Touch is now recognized as a stand alone contributor to a young child’s healthy development. Aside from providing comfort and security, touch has also proven to be fundamental to the social and physical development of the infant. Such findings have wide implications for health-promotion programs and for managing costs of early infant care.
Prematurity is a serious concern for the health and survival of newborns as it often leads to prolonged hospital care. Given the financial restrictions experienced by health care systems, there is an urgent need for government officials to find inexpensive ways of treating young infants. Recent research suggests that one simple solution might be increased physical contact.The importance of physical contact for infants has long been limited to its indirect association with activities deemed necessary for the infant’s survival, such as breastfeeding. Infants fed by their mothers were thought to associate with the enjoyable sensation of satisfying hunger. It was not until the middle of the 20th century that physical contact between a mother and a child became recognized as an independent contributor to infant development.
In 1958, Harry Harlow and his infant rhesus monkeys revolutionized scientific ideas about the role of touch (1). In his now classic work entitled The Nature of Love, Harlow examined the preference of infant monkeys for two surrogate mothers made out of wire frames. One of the surrogate mothers provided the infant monkeys with food from a nipple-like structure, while the other mother was covered with a soft cloth but offered no opportunity for feeding.
Figure 1 :Infant rhesus monkey with the ‘feeding mother’ (left) and cloth covered ‘soft mother’ (right) (2). Courtesy of Harlow Primate Laboratory
Contrary to expectations, the infant monkeys spent more time with the “soft” mother than with the feeding surrogate mother. Moreover, when the “soft” mother was not available and the infants were subjected to a stressful event such as a loud noise or an electronic toy, the monkeys still did not seek the bare-wire feeding mother. These findings suggest that soft physical contact may directly impact a young infant’s sense of security, which in turn allows the development of healthy coping strategies in times of acute distress. Harlow’s research created a vast interest in the potential benefits of touch for humans. In addition to comfort and emotion regulation, touch has been portrayed as a communication tool to be used by parents with their preverbal baby (3). Gentle contact or a hug, for instance, may signal to the infants that they are in safe hands.
In general, research has illustrated that infants smile more frequently during physical play than during any other form of play involving parent-child interactions (4). Their enjoyment has also been shown to be reciprocated by parents. Fathers, who are given a one-month baby massage training, report greater involvement with their infants than fathers, who do not receive such training (5). Additionally, touch has also been shown to affect the physical growth of infants. For example, in healthy newborns, one daily massage during the first month of life has been associated with accelerated weight gain (6). This is especially true when the massage involves moderate tactile pressure as compared to light pressure or vibratory stimulation. Infants receiving moderate pressure massages also show a more pronounced decrease in stress compared to children receiving other types of tactile stimulation.
These beneficial consequences have important health implications for high-risk infants. Researchers have studied the effects of massages in premature infants of mothers addicted to cocaine (7). For 10 days, half of the babies were exposed to regular care (control group) while the other half received 15-minute massages three times a day. The results were stunning: infants who received the massages gained 28% more weight than the control group and had less health-related complications. So far, benefits related to physical contact seem to be restricted to early developmental stages. Little is known about long-term consequences of touch during infancy. Hopefully future studies will begin to address this by means of a longitudinal study.
Touch Deprivation in Infancy
If the amount and quality of touch is important for optimal infant development, the complete absence or limitation of touch, on the other hand, could be individually and collectively harmful. Conducting controlled studies on touch deprivation poses significant ethical problems and evidence of its negative impact comes mostly from case studies and correlational research. For instance, according to some scientists, cultures that show little physical affection to their young children exhibit higher rates of adult violence than cultures for which physical contact with children is common place (8).
The unfortunate reality of overcrowded orphanages provides indirect support for the negative impact of touch deprivation. Recently, researchers observed the development of infants raised in orphanages where the ratio of care providers to infants was low (9). While infants were appropriately fed, most often they were left alone in their cribs with minimal or no physical contact with the care providers. These children suffered from severe delays in physical growth and neurobehavioral development, and elevated rates of serious infections. Although these case studies suggest a link between tactile deprivation and developmental delays, findings should be interpreted with caution as several other factors may have had an impact on development. For instance, these orphans were unable to form a close relationship with a primary caregiver and they did not have access to important resources such as proper hygiene and stimulating environments. Although it is possible that the absence of touch led to poor developmental outcomes in these babies, the role of other important factors should not be ignored?
Overall, touch seems to have important implications for the physical, social and emotional growth of infants, and deserves to be highlighted in parenting programs and in health promotion plans. More specifically, physical contact could be incorporated in the treatment of premature infants. Physical contact could accelerate the recovery process of these newborns, and consequently reduce the hospital costs associated with their health care. Parent training in infant massages should also be considered by health care systems to promote infant health development, and to foster positive parent-child interactions. In the end, giving a hug is a simple and easy act with far reaching benefits in the early stages of life.
(1) Harlow, Harry F. “The Nature of Love.” American Psychologist 13.12 (1958): 673-685.
(2) Harlow Primate Laboratory, University of Wisconsin, Madison. The Adoption History Project. Harry F. Harlow Love Experiments 30 June 2007 <http://darkwing.uoregon.edu/~adoption/studies/HarlowMLE.htm>
(3) Field, Tiffany M. Touch in Early Development. Hillsdale: Lawrence Erlbaum Associates, 1995.
(4) Dickson, Laurie K., Walker, Heather, and Fogel, Alan. “The Relationship Between Smile Type and Play Type During Parent-Infant Play.” Developmental
Psychology 33.6 (1997): 925-933.
(5) Cullen, Christy, Field, Tiffany, & Escalona, Angelica. “Father-Infant Interactions are Enhanced by Massage Therapy.” Early Child Development and Care 164. (2000): 41-47.
(6) Field, Tiffany, Hernandez-Reif, Maria & Diego, Miguel. “Massage Therapy by Parents Improves Early Growth and Development.” Infant Behavior &Development 27.4 (2004): 435-442.
(7) Wheeden, Abigail, Scafidi, Frank A. & Field, Tiffany. “Massage Effects on Cocain-Exposed Preterm Neonates.” Journal of Developmental & Behavioral Pediatrics 14.5 (1993): 318-322.
(8) Herzberg, Leonard J., Gene F. Ostrum, and Joan Roberts Field. Violent Behaviors–Assessment and Intervention (Vol. 1). New York: PMA Publishing, 1990.
(9) Albers, Lisa H. Johnson, Dana E., and Hostetter, Margaret K. “Health of Children Adopted from the Soviet Union and Eastern Europe: Comparison with Preadoptive Medical Records.” Journal of the Medical Association 278.11 (1997): 922-924.
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