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Background

For decades, researchers have studied the psychosocial factors that shape an individual's level of resilience, a protective mechanism that provides humans with the ability to cope under stress (Folkman & Lazarus, 1984). The benefits of resilient coping are numerous. It is linked to more positive affect, self-esteem, socialization, language fluency, better school performance, and health (Svanberg, 1998). Studies also demonstrate that successful coping assists in aging and survival (Gooding, Hurst, Johnson, & Tarrier, 2012).

Evidence shows that a baseline for coping and resilience is developed in the mammalian brain during the first year of life (Kaffman & Meaney, 2007). In this study, primates and rats were studied to determine which factors give rise to this infantile basis of coping. It was discovered that mother-infant bonding through touch in the first year of life launches a specific sequence of DNA methylation, which is central to normal physical and psychological development (Kaffman & Meaney, 2007). These and other animal studies led researchers to conclude that parent-infant touch is responsible for a similar coping framework in the human brain (Gunnar & Quevedo, 2007).

Positive touch is a form of tactile stimulation that plays a significant role in human interaction and the process of bonding. It often is used to increase relaxation and decrease pain (Moyse, 2005). Studies show that parent-infant bonding through positive touch elicits a parasympathetic response in babies. Cuddled, or positively touched, infants display a marked decrease in blood pressure, increased depth of breathing, and increased digestion. Infants who have been abused and neglected exhibit an opposed response through increased heart rate, shallow breathing, and slower digestion (Benjamin, Werner, & Chellos, 2009). Increased caregiver attentiveness and bonding promote the level of attachment necessary to cope resiliently (Svanberg, 1998).

John Bowlby (1988) developed Attachment Theory and defined attachment as a fundamental and instinctual desire that begins at birth to form strong connections among certain individuals. In his Attachment Theory, Bowlby defined four modifiable systems believed to determine infantile levels of attachment. Bowlby's theory proposes that triggering these systems through infant bonding within the first three years of life promotes secure parent-infant attachment (Boris, Aoki, & Zeanah, 1999).

In an effort to find relationships among touch, attachment, and resiliency, Anisfield, Casper, Nozyce, and Cunningham (1990) studied the effects of kangaroo care (KC) on attachment. KC is a form of positive touch that promotes parent-infant bonding when a baby is carried across the chest in a sling. Research showed a notable increase in the level of attachment between parents and infants when babies were carried in slings rather than in infant seats. In addition, parents who practiced KC were more attuned to their infant's needs than those who touched their baby less frequently. As determined by home observations and parent self-report questionnaires, KC babies were more securely attached by the end of the first year of life than babies whose parents did not practice KC (Anisfield, Casper, Nozyce, & Cunningham, 1990).

Despite the abundance of research supporting parent-infant bonding, many still argue that touch does not promote resilience. For instance, the director of The Center for Pediatric Sleep Disorders, Richard Ferber (2004), advises parents to practice less hands-on techniques, like letting the infant "cry-it-out" rather than holding the baby close and cuddling them to sleep. This parenting technique developed from a 1940s finding that some newborns are "hypersensitive to touch," meaning that they actually elicit a stress response to physical stimulation. When this hypersensitivity phenomenon was discovered, even orphanages stopped using touch in care of their infants (O'Brien & Lynch, 2011).

Spitz's 1940s study, however, found that infants residing in such orphanages failed to thrive and died prematurely, even though their physiological needs were being met. In the study, surviving infants were placed into orphanages that utilized tactile stimulation. The infants were given the same amount of nutrition, yet the new feelings of safety and attachment that resulted from therapeutic properties of touch enabled them to gain weight and develop more successfully psychologically and physiologically (as cited in Richter, 2004). This study illustrated that denying bonding touch, which promotes secure attachment, directly affects an infant's ability to survive. In addition to increased health risks and poor coping skills, insecure attachment in infancy can also lead to decreased self-esteem and trust issues. A comprehensive review of the literature concluded that the negative results of insecure attachment in infancy are associated with poor coping, lower levels of resiliency, and psychosocial issues, which are exacerbated in adulthood (Segal & Jaffe, 2012).

The positive effects of touch on infant development are clearly documented in the literature. However, research has only begun to scratch the surface in discovering the effects of mother-infant touch on the mother. In 2010, a study found that mothers who participated in more frequent skin-to-skin contact with their infant experienced a shorter placental delivery time. These mothers also chose to breastfeed more frequently than those who had less physical contact with their newborn after delivery (Marin, Llana, Lopez, Fernandez, Romero, & Touza). This study discussed how tactile stimulation positively affected a group of mothers physiologically and encouraged a stronger attachment to their newborn. However, it does not describe the effects of touch on the mothers' resiliency or mental state.

Dombrowski, Anderson, Santori, and Burkhammer (2001) found that kangaroo care helped reverse feelings of depression in postpartum women. Corticotropin-releasing factor (CRF) is a hormone normally released in the human body in response to stress. During the third trimester of pregnancy, the placenta begins increasing the release of this hormone, affecting the hypothalamic-pituitary-adrenal (HPA) axis. Delivery of the placenta suppresses the HPA axis, causing some new mothers to experience postpartum depression. These researchers believe that stimulation experienced during KC reactivates these hormones and the HPA axis, thereby reversing depression and increasing maternal resiliency. From the wealth of information available, most researchers conclude that increased attention and bonding through positive touch during infancy promotes better resiliency in adulthood. However, research has failed to uncover whether resiliency is modified by life events, such as a mother bonding (or using touch) with her infant during adulthood. The same level of bonding that enhances an infant's resiliency may play a role in the resilience of the infant's mother as well.

This research study examines correlations among feelings about touch in the mother's life (past and present), current level of mother-infant touch, and the mother's level of resilience. The major hypothesis to be tested is: high level of comfort with touch and reported infant touch will correlate with a high level of resiliency in mothers of children less than one year of age.

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