There are millions of families and children suffering from emotional, behavioral, and developmental problems. Currently available treatment strategies are not effectively meeting the needs of many of these families. The Nurture Science Program explores the biological and behavioral underpinnings of nurture, and at the same time it, documents the effects of nurture as the basis for possible interventions.
One of the goals of this research and treatment program is to reveal the mechanisms that account for the healing power of nurture and develop a new generation of biological-based behavioral therapies that provide families with effective treatment strategies. Studies have shown that nurturing interactions between mothers and infants can shape either vulnerability or resilience to a broad range of mental, behavioral, and physical disorders. Our research holds the promise that someday even infants and children who did not have access to optimal parental bonding and nurture may someday soon experience the benefits of these critical interactions through these new treatments.
The Family Nurture Intervention Study
The Family Nurture Intervention study is a controlled clinical trial conducted by Columbia University Medical Center's Nurture Science Program in the NICU at New York Presbyterian/Morgan Stanley Children's Hospital. The recently published results suggest hospital-based family nurture is a powerful force in helping prevent or overcome emotional, behavioral and developmental problems in prematurely born infants.
The term nurture is used by scientists to mean the emotional connection between mother and infant that occurs during specific interactions, behaviors, and communications such as vocal soothing, comfort touch, eye contact, and holding.
The purpose of the study was to determine the effectiveness of Family Nurture Intervention in the NICU. The intervention includes several nurture-based activities that are designed to overcome the ill effects of premature birth. The main goal of the intervention is to facilitate an emotional connection between mother and infant so that contact is pleasurable and calming, as opposed to unpleasant and stressful.
Results of the Study
- The results show that babies receiving Family Nurture Intervention had robust increases in infant brain activity (by electroencephalographic power) when the infants reached full term age.
- Increases up to 36% were observed in the frontal polar region in the intervention group, as compared to the control group.
- The electroencephalographic findings in the Family Nurture Intervention study are highly significant because other researchers have reported preterm infants to have deficits related to frontal polar function.
- In addition, still others have found that infants with greater power in this region have improved cognitive function, language, and attention to regulate and manage emotions at older ages.
- Depression in mothers of preterm infants has been identified as a major problem. The results of this study show that the Family Nurture Intervention mothers benefited from the intervention.
- Maternal care giving behavior was enhanced while in the NICU, and levels of anxiety and depressive symptoms were reduced at four months post discharge.
- Increased mutual calm was achieved from periods of eye contact as well as improved sleep.
- Evidence that the negative effects of the stress and trauma of preterm birth are not necessarily permanent.
- A small dose of Family Nurture Intervention can lead to relatively large effects that are sustained throughout the critical 18-month stage following discharge from the NICU.
Calming Cycle Theory
Family Nurture Intervention is based on the Calming Cycle theory of Dr. Martha Welch. The central hypothesis of the theory is that repeated calming sessions between mother and infant will lead to improved outcomes for both infant and mother.
Establishing a calming session routine helps restore a normal state of co-regulation between mother and infant. This helps the two to become mutually attuned to one another’s emotional, physiological and behavioral cues and needs. It also bolsters the mother’s confidence in her ability to care for her infant.
The calming sessions of Family Nurture Intervention include mother and child exchanging scent cloths, vocal soothing, comforting touch, eye contact, clothed and skin-to-skin holding and cuddling.
Elements of a Calming Session
- During a calming session, the mother is assisted in holding her infant safely and securely skin-to-skin and chest-to-chest between her breasts under her clothes.
- Clothed holding is facilitated if the mother does not want to engage in skin-to-skin holding.
- Holding is done in an upright position while seated in a designated reclining chair.
- The infant's head is tilted up to ensure the airway is not constricted and a blanket is placed over the infant's back to help maintain temperature.
- Once initiated, the mother is encouraged to engage in the calming activity for a minimum of one hour, but longer if possible.
As the calming sessions proceed, the mother learns to recognize four phases through which mothers and infants cycle: 1) separate mother and infant discomfort/distress; 2) mutually shared distress; 3) mutual resolution of discomfort/distress; 4) mutual calm that may include periods of eye-to-eye contact and/or sleep.
The intervention also provides sessions with other family members whenever possible including the father and grandparents. These sessions encourage and assist the family in developing strategies to support the mother as she continues these interactions with her infant within the NICU and at home.
The intervention employs repeated calming sessions in order to reduce discomfort and distress between mother and the infant and to attract the two to one another emotionally. Families are encouraged to establish a calming session routine at home, as it will help the mother calm her infant when distressed.