Human milk and breastfeeding: An intervention to mitigate toxic stress

Hallowell, Sunny G.; Froh, Elizabeth B.; Spatz, Diane L.

doi:10.1016/j.outlook.2016.07.007

Cited by 19 publications

(13 citation statements)

References 54 publications

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“…Human development in early childhood has been shown to be highly sensitive to both nature and nurture: nature influences through epigenetic mechanisms responding to the early environment or ecology that determine subsequent biological developmental processes; nurture influences when there are unexpected disruptions and adverse events that negatively and permanently impacts learning and behavior, and physical and mental wellbeing (Shonkoff & Garner, ). The policy discourse has, however, been mainly aimed at toddlers, and perhaps a little to infants, but the neonatal period has been almost totally neglected, and only recently have a few articles identified the neonate as a candidate for toxic stress (D'Agata, Coughlin, & Sanders, ; Hallowell, Froh, Spatz,, & Expert Panel on Breastfeeding of the American Academy of Nursing, ; Sanders & Hall, ; Weber & Harrison, ). The definition of toxic stress is lucid enough: “the absence of the buffering protection of adult support.” Parental presence in the neonatal intensive care unit (NICU) was previously (and still in some cases and places) strongly discouraged.…”

Section: Introductionmentioning

confidence: 99%

Birth practices: Maternal‐neonate separation as a source of toxic stress

Bergman

2019

Birth Defects Research

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Maternal‐neonate separation for human newborns has been the standard of care since the last century; low birth weight and preterm infants are still routinely separated from their mothers. With advanced technology, survival is good, but long‐term developmental outcomes are very poor for these especially vulnerable newborns. The poor outcomes are similar to those described for adversity in childhood, ascribed to toxic stress. Toxic stress is defined as the absence of the buffering protection of adult support. Parental absence has been strictly enforced in neonatal care units for many reasons and could lead to toxic stress. The understanding of toxic stress comes from discoveries about our genome and epigenetics, the microbiome, developmental neuroscience and the brain connectome, and life history theory. The common factor is the early environment that gives (a) signals to epigenes, (b) sensory inputs to neural circuits, and (c) experiences for reproductive fitness. For human newborns that environment is direct skin‐to‐skin contact from birth. Highly conserved neuroendocrine behaviors determined by environment are described in this review. The scientific rationale underlying skin‐to‐skin contact is presented: autonomic development and regulation of the physiology leads to emotional connection and achieving resilience. Maternal‐neonate separation prevents these critical neural processes from taking place, but also channel development into an alternative developmental strategy. This enables better coping in a stressful environment in the short term, but with permanently elevated stress systems that negatively impact mental and physical health in the long term. This may explain the increasing incidence of developmental problems in childhood, and also Developmental Origins of Health and Disease. Arguments are presented that maternal‐neonate separation is indeed a source of toxic stress, and some suggestions are offered toward a “zero separation” paradigm.

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Section: Introductionmentioning

confidence: 99%

Birth practices: Maternal‐neonate separation as a source of toxic stress

Bergman

2019

Birth Defects Research

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“…Mother-infant interactions stimulate maternal milk production and prepare infants to breastfeed by downregulating the neuroendocrine stress response and activating blood glucose regulation. [41,42] The evidence of a link between close maternal-infant contact and breastfeeding is compelling: mother-infant pairs who engaged in SSC after birth were more likely to successfully breastfeed during their first feed, continue breastfeeding after 1-4 months post-birth, score higher on breastfeeding effectiveness, and breastfeed exclusively and for longer durations when compared to those without SSC. [30,43] This underscores the need to foster mother-infant interactions and minimize unnecessary interventions in maternity care.…”

Section: Article Summary Strengths and Limitations Of The Studymentioning

confidence: 99%

Separating Newborns from Mothers and Maternal Consent for Newborn Care and the Association with Health Care Satisfaction, Use and Breastfeeding: Findings from a longitudinal survey in Kenya

Nakphong¹,

Sacks²,

Opot³

et al. 2020

Preprint

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Objectives Disrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors, or associated outcomes. This study aimed to examine these practices and associations with health care satisfaction, use, and breastfeeding. Design Prospective cohort study Setting Health facilities in Nairobi and Kiambu counties in Kenya Participants Data were collected from women who delivered in health facilities between September 2019 and January 2020. The sample included 1,014 women surveyed at baseline and at least one follow-up at 2-4 or 10 weeks postpartum. Primary and secondary outcome measures 1) Outcomes related to satisfaction with care and care utilization, 2) Continuation of post-discharge newborn care practices such as breastfeeding. Results 17.6% of women reported being separated from their newborns at the facility after delivery, of whom 71.9% were separated over 10 minutes. 44.9% felt separation was unnecessary and 8.4% reported not knowing the reason for separation. 59.9% reported consent was not obtained for procedures on their newborn. Women separated from their newborn (>10 minutes) were 44% less likely to be exclusively breastfeeding at 2-4 weeks (aOR=0.56, 95%CI: 0.40, 0.76). Obtaining consent for newborn procedures corresponded with 2.7 times greater likelihood of satisfaction with care (aOR=2.71, 95%CI: 1.67, 4.41), 27% greater likelihood of postpartum visit attendance for self or newborn (aOR=1.27, 95%CI: 1.05, 4.41), and 33% greater likelihood of exclusive breastfeeding at 10 weeks (aOR=1.33, 95%CI: 1.10, 1.62). Conclusions Newborns, mothers, and families have a right to high quality, respectful care, including the ability to stay together, be informed and have proper consent for care. The implications of these practices on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care.

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“…Sunny Hallowell (Cohort 1), who participated while she was a postdoctoral fellow, had the opportunity to lead a Call to Action to consider breastfeeding as a mitigator for Toxic Stress. The paper highlighted the potential for breastfeeding to promote parenting skills and capacities that can buffer against adverse biological, socioeconomic and behavioral stressors encountered during infancy and childhood (Hallowell, Froh, & Spatz, ). Exploration of the concepts in the publication have been a launching pad for a new trajectory of her research focused on development of parent‐infant relationships related to communication, language, nutrition and brain development (Darcy Mahoney, Zauche, Hallowell, Weldon, & Stapel‐Wax, ).…”

Section: The Academy Jonas Policy Scholar Experiencementioning

confidence: 99%

The American Academy of Nursing Jonas Policy Scholars Program: Mentoring future nurse leaders to advance health policy

Oerther

Hallowell

Rossiter

et al. 2018

Journal of Advanced Nursing

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Future of Nursing: Leading Change, Advancing Health," calling for a transformation of the nursing profession in education, leadership, and practice (Institute of Medicine, 2010). Consistent with the call to transform nursing and its role in health and health care, the American Academy of Nursing (the Academy), an organization of approximately 2,500 nursing leaders from around the world, created the Jonas Policy Scholars Program. The purpose of this editorial was to provide an overview of the Jonas Policy Scholars Program and describe how the program has empowered emerging nurse leaders to improve health policy outcomes domestically and abroad.

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Human milk and breastfeeding: An intervention to mitigate toxic stress

Cited by 19 publications

References 54 publications

Birth practices: Maternal‐neonate separation as a source of toxic stress

Birth practices: Maternal‐neonate separation as a source of toxic stress

Separating Newborns from Mothers and Maternal Consent for Newborn Care and the Association with Health Care Satisfaction, Use and Breastfeeding: Findings from a longitudinal survey in Kenya

The American Academy of Nursing Jonas Policy Scholars Program: Mentoring future nurse leaders to advance health policy

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