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Global Health Thought Leader Uncategorized

Focusing on Early Infancy Can Create Sustainable Societies and Prevent Chronic Disease

By Dr. Jose Miguel De Angulo, Regional Director for Latin America, MAP International & Luz Stella Losada, Bolivia Community Health Specialist, MAP International

Dr. Jose Miguel De Angulo, Regional Director for Latin America, MAP International & Luz Stella Losada, Bolivia Community Health Specialist, MAP International

Dr. Jose Miguel De Angulo, Regional Director for Latin America, MAP International & Luz Stella Losada, Bolivia Community Health Specialist, MAP International

Health paradigms keep evolving through history.  In the 21st Century we are witnessing the emerging of a new health Paradigm.  Neuroscience is showing how the brain architecture of the person is established during the intrauterine period and the first two to three years of life. This brain architecture is what determines the capability of the organism to self-regulate its biological, emotional, cognitive, and interactional processes with the environment. The more robust this brain architecture is in an individual, the more potential and capability that individual has to enjoy physical, emotional, and mental health at the personal level as well as his/her capacity to contribute through his/her life to the health and wellbeing of others. The new understanding of the key determinants of the development of infant brain architecture is generating a profound shift toward focusing on early infancy as the best strategy to invest resources to foster development of healthy and sustainable societies. The emergence of this health paradigm to achieve healthy and successful societies is making a shift from what is happening on systems to what is happening in a very specific arena: early infancy development.

To see the critical role that infants´ experiences play not only in their future life, but also in the wellbeing and health of society, it’s important to read J.P. Shonkoff’s The Foundations of Lifelong Health.  Through research and after reviewing a broad spectrum of the evidence accumulated in the last decade Shonkoff says it best.

moms“A vital and productive society with a prosperous and sustainable future is built on a foundation of healthy child development. Positive early experiences provide a foundation for sturdy brain architecture and a broad range of skills and learning capacities…  Advances in neuroscience, molecular biology, and genomics have converged on three compelling conclusions: Early experiences are built into our bodies, creating biological “memories” that shape development, for better or for worse. Toxic stress caused by significant adversity can produce physiological disruptions that undermine the development of the body’s stress response systems and affect the architecture of the developing brain, the cardiovascular system, the immune system, and metabolic regulatory controls. These physiological disruptions can persist far into adulthood and lead to lifelong impairments in both physical and mental health.

This new paradigm implies that governments and society will need to focus on infants and how families and society can better care for and protect them.  Because brain architecture is constructed during pregnancy and especially during the first two years of life, parents play a critical role in the generation of a robust brain architecture. Now parents need to understand and be equipped for a new radically different way of seeing, listening to and interacting with their infants. Early childhood is the most vulnerable period of human life, as well as the period with the largest potential for development. On top of that, research is showing how the infant’s brain powerfully transforms the parent´s brain and equipping them to become sensible and responsive to the infant`s brain expressions of need for her development.

Dr. Jack P. Shonkoff, the Chair of the National Scientific Council on the Developing Child, made a presentation to Westchester Children’s Association in, New York on March 24, 2006. In this presentation, “No Time to Lose: Closing the Gap between What We Know and What We Do,” he presented the conclusions of multiple years of research into the science of early childhood development. These were his main points:

“The healthy development of all young children benefits all of society by providing a solid foundation for responsible citizenship, economic productivity, lifelong physical and mental health, strong communities, and sustainable democracy and prosperity. Relationships are the “active ingredients” of early experience. Nurturing and responsive relationships build healthy brain architecture that provides a strong foundation for learning, behavior, and health. When protective relationships are not provided, elevated levels of stress hormones (i.e., cortisol) disrupt brain architecture by impairing cell growth and interfering with the formation of healthy neural circuits.”

moms2Research conducted and published by the CDC on “The Relationship of Adverse Childhood Experiences to Adult Health Status” pushes us to completely rethink the traditional way of understanding the “history of diseases” (from the moment of exposure to causal agents until recovery or death). This research is opening the door to a new way of understanding why diseases are present in society. Dr. Vincent J. Felitti and Robert F. Anda are the authors of The Adverse Childhood Experiences (ACE) Study. This was the largest study of its kind ever done to examine the health, social and economic effects of adverse childhood experiences over the lifespan (18,000 participants). The findings showed that an individual’s childhood experiences shape the epidemiological profile of that child in his/her adult life, as well as the epidemiological profile of the entire nation. Some of their conclusions are:  “Adverse childhood experiences determine the likelihood of the ten most common causes of death in the United States;” “Adverse childhood experiences are the most basic cause of health risk behaviors, morbidity, disability, mortality, and healthcare costs;” and “Many chronic diseases in adults are determined decades earlier, in childhood.”

Adverse childhood experiences are also clearly related to mental health. For example the conclusion of this study related to prescribed psychotropic medications in adults states: “The strong relationship of the ACE Score to increased utilization of psychotropic medications underscores the contribution of childhood experience to the burden of adult mental illness. Moreover, the huge economic costs associated with the use of psychotropic medications provide additional incentive to address the high prevalence and consequences of childhood traumatic stressors.”  Empathy underlies virtually everything that makes society work, such as trust, altruism, collaboration, love, and solidarity. Failure to empathize is a key part of most interpersonal and social problems, including-crime, violence, war, racism, child abuse, inequity, among others. Empathy is associated with prosocial behavior, and this relationship has been found to be mainly due to environmental effects through the expressions of sensitivity and responsiveness of parents. Empathy is experienced and developed through secure attachments with the father and mother. Insecure and disorganized attachments seriously obstruct the cultivation of empathy, which—on a broad social level—can easily lead to a society in which no one would want to live because of the cold, violent, chaotic, and terrifying interactions of all against all. Parental sensitivity. Responsiveness and proactive involvement with infants and toddlers play a key force in their capability to express empathy and prosocial behaviors in future stages of their lives.

global healthAppropriate interactions with infants cannot only generate changes at the society when they will become productive citizens, but they also generate changes in the brains of the father and mother, bringing plasticity and new way of thinking, interacting and engaging with the world.  For example, research show the importance of paternal caring behaviors to establish strong bonds, and how this is dependent on appropriated postnatal offspring interactions. In bi-parental mice this has been associated with increased neurogenesis in the paternal olfactory bulb and hippocampus.  These male mice can even recognize their offspring as adults if they interacted with their infant pups.  Research today presents exciting new ways of understanding parenting as this research conclusion:  “The brains of parents are clearly different from those of non-parents, having been changed by the presence of offspring and corresponding hormonal fluctuations. Available evidence suggests that structural reorganization occurs in the hippocampus and PFC of mothers and fathers”. The book `Sex and the Brain the Neuroscience of How When Why and Who We Love´ clearly shows how the baby’s brain interaction with the father “rewires the daddy brain” and how “Love spurs the very growth of the parental brain and even causes new brain cells to develop… Those parental impacts on your brain begin long before birth, setting into motion major factors for your future relationships.”

We must focus on children in early infancy to change society and create sustainable societies with less chronic disease.  MAP International’s uses this cutting edge evidence based approach to comprehensive Early Childhood Development in all their Focus 1365 Early Childhood Development Programs in Bolivia and Ecuador.  This new concept of care, cognitive development, freedom and autonomy for children and their caregivers is changing the marginal, rural and urban communities that we work in.

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