Path: bloom-picayune.mit.edu!snorkelwacker.mit.edu!americast.com!americast.com!americast-post Newsgroups: americast.twt.life From: americast-post@AmeriCast.Com Organization: American Cybercasting Approved: americast-post@AmeriCast.com Subject: The laying on of hands Date: Tue, 10 Nov 92 15:13:22 EST Message-ID: \SE E;LIFE;WAY OF LIFE \SS (WS) \HD The laying on of hands \SH More tactile stimulation helps babies \BY Jack Williams \CR COPLEY NEWS SERVICE Just a second ago, she was as quiet as a daydream, 6 pounds, 12 1/2 ounces of rocked-solid contentment. Now, Kymberlee, eyes alert, mouth aquiver, nose askew, was emitting an enigmatic "Aaaeeh!" Beverly Franklin, a volunteer in the University of California at San Diego Medical Center's infant Cuddler Program, had heard this siren before. She switched Kymberlee from her left arm to her right. She caressed her with a soft voice. She applied ample love pats. And all was OK again with the world. The call to arms had been answered. In UCSD's Infant Special Care Center, where volunteers, nurses and parents hold and console infants in a Team TLC environment, contentment is only a symptom of success. Research tells us that the ultimate victory in touching and cuddling may be in helping premature babies and sick newborns such as Kymberlee - who was fighting a bacterial infection on this recent day - to grow and develop faster. They also may go home earlier. In a landmark 1982 study by Dr. Tiffany Field at the University of Miami, preemies who were massaged gained 47 percent more weight than those who weren't. They were discharged from the hospital six days earlier. The research involved specific techniques - fairly firm Swedish massage applied to premature infants in Dr. Field's work, and stroking and rubbing of rat pups in more recent studies by Dr. Saul Schanberg at Duke University Medical Center. There has been no significant research in "simple holding," says Dr. Field. "But we do know that the need for oxygen is reduced by laying on a hand." Dr. Schanberg says his studies showed that mimicking a mother's touch reversed the biochemical and hormonal changes that retarded the growth of rat pups deprived of their mothers. "We understand," says Dr. Schanberg, "that touch is an absolute requirement for normal growth and development [of humans and animals]. A sicker baby needs this more, but a normal baby does, too. "We've seen babies come into a hospital failing to thrive - with an illness called psychosocial dwarfism - who would start growing normally after a couple of weeks in a pediatric ward with TLC." * * * In the high-tech meets hands-on ambience of UCSD's Infant Special Care Center, 20 volunteer cuddlers work in four-hour shifts, one at a time, usually from 8 a.m. to 10 p.m. And always with the parents' consent. Part surrogate parents, part nurse's aides, part sanctuaries of security, they provide a human buffer against the tubes, incubators, ventilators, needles and digital sensors that can turn an infant intensive care unit into a house of horrors. "In the last six years, this approach has become more the norm," says Dr. Laurence Shaw, director of the Neonatology Intensive Care Unit at another hospital that recruits volunteer cuddlers, Palomar Medical Center in Escondido, Calif. "Babies seem to grow a lot better and, perhaps, mature faster. The way nursing is set up, there is less time to do the holding that's so advantageous for the baby, so volunteers kind of extend the quality of care. "When a child is incubated, hooked up to a ventilator, stuck with multiple lab tests, they respond better in a normal environment - which is what cuddling provides. It minimizes the invasiveness." The less agitated and intimidated a baby is, the better he can conserve calories vital to growth, say health professionals. When infants weigh 3 pounds or less - weights that usually require them to be in an incubator - every calorie counts. * * * Hoping to enhance the cuddling effect, UCSD's Infant Special Care Center invokes some other subtle touches. Among them: dimmed lights, noise control and balmy 75 degree temperatures. The effect is one of a human greenhouse, a protective cocoon designed to promote unobstructed healing and growth. "We know that when we reduce noise and light, we pick up comforting cues from the babies," says Janine Dubina, nursing supervisor in the UCSD Infant Care Center. "We also ask parents to record children's stories on tape whenever possible." In January, UCSD extended its 3 1/2-year-old Cuddling Program for premature infants to other babies in intensive care. More recently, it launched a snuggling program for healthy newborns whose parents may not be readily available. "We know from observing the preterm infants that the handling makes them quieter, more comfortable, less likely to be agitated - and there is a drop in the oxygen level of their blood, so they're able to utilize their calories for growing," says Ms. Dubina. Similar responses have been reported in other hospital neonatal intensive care units throughout San Diego and the rest of the country. Some have strict guidelines for formal volunteer cuddler programs. Some, on the other hand, informally enlist volunteers to rock and cuddle infants, as well as comfort older children who are hospitalized after surgery or for a variety of illnesses. * * * Wherever the venue, it's subtle cues and responses - not scientific studies - that tell cuddlers they're on the right track. "Preemies need a lot of talking to - the love you give in the voice and the closeness," says Beverly Franklin, 70, a UCSD Medical Center volunteer. "But each baby is different. You work until you find out what they want, then let the motherly instincts take over." A volunteer's instincts aren't always motherly, though. Says Ken Watson, 77, also a volunteer: "I go from one shoulder to the other, or maybe hold 'em on the crook of an elbow and talk to 'em, and just move around to find out their comfort zone. "There's a chemistry there, and when they leave - whether it's with their parents or if they don't make it - the void is like losing one of your own kids." Says Elena Hery, 49, a cuddler who spends most of her time with infants going through drug withdrawal: "The so-called rules you find in Dr. Spock or other baby-rearing manuals are not the only way to succeed. "Some of these drug babies are inconsolable. The challenge is to keep them calm so they will eat. What's scary about drug-addicted babies is that nobody's sure what works. You can't establish tried-and-true guidelines." Mrs. Hery, whose children are 21 and 23, read about volunteer cuddling in a Toronto hospital about eight years ago. She discussed offering similar care with the head of volunteer services at Sharp Memorial Hospital in San Diego, and within a few months Sharp had San Diego County's first volunteer cuddling program. * * * Recently, Sharp added another dimension: Kangaroo Care for preemies. It's a skin-to-skin approach involving visiting parents only, usually the mother. The warmth of her skin comforts the baby as she cuddles and breastfeeds. The techniques are based on therapy launched 13 years ago in Bogota, Colombia, said Mary Richards, a neonatal clinical nurse specialist at Sharp. "The babies seem to grow better this way," she said, "and a study at UC San Francisco indicated that mothers who didn't complete a full-term pregnancy felt that the physical closeness of Kangaroo Care was a way of completing the pregnancy." For all the benefits of hands-on attention, there are times when these carefully monitored infants are best left alone. After 15 minutes to an hour of being held, they have ways of getting the message across. "They'll blink their eyes rapidly, furrow their brow, start to cry," says Ms. Dubina. "Sometimes, all they need is for their arms and legs to be brought together." Volunteers are taught to respond to specific cues as part of the screening and orientation process. "I feel there's an art to this," says Ms. Richards. "Some things need to be taught, like a soothing tone to the voice and adding one stimulation at a time - not talking, jiggling and rubbing the baby all at once, for example. Maybe just talking. Or just holding." Basically, though, it comes down to instinct, says Mrs. Hery, the Sharp volunteer. "I think most people have it, if they're dealing with discomfort and suffering, and with motivation the skills will come." Along with the rewards. "I find it very satisfying to know I've made a difference in a baby's life," says Mrs. Hery. "Even if there's no one coming to see the baby, I've given it something that day to make it feel loved." This article is copyright 1992 The Washington Times. Redistribution to other sites is not permitted except by arrangement with American Cybercasting Corporation. For more information, send-email to usa@AmeriCast.COM