Maija Purhonen

The effect of nursing on the brain activity of the newborn

OBJECTIVE To determine whether nursing influences brain activity in the newborn and whether there are differences in this respect between breast- or bottle-feeding and pacifier sucking. STUDY DESIGN Fifty unselected volunteer mothers and their healthy full-term infants, under care in the maternity ward after delivery, served as subjects. Thirty mother-infant pairs were studied in relation to breast-feeding and 20 to bottle-feeding and pacifier sucking. Breast-fed infants were studied between the 1st and 7th day after delivery (mean +/- 2.7 days) and the infants in the bottle-fed group between the 1st and 8th day after delivery (mean +/- 3.3 days). METHODS Qualitative and quantitative electroencephalogram (EEG), electrooculogram, submental electromyogram, and electrocardiogram were recorded before, during and after breast- and bottle-feeding and pacifier sucking. RESULTS The amplitude of the EEG increased significantly during breast-feeding in the posterior cortical areas in both hemispheres with a slight predominance on the right. Bottle-feeding caused a similar, but somewhat less marked change. When the breast- and bottle-fed infants were compared, a significant difference was found in only one parameter of the 84 studied. Pacifier sucking had no significant effects on EEG activity. CONCLUSION Nursing effects a change in the brain activity of the newborn. The cortical response to nursing is most probably a result of activation of the neurohumoral mechanisms related to hunger and satisfaction, including the hypothalamic, limbic, and other brain stem structures, which also regulate the sleep-wake cycle and modulate the level of cortical activity with respect to attention and vigilance.

Effects of maternity on auditory event-related potentials to human sound.

Auditory event-related brain potentials (ERPs) were recorded in response to an emotional (a babys cry) and a neutral (a word) stimulus in a group of mothers 2–5 days after childbirth (n = 20) and in control women (n = 18) who were not in the state of early motherhood. For each mother, her own infants cry was recorded and used as the cry stimulus, whereas a strange babys cry was used for control women. The word stimulus was identical for both groups. Stimuli were presented in intermittent trains in order to study the arousal responses to the first stimuli of the trains, and refractoriness of ERPs during stimulus repetition. The N100 responses were significantly larger in amplitude in mothers than in control women, not only to the emotional cry stimuli but also to the neutral word stimuli. The finding suggests a general increase in alertness and arousal in mothers, which may be necessary in enabling the mother to be continuously alert to her infants needs. This allows good care of the infant and may be essential in building an emotional tie between the mother and her child.

The effects of feeding on the electroencephalogram in 3- and 6-month-old infants

The human infants neurophysiological responses to feeding are poorly understood. We found recently a significant increase of EEG amplitude in the newborn during nutritive feeding, but not during pacifier sucking. In this study, we report EEG responses to feeding in 13 infants at the ages of 3 and 6 months. The undifferentiated response of the newborn was found to wane until the age of 3 months, whereas in 6-month-old infants, relatively abundant rhythmic 3-5 Hz theta activity was recorded during feeding with an amplitude maximum in right posterior areas. Cessation of feeding was followed by cessation of theta activity. The rhythmic 3-5 Hz theta response to feeding is likely to represent emotional arousal, as it is similar to previous findings showing posterior theta increase in other settings connected with emotional arousal in infants.

Nascent body ego: Metapsychological and neurophysiological aspects

For Freud, body ego was the organizing basis of the structural theory. He defi ned it as a psychic projection of the body surface. Isakowers and Lewins classical fi ndings suggest that the body surface experiences of nursing provide the infant with sensory‐affective stimulation that initiates a projection of sensory processes towards the psychic realm. During nursing, somato‐sensory, gustatory and olfactory modalities merge with a primitive somatic affect of satiation, whereas auditory modality is involved more indirectly and visual contact more gradually. Repeated regularly, such nascent experiences are likely to play a part in the organization of the primitive protosymbolic mental experience. In support of this hypothesis, the authors review fi ndings from a neurophysiological study of infants before, during and after nursing. Nursing is associated with a signifi cant amplitude change in the newborn electroencephalogram (EEG), which wanes before the age of 3 months, and is transformed at the age of 6 months into rhythmic 3‐5 Hz hedonic θ‐activity. Sucking requires active physiological work, which is shown in a regular rise in heart rate. The hypothesis of a sensory‐affective organization of the nascent body ego, enhanced by nursing and active sucking, seems concordant with neurophysiological phenomena related to nursing.

The impact of stimulus type and early motherhood on attentional processing

The present study evaluated the impact of stimulus type and early motherhood on attentional processing. Auditory ERPs were recorded with a modified novelty oddball paradigm both in mothers who had recently given birth and in control women who were not in the state of early motherhood. Conventional tone pips were used as standards and deviants, and an infant cry served as an experimental stimulus of novelty value. Differences were revealed in the N100 amplitudes between the study groups with higher amplitudes in the mothers. A few days after childbirth the mothers seemed to be in a stage with an increased level of alertness and different types of surrounding stimuli may elicit a stronger arousal response than normally, not just those directly related to the new baby. The gating and the mechanisms of further processing of stimulus information were not different in mothers from controls and seemed to guarantee normal control of stimulus-elicited cognitive load in early motherhood.

Determinants of psychiatric hospital care in a general hospital

We studied the determinants of the referral of psychiatric emergency consultation patients for hospital care (48 patients) or for psychiatric outpatient care (82 patients). The assessment was based on the clinical examination conducted by a physician. Those referred for psychiatric hospital care were older and more often single and unemployed than others. The sex and basic education of the patients were not connected with the treatment decision. Those referred for psychiatric hospital care lived more often alone than others. There was no statistically significant difference between the therapy groups in relation to psychiatric treatment immediately before coming to the general hospital. The distribution of somatic and psychiatric diagnoses was similar in the two groups. The level of psychosocial functioning had already been poorer among those referred for psychiatric hospital care during the preceding year, and a similar situation was observed at the time of consultation (GAFS score). In discrimination an...

Bifrontal active and sham rTMS in treatment-resistant unipolar major depression

Abstract Background and aim: Prevention of the recurrence of major depression and its residual symptoms requires effective treatment. Our aim was to study the effects of bifrontal active rTMS controlled by sham rTMS in treatment-resistant unipolar major depressive disorder (MDD). Methods: Thirty-seven patients with treatment-resistant MDD were randomized into two groups. One group received a total of 30 sessions of active bifrontal rTMS (10 Hz rTMS on left dorsolateral prefrontal cortex (DLPFC) and 1 Hz rTMS on right DLPFC) and the other group received bilateral sham rTMS on five days a week for six weeks. Results: Depressive symptoms significantly improved in both the groups, but without a significant group difference. Furthermore, patients with psychotic depression improved similarly to those with moderate or severe depression. Conclusions: The results of present study indicate a large sham effect of stimulation treatment. The intensive structured treatment protocol may explain the positive outcome in both the groups. It is important to recognize, appreciate, and utilize placebo effects as a significant means of rehabilitation in psychiatric care.