, but to survival. In 1971, Ashley Montagu published his landmark book, Touching: The Human Significance of the Skin, which proved to be one of the first detailed discussions of the importance of skin-to-skin contact for healthy development of infants.
Montagu points to earlier researchers who noted that some orphanages had infant mortality rates of 30–40 percent, even when infants’ basic physical survival needs were satisfied. The researchers attributed the high mortality rate to insufficient physical nurturing (via touch), as well as insufficient relational nurturing with appropriate stimulation and responses by caregivers (Montagu 1971). More current research has confirmed the importance of skin-to-skin contact (sometimes referred to as “kangaroo care”), particularly in the first few days and weeks of life. Skin-to-skin contact can improve the connection required for breastfeeding, boost weight gain and growth rates, improve immune function, and increase the stability of hormone levels (Bigelow et al. 2014).
For babies born prematurely, this skin-to-skin contact can play a huge role in the infants’ survival, partly because an infant’s thermoregulation is better calibrated with skin-to-skin contact than it is in an incubator. This is because mothers who have recently given birth have a warmer skin temperature, up to two degrees higher than the rest of their body, on the area of their chest where the baby would naturally rest while being soothed or breastfed, which helps the baby maintain his body temperature more effectively.
We know from the research conducted with Romanian orphans that those who lived in orphanages for longer than eight months had higher levels of cortisol and lower levels of oxytocin and vasopressin (hormones affiliated with support for bonding and regulation of emotions)—even as long as twelve years later—than did babies who had been in the orphanages for less than four months (Nelson et al. 2011). Of course, it’s not only touch that may have contributed to those differences. There are many factors that influence development and many different ways neglect can manifest in later development.
However, there is now sufficient research to show clearly that skin-to-skin contact does indeed make significant differences for the infant in long-term development and health outcomes. Particularly for newborns, touch helps calm the nervous system and improves sleep (Bigelow et al. 2014).Skin-to-skin contact also supports bonding and promotes physiological changes, in both the caregiver and the infant, that support better overall regulation. Tiffany Field’s research at the Touch Research Institute has clearly shown that massage therapy, whether in newborns or senior citizens, provides the following benefits (Field 1998, 2017):
-Facilitates weight gain in pre-term infants
-Enhances attentiveness
-Alleviates depressive symptoms
-Reduces pain
-Reduces stress hormonesImproves immune function
Skin-to-skin contact is our earliest experience of co-regulation outside the womb. It is fundamental to the essential process of learning mutuality. Babies thrive when caregivers are actively engaged with them, and this includes engagement through responsive touch. Some cultures are highly touch-oriented, whereas others have lower rates of social touch, but touching infants is universally common. Early, positive experiences of touch and physical connection with caregivers provide some of the critical architecture for self-regulation and resilience.
Touch also helps us develop our interoceptive abilities. As stated earlier, Porges (1993) refers to interoception as the “infant’s sixth sense” and assigns it a critical role in survival. As discussed in chapter 2, accurate interoception helps regulate our physiological systems and helps usperceive safety and connectedness, the very underpinnings of resilience development. As was discussed in the previous chapter, infants learn during the co-regulation process that the caregiver not only affects them, but that they in turn have an impact on the caregiver; they learn that they have agency and active influence over their environments and the people who share those environments. Caregivers are responsive to babies; they areusually drawn to touch and enjoy cuddling infants. One of the most commonly repeated cycles between caregivers and babies—and even between strangers and babies, for that matter—is that of smiling. The baby smiles, and the caregiver smiles back. The baby begins to learn that she isthe causal agent in this “smile cycle.”
The same holds true with touch and co-regulation. The baby is not only learning how to regulate himself; he is learning he can influence the regulation of his caregiver. Much of the earliest experience of this comes from subtle somatic cues, including tactile responses, as well as experiencing the caregiver’s somatic responses, such as heart rate and breathing changes, or changes in muscle tone. Touch research shows that healthy touch during our early development helps us develop empathy and deepens our ability to understand the social cues of those around us (Field2014).
If we have reliable access to this early experience of co-regulation, we will more effectively develop our individual ability to notice cues regarding our own experience of regulation: settling, the pleasure of feeling well-fed, a sense of safety, and so on. As was discussed in previous chapters, the foundational development of the autonomic nervous system, which gives usfull access to the ventral parasympathetic physiology, occurs during these early phases of our lives and requires the attentive responsiveness of our caregivers. Caregivers literally nurture our resilience.
As we also know from many different sources of research (Carter andSanderson 1995), neglect, including lack of skin-to-skin contact, profoundly impacts our development, often throughout our lifetimes. Our stress chemistry is negatively impacted, our immune systems don’t function as well, and we experience greater difficulty regulating both our physiological and emotional responses.
Research tells us that the long-term effects of neglect can be greater than those of physical or sexual abuse for the child. These changes are documented through MRIs and PET scans. The structure and chemical activity of the brain show a decrease in both size and structural connectivity. Such early neglect or abuse can also be blamed for hypersensitivity in stressful situations, as well as the inability to respond to nurturing and kindness (Shonkoff and Phillips 2000; Shonkoff, Boyce,Cameron, et al. 2004; Shonkoff et al. 2012).
