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The science of nurturing and its impact on premature babies
One of the great medical advances in recent years is the treatment and care of premature babies. Despite that, these tiny infants born before full term are still at higher risk for a range of problems down the road.
Correspondent William Brangham and producer Jason Kane bring us the first of two stories about a study under way that's testing whether the simplest human interactions can make a big difference in these children's lives.
Most moms don't have to travel 25 miles every morning to see their newborn baby. But for Kate Ilie, there's an hour-long commute … frantic calls …
I would rather just meet in the unit, if we're allowed to.
… Manhattan gridlock. All to do the one thing she most desperately wants: to be with her baby girl Caroline.
MARY MCKIERNAN, Nurture Specialist:
All right, Caroline, so we are going to reconnect with Mommy now.
But, as you can see, Caroline had a rough path into the world. Born 13 weeks too soon, she's had to live here, in Morgan Stanley Children's hospital, for months.
OK, now we're going to go skin-to-skin.
Kate and baby Caroline are part of an ongoing research effort out of Columbia University Medical Center and NewYork-Presbyterian examining whether the most basic nurturing techniques, like this quiet moment, can help heal the traumas of premature birth.
The more you do this, the more you reinforce that connection.
It took us a little while, but we're doing it now.
DR. MARTHA WELCH, Director, Columbia University’s Nurture Science Program:
You are calming me, and I am calming you, and then the two crave being together, and it's self-perpetuating.
This intervention is the brainchild of Dr. Martha Welch. She says that, while much of this seems like the standard care offered to premature babies and their parents, here, the focus is 100 percent on strengthening the emotional connection between mother and child.
DR. MARTHA WELCH:
It's not cerebral. It's visceral. It's gut feelings. And they're beginning to set this pattern of calming each other.
It seems so basic.
For the last few months, we have been following several moms and their premature babies through this process.
Neonatal intensive care units give these children a better shot at survival now than at any other time in history. In the early '90s, a child born as early as 23 or 24 weeks was unlikely to survive. Now they routinely do.
But, despite that, leaving the womb so early still puts these kids at high risk for emotional, behavioral and developmental challenges. This intervention is meant to help minimize those impacts.
You make Mama feel more comfortable now.
Nurse Mary McKiernan says step one is often connecting with a child that's literally wrapped in lifesaving technology. They call these 'Calming Sessions.'
MARY MCKIERNAN, Nurture Specialist, Columbia University’s Nurture Science Program:
There's so much medical equipment, and monitors, and beeping, and some mothers, they're afraid. They're afraid to speak to their babies.
I'm trying to figure out how to hold Caroline. She has her CPAP on. She has her tube in. This woman comes up to me, and she says, 'My name is Mary, and I'm a nurse here. Do you want me to help you hold your baby?'
And I could cry just telling this. So I was like, 'I will take anything.'
I know she's sleeping, but she can — she knows your voice, so talk to her in your emotional tone, as you always do.
You have had a long morning. You finished your whole bottle…
It feels good, right?
There's nothing better.
It's like therapy for both of us.
I'm telling you, that was the first time I felt like I could breathe, and I could bond with my baby.
For the first time?
Yes. And it was so emotional.
Welch and McKiernan say this is a step beyond what's known as 'kangaroo care,' the skin-to-skin contact that's been taught in many NICUs since the 1990s.
I have been a nurse here many years, but there was something missing. And what was missing was that … helping the mother to get to that emotional connection.
Take care of them for me, St. Jude.
Getting past her fear of losing her babies has been one of the biggest obstacles for Elia Cardenas.
Please help the nurses give them all the care that they need, so I can bring them home.
Her twin boys, Lukas and Tadeo, were born at 26 weeks — three-and-a-half months too soon. Her previous child had also been born prematurely, but he only lived a few hours. And she's terrified the twins won't survive either.
On my way home, I was crying the entire way. I wasn't planning on having them so early. And then, when I got home, it was even worse, because, you know, I had all these things for the babies ready.
Each day, Cardenas makes the hour-long trip to the hospital from her home in Port Chester, New York. But she's put up her own barriers.
It made me feel helpless. It made me feel — I didn't feel like a mom seeing them there. I didn't feel like they were my babies because they were in the hospital, and I didn't know if they were going to make it or not. And I really didn't want to get close with them. I didn't want to — I don't know. It's hard to describe that feeling.
Like everyone who was part of this intervention, Cardenas was also encouraged to talk with the boys, and taught how to hold them inside the incubators.
Dr. Welch will even put her hands on Cardenas' back and on her arm to mimic the touch and pressure she can use on the boys.
I was trying to elicit emotion from Elia. I was holding her back, so that she would feel the kind of comfort that I wanted her to convey to her baby. This is not a didactic session. It's experiential. She has to experience me and she has to experience what she's doing to the baby.
I'm trying to be here for them.
And you have been.
Yes. And I'm always scared.
Yes, and even though things are really good now, that feeling doesn't exactly go away.
No, it doesn't.
It will. It will go away.
Once the baby calms the mother, and the mother feels that, she begins to believe in the baby's survival capacity. Because, if this baby can make her feel like that, the baby's viable.
'We had eggs. After dinner, I told my dad a ghost story. Boy, did he get scared.'
Another mother in the study, Miguelina Tavarez, says she can't really explain why, but these simple interventions have had a powerful effect on her ability to connect with her daughter, Reylin.
I actually come in now, and I can take a deep breath and be like, 'I'm all right. And she's all right.' And then, in the long run, I will be like, 'You know what? Me and you have a trust besides a mother and a daughter bond. I can express myself to you, and you will appreciate it.'
Today, she's learning another part of the intervention: using what's known as a 'scent cloth.'
We have a little flannel square that the mother wears in her bra, which she then gives to the baby. And we put the same kind of cloth under the baby's head, and give that to the mother.
I felt like my whole body was relaxed.
How do you feel now when you smell it?
The same way. It's like …
Let all the stress drain out.
But do these interventions really make any tangible difference?
Tomorrow, we will examine some of the surprising results, and we will look at questions over some of Dr. Welch's past practices.
For the PBS NewsHour in New York, I'm William Brangham.
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William Brangham is a correspondent and producer for PBS NewsHour in Washington, D.C. He joined the flagship PBS program in 2015, after spending two years with PBS NewsHour Weekend in New York City.
Jason Kane is a PBS NewsHour producer, focusing on health care and national affairs.
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