In his research on infant care, and especially premature infant care, Dr Nils Bergman is working assiduously to debunk the mythology that premature babies are more healthy in incubators.  The whole emergence of incubator use was a great money maker of “Dr” Couney, who set up his Infant Incubator exhibits at World Fairs and amusement parks, including Coney Island, and all across the US in the late 1800s.   Martin Couney was not a doctor, he was a promoter, and put himself in the position of being the ‘rescuer’ of babies who were failing in the hospital.

Follow this link that gives us a Minnesota historic participation in ‘modern’ care for babies. Scroll into 1:37 to see the Infant Incubator House at the Wonderland Amusement Park.  While you are watching, please consider: What were the conditions and choices for these vulnerable babies and their mothers?

https://www.youtube.com/watch?v=bk-WrcnWtaI

To begin, please note that the ‘research’ that is claimed to be behind Couney incubators is highly questionable. What practices are being compared to what other conditions of care?

As Dr Bergman says, it all depends on what we are comparing.  So:  Are we comparing premature babies in an incubator with premature babies in an isolette (isolated box!!!) in a nursery separate from the maternity ward where mothers are laying in?  This was modern hospital care in big cities from the late 1800s through mid-century 1900s and beyond. Or are we comparing premies in an incubator with premature babies who are carried skin-to-skin on their mothers?

Guess which of the three groups has the most excellent outcomes for both survival and for long term development.  Yes, premature babies held skin-to-skin (also known as kangaroo care) have better vitals on every measure (breathing, heart rate, temperature, glucose levels) as well as a hugely improved arc of development for physical, social/emotional and cognitive outcomes.

So, why does history matter? The incubator continues to be treated as a superior piece of technology and as the gold standard of medical care that still trumps mothers holding their own vulnerable babies.  This is reflected in the way that almost all neonatal intensive care units (NICUs) are set up in the USA.

In order to carry out effective skin to skin care, babies need to be held basically all the time on their mothers/fathers/primary person.  Mothers/parents needs to live and sleep with their babies – called rooming-in – with a bed and care for the mother.  Rooming-in is very rare in NICUs.  Most NICUs have zero beds for mothers.  Or a hospital has one bedroom for mother-baby – then the medical center can claim that they have rooming-in.  Hospitals will also say that they have kangaroo care for premies, but then only ‘allow’ babies to be skin-to-skin for an hour a day or intermittently. Most medical centers only allow babies to be skin to skin with mother IF baby’s vitals are good.  However, Dr Bergman’s research clearly concludes that babies’ vitals are better in skin to skin.  In other words, incubators destabilize premature babies and hinder their development, compared to skin to skin care.

Dr Bergman’s strong recommendation is that NICU’s must be totally redesigned to place baby AND mother at the center of care, with all the technology and medical staffing support adapting to the best practices for best outcomes for premature and fragile babies.

And of course, additionally we need social policies that support women financially in being with their premature babies during this vulnerable time, and to provide care for their other children at home.  Otherwise many, many mothers are not able to be in the medical center with their babies.

This is also a social justice issue, as babies of African American descent are at higher risk of prematurity.  And their higher risk of prematurity is due to several reasons that are also social justice issues.  Among the independently contributing variables are stress of family economics, and racism as it own stressor (independent of other variables, all by itself).