Each year, 1 in 10 babies born in the U.S. spends time in the NICU, the neonatal intensive care unit. Years later, many of these children have developmental, learning or behavioral problems, including autism.
A new study is designed to determine if different kinds of nurturing in the first few months of life could improve outcomes. San Antonio mothers and babies are taking part in the research.
Baby Angel came into the world early, 11 weeks early to be exact, weighing less than four pounds.
"He was so tiny and had all these wires on him and I was scared to hurt him," said Angel's mother Connie De La Rosa.
De La Rosa spends as much time as she can with her son in the Neonatal Intensive Care Unit of San Antonio’s University Hospital.
Umber Darilek , RN, said there’s no playbook for mothers of tiny, sometimes sick babies. No book to read, no real world advice from your grandmother on how to cope.
"We see moms looking terrified," Darilek commented. "A lot of women don’t know how to approach their babies, especially when there are tubes and lines coming out of all directions."
That’s why Martha Welch, MD, of Columbia University Medical Center in New York is studying an intervention called Family Nurture. Welch believes early physical trauma and a potential lack of emotional connection between mother and baby may set up these young patients for difficulties later.
"They’re isolated," Welch stated. "They’re not having social involvement. We think they are being adversely conditioned to human contact because so much of the contact is challenging. It’s tubes and IVs and skin pricks. Pre-term infants have a higher rate of risk for developmental problems including autism."
Welch says early in life, when babies cuddle in their mother’s arms, or nurse, or have eye contact, they develop a bond at the visceral level, in the autonomic nervous system that’s responsible for what we call “gut feelings.” That means later in life, you may feel calmer just be being around your mother.
To help establish that connection in the NICU, nurture specialists help new moms with skin-to-skin holding, comforting touch, scent exchange, eye contact and vocal soothing.
"We did a very successful first trial with amazing outcomes, totally different from the usual outcomes for pre-term infants in terms of cognition, language, risk for autism, behavior," Welch said.
Now, University Hospital is taking a page from Columbia’s playbook, conducting a family nurturing study of its own to try and replicate positive results for NICU babies.
"It was like a light bulb. It was like ‘wow,'" said neonatologistAlice Gong, MD, of UT Health San Antonio.
Gong said during her three decades of dealing with mother-baby interaction, she has witnessed the temper tantrums and intestinal issues that often plague NICU babies for years.
"They’ve been sheltering their baby for so long," Gong said of the new mothers. "They’re so scared they are going to die that they pretty much don’t mother them the same way they do their other children."
Gong is recruiting 50 moms and babies for her study. De La Rosa is the first.
"She told me that I would help my baby connect," De La Rosa commented. "I hold him skin to skin, talk to my baby, show him emotions. Now mommy instincts are kicking in."
Welch said science backs up her early positive results. By 18 months, one in four NICU babies has behaviors that fall somewhere on the autism spectrum. With Family Nurture Intervention, that number decreased to one in ten. The ultimate goal of these studies is to change the culture in NICUs around the country.
