A review of What’s Going on in There? How the Brain and Mind Develop in the First Five Years of Life, Lise Eliot, PhD, A Bantam Book, 1999.

Debbie Page, RN, IBCLC, RLC

In this all encompassing book, What’s Going on in There? How the Brain and Mind Develop in the First Five Years of Life, Dr. Lise Eliot seeks to help us better understand how the human brain develops and what roles nurture versus nature play. She makes a profound argument for early touch in infancy as a significant part of healthy brain development. Infant massage is an excellent way to promote touch and therefore brain development in the newborn baby. All aspects of child brain development are fascinating; however I have chosen to focus on the senses of touch, balance and motion.

At birth, touch is the baby’s most developed sense. It succeeds seeing, hearing and even taste. The importance of early experiences of touch can not be underestimated. They greatly impact later on the baby’s motor skills, tactile sensitivity and her understanding of the world around her. Human contact for the infant is essential for her physical and emotional health.

Touch is not just limited to skin contact. Four different sensory abilities make up the anatomy of touch; each with its own neural pathway. Temperature, pain and touch all begin with the skin, each having its own specialized receptors. The ability the body has to recognize the position of arms and legs, known as proprioception, stems from the skin as well as the muscles and joints. The only difference in how the body recognizes these unique abilities to feel different sensations is the different pathways the neurons are following on their way to the brain. Once in the brain, the neurons reach the “touch center” and combine. This gives the perception of what you are feeling–pressure or pain, heat on the hand, etc.

The human fetus feels many sensations while in utero. These along with touch stimulation after birth appear to determine the magnitude of “possible tactile sensitivity.” Studies on rats indicate that variety of touch stimulation actually increase the size of their somatosensory cortexes.

Babies’ mouths are the most sensitive part of their body due to the fact that sensitivity to touch develops from the head down to the toes. Experiments show that a baby can visually recognize an object it has explored with its mouth, i.e. a pacifier, but has not previously seen. Another interesting observation is that newborn girls are more sensitive to touch than boys.

Touch is a vital constituent of early nurturing in all mammals. Premature infants thrive much better when provided with “nesting” that imitates the womb and provides feedback from touching the sides of the “nest”. Holding a premature baby in “kangaroo care” has proven to have tremendous benefits, including temperature stabilization, better sleep, less crying, more regular breathing, longer breastfeeding, faster weight gain and earlier discharge from the hospital. Kangaroo care is skin-to-skin contact between the baby and its parent’s bare chest.

 
Adding massage to the premature baby’s daily care improves the child’s overall health and development, as well as weight gain. These babies are more receptive to touch by the time they reach full term. Studies show that premature infants that receive daily massages score higher on cognition and visual recognition at six months of age.

 
Babies love to be bounced, rocked, jiggled and carried right from birth. This is due to the fact that the vestibular system is highly developed at birth. Though it is a sense we are typically unaware of, it plays a crucial part in helping us assume and maintain our balance and posture. Several newborn reflexes–asymmetrical neck response, traction response, doll’s eye reflex–  result from vestibular function which detects the rapid change of the infant’s head and therefore bids the body to move so as to maintain balance. Development of this sense plays a crucial role in mental and neural development.

Vestibular stimulation is advantageous to young babies. Most parents recognize how their baby calms down and stops crying when picked up, rocked, carried or placed over their shoulder. These actions which stimulate the vestibular system help the baby to reorganize and therefore calm down. If parents continue this stimulation it decreases the baby’s level of arousal and oftentimes results in the infant succumbing to sleep.

 
The development of the brain is a fascinating subject. Studies are regularly emerging that give us more and more insight into how this phenomenon happens. Overwhelming evidence points to the necessity of early nurturing and stimulation in order for the child to develop optimally. Sensation, movement, emotion, memory, language and “intelligence” all play their part in brain development. As stated by the author, “we cannot understand children’s minds until we understand the structure and physiology of their brains…. From the first cell division, brain development is a delicate dance between genes and environment, and it is only by understanding each of these…that we can grasp…the degree to which heredity and experience make us who we are.”

 
The information I gleaned from Eliot’s work will help me as I teach parents and other caregivers the art of infant massage. Though infant massage is an art, the science behind the development of touch, motion and balance all support the essential necessity for early touch and massage of all babies, premature and full term.