The brain, prematurity & learning

What is learning?
Generally, parents think of learning as something that starts when a child goes to school, but learning starts way earlier than that. Learning had already started a few weeks after conception when baby responded to touch and later to smell and taste and even later to sound and mostly after birth only, to seeing. What is remarkable is that your baby’s ability to read, write and reason six and a half years later when he enters Grade 1 is substantially developed before he is only 14 months old!

The Brain and Prematurity
When a baby is born before 37 weeks, the baby is medically regarded as premature. If a baby is born before 28 weeks gestation, such a baby is termed extremely preterm or premature. Developmentally any baby born before 40 weeks gestation is premature, because the baby has missed out on the perfect conditions for optimal brain development – the womb.

Let us consider a few facts:

  • The brain is the last major organ to develop.
  • The baby’s brain at 35 weeks weighs only 2/3’s of what it will weigh at term (40 weeks).
  • A lot of important brain growth happens in those last few weeks.

What challenges do premature babies face?
Premature babies are separated from mom and placed in an incubator instead of experiencing the perfect in utero conditions designed to nourish and nurture a baby’s brain and body. When a baby is removed from the uterus prematurely:

  • There no longer is an online supply of perfectly formulated food.
  • There no longer is a firm uterus wall that cocoons baby and provides a constant body massage.
  • There no longer is a rhythmic heartbeat that comfortingly reminds baby that mom is near.
  • There no longer is a relaxing darkness surrounding baby.
  • There no longer is a protective boundary that filters noise.
  • Nakedness is no longer the perfect clothing.
  • Pain is no longer absent.

The above mentioned conditions are imperative to the final stages of brain development and should be mimicked as far as possible to ensure a healthy brain and body, as both the brain and body are central to lifelong learning.

Because a premature baby is not ready to be born, the baby needs special care. Immature senses and organs become stressed in the well-meaning but harsh conditions of the Neonatal Intensive Care Unit (NICU) where little light is replaced by bright lights; filtered sound by loud noises; soothing sleep and rest rhythms by intrusions and interruptions; constant touch is replaced by no touch at all, or instead- painful procedures.

What are their needs?
The premature baby needs to survive. To do so, a premature baby needs an environment that feels protective, safe and similar to the warmth and cosiness of the womb. Tiffany Field from the Touch Institute says touch, and creating a feeling of safety and security, boosts the immune system, growth and the development of the baby – even more so for a premature baby.

What can you do to develop your premature baby’s brain?
Parents seldom realise that their new baby needs to learn a lot in his first year and that he needs them to give him the opportunity and stimulation to learn those things, because stimulation builds a clever brain and a fool-proof recipe for life. Brain stimulation occurs when you gradually and gently wake up of all baby’s senses and muscles in a specific sequence. No matter how clever the brain is, the brain needs wide-awake senses to prompt the brain into action.

What is stimulation?
Stimulation is less about a full tummy and more about the brain.

Natural development unfolds according to an innate blueprint powered by the intrauterine and primitive reflexes. Each of these reflexes has to wire a specific sense, muscle and part of the brain to complete a part of baby’s body map. Only once baby’s entire body map is in place, can he create useful maps about the world in which he is going to operate. Babies are not born as human beings, but human ‘becomings’ - they become human in their interaction with other people, the way people move, do things and talk. It is in mom and dad’s caring and cuddling, feeding, playing and talking that baby learns what it looks like, sounds like and feels like to be part of the human race – those creatures that can walk on two legs, speak a complicated language and use tools.

It is while mom and dad playfully stimulate each of baby’s senses and enthusiastically encourage each little muscle to move, that baby’s brain maps create intricate connections - the things that intelligence is made of.

To do:

  • Aim to use a ventilation (breathing) strategy that is as gentle as possible.
  • Place baby on mom or dad’s chest, skin-on-skin as often as possible.
  • To prevent flattening of the soft skull it is best to place baby on a memory foam-, or gel mattress.
  • To simulate the comforting confines of the uterus, place blanket boundaries made of 100% cotton around the head, body and at the feet of the baby. Mom’s rolled up cotton night shirt works extremely well, not only because it provides a cosy nest, but also because it smells like mom – a smell baby got used to during pregnancy. The nest also helps to keep baby in a flexed position, (the in-utero space saving posture) when on the side, on the back and on the tummy.
  • Place baby’s hands close to the mouth. This is comforting to baby and creates a sense of ‘togetherness’.
  • Ensure that baby’s nappies fit correctly. If the nappies are too big it might push the legs apart and hamper physical development, which could delay motor milestones.
  • If baby is in an incubator, a closed incubator is helpful to control the temperature and humidity. If baby’s body temperature is constant, baby can use the available energy to grow and develop, instead of trying to keep warm.

Once baby has reached the 40-week mark it is time to introduce baby to the “outside�? world. Mom and Dad can now start to massage baby and introduce tummy-time for short periods at a time. The BabyGym Institute recommends a few easy and practical exercises daily to make sure baby’s brain and body have adjusted to life outside the womb. Encourage your baby in the months that follow to move, explore his or her body, and fight the pull of gravity by allowing ample free exploration time on the floor. When a baby is placed on the floor he or she needs to work hard to lift that body off the floor and to become mobile. As a baby discovers his or her body, so the variety of movement increases to include head control, neck turning, rolling, grasping, sitting, crawling and eventually walking. Each of these baby milestones is imperative to brain development and academic learning that will follow years later.

What about an older child who was born prematurely?
A correlation between babies born prematurely and deficits in cognitive ability and school achievement has been established by numerous studies. The majority have found that the greater the medical complications at birth, the greater the:

  • Problems with motor milestones and motor skills,  
  • Cognitive deficits,
  • The lower the achievement at school, and
  • The higher the likelihood of emotional and behavioural problems at school.

This may seem like a very grim prognosis, and that the future for babies who suffered medical complications as a result of being born prematurely only holds challenges. However, studies have also found that early medical intervention and a stimulating social environment can often decrease the effects of early trauma and the appearance of later developmental problems. Programs such as BabyGym® and Mind Moves® have been developed to address precisely these challenges.

Tip: To counter the early patterns of anxiety, breathlessness and rapid heartbeat that are closely associated with prematurity, swimming has been found excellent to build lung capacity and muscle tone to leave a child feeling healthy and confident.

You might also want to read more about how movement can address learning difficulties.