The Importance of Healthy Touch
We all know that babies born with a visual or hearing impairment can, with the right support and services, develop healthily – without any negative developmental effects associated with missing out on sensory input through their eyes and ears. In contrast, healthy touch is crucial to the development of all babies.
Without sensory input through their skin, babies can experience serious complications. In the worst case scenarios – such as in poorly run overseas orphanages – lack of healthy touch results in serious, long term developmental delays and brain damage (Harmon, 2010). This is most likely associated with stress hormones which, when present in persistently high levels, are extremely toxic to the developing brain (American Academy of Pediatrics, 2011).
Although extreme forms of touch deprivation are far less common in Australia, it is believed that even mild to moderate absence of healthy touch can also have consequences for the baby’s developing brain. For example, a reduced level of healthy touch in infancy has been associated in animal and human studies with:
- Failure-to-Thrive (FTT) (Feldman, et al., 2004; Polan & Ward, 1994);
- the development of violent behaviours and lack of empathy (Field, 2002; Field, 1999; Prescott, 1996);
- development of body image and eating disorders (Gupta & Schork, 2006; Iwasaki, et al., 2000); and even
- predisposition to opioid addiction (Schwarz, Hutchison & Bilbo, 2011).
The studies and reviews included here do not provide enough evidence to conclusively say that adequate “healthy touch” in infancy either prevents or cures any particular illness. It is important to recognise these (and other conditions associated with low levels of touch) are not “caused” by any single trigger, but are multifactorial in their development. In addition, it is neither ethical nor practical to conduct studies which deprive infants of healthy touch (but not other forms of stimulation) to draw absolute conclusions about what specific conditions lack of touch may cause – we may never know the answer to this! Instead, together, these and other studies – as well as the field observations of children who have been deprived of touch – do confirm that healthy touch plays some sort of crucial role in healthy development of human babies.
More recently, scientists have become curious as to what that role might be, and have begun exploring exactly how healthy touch acts on infant (human) development and growth. The findings are quite surprising. Rather than simply providing an “emotionally nice” sensation for a baby, healthy touch appears to:
- directly reduce inflamation and vagus nerve activity (a key part of the body’s stress management system) (Feldman, Singer & Zagoory, 2010; Schore, 2001);
- help regulate and stimulate healthy brain growth and activity – particularly on the right side of the brain (Diego, et al., 2006; Guzetta, et al. , 2011; Jones, Field & Davalos, 1998; Schore, 2001); and
- set up a cascade of chemical processes which influence the activity and activation or suppression of genes ( Meaney, 2011; Schanberg, in Field, 2014).
What is “Healthy Touch”?
Some studies on infant touch, and particularly infant massage, have been poorly interpreted and applied. These studies do not, in any way, suggest that babies benefit simply from “being touched”. These studies do not imply that all babies should, for example, be massaged for a set amount of time each day before their bath (or whatever the fashionable advice is at any point in time). There is a vast difference between healthy touch, compared with touch that may be unhelpful…to say nothing of the forms of touch that are harmful or traumatising to babies.
At Baby in Mind we define “healthy touch” as being the sort of touch that helps a baby regulate their behavioural and neurological state. In simple terms, healthy touch is the sort that helps a baby to stay in, or return to, a focussed and calm state.
Although research can give us generalisations about what is true for some babies, some of the time, all babies can, and do, vary widely in their responses to different types of touch, under different circumstances and at different times. Pre-term babies, for example, often start off with much lower thresholds for moving touch than babies born at full-term (Warren & Bond, 2010). And even within groups of babies at similar developmental ages the impact of touch on behavioural and neurological regulation can vary widely (Harrison, Leeper & Yoon, 2006; Warren & Bond, 2010). There also appear to be gender and other genetically-driven differences in infant’s responses to touch.
As well as differences between babies there is, of course, great variation in the way each individual baby responds to touch. As any parent will know, a baby can be more responsive to interaction at different times of the day depending on their sleep needs, hunger, other activities happening, their growth spurts and other transitions.
In short, there is no one-size-fits all approach to healthy touch for babies.
Almost all of us as parents have interactions with our baby when we our touch does not help settle or calm our babies: for example when we inadvertently tickle our baby a for a bit longer than they can handle, or when we are still learning what works best to settle and soothe our baby and haven’t yet quite “got the touch”. This trial and error, or rupture and repair, is a normal part of the parent-baby relationship – and in fact is necessary and contributes to healthy development (Lewis, 2000; Tronick & Beeghly, 2011).
However, if intrusive touch (such as poking or overwhelming a baby with sensory stimulation) or other types of touch which irritate (dysregulate) a baby’s stress responses, begins to occur frequently and persistently, development can be impacted (Stack, in Field, 2004; Tronick & Beeghly, 2011).
Persistent, dysregulating touch is usually unintentional. It is sometimes seen when a caregiver is experiencing depression or other mental health difficulty, is overwhelmed, or is simply still working out how to help their baby manage their reactions (Stack, in Field, 2004). It is also sometimes seen when approaches to care of fragile babies focus only on procedures and technology, and does not provide care in a way that helps the baby achieve a state of neurological regulation and relaxation.
Therefore, a crucial part of the Baby in Mind First Touch infant massage program, focuses on supporting parents to recognise, understand and respond to their baby’s cues. These cues are the (sometimes subtle) signs a baby gives to a parent. These cues tell a parent whether the touch, massage or interaction is helping them regulate their neurological state, or whether the baby is asking their caregiver to to adapt, modify or change what they are doing. In this context, each and every baby is different. This is why Cue Recognition is an equally important element of our program as touch itself.