The 4 B’s of Neurodevelopment – Optimizing Brain Development

When we think of optimizing neuro-development we probably should start pre-natally with things like maternal nutrition, exposures, and infection.

Although these things definitely contribute to the infant’s brain development before the are admitted to the NICU, unfortunately there is little we can do about it (apart from public health advocacy work — which is something I am extremely passionate about too, but will save for another day!)

So let’s break down optimizing brain development in to two parts:

1. Promoting neuro-genesis or basically growing new neurons
2. Nurturing existing neurons, whether healthy or injured

When it comes to neuro-genesis there are several investigational therapies that are on the horizon and will hopefully be a reality for us in the future.  But in the meantime, there are several interventions that we can offer almost on a daily basis that can help neurons grow.  These are:

1. Massage
2. Kangaroo Mother Care or Skin-to-Skin

Yes.. you read that right…. Massage and skin-to-skin can actually grow new neurons!! And this is actually seen as larger brain volumes on MRI and more complex EEG patterns too.

For nurturing the existing neurons there are a variety of interventions that contribute to this goal:

1. Protecting sleep
2. Minimizing sensory overload – regulate exposure to noxious light, sound, smells, tastes, and touch
3. Minimize maternal/infant separation (and yes.. offer more skin to skin exposure)
4. Minimize stress and pain
5. Provide optimal supplementation and nutrition

There are endless publications and potential interventions that address each of these five areas of intervention.  Which of these interventions is your NICU focusing on??