THE INTERACTION BETWEEN THE INFANT AND THE ENVIRONMENT: THE IMPORTANCE OF MOTHER-CHILD CONTACT AFTER DELIVERY

Abstract. Birth is more than just the physical beginning of a new life — it is also the start of the psychosocial development of the newborn infant together with its family. Immediately after delivery parents and infants can start to exchange signals that maybe are of major importance for this development. The early post partum period has been regarded to have great potentials and especially the mother has been regarded to play a very powerful role, whereas the infant's contribution has been accorded little discussion. The individual reactive capacity of the newborn baby and its influence on the environment can be illustrated in a number of ways. In recent years studies of fetal movements have been made by means of ultra sound registration and it has been discussed whether these are precursors of later behavior in the neonate-infant. The transition at birth can be considered either to be continuous or discontinuous, the outcome of this discussion has great bearing on the importance of early neonate-environment interactions.
Short and long term outcome of different routine care procedures around the time of delivery and transition are controversial subjects. Although several studies support the importance of early post delivery interaction, other studies do not seem to find correlations between early experiences and later developmental outcome measurements. In this paper several of these aspects will be discussed, examples from the literature given and possible clinical applications suggested, as well as their impact on the care of healthy and sick newborns and their families.     

THE EFFECT OF ANTEPARTUM HAEMORRHAGE ON THE HEALTH OF THE CHILD*

In this prospective study the infants born to mothers who suffered an antepartum haemorrhage after the 28th week of pregnancy were matched with a control series. The neonatal mortality and morbidity and later assessment at 6 weeks and 2 years of age regarding their general maturity were compared.     

THE MUCOSAL IMMUNE RESPONSE IN THE NEONATE

Hanson LÅ, Brinton C, Carlsson B, Dahlgren U, Mellander L, Sutton A and Söderström T. (Departments of Clinical Immunology and Paediatrics, University of Göteborg, Sweden, Bureau of Biologies, FDA, Bethesda, and Department of Life Sciences, University of Pittsburg, USA). The mucosal immune response in the neonate. Acta Paediatr Scand, Suppl. 296:53, 1982. — Human infants are relatively deficient in the IgA system defending mucosal membranes, but are provided via the maternal milk with considerable amounts of SIgA directed against microbes and food antigens to which both mother and infant are exposed. It is possible that serum antibodies may support the mucosal defense as do the lactoferrin, lysozyme and other defense factors present in the milk.     

THE INFLUENCE OF THE PLACENTAL TRANSFUSION ON THE CAPILLARY BLOOD GAS AND ACID-BASE BALANCE IN THE NEWBORN INFANT

Of 77 normal newborns, 42 were clamped early while 35 were clamped late. Using capillary blood from an unwarmed heel, the hema-tocrit and the acid-base balance of the two groups were compared. During the first day of life the hematocrit of late-clamped newborns was fairly constant and higher than that of early-clamped babies, the latter showing a definite fall 2–24 hours after birth. Regarding the acid-base balance, no difference was found between the two groups of newborns except when measurements were performed 3–5 hours after birth. At this time actual pH and standard bicarbonate were lower in late-clamped babies than in early-clamped, while P_CO2 was identical. On the basis of the hematocrit findings it is proposed that the placental transfusion, by creating oedema of the interstitial space, may contribute to the well known discrepancy between the acid-base status of the capillary and the arterial blood of the newborn.