by Meril Schulman, RNC

The power of touch can convey feelings of comfort, concern, caring and empathy without benefits of words. The noted French obstetrician Frederick Leboyer, who pioneered the gentle birth method says, "Being touched and caressed, being massaged is food for the infant, food as necessary as minerals, vitamins and proteins. We have to feed babies, fill them both inside and outside. We must speak to their skins, we must speak to their backs, which thirst and hunger and cry as much as their bellies."

A recent study published in the December 2000 issue of Research in Nursing and Health reports that gentle touching of premature babies for a few minutes twice daily has a very calming, beneficial effect. The study, conducted by scientists at the University of Alabama at Birmingham School of Nursing involved nurses touching a sample of 42 babies on the head and lower back for ten minutes twice a day for ten days. The lead investigator of the study, Lynda Harrison, states, "Babies showed significantly fewer stress behaviors, such as clenching fists or grimacing, during periods of gentle touch."

There are many concerns in Neonatal Intensive Care Units about a premature baby's ability to cope with the overwhelming stimulation of the environment. Therefore, many NICUs have instituted policies that require minimal handling of these fragile infants. However, this study showed no change in the baby's oxygen need or heart rate, which increase when a premature baby experiences stress. This would indicate that gentle touch is safe for preemies.

Researchers have examined the effects of gentle touch on the behavior and development of newborns for about twenty years. But many of the previous studies are inconsistent with specific effects as they relate to premature babies. There are positive studies that have shown that gentle touch can stimulate weight gain and improve immune functioning in the preemie by lowering the levels of some stress hormones. These hormones, ACTH and cortisol, can suppress growth and inhibit the immune system. Other studies have also found that touch relaxes muscles, increases circulation and prompts the body to release endorphins, which are natural painkillers that produce a sense of well being. With touch there is a strengthening of the bond between parent and child. Using gentle touch helps us to communicate the gift of our love and strength to our infants.

Are you interested in reviewing the University of Alabama School of Nursing study for further information? You can find it in the journal Research in Nursing & Health, 2000, volume 23, pages 435-446. The title of the article is Physiologic and Behavioral Effects of Gentle Human Touch and the authors are Lynda Harrison, Anita Williams, Michael Berbaum, John Stem and James Leeper.

If you would like to learn more about touch and the newborn, you can log on to the site of the Touch Research Institute at http://www.miami.edu/touch-research. This is a wonderful website that provides access to a wealth of information about research that explores the benefits of touch for newborns of cocaine addicted mothers, HIV exposed newborns, infants of depressed mothers and infants with cancer. Frederic Leboyer's book, Loving Hands, the Traditional Art of Baby Massage, published in 1979, is a beautiful pictorial essay about infant massage. You can feel the positive effects that touch has on newborns by gazing at Dr. Leboyer's photographs.

by Meril Schulman, RNC

Emotional support is not only a comfort, it actually can be life giving. Studies have repeatedly shown a greater survival in patients with emotional support than those that do not have it.

According to a March 2, 2001 Reuters Health article, there is an increased risk of breast cancer among women who experience a highly threatening life stress and do not have intimate emotional support. The Reuters article cites a study reported in the February 15, 2001 issue of the journal Cancer. The study concludes that women reporting a recent highest level of life event stress have a ninefold increase in risk of developing breast carcinoma, but only for those without any intimate emotional support. This may be because life event stress, personality and social support all influence an individual's ability to cope. This, in turn, may influence breast carcinoma risk by altering neuroendocrine and immune functioning.

There have been many studies about the potential benefits of social support on health, quality of life and immunity. These studies have focused on the ability of social support to lessen the impact of a diagnosis and help the patient adjust to her illness and prognosis. But this study considers social support in relationship to the development of breast cancer and finds that there is significant interaction between major stressors and emotional support.

The lead investigator of this study, Dr. Melanie Price, suggests that these results can be reassuring to women, in that stress on its own does not cause cancer. As health professionals, we should be encouraged to identify women experiencing severe stress but lacking in emotional support. We can promote the use of available support systems and encourage the use of counseling and other supportive services.

I was very encouraged by the results of this study and searched the Internet for sites that offered access to cancer support groups. There is an excellent comprehensive site providing practical support information for patients at http://www.canceronline.org. Some of the topics that are discussed include the mind-body connection, and how you can influence your health (includes a nice introduction to PNI [Pyschoneuroimmunology]). There is also an extensive section about building supportive relationships that connects very well with the information in the research study.

If you would like to check out this study article in its entirety it can be found in the journal Cancer, Volume 91, Number 4, pages 686-697. The title of the research is The Role of Psychosocial Factors in the Development of Breast Carcinoma and is well worth your read.

by Meril Schulman, RNC

About a year ago, President Clinton established a commission whose task was to develop a comprehensive policy to govern the growing field of complementary and alternative medicine. The Commission is working on developing recommendations that ensure that public policy maximizes benefits to Americans who utilize complementary therapies such as acupuncture, therapeutic touch, aromatherapy and many other hands-on therapies. Developing a comprehensive policy to govern this "industry" may sound simple, but it's not.

In an article appearing in the March 17, 2001 issue of the Saint Paul Pioneer Press, a reporter, Tom Majeski writes, "Trying to regulate the growing field of complementary and alternative medicine is like lassoing a cloud." Mr. Majeski was present at a daylong town meeting at the University of Minnesota where the White House Commission was hearing testimony from many complementary therapy practitioners.

The national government first became involved because of the increasing demand, by Americans, for these therapies. People were growing more and more dissatisfied with allopathic or traditional western medicine and wanted to become active participants in their own care. Interest in alternative medicine had become so strong that in 1992 the National Institute of Health (NIH) established its Office of Alternative Medicine to evaluate a wide range of nontraditional therapies. The Journal of the American Medical Association (Vol. 280, No. 18, p.1616) reports that in 1998 more than 40% of Americans had used complementary and alternative therapies. Today there are 60% of American medical schools that offer information in alternative medicine and complementary care as part of their curricula. Hospitals and clinics are offering a growing number of complementary and alternative treatments and independent practitioners are opening up offices as well.

It has been difficult to create licensing, training and research standards in this field because it encompasses such a variety of cultures and overlapping practices. State regulations remain highly confusing, even to the professionals of the White House Commission. Participants, many of them health care professionals from a variety of backgrounds, at the town hall meeting offered suggestions and raised questions regarding licensing requirements, regulatory practices, education and training standards and research challenges. Robert Patterson, a professor of medicine at the University of Minnesota, spoke about how difficult it is to get the university's institutional review board to approve research projects that do not fit the western medicine's traditional double-blind, placebo-controlled research model. Mary Ellen Kinney is the coordinator of complementary therapies research at St. Paul's United Hospital and she is involved in a healing touch and cancer study. She expressed the thought that randomized studies miss something very important, that is, the spirit of the patient. Barbara York is a practitioner of Jin Shin Jyutsu, an ancient natural healing art of harmonizing the life energy of the body. She told commission members that because of the variety and cultural aspects of many therapies one education should not apply to all. She expressed the thought that while formal training is important, our best lessons are learned from hands on experience.

The twenty commission members are required to complete their investigation and report by March 7, 2002. Over the next year they will be hearing testimony from health care professionals around the United States. Perhaps one of us, as nursing professionals, might be given the opportunity to have our voice heard as government policy is being developed.

It's interesting to read about the other ways that the Federal Government has become involved in legislation and complementary medicine. The search engine 'eLibraryPLUS' (http://www.encyclopedia.com)is available for free in many public libraries (there is a fee for home use). There you can find the transcripts of congressional testimony related to alternative, complementary and integrative medicine. Among the transcripts are those of Andrew Weil, M.D., Director of the University of Arizona Program in Integrative Medicine, Dean Ornish, M.D., President of the Preventive Medicine Research Institute, and proceedings from Chairman Dan Burton's Committee on Government Reform. Just type in the words 'Alternative Medicine' when asked for a search.