Carried out among 2,500 children born large or extremely premature, this research from Inserm, INRAE and Paris Cité University shows an average difference of 2.3 IQ points at five years in those who benefited from “skin to skin” in the first week of life.
A gesture of tenderness that has become a public health issue
In the cozy corridors of neonatal departments, the first contacts between a premature newborn and his parents are often suspended moments. This skin-to-skin contact, long seen as a simple moment of gentleness, is now being scrutinized as a possible factor in long-term brain development.
THE skin to skin consists of placing the baby, naked or almost, on the chest of a parent, just after birth. In low-income countries, it already helps improve the survival of premature children and support their immediate physiological stability; in countries like France, it is known to stabilize the breathing and heart rate of infants and strengthen the emotional bond. But its long-term effects on the brain remained little explored on a large scale.
This is what researchers from Inserm, INRAE and Paris Cité University wanted to understand, based on the large cohort Epipage-2which has been following thousands of children born prematurely in 25 French regions since 2011.
+2.3 IQ points: the striking results of the study
The team analyzed nearly 2,500 children born between 24 and 31 weeks of pregnancy. Half had benefited from skin to skin during the first seven days of life, the other not. At age five, all took standardized cognitive tests.
The researchers then observed an average difference in +2.3 IQ points for children who have experienced skin-to-skin contact. “This difference of 2.3 points may seem minimal at the individual level, but is not negligible when it is an average over an entire population.“, explains Ayoub Mitha, first author of the study.
The gap even climbs to +2.9 points for children born very prematurely, those whose birth occurs between 28 and 31 weeks. “This is explained by the lower use of skin-to-skin care for children born extremely premature in 2011, a trend which has since evolved, with skin-to-skin care being an increasingly encouraged practice in neonatology departments.he continues.
However, the study did not show a link between skin-to-skin contact and the reduction in behavioral problems. But it reinforces the idea that these first moments of contact would have an effect neuroprotective.
The study, however, has certain limitations: the observation does not prove direct causality, and differences between care units may introduce bias (for example, more fragile children could have been less likely to benefit from skin-to-skin care).
Supporting skin-to-skin everywhere, for everyone
For researchers, these results go beyond statistics. They recall the need for structural change in French hospitals, so that every premature newborn can benefit from this founding gesture. “These results are further proof in favor of skin-to-skin contact in the very first hours of life for a child born prematurely. They highlight the importance of promoting non-separation of parent-child at birth and are in line with the recommendations for the establishment of parental rooms in neonatal intensive care units.underlines Ayoub Mitha.
“As an inexpensive intervention, skin-to-skin treatment appears to be a simple treatment to implement in current practices. However, today there are many disparities in practices between care units. Additional studies are necessary to better understand the variability of practices and identify levers to support teams in its implementation.“, adds Véronique Pierrat, last author of the study.
To transform these results into concrete actions, several avenues would be worth exploring:
- Promote the training of neonatology staff around skin-to-skin, with clear protocols adapted to different degrees of prematurity.
- Promote hospital architecture oriented towards the integrated parental bedroom, to avoid the separation of parents and baby.
- Monitor the evolution of practices within the units: measure the skin-to-skin rate practiced, identify obstacles (technical, logistical, cultural), and share good practices.
- Conduct additional studies to refine the understanding of the biological mechanisms (hormonal, sensory) which link this early contact to subsequent brain development.
These projects are essential to reduce regional disparities: in certain hospitals, skin-to-skin contact is already well established; in others, it remains rare. However, this “loving care”, accessible and free, could become one of the most powerful levers for equity in neonatal health.