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Thursday, October 5, 2023

Baby colic: skin contact after birth protects the baby’s intestines

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They have been studied for a long time the positive effects of skin-to-skin contact between mother and baby immediately after birth. Now, in addition to confirming its effectiveness for the initiation and duration of exclusive breastfeeding, new Italian research is putting the spotlight on its benefits for the functionality of the newborn’s intestine.

This is the study carried out by the University of Bari in collaboration with the Neonatology of the San Giovanni di Dio Hospital in Melfi, led by Doctor Saverio De Marcawhich, for the first time in the world, emphasizes the protective role of this perinatal practice – two hours of immediate and uninterrupted contact skin to skin (skin to skin) between mother and baby – on «functional gastrointestinal disorders»in early childhood.

These include colic which, because of their spread and impact on the quality of family life, are a ‘slogan’ for many new parents. According to the new study, which will be presented by one of the authors, Dr Michela Casolinoat the XXX Congress of the Italian Society of Pediatric Gastroenterology (SIGENP) in Matera from September 28 to 30, simple skin-to-skin contact after delivery appears to halve the overall incidence of these conditions and protect two-thirds of babies from the risk of colic.

“The benefits of skin-to-skin contact are clear,” he says Mariella Baldassarre, associate professor of pediatrics at the University of Bari —. The results of this first study form the starting point for collecting further data on larger groups of patients. And it will be necessary to investigate and clarify the mechanisms by which this happens this practice counteracts the factors that cause functional gastrointestinal disorders and, in particular, colic.”

Colic: the terror of all new parents

The crises of crying inconsolably of the child, which are the most striking manifestation of this disorder a cause of great stress, anxiety and a sense of helplessness for mothers and fathersso much so that it represents a risk factor for postpartum depression and shaken baby syndromeIt is telling shaken baby syndrome by irritated adults who, in a clumsy attempt to comfort him, cause him serious harm. That also needs to be said a significant proportion of child visits in the first months of life – approximately 10-20% – are prompted by colic. Their heavy impact on the psychological well-being of the family is not surprising if we look at the way in which they occur: the little one turns red in the face, cries suddenly, uncontrollably and continuously, stiffens his arms and bends his legs, presents abdominal tension is often accompanied, but not necessarily, by gasThat is why colic is also called “gaseous”. In addition, these episodes concentrate in the evening hours, disrupting the rest of mothers and fathers. Beyond that, it’s about a fairly common condition, which can affect 20% to 30% of babies, usually between the ages of 2 and 4 monthsFortunately, it is benign (if there are no other symptoms or warning signs) and temporary, i.e. it tends to be self-limiting and then resolve spontaneously.

A disorder that needs to be investigated to find effective answers

New research has highlighted the protective role of early and long-term contact skin to skin mother-newborn after delivery compared withonset of functional gastrointestinal disorders, especially the well-known colic. But we must ask ourselves how this practice actually affects the underlying causes of the problem. “The etiopathogenetic factors of infantile colic that can be influenced are numerous – emphasizes Professor Mariella Baldassarre – and include the microbiota-brain-gut axis, intestinal epithelial barrier function, intestinal inflammation and motility, visceral hyperalgesia. But it must also be considered epigeneticsthat is, also the action of environmental factors on individual genetic predispositions oxytocinergic mechanisms, that is, the endogenous opioid system that promotes both breastfeeding and the creation of the mother-newborn bond of attachment and empathy. We have opened a path, but there is still much to discover.” In this regard, it must be said that, despite the significant amount of research produced over time, the causes of the onset of colic are not yet fully known although it is probably believed, as with other functional gastrointestinal disorders, a multifactorial character which makes the therapy chapter even more challenging. The factors underlying colic include: dysbiosis (changes in quantity and quality of the bacterial intestinal flora), intestinal neuronal dysmotility and hyperexcitability, abnormal absorption of food antigens, intolerances (also for allergens from the mother’s diet), the abnormal production of inflammatory cytokines and neurotransmitters sensitive to receptors that cause contractions of the smooth muscles of the intestine, disorders in the parent-child relationship as a result of an accumulation of fear and tension.

The brain and the intestines are connected by the microbiota

Today, the most important innovative contribution of research concerns hypotheses immaturity of the microbiota – or the compositional characteristics of the bacterial intestinal flora – which could be among the predisposing causes. This has been especially the case in recent years gut-brain axisThat is, a complex bidirectional communication network that allows the central nervous system to regulate many functions of the gastrointestinal tract, which in turn can modulate brain functions. And it would be precisely the microbiota of the gut – that is, the enormous ecosystem of microbial populations living there – that forms the interface of this ‘dialogue’. orchestrating a multitude of functions through nervous, hormonal, metabolic and immune pathways. This is why it is believed that the intestinal microbial changes found in infants suffering from colic may extend thereby compromising the integrity of the mucosal barrier and cause an inflammatory condition. Hence the use of specific probiotic strains to try to restore the right balance.

More than healing, reassurances are worthwhile

Despite the different treatment approaches (drugs, supplements, phytotherapeutic agents), including the recent use of probiotics, which, moreover, do not represent a validated option in terms of cost-benefit ratio, Until now it has not been possible to develop a standardized therapeutic protocol due to the lack of clear data. This is why at this time the most effective strategy remains to reassure the parents, to whom the pediatrician should provide adequate guidance by explaining that although the child’s crying may seem inconsolable, These crises are not a manifestation of pathology nor do they interfere with growth. Not to mention that the disorder can be traced back to a paroxysmal crying expression that occurs in the first months of life. the only method of communication that allows the child to express his discomfort and difficulties in comforting himself. Therefore, it is essential that parents remain calm and avoid reacting in a fearful and stereotypical way, for example by offering milk, which ultimately overfeeds the baby and aggravates his discomfort. In short, the risk is that the newborn suffering from colic will turn from a person experiencing a stressful state ‘object’ of stress for his parentsthereby amplifying the manifestations of the disorder in a vicious circle is in no small way influenced by the emotional component. Also for this breastfeedingin addition to providing the child with the ideal food from a nutritional and immunological point of view, they strengthen the psycho-affective bond and the mother’s sense of self-efficacy precisely thanks to the ‘skin-to-skin’ contact examined in the new study. And it is no coincidence that physical proximity, the sweet and delicate effect of rocking and massaging are, in the daily experience of many parents, the winning steps to ease the baby’s discomfort with colic.

What the new Italian study reveals

The study has two objectives: to evaluate the potential impact of mother-newborn ‘skin-to-skin’ contact (SSC) after birth on the prevalence and duration of breastfeeding and on the prevalence of functional gastrointestinal disorders (FGID) . To this end, the study included the recruitment of 160 healthy newborns, delivered vaginally and then divided into two groups among those who had benefited from the skin-to-skin contact (79) and the others (81). The perinatal procedure was performed immediately and continuously in the first two hours after birth. All infants were then followed at ages 1, 3, and 6 months using questionnaires to collect data. both on breastfeeding and on FGIDs in early childhood, as defined in the most updated guidelines (Rome IV criteria). As far as the first objective is concerned, yes the prevalence of exclusive breastfeeding
at three months of age, it was found that 70.9% of babies who underwent the procedure were fed only breast milk, compared to 53.1% of the others. «And this supports the hypothesis according to which the timely contact skin to skin represents an optimal viaticum for the correct initiation of breastfeeding,” says Professor Baldassarre. For the second purpose, yes the prevalence of functional gastrointestinal disordersThe results showed that of the 160 children recruited for the study, 82 subsequently showed at least one disorder as defined by the most recent criteria. More than half of the children (51.25% to be precise) suffered from one or more disorders the proportions were significantly to the detriment of babies who had no skin contact at birth which subsequently became a problem in a large proportion of cases, namely 62.9%, compared to 39.2% of the other cases.

Colic and dyschezia clearly decreased due to skin contact

If we then turn to the specific analysis of colic, we have seen that the protective effect of contact is skin to skin it’s even more consistent because it reduces the incidence to 7.6%, compared to 22.2% in the other group. The difference in the prevalence of dyschezia (difficulty with evacuation) was also significant: 3.8% in the group of children who benefited from the procedure, compared to 13.6% in the others. And that must be emphasized none of the infants presenting with dyschezia were exclusively breastfedThis therefore suggests a decisive protective role of maternal food. In summary, the results of the research first of all indicate that contact skin to skin which will be confirmed after birth important factor in supporting the initiation and maintenance of exclusive breastfeeding up to six months of life. It also turned out that children were deprived of contact skin to skin they presented greater susceptibility to functional gastrointestinal disorders, especially infantile colic and dyschezia. “The skin to skin immediately after delivery certainly leads to an increase in the occurrence and duration of exclusive breastfeeding in the first months of life a significantly lower incidence of colic and dyschezia in the little ones,” concludes Baldassarre.

Source: Corriere

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