Caring First for the Littlest: Caregiver Touch and a Revolution of the Heart
Original illustration by Brian Faulkenberry, The Southpaw Collective
by Sofia Carozza
As a species, human beings are uniquely helpless during the first years of our lives. Over the course of evolution, as our human brain grew magnificently large and complex, its development extended further and further into the years after birth. As a result, even the experiences that a child has early in life shape her neural structure and function. An environment rich in stimulation and in care creates strong brain architecture, while an environment of deprivation limits learning and growth.
No feature of a baby’s early environment is more important than her relationships. Through a cascade of hormonal and neural signals, the loving care of the adults in her life – the smile baby sees, the babbling she hears, the cuddling she receives when she cries – fosters the development of her brain and body.
“No feature of a baby’s early environment is more important than her relationships. Through a cascade of hormonal and neural signals, the loving care of the adults in her life – the smile baby sees, the babbling she hears, the cuddling she receives when she cries – fosters the development of her brain and body. ”
In the past few decades, public health messaging has shifted to reflect this reality, encouraging parents to “talk with your baby!” or “play with your baby!” But the current discourse on infant health consistently omits one essential feature of the early interactional landscape: affectionate touch. This oversight is a loss for all of society, because recent findings from neuroscience suggest that a caregiver’s loving touch is a powerful determinant of child flourishing.
Touch is the very first sensation that an infant experiences. A mere two months into pregnancy, the growing fetus reacts to skin contact with the umbilical cord or his own hands, and from the start, this touch is a pleasant feeling that he prefers to receive on the sensitive skin of his face and feet. Furthermore, the fetus responds with distinctive patterns of movement when his mother touches her abdomen, making touch the first means of intentional interaction between the pair. This points to an essential role for touch in the life of every infant: it is the bedrock on which communication is built.
Psychology research suggests that the self-awareness of the infant begins with the feeling of touch. By alerting the infant to the fact of her embodiment, touch allows the baby to discover her agency in the world. And her own self-awareness, in turn, opens the door to gaining awareness of others and beginning to communicate with them. A wide range of evidence supports the idea that touch lies at the origin of the social nature of the human person. For instance, infants whose parents touch them more often during playtime pay better attention to social cues, while a mother’s gentle stroking enables younger infants to recognize faces. Even the infant’s neurobiology expresses this reality, as maternal touch leads to stronger activity and interconnections between brain regions that are involved in social understanding. Given that relationships are the greatest determinant of resilience across the lifespan, early touch sets the stage for a lifetime of health.
But the effects of touch do not stop on the level of psychology. As touch communicates the presence of the mother to her infant, it has deep and far-reaching effects on the internal physiology of the child. Consider, for instance, the stress response. The brain triggers this intricate set of biological processes when it detects a possible threat in the environment. Just like the gas pedal of a car supplies fuel and air to the engine to speed it up, the stress response increases blood flow and breathing and slows down digestion to prepare the body to defend itself through “fight or flight.” But if the stress response is engaged too much or for too long, it leads to excessive inflammation throughout the brain and body. This takes a toll on mental and physical health. Instead, the stress response needs to be kept in balance with parasympathetic tone, a specific message in the nervous system that stimulates growth and repair processes, allowing the body to “rest and digest.” The risk of chronic or acute stress is particularly pronounced in early childhood, when the body has yet to learn how to maintain its own balance.
This is where caregiver touch comes into play. Research shows that when a mother holds or cuddles her crying baby, she shuts down the activity of the stress response and turns up parasympathetic tone, not only alleviating the child’s momentary distress but leading the child’s body to grow and heal. In fact, interventions that introduce skin-to-skin contact between a mother and her infant are proven to increase the child’s weight gain, stabilize her heart rate, and protect her against infection; positive effects on her cognitive and physical health remain over a decade later. While most research has focused on the touch of a mother, studies suggest that skin contact with other adults similarly benefits an infant. The embodied act of a caregiver’s love can set a child up for a lifetime of flourishing.
If loving touch is such an essential feature of a child’s landscape of experience, it could be a powerful accelerator for children’s health across society. But in order to get there, we need to learn three essential lessons from the research.
First, neuroscience research specifies exactly which form of caregiver touch is most effective: affectionate touch, which involves gentle stroking and holding. The speed, pressure, and temperature of affectionate touch trigger the activity of a unique kind of nerve in a child’s skin called C tactile afferents. Not only do these nerve fibers produce positive feelings of connection and pleasure, but they also actually lead to higher levels of oxytocin, the hormone known for its powerful role in social bonds and holistic health. Strikingly, research shows that parents instinctively touch their children – and adults their romantic partners – in a way that optimally activates these neural fibers. Human beings are wired to communicate well-being through loving touch.
Research on caregiver touch also tells us when it is most beneficial: during the neonatal period. For decades, the excessive medicalization of childbirth deprived women of the chance to hold their newborn after birth, but recent developments in medical practice now respect the importance of these sacred hours. In particular, many hospitals across the world now use an intervention known as kangaroo care, in which the neonate is placed on the bare chest of his mother for skin-to-skin contact and nursing. The effects on maternal and infant health are astounding. And if the mother is not available, fathers, family members, and even strangers can step in to provide the newborn with skin-to-skin contact. But kangaroo care is still far from standard practice, as many healthcare facilities face barriers such as time constraints and a lack of training. Establishing the universal practice of kangaroo care is a key step toward child health.
Finally, research also shows that children continue to need interactions involving affectionate touch throughout the first years of their lives. Well beyond the neonatal period, caregivers should consistently cuddle and hold their infants, acts of love that nourish the nervous system just as food nourishes the body.
“Research and public policy must be the tools of a broader social transformation: we must begin to esteem embodied caregiving as one of the highest acts any human person can do for another. Only such a revolution of the heart can fill our society with tenderness, teaching us to embrace our mutual interdependence and care first for the needs of the littlest in our midst. ”
Thus, if children are to be given a foundation of health, public policy must place families first. Employers and legislators alike should support a wide range of measures that would enable parents to care for their young children, from family leave policies to a just wage, from nurse-family partnerships to accessible health care. Governments should pay particular attention to children who are at risk of being deprived of this form of love, such as those who live in group homes or face long-term hospitalization. Through education on the importance of loving touch, and support for safe and appropriate ways of providing this touch, we can work toward achieving justice and securing the flourishing of all children.
But of course, research and public policy must be the tools of a broader social transformation: we must begin to esteem embodied caregiving as one of the highest acts any human person can do for another. Only such a revolution of the heart can fill our society with tenderness, teaching us to embrace our mutual interdependence and care first for the needs of the littlest in our midst. Only such a revolution will allow the full realization of the extraordinary neurobiological reality of a parent’s loving touch.
For further reading:
5 questions with Sofia Carozza (August 2019)
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Sofia Carozza is a Ph.D. student in neuroscience at the University of Cambridge. Her academic paper with Victoria Leong on the role of caregiver touch in early neurodevelopment and parent-infant interactional synchrony will soon be published in Frontiers of Neuroscience (preprint). Sofia is a graduate of the University of Notre Dame, where she studied neuroscience and theology as a Hesburgh-Yusko Scholar and was the valedictorian of the class of 2019.