1. The document discusses the importance of skin-to-skin contact between mothers and newborns from a neuroscience perspective. It summarizes evidence that separation from the mother is a form of toxic stress that can disrupt brain development and have lifelong negative impacts on learning, behavior, and health. 2. The author argues that reducing toxic stress for newborns is very easy and involves practices like skin-to-skin contact, attachment, bonding, and breastfeeding that allow the mother's body to regulate the infant's physiology. Public health policies should focus on supporting these early interactions between mothers and babies. 3. Evidence is presented showing that early adversity can get "under the skin" and alter stress response systems

1. 1
Dr Nils Bergman
MB ChB, DCH, MPH, MD
(USA equiv: MD, MPH ,PhD)
Cape Town, RSA
www.skintoskincontact.com
SKIN-TO-SKIN CONTACT –
Making perinatal neuroscience
into evidence based practice.
Speaker Disclosure
Under ACCME guidelines:
a) I am the South African distributor of
MIRIS : Human Milk Analyzer
b) My wife markets educational materials and shirts related
to the talk content
Kangaroo Mother Care Promotions
SKIN-TO-SKIN CONTACT –
Making perinatal neuroscience
into evidence based practice.
“For species such as
primates, the mother
IS the environment.”
Sarah Blaffer Hrdy, Mother Nature (1999)
Babies Celebrated, Beatrice Fontanel and Claire D’Harcourt, © 1998 Harry N. Abrams, Inc.
Nothing an infant can or
cannot do makes sense,
except in light of mother’s body
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Brain
EPIGENETICS
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
“except in the light of
mother’s body.”
“EEA”
Environment of
Evolutionary
Adaptedness
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION

2. 2
MOTHER
is the key to
neurodevelopment …
Environment of
Evolutionary
Adaptedness
MOTHER
is the key to
neurodevelopment …
… because she is the
RIGHT PLACE !!
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
The Brain
EPIGENETICS
… because she is the
RIGHT PLACE !!
DEFENCE NUTRITION REPRODUCTION
HORMONES NERVES MUSCLES
endocrine autonomic NS somatic
HIGHLY CONSERVED
NEURO-ENDOCRINE
BEHAVIOR
“The newborn may appear
helpless, but
raises its own temperature,
has a higher blood glucose,
metabolic adaptation faster.
(Widstrom 1987)
METABOLIC ADAPTATION
SSC started in the first
20 minutes after birth
SSC Cot
Blood glucose (1 hr) 3.17 2.56
Base excess drop 3.4 1.8
(Christenson 1992)

3. 3
Warming,
feeding and
protection
behaviours are
intricately, inseparably
linked to the right place.
(Alberts 1994)
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
The Brain
EPIGENETICS
Kangaroo POSITION
Kangaroo NUTRITION
Kangaroo SUPPORT
DISCHARGE
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
KANGAROO MOTHER CARE
 SKIN-TO-SKIN CONTACT
“Cells which
FIRE TOGETHER,
WIRE TOGETHER,
and those which
don’t, won’t.”
Carla Shatz
fetal REM sleep
(or active sleep) seems to be
particularly important
to the developing organism
... spontaneous
synchronous firing
Marks et al 1995
Panksepp 1998
Siegel 2005
Non-REM 4

4. 4
REM
NR1
NR2
NR3
NR4
ACQUISITION CONSOLIDATION MEMORY
FORMATION
poly-sensory input transfer information P waves
short-term memory “SNR” strong signals returns info
stored cortex amygdala / to neocortex:
hippocampus organized
Awake and REM NREM stage 4 REM
BRAIN WIRING
Stanley Graven 2006
BRAIN WIRING
Peirano 2003
When does
the infant
become
conscious? Noradrener-
gic neurons
from locus
coeruleus may
activate the
whole brain
during
wakefulness
Awake at birth
AT BIRTH,
the brain has
TWO
CRITICAL
SENSORY
NEEDS:
SMELL & CONTACT
connect direct to the amygdala
THE
NEWBORN
BRAIN
SKIN-TO-SKIN
CONTACT
fires and wires
the amygdala-prefronto-orbital
cortical pathway (PFOC)
AMYGDALA:
Emotional
Processing
Unit
Prefrontal cortex
Executive
function
approach / avoid

5. 5
AMYGDALA:
Emotional
Processing
Unit CPU
Prefrontal cortex
Executive
function
SOCIAL and EMOTIONAL
INTELLIGENCE
SOCIAL EMOTIONAL
INTELLIGENCE INTELLIGENCE
Behavioural
activation system
reward-based
(dopamine)
In humans, oxytocin increases gaze to the
eye region of human faces and enhances
interpersonal trust and the ability to infer
the emotions of others from facial cues.
Interpersonal
awareness
Emotions
Kerstin
Uvnas-Moberg
Ross 2009

6. 6
Smell
Skin contact
The BOND
is made up of the
sensory inputs
from the parent
to the infant
REGULATION
Bowlby 1969, 1973, 1980
Through “hidden maternal regulators” ...
warmth  activity level
milk  heart rate
“ physiological set points “
internal working models
scripts – templates

7. 7
a mother precisely controls every
element of her infant’s physiology,
from its heart rate to its
release of hormones
from its appetite to the
intensity of its activity
(Gallagher 1992)
Through “hidden maternal regulators” ... Clinics in Perinatology,
June 2004, Vol 31(2) page 210
Stanley Graven
Early neurosensory visual
development of fetus and newborn.
“It is a serious mistake to assume that the
principles derived from careful animal studies
do not apply to human infants.
The risk of suppression or disruption of
needed neural processes ...
is very significant and potentially lasts a life time.
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Brain
EPIGENETICS
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
“needed neural
processes”
SEPARATION DYSREGULATES
CORTISOL
MICHAEL MEANEY
Unsafe environment activates HPA
axis (autonomic nervous system, ANS).
“In response to stress, CRF
… and vasopressin are
released … anterior pituitary
… synthesis release ACTH
…glucocorticoids  ”
CORTISOL

8. 8
HG BABY HG BABY
LOW Grooming care
HG - High Grooming Low Grooming LG
HG BABY LG BABY
MOTHER MOTHER
Healthy UNHEALTHY
adult adult
HG – High Grooming Low Grooming - LG
Makes MOTHER Makes MOTHER
UNHEALTHY
adult
LOW Grooming LG
Makes MOTHER
CORTISOL
LG BABY LG BABY
HIGH grooming care
HG - High Grooming Low Grooming LG
HG BABY LG BABY
MOTHER MOTHER
Healthy UNHEALTHY
adult adult
HG – High Grooming Low Grooming - LG
Makes MOTHER Makes MOTHER
HEALTHY
adult
HIGH Grooming HG
Makes MOTHER
HG – High Grooming Low Grooming - LG
Makes MOTHER Makes MOTHER
HEALTHY
adult
HIGH Grooming HG
Makes MOTHER
Earliest care
at birth matters
Same gene  switched
LG BABY LG BABY
HIGH grooming care
Primate separation studies
Maternal Separation Paradigm
Early Deprivation (ED) vs control (CON)
0d 2d  28d   48w
ED n 11 Mat 30 -120 min daily 
CON n 4 Mat       48w
Repeated short
separations:
LOW gene expression
Correlate to human adult depression
CORTISOL

9. 9
Allostasis the mechanism by which
homeostatic systems are maintained in balance …
Allostatic state elevated activity of mediators,
with return to baseline and no impact on health.
Allostatic load elevated activity –
sustained over time, or severe …
 changes target cells of mediators,
and so changes the “set points” for homeostasis
(e.g. increasing blood pressure,
change in cholesterol level)
BRUCE McEWEN allostasis
 RESILIENCE / SENSITIVITY 
PERCEPTIONS
“NEUROCEPTION”
RESPONSESTRESS
ALLOSTATIC STATE
ALLOSTASIS
Psychological
Neurological
Endocrine
Immune
HEALTH DISEASE
ALLOSTATIC LOAD
ALLOSTATIC OVERLOAD
WELL-BEING  SUSCEPTIBILITY  MORBIDITY  MORTALITY
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
SPECTRUM of expression in POPULATION
HEALTH DISEASE
“Scientific foundation” … a synthesis
The Brain
EPIGENETICS
EXPECTED UNEXPECTED
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
SPECTRUM of expression in POPULATION
HEALTH DISEASE
“Scientific foundation” … a synthesis
Platform for better understanding of PUBLIC HEALTH.
… policy and practice that impacts the care of mothers and babies.
The Brain
EPIGENETICS
EXPECTED UNEXPECTED

10. 10
Positive Stress
•Moderate, short-lived stress responses, such
as brief increases in heart rate or mild changes
in stress hormone levels.
•An important and necessary aspect of healthy
development that occurs in the context of
stable and supportive relationships.
Slide by: Jack P. Shonkoff, M.D.
Under-
activity
EUSTRESS
Over-
activity
Positive Stress
= Eustress
• An important and necessary
aspect of healthy development
that occurs in the context of
stable and supportive relationships.
Tolerable Stress
• Stress responses that could disrupt brain
architecture, but are buffered by supportive
relationships that facilitate adaptive coping.
• Generally occurs within a time-limited period,
which gives the brain an opportunity to recover
from potentially damaging effects.
Slide by: Jack P. Shonkoff, M.D.
JACK SHONKOFF
“Buffering protection
of adult support”

11. 11
The basic
science of
pediatrics.
Shonkoff J P et al.
Pediatrics 2012;
129:e232-e246
©2012 by American Academy of Pediatrics
2 … advances in the biological sciences underscore the foundational
importance of the early years and support an EBD framework for understanding
the evolution of human health and disease across the life span.
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
3. The biology of early childhood adversity reveals the important role of toxic
stress in disrupting developing brain architecture and adversely affecting the
concurrent development of other organ systems and regulatory functions.
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
4 Toxic stress can lead to potentially permanent changes in learning ( … ),
behavior ( … ), and physiology ( … ) and can cause … higher levels of stress
related chronic diseases, …increase the prevalence of unhealthy lifestyles that lead
to widening health disparities.
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
MAKES POORER
Linguistic
Cognitive
Emotional
Adaption
responsivity
 unhealthy lifestyle
Chronic disease
health disparity
5. The lifelong costs of childhood toxic stress are enormous, … and
effective early childhood interventions provide critical opportunities
to prevent these undesirable outcomes and generate large economic
returns for all of society.
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
MAKES POORER
Linguistic
Cognitive
Emotional
Adaption
responsivity
 unhealthy lifestyle
Chronic disease
health disparity
MASSIVE
COST $$$$
6. The consequences of significant adversity early in life prompt an urgent call for
innovative strategies to reduce toxic stress within the
context of a coordinated system of policies and services guided by an
integrated science of early childhood and early brain development.
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
MAKES POORER
Linguistic
Cognitive
Emotional
Adaption
responsivity
 unhealthy lifestyle
Chronic disease
health disparity
MASSIVE
COST $$$$
REDUCE
TOXIC STRESS

12. 12
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
BERGMAN COMMENTARY – NEWBORN
Early years = early hours & days
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
BERGMAN COMMENTARY – NEWBORN
Maternal absence is TOXIC STRESS
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
MAKES POORER
Linguistic
Cognitive
Emotional
Adaption
responsivity
 unhealthy lifestyle
Chronic disease
health disparity
BERGMAN COMMENTARY – NEWBORN
For separated preterm newborns, we
have decades of evidence for this.
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
MAKES POORER
Linguistic
Cognitive
Emotional
Adaption
responsivity
 unhealthy lifestyle
Chronic disease
health disparity
MASSIVE
COST $$$$
BERGMAN COMMENTARY – NEWBORN
even more massive ??
EARLY YEARS  LIFE SPAN
Learning
Behavior
Physical well being
Mental well being
TOXIC
STRESS
EARLY LIFE
ADVERSITY
MAKES POORER
Linguistic
Cognitive
Emotional
Adaption
responsivity
 unhealthy lifestyle
Chronic disease
health disparity
MASSIVE
COST $$$$
REDUCE
TOXIC STRESS
BERGMAN COMMENTARY – NEWBORN
Reducing toxic stress IS VERY EASY !!
Skin-to-Skin
Contact
Attachment
Bonding
Breast-
feeding
Regulation

13. 13
An ecobiodevelopmental framework for early childhood policies and programs.
BERGMAN COMMENTARY – NEWBORN
Reducing toxic stress IS VERY EASY !!
Attachment
Bonding
Breast-
feeding
Skin-to-Skin
Contact
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
SPECTRUM of expression in POPULATION
EXPECTED   UNEXPECTED
HEALTH DISEASE
“Scientific foundation” … a synthesis
Platform for better understanding of PUBLIC HEALTH.
… policy and practice that impacts the care of mothers and babies.
The Brain
EPIGENETICS
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Brain
EPIGENETICS
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
“buffering protection
of adult support”
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Brain
EPIGENETICS
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
“needed neural
processes”
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Brain
EPIGENETICS
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
“except in the light of
mother’s body.”
NEUROSCIENCE
The DNAEverything else
EVOLUTIONARY
BIOLOGY
The Brain
EPIGENETICS
The Place
ENVIRONMENT
EXPERIENCEFITNESS ADAPTATION
“Scientific foundation” … a synthesis
ZERO SEPARATION

14. 14
EVOLUTIONARY
BIOLOGY,
EPIGENETICS,
NEUROSCIENCE
THE SCIENTIFIC AND
EVIDENCE BASIS FOR
SKIN-TO-SKIN CONTACT
HABITAT
MATERNAL
MOTHER
OTHER
ALTERNATE
AM I SAFE HERE ??
MATERNAL DEPENDENCE
HABITAT NICHE
BREAST-
MOTHER FEEDING
OTHER PROTEST-
DESPAIR
SAFE ?  YES
SAFE ?  NO
BREAST- VAGAL
MOTHER FEEDING (PSNS) GROWTH
OTHER PROTEST- STRESS SURVIVAL or
DESPAIR (SNS)
SKIN-TO-SKIN CONTACT
SEPARATION
THE PLACE MODEL
The PLACE MODEL
 scientifically derived
 alternative approach
 falsifiable/testable hypothesis
PERINATAL NEUROSCIENCE
& SKIN-TO-SKIN CONTACT
Reference
RCT of skin-to-skin contact from birth
versus conventional incubator care
for physiological stabilisation
in 1200- and 2199-gram newborns.
Bergman NJ, Linley LL, Fawcus SR.
Acta Paediatrica 2004
Vol 93(6); 779-785
Bergman et al 2004

15. 15
Primary hypothesis
SSC (skin-to-skin contact)
from birth is superior
to incubator care for
low birthweight infants
ONLY PLACE DIFFERS
Bergman et al 2004
Results
Minimisation technique
ensured groups balanced
for confounders.
( n = 34) SSC CMC
Mean weight 1813g 1866g
Mean GA 34.2w 35.3w
Approp’ GA 65% 64%
Male 60% 50%
(p 783)
Bergman et al 2004
BAILOUT points ….
“physiological parameters exceeding normal
limits, requiring medical assessment and or
intervention”
1 Skin temp consistently <35.5oC
2 Heart rate <100; or > 180 bpm
3 Apnoea longer than 20 seconds
4 O2 sats below 89% (x2), (CPAP/60% O2)
5 Blood glucose < 2,6mmol/l, (laboratory)
Bergman et al 2004
INSTABILITY H1b (SPECIFIC)
Doctor Stable
summoned: .
INCUBATOR 92% 8%
SKIN-TO-SKIN 17% 83%
Bergman et al 2004
BREAST- VAGAL
MOTHER FEEDING (PSNS) GROWTH
OTHER PROTEST- STRESS SURVIVAL or
DESPAIR (SNS)
SKIN-TO-SKIN CONTACT
SEPARATION
THE PLACE MODEL
8% “STABLE”
83% “STABLE”
SCRIP
SCORE
2 1 0
Heart rate Regular Deceleration
to 80-100
Rate <80 or
>200 bpm
Respiratory
rate
Regular Apnoea <10s,
or periodic
breathing
Apnoea >10s
Tachypnoea
>80 pm
Oxygen
saturation
Regular >87% Any fall to 80
– 87%
Any fall below
80%
“Stability of Cardio-Respiratory system In Preterm Infants”
Score allocated for a five minute period of
continuous observation, maximum six for period
Fischer et al, 1988 STABILITY

16. 16
“100% SCRIP STABILIY”
S S C C M C
1200g to
2200 g
1 - 6h 56% 11%
@ 6h 100% 46%
BREAST- VAGAL
MOTHER FEEDING (PSNS) GROWTH
OTHER PROTEST- STRESS SURVIVAL or
DESPAIR (SNS)
SKIN-TO-SKIN CONTACT
SEPARATION
THE PLACE MODEL
46% STABLE
100% STABLE
“100% SCRIP STABILIY”
S S C C M C
1200g to
2200 g
1 - 6h 56% 11%
@ 6h 100% 46%
1200g to
1800g
1 - 6h 44% 0%
@ 6h 100% 25%
Stabilisation first 6 hours, average hourly SCRIP score
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
6
6.1
2nd 3rd 4th 5th 6th
KMC all
KMC <1
CMC all
CMC <1
Hourly average of SCRIP score, 2nd to 6th hour
Stabilization 1200g – 1800g
Skin-to-skin
Incubator
BREAST- VAGAL
MOTHER FEEDING (PSNS) GROWTH
OTHER PROTEST- STRESS SURVIVAL or
DESPAIR (SNS)
SKIN-TO-SKIN CONTACT
SEPARATION
THE PLACE MODEL
DYS-REGULATION
STABILISATION
SEPARATION DYSREGULATES
CORTISOL

17. 17
INCUBATORS
DE-STABILISE
NEWBORNSStabilisation first 6 hours, average hourly SCRIP score
5.1
5.2
5.3
5.4
5.5
5.6
5.7
5.8
5.9
6
6.1
2nd 3rd 4th 5th 6th
KMC all
KMC <1800
CMC all
CMC <1800
Premature babies are
not in incubators because
they are unstable.
Premature babies
are unstable because
they are in incubators.
The Relation of Early Mother-Infant
Skin-to-Skin Contact
to Later Maternal Sensitivity
in South African Mothers
of Low Birth Weight Infants
Ann E. Bigelow, et al (in press IMHJ)
From Bergman et al 2004 RCT
SSC time first 24 hr correlated
with SSC time first month.
0
5
10
15
20
25
-0.2 0 0.2 0.4 0.6 0.8 1
Maternal Behavior Q-Sort
HoursofSSCinInfants'First24Hours
Maternal behaviour Q Sort
Predicts attachment security
NCATS ( Nursing Child Assessment
Teaching Scale )
Predicts subsequent cognitive outcome
0
5
10
15
20
25
25 27 29 31 33 35 37 39 41 43 45
Maternal Behavior Subscale of the NCATS
HoursofSSCinInfants'First24Hours
A mother and baby
DYAD
are a single
psychoneurobiological
organism

18. 18
BONDING (Bergman mini-model)
Birth experience:
Sensations  hormonal changes
 neural circuits
LIMBIC PLATFORM
MATERNAL
SENSITIVITY
Early life experience:
Neural circuits 
emotional & social intelligence
CORTICO-LIMBIC CIRCUITRY
ATTACHMENT
BONDING
MATERNAL SENSITIVITY
… this suggests that VD mothers are more sensitive
to own baby-cry than CSD mothers in the early
postpartum in sensory processing, empathy, arousal,
motivation, reward and habit-regulation circuits.
The results of this study show that
attending to own baby-cry evokes
a unique pattern of neural
responses in VD mothers as
compared to CSD mothers in the
early postpartum..
BONDING (Bergman mini-model)
Birth experience:
Sensations  hormonal changes
 neural circuits
LIMBIC PLATFORM
MATERNAL
SENSITIVITY
Early life experience:
Neural circuits 
emotional & social intelligence
CORTICO-LIMBIC CIRCUITRY
ATTACHMENT
BONDING
SEPARATION
VIOLATES
THE INNATE AGENDA
OF MOTHER
AND NEWBORN
SSC 83%
MIS 8%
NORMAL
Perceived HARM:
NO YES
SSC 17%
MIS 92%

19. 19
PRIMUM NON NOCERE
TOXIC STRESS ??
HARM ?
evolutionary survival machine
ANS
HRV
EEG BAS
autonomic
upstream
autonomic MEDIATOR
downstream
ANDERSON BEHAVIOURAL STATE SCALE
12
11 Crying
10 Fussing
9 Active
8 Breastfeeding
7 Alert Awake
6 Quiet Awake
5 Drowsy
4
3 Active Sleep
2 Irregular Sleep
1 Regular / Quiet Sleep
PLACE convention
4 Breastfeeding
3 Holding
2 MIS (Cot)
1 SSC (Skin-to-skin)
HRV produces IBI
(Inter Beat Interval)
FFT / AR / wavelet
• social vagus (validated)
• sympathetic (accepted)
• “old vagus” (our hypothesis)
D
V
C
V
V
C
S
N
S
Skin-to-skin contact
= *NORMAL* PLACE
Babies 2 days old
SSC vs MIS, 1hr
Skin-to-skin contact
= *NORMAL* PLACE
SEPARATE
176%
Increase
Autonomic
activity
SEPARATE
86%
Decrease
Quiet Sleep

20. 20
SLEEP CYCLE - Neurodevelopment
Peirano 2003
BREAST- VAGAL
MOTHER FEEDING (PSNS) GROWTH
OTHERPROTEST- STRESS SURVIVAL or
DESPAIR (SNS)
SKIN-TO-SKIN CONTACT
SEPARATION
Higher state arousal
Normal sleep cycling
Separated neonates experience
disturbed sleep cycling: instead
FREEZE & DISSOCIATION.
NEURO PHYSIOLOGY
of SEPARATION
Maternal separation may be
a stressor the human neonate
is not well-evolved to cope with,
and may not be benign.
Maternal separation may be
a stressor the human neonate
is not well-evolved to cope with,
and may not be benign.
NILS’ TRANSLATION:
MATERNAL SEPARATION
IS TOXIC STRESS !!
NO
INCUBATORS
DE-STABILISE
NEWBORNS
TRUE or FALSE ?

21. 21
INCUBATORS
DE-STABILISE
NEWBORNS
1. FALSE
2.
3.
INCUBATORS
DE-STABILISE
NEWBORNS
1. FALSE
2. TRUE
3.
INCUBATORS
DE-STABILISE
NEWBORNS
1. FALSE
2. TRUE
3. DON’T KNOW
www.skintoskincontact.com
INTRODUCTION
“It is easier to build strong children
than to repair broken men.”
Frederick Douglass (1817–1895)
PERINATAL NEUROSCIENCE
and SKIN-TO-SKIN CONTACT