This second post of my chronic illness and trauma series builds on early risk factors for autoimmune disease such as type 1 diabetes that I introduced in post #1. It focuses on similar links between adverse babyhood experiences and asthma.
Here you’ll see how a child’s chronic illness – asthma in this case – can heal and how a mother’s difficulty feeling the bond with her baby is a symptom of trauma rather than a problem with her innate ability to be a mother.
You’ll learn how to identify what I refer to as adverse babyhood experiences (ABEs), how to understand that it’s not a mother’s fault, and how helping a mother heal from these early traumas also helps her repair and heal her natural ability to feel love for her baby. It also explains how helping a mother heal can help her baby heal too.
The stories and studies below help make sense of how trauma and other adverse events and environmental stressors during pregnancy, birth and infancy increase risk for symptoms such as depression in mothers and chronic disease in her child.
It also offers clues to those of us who have asthma and other chronic diseases as adults.
I’ve coined the term adverse babyhood experiences (ABEs) as a subset of adverse childhood experiences (ACEs) studies. There’s a full overview of ABEs in this post.
Recognizing my own early risk factors for asthma also began to make sense of my ME/CFS (chronic fatigue syndrome / “myalgic encephalitis).
Free Downloads of this Post or The Series
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Get the free PDF of this post with all the pictures or my free Book 4, which includes this and 4 other posts in this discovery series describing how adverse babyhood experiences (ABEs) affect risk for asthma, autoimmune diseases such as type 1 diabetes and other chronic illnesses.
This series shares research that changed my understanding of chronic illness.
I think of it as “How Understanding Trauma Makes Sense of Chronic Illness Series” and sometimes also refer to it as The Discovery Series because of all it taught me.
The studies presented here introduced me to perspectives I had never heard of when I was a family doctor.
They offered a new way of thinking about causes. They also suggested potential new tools for treatment and prevention.
These tools appear to be applicable far beyond asthma and to be helpful in working with other chronic diseases, many of which (as I have since discovered) are also affected by similar early risk factors.
Even though painful emotions influence symptoms, the role of life experiences in shaping long-term health is not psychological.
As you’ll see today and in the next post, it’s because life experiences interact with and alter our genes.
Asthma and Stress
My Personal Experience of Asthma
I developed asthma as a 5 or 6 year old when our household expanded from a single dog and 3 cats to a family with 15 kittens from 3 litters that were all born at the same time. There are stories from back then of going to the zoo on holiday with my cousins and having to alternate between a wheelchair and riding on my Dad’s shoulders because I was too short of breath from asthma to walk. My symptoms worsened pretty quickly at one point and after a trip to the emergency room I was hospitalized. The second time I was admitted the doctors wouldn’t let my parents bring me home until our pets were gone and the house had been thoroughly cleaned and dusted (dust and animal dander are two of the most common triggers of asthma flares).
My asthma persisted into adulthood. I took daily medications in my early 30s during my medical training but after that it was mostly intermittent and mild, triggered by exposure to animals, pollen, cold weather and to the bronchitis I always developed after having a cold. I was able to manage it with just an occasional puff from my inhaler during flares. Over the years I tried alternative medicine such as acupuncture and homeopathy in hopes of resolving or curing it but didn’t have any success.
So when I learned of Dr. Tony Madrid’s research and he had accidentally helped a girl recover from severe asthma, I was intrigued.
First, let me tell you about a few well-known risk factors for asthma.
Similarities Between Asthma & Type 1 Diabetes
Asthma symptoms include wheezing, coughing, tightness in the chest and shortness of breath. It can begin at any time in life but develops about half of the time in childhood.
There are a number of similarities between asthma and type 1 diabetes (T1D):
- Although a family history of asthma increases risk, a large percent of individuals with asthma have no family members with the disease,
- genetics account for less than half of the risk: if one identical twin develops asthma, for example, the co-twin develops asthma only 25% of the time (in type 1 diabetes co-twins develop T1D less than half of the time)
- environmental factors make up 50% or more of risk for asthma
- causes of asthma remain unclear although air pollution, some medication such as aspirin and beta blockers (commonly used to treat blood pressure), and smoking during pregnancy appear to increase risk or to act as triggers (see more on wiki)
- there are many perinatal risk factors for asthma, including premature birth; delivery by cesarean; complications during pregnancy, labor and delivery; and respiratory illness in the first week of life, among others. These are examples of environmental factors (1)Mead, V. P. (2007). Timing, Bonding, and Trauma: Applications from experience-dependent maturation and traumatic stress provide insights for understanding environmental origins of disease. Advances in Psychology Research. A. M. Columbus, Nova Science Publishers. 49: 1-80.
- as in T1D, symptoms of asthma can be managed with certain medications but not cured
Unlike T1D, some kids “outgrow” their asthma. It may recur at any time or it may never return. The more severe asthma is after age 5, however, the more likely it is to continue rather than to resolve.
An Unexpected Cure for Asthma
I first met Dr. Tony Madrid at a conference on prenatal and perinatal health. He was an adjunct faculty member at the University of San Francisco at the time and a practicing psychologist who worked with families and kids. He had a wonderful sense of humor, a smile that lit up a room, and a fundamental faith that the world – and people – are good. What follows is Tony’s story about an 8 year old girl whose asthma disappeared after a new approach he tried. I’ll call her Gillian.
Gillian’s Asthma Story
When Tony and his staff first started working with Gillian she was on multiple medications. She also needed frequent emergency care (4 trips to the emergency room in the 2 months before he first saw her) and steroid treatment a few times a year (steroids are used sparingly due to potent side effects and indicate the presence of severe inflammation), all of which were indications of just how severe her asthma was. Staff were unsuccessful in treating her symptoms despite a variety of approaches they tried such as relaxation techniques, visualization methods, behavior therapy, family therapy and hypnosis. Gillian would get better for an hour or two but the improvements didn’t last (2)Madrid, A. (2010). The Mother and Child Reunion: Repairing the broken bond. Monte Rio, Lulu Press, p. 11.
When nothing worked and they stopped treating Gillian, her mom asked to keep doing counseling for herself. They continued with her for another 5 months.
It was during a conversation with Gillian’s mother one day that new information arose.
She tearfully explained to Tony that she felt shame because she did not love her daughter. Because she had none of the maternal feelings towards Gillian that she had heard other mothers express. And that she had had these feelings from the beginning.
Having just read a book his pregnant wife had given him called Maternal-Infant Bonding, Tony asked her to tell him the story of Gillian’s birth.
“The child’s father had left 3 months before the birth, totally devastating her. Her own mother had been in the labor room and berated her throughout the entire process. The medical staff greatly disappointed her. She was harangued and insulted by a labor room nurse. Her own physician was not there and her baby was delivered by a stranger … Because the baby girl was born jaundiced, she was immediately taken away for treatment, and the mother did not see her baby for eight hours. When the baby was allowed to come home she became ill again and had to return to the hospital for almost a week. When the baby recovered and was finally returned home, the mother reported the baby felt so strange … (3)Madrid, A. and D. Pennington (2000). “Maternal-infant bonding and asthma.” Journal of Prenatal and Perinatal Psychology and Health 14(3-4)(Spring): 279-289, p. 285.
‘This doesn’t feel like my baby. I think it belongs to the hospital more than me. Maybe they should keep it.’ “(4)Madrid, A. (2010). The Mother and Child Reunion: Repairing the broken bond. Monte Rio, Lulu Press, p. 12.
Tony saw how strong the links were between asthma and stress during this very early period in Gillian’s life. He worked with her mother that day in his office. He used hypnotherapy to help her change the birth in her imagination to a perfect birth, including one in which
there was no sadness from separation from the father … her own mother was not in the room, a good nurse was present, the correct doctor was in attendance, and a healthy child was born who stayed with her (5)Madrid, A. and D. Pennington (2000). “Maternal-infant bonding and asthma.” Journal of Prenatal and Perinatal Psychology and Health 14(3-4 (Spring): 279-289, p. 285.
During the mother’s last session of counseling 3 months later, as she was preparing to leave,
… she stopped in the office doorway, came back in, and said: “Oh, remember that session where we did that hospital thing? Well, my daughter’s asthma went away after that and it hasn’t returned except for one time, when she was away from home; and it got better as soon as she got back home. She had not been to an emergency room since that session. And she does not need any medicine. And remember how I never felt any love for her? Well, I do now.”
I was stunned by Tony’s story.
Asthma – in a severely asthmatic child – over the age of 5 – cured?
By working with the mother?
By treating issues that seemed to have nothing do with asthma or health from any medical perspective I could understand or relate to?
I decided to learn more about what Tony had discovered. What I found further changed everything I knew about chronic illness. It started with research from the 1970s that showed links between asthma and stress in early life. And that events occurring during pregnancy and around the time of birth have an impact on the well being and health of both mothers and their babies. The critical element was similar to Dahlquist’s finding in type 1 diabetes showing that it wasn’t jaundice that was a risk factor for T1D but maternal-infant separation.
Birthing Practices Affect Health
Marshall Klaus and John Kennell, pediatricians at Case Western Reserve School of Medicine in Cleveland, Ohio, wrote the book “Maternal-Infant Bonding” that inspired Tony to ask Gillian’s mother about her birth (6)Klaus, M. H. and J. H. Kennell (1976). Maternal-infant bonding. St. Louis, Mosby. They added more information in a second edition that included fathers called Parent-Infant Bonding. Despite it’s having been published in 1982, it remains relevant even with all the other research I’ve since found.
Studying Effects of Birth in Hospitals
Birthing in hospitals started in the early 1900s in the United States (7)Klaus, M. H. and J. H. Kennell (1976). Maternal-infant bonding. St. Louis, Mosby, p17 and nurseries were originally created as a place for babies to be watched while their mothers recovered from the drugs they were given for delivery, which knocked them out in what was referred to as “twilight sleep.” Nurseries also offered what became “perceived as a necessary ‘vacation’ for weary new mothers in search of a little sleep.” (8)Grayson, J. (2016). Unlatched: The Evolution of Breastfeeding and the Making of a Controversy. New York, Harper Paperbacks, p. 161.
During their work with newborns in hospital settings and neonatal intensive care units in the 1960s and 70s, Klaus and Kennell began to wonder whether the routine practice of separating babies from their mothers after birth was having deleterious effects.
In their studies, they explored whether there were any differences between groups of mothers who were given extra time with their babies in the first hours and days after birth and mothers who experienced routine hospital care.
Routine Separation of Mothers and Babies
In the 1960s and 70s, which is also when I was born, routine birthing care involved giving a mother a glimpse of her baby at birth, brief contact to identify him or her 6 or 8 hours later, and 20 to 30 minute visits for feedings every 4 hours. Babies were kept in the nursery under the care of nursing staff at other times.
Fathers and family members were not allowed in the delivery room during birth until some years later.
Mother-baby pairs who were receiving the standard of care at the time served as the control group in Klaus and Kennell’s studies.
The Unrecognized Benefits of Mother-Baby Time
Mothers who spent more time with their newborns (the “extended contact” group) were given their babies to hold for an hour in the first 2 hours after birth and for 5 extra hours on each of the next 3 days of life.
Mothers held their babies skin to skin.
In a few studies, extended contact mothers held their babies for only an extra 30 minutes more than control mothers. This was during the first hour after birth.
The results of this seemingly insignificant amount of extra time given to mothers and their babies are nothing short of astounding (9)Kennell, J. H. and M. H. Klaus (1998). “Bonding: recent observations that alter perinatal care.” Pediatr Rev 19(1): 4-12.
In fact the results have been so striking that The Cochrane library, a collection of high-quality, independent evidence that informs medical decision-making and evidence-based practices, analyzed 34 studies looking at effects of skin-to-skin contact in 2012 and came up with the same kinds of findings that Klaus and Kennell had (10)Moore, E. R., et al. (2012). “Early skin-to-skin contact for mothers and their healthy newborn infants.” Cochrane Database Syst Rev(5): CD003519. Here is some of what they all found.
When Mothers get more time with their babies
- Mothers who get more time with their babies show more attachment behaviors such as gazing at, fondling, caressing, kissing, holding close, and talking to their babies (control group mothers spend more time cleaning their babies)
- nurse for longer and with more ease (77% nursing at 2 months vs 27% in the control group)
- have calmer babies and children who are easier to please
- show more soothing behavior when their babies cry
- are more reluctant to leave their infants with someone else
The number and extent of these behaviors increases with each additional increment of time that mothers have with their babies in the first hours and days after birth. These mothers also have less postoperative pain after cesareans and greater ease after birth and in the first week at home.
When Babies get more time with their mothers
Babies who get more time with their mothers:
- smile and laugh more
- cry less
- have less colic, shorter hospital stays, fewer infections and deaths
- have slightly higher blood sugar levels
- have slightly higher and more stable body temperatures
- have slightly lower and more stable heart and respiratory rates
- have greater weight gain at 6 months (1.5 pounds)
- have IQs & language at 2 and 5 years that mirror their parents’ more closely
Parent-Baby Time Affects Health
Early Contact Affects Parent-Baby Bonds
What Klaus and Kennell – and others – have discovered is that routine separation at birth and in early life interferes with the bond between mothers and their newborns. They learned that seemingly innocuous hospital practices have significant effects on physiology and nervous, immune and other organ system regulation in babies.
In other words, the amount of time mothers get with their babies affects the parent-infant bond. More recent studies have found the same to be true for fathers.
Parent-Baby Bonds Affect Health
The parent-infant bond influences the amount of physical closeness parents maintain with their babies, the way they talk to and relate to them, as well as how their babies respond.
Studies have shown that a baby’s nervous system and other organ functions don’t regulate themselves in a void but that human biological functions are very specifically influenced by emotional connection and physical closeness to parents.
In other words, behaviors and relationships have a profound effect on short and long-term health.
Early behaviors are influenced by hormonal levels during the process of pregnancy, labor and birth and physical proximity at and around the time of birth. Physical, behavioral and emotional processes all interact to affect one another in an ongoing cycle.
Babies’ bodies are immature at birth. The bond between parents and babies regulates bodily functions and health through emotional connection and behaviors.
A 20 year follow-up study looking at the impact of skin-to-skin contact or “Kangaroo Care” in a group of preterm and low birth weight infants has found that there are still positive identifiable differences even decades later (11)Charpak, N., et al. (2016). “Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care.” Pediatrics Abstract. Full Text.
Early Relationships Regulate Physiology
Like Hofer’s studies in rat pups (12)Hofer, M. A. (1994). “Early relationships as regulators of infant physiology and behavior.” Acta Paediatr Suppl 397: 9-18, and Dahlquist’s studies about type 1 diabetes in baby humans (13)Dahlquist, G. and B. Kallen (1992). “Maternal-child blood group incompatability and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus.” Diabetologia 35(7): 671-675 and mice (14)Dahlquist, G. and B. Kallen (1997). “Early neonatal events and the disease incidence in nonobese diabetic mice.” Pediatr Res 42(4): 489-491, Klaus and Kennel found that physical closeness between human mothers and their babies affects newborn physiology.
These include body temperature, blood sugar levels, oxygen levels , breathing and heart rate (15)Moore, E. R., et al. (2012). “Early skin-to-skin contact for mothers and their healthy newborn infants.” Cochrane Database Syst Rev(5): CD003519.
Maternal-infant bonding in humans enhances bodily functions that were thought to regulate themselves all on their own.
Hofer described the presence of invisible processes that supported greater regulation in rat pups who remained in close physical proximity with their dams.
He referred to these processes as “hidden regulators.”
We now know that hidden regulators operate in humans too. Babies, for example, find the nipple by smell.
Mothers experience a greater intensity of bonding with their babies in part due to oxytocin, the love and bonding hormone, which surges during labor, right after birth, and with breastfeeding (16)Moore, E. R., et al. (2012). “Early skin-to-skin contact for mothers and their healthy newborn infants.” Cochrane Database Syst Rev(5): CD003519.
Making Sense of Gillian’s Asthma
Klaus and Kennell discovered that maternal infant separation has many consequences. Babies cry more, are more difficult to soothe, have more difficulty breast feeding, and get sick more often.
Mothers, however, are ALSO particularly and significantly impacted, both by physical as well as emotional separation.
Tony Madrid found that physical and emotional separation were also critical risk factors for asthma.
Physical Separation at Birth
Events that increase risk of physical separation at birth include difficult or complicated deliveries, cesarean births, illness in mother or child at birth, anesthesia or medication that makes a mother less mentally present, when a baby needs intensive care or to be placed in an incubator, and having twins or triplets, among others.
As in Dahlquist’s study of type 1 diabetes, Gillian had jaundice. And as in Dahlquist’s follow-up study, it was the 8 hours of separation after birth, followed by another week of hospitalization that interrupted the maternal-infant bond.
When Gillian’s mother felt as though her baby belonged more to the hospital than to her, she was describing an experience that is actually typical of mothers whose bond to their babies has been interrupted (17)Madrid, A., et al. (2012). “The Mother and Child Reunion Bonding Therapy: The Four Part Repair.” Journal of Prenatal and Perinatal Psychology and Health 26(3), p. 166.
My grandmother described a similar sense about her premature daughter, a twin who had been born prematurely by cesarean and who had been hospitalized for much longer than her sister. When her second daughter had come home after months of care at the hospital, she had felt as though her little baby belonged more to the nurses than to her.
These are all examples of the links I was beginning to see between adverse babyhood experiences and asthma.
Emotional separation occurs when a mother is “experiencing an emotion that is so strong that it competes and interferes with the emotions of bonding” (18)Madrid, A., et al. (2006). “Repairing failures in bonding through EMDR.” Clinical Case Series 5(4): 271-286, p. 273. Events that interfere with bonding can occur during pregnancy, labor and birth, in the first weeks or months of life, and even into the first few years of a baby’s life. These may include a mother’s intense or unresolved grief after the loss of a loved one during or after pregnancy or from a previous miscarriage; delay in holding the baby after birth; separation from a partner; moving before or soon after birth; intense fear, such as in the context of domestic violence, an assault or an accident, among others.
Gillian’s mother had been devastated when her baby’s father left during her pregnancy. She had also felt unsupported and harangued during labor by her mother and an unfriendly nurse, and by the added loss of support when a strange doctor delivered Gillian. All of these are remarkably common during many women’s pregnancies, labors and deliveries – and they have a much greater impact than we have realized.
Like Dahlquist, the Swedish researcher who discovered that difficult events during pregnancy, birth and infancy increased risk for type 1 diabetes, it appeared that a common denominator among risk factors linked asthma and stress in different ways.
These examples also helped me begin to recognize the links between adverse babyhood experiences and asthma and other chronic diseases.
Gillian’s Risk Factors for Asthma
As a result of having read Klaus and Kennell’s book, Tony had had a context for asking about Gillian’s birth story.
Gillian’s mother had experienced a number of events that had interfered with her ability to bond with her daughter.
Tony’s research found that such experiences are also risk factors for asthma, which Pennington coined as “non-bonding events” (19)Madrid, A. (2005/2006). “Helping children with asthma by repairing maternal-infant bonding problems.” Am J Clin Hypn 48(3-4): 199-211, citing Pennington, R. (1991). Events associated with maternal-infant bonding deficits and severity of pediatric asthma, The Professional School of Psychology, San Francisco.
Events that Interfered with Bonding
- devastation when Gillian’s father left early in her pregnancy (emotional separation or “ES”)
- being berated by her own mother during her labor (ES)
- feeling harangued and insulted by the labor room nurse (ES)
- having a stranger deliver her baby (ES)
- delay in holding Gillian (physical separation or “PS”)
- separation when Gillian was treated for jaundice (PS)
- more separation when Gillian was sick and hospitalized for almost a week after birth (PS)
How Bonding Disruptions Can Heal
Parents and babies often recover spontaneously from bonding disruptions when given enough time and support. But sometimes there is too much pain, grief or other experiences that interfere with this natural process of recovery. This is where Tony’s work with Gillian’s mother came in.
Risk Factors for Asthma
Tony ended up doing a number of research studies after witnessing Gillian’s recovery (20)Madrid, A. and M. Schwartz (1991). “Maternal-infant Bonding and Pediatric Asthma: an Initial Investigation.” The Pre and Perinatal Psychology Journal 5(1): 347-358, (21)Madrid, A. (2005/2006). “Helping children with asthma by repairing maternal-infant bonding problems.” Am J Clin Hypn 48(3-4): 199-211.
1. Bonding Interruptions
He explored whether bonding disruptions were common risk factors for asthma and found that 85% of asthmatic kids had experienced non-bonding events compared with 25% of healthy kids.
85% of asthmatic kids have experienced non-bonding events compared with 25% of healthy kids
2. Number of Interruptions Increases Risk
He also found that 70% of asthmatic children experienced more than one non-bonding event compared with 25% of healthy kids. In fact, asthmatic kids had an average of 2.8 non-bonding events compared to 1.2 episodes for well children (22)Madrid, 1991, p. 351.
70% of asthmatic children experience more than one non-bonding event compared with 25% of healthy kids
3. The Greatest Risk Factors for Asthma
The non-bonding events associated with greatest risk for asthma turned out to include (23)Madrid, A. (2005/2006). “Helping children with asthma by repairing maternal-infant bonding problems.” Am J Clin Hypn 48(3-4): 199-211:
- a mother’s loss of a family member in the first year of her child’s life
- a delay in first holding her child
- emotional distress during pregnancy, such as grief from loss or other difficult feelings following challenging events
- emotional distress after birth, such as PTSD from traumatic events, worry about finances or a relationship, or other difficult experiences
Who is At Risk for Asthma?
1. Not All Interruptions Cause Asthma
As with research in type 1 diabetes, Tony found that not every child whose mother had experienced separation and bonding disruptions developed asthma.
In addition, not all asthmatic kids experienced bonding problems (24)Madrid, A. (2005/2006). “Helping children with asthma by repairing maternal-infant bonding problems.” Am J Clin Hypn 48(3-4): 199-211. The extent to which non-bonding events affected risk for asthma, however, remained striking.
Based on research in type 1 diabetes and other autoimmune diseases, however, bonding disruptions and traumatic events in pregnancy, birth and infancy may still affect risk for different symptoms or chronic health conditions later in life. What’s helpful to remember is that recognizing potential links between adverse babyhood experiences and asthma can lead to healing bonding disruptions.
In other words, healing and repair of bonding disruptions is possible and changing birthing practices can be preventative.
2. Later Bonding Interruptions can Occur
Even if a mother is strongly bonded with her child, later events can interrupt this bond and increase risk for asthma. Tony worked with a woman whose son developed symptoms of asthma for the first time within 24 hours after she was assaulted. When he helped her to heal from the PTSD that had resulted, her little boy’s asthma resolved as well (25)I have been unable to find where I read this case study.
3. Not All Mothers of Asthmatic Children Feel UnBonded
Tony and colleagues found that it was not uncommon for a mother to say she was bonded despite evidence suggesting the contrary. After treatment, these mothers would notice a positive change and feel more bonded and connected to their children than they had before.
Repairing Parent-Baby Bonds & Healing Asthma
1. It’s Not Your Fault
One of the added benefits of Tony’s perspective and approach was that it offered relief to mothers who had been blamed and told it was their fault when all they had ever wanted was to love their child. The difficult relationships parents had with some of their children was not their fault. Learning it was due to events outside their control took the judgment and shame out of the equation (26)Madrid, A., et al. (2012). “The Mother and Child Reunion Bonding Therapy: The Four Part Repair.” Journal of Prenatal and Perinatal Psychology and Health 26(3) .
It also gave parents a way of healing asthma and repairing these bonds.
2. Heal Bonding, Heal Asthma
As discussed at the beginning of this post, it is possible to reinstate a strong bond to one’s child even if physical and emotional events interrupted the bond in early life. The fact that healing these specific events can also cure asthma is a remarkable indication that early events are indeed risk factors for asthma. The fact that healing can occur by helping mothers heal is also hugely inspiring and encouraging.
It also offers hope for healing other health consequences of early bonding disruptions, including the possibility of reducing and possibly even reversing symptoms of other chronic illnesses.
3. Similar Cures in Adopted Children
Children who are adopted experience bonding disruptions. This comes from the physical separation and other emotional stressors that are inherent aspects of leaving their biological mothers.
Tony found a similar association between adoption as another example of adverse babyhood experiences and asthma.
Treating adoptive mothers could heal asthma in their children as well, even when these moms felt strongly bonded to their adopted children and even though these women were not the biological mothers (27)Madrid, A., et al. (2012). “The Mother and Child Reunion Bonding Therapy: The Four Part Repair.” Journal of Prenatal and Perinatal Psychology and Health 26(3). Here’s one story in Mothering magazine about a mother whose adopted daughter healed from asthma as a result of bonding therapy.
4. Younger Kids Recover Most Quickly
As Tony worked with mothers of kids of all ages he also discovered that the youngest kids, especially infants and toddlers, recovered the most fully and quickly. For kids under 9, treating mothers alone was usually sufficient to address risk factors for asthma. Some of the older children he treated also recovered, but others were not completely cured. He wondered whether the older kids had been exposed to additional risk factors for asthma.
I describe mechanisms that explain how treating a mother can have such a direct effect on the health of her child in the next post of the series. One of these is about the effects of bonding and how life experiences alter genes.
Another is about the cell danger response, which is a healthy biological function that occurs in our mitochondria when faced with threats from environmental stressors such as infections, toxins, as well as physical and psychological events. As I mentioned in the previous post of this series, the effects of such events interact with and can compound one another, such as when babies are placed in incubators to receive oxygen for prematurity or other difficulties or treatment for infections – all which can be relatively life-threatening, and now occur in the context of physical and emotional separation. Here’s an introduction to the cell danger response.
My Risk Factors for Asthma (& ME/CFS?)
Taking everything I had learned, I reexamined my own early history for possible risk factors and links between adverse babyhood experiences and asthma very early in my life. What I had always thought of as a completely normal pregnancy and birth could now be seen as having much more nuance and complexity.
My mother experienced a number of non-bonding events during pregnancy, labor and delivery, and in the first 2 years of my life.
My Mother’s Experiences of Emotional Separation (ES)
When my mother was pregnant with me, she moved to another country, leaving behind her family and support system as she followed my father to his new job (ES1). She cried on seeing the ugly industrial neighborhoods in her new city, a place where she didn’t yet speak the language (ES2). When she went into labor she felt very alone (ES3?).
After the first 24 hours of contractions, feeling exhausted and overwhelmed when I still hadn’t been born, she took the doctor’s recommendation for an epidural. She found the procedure incredibly painful, however. To this day my mother wonders if the fact that I arrived almost immediately afterwards was an indication that she had gone through extra suffering for no reason (ES4?).
I was born in the 1960s when fathers weren’t allowed in the delivery room, so my mother had no one she knew with her during her labor or when giving birth and no one who spoke her language (ES5). She was also dismayed after she left the hospital because she had no family or friends to show her new baby to (ES6?).
My parents were both present with me during the first hour after birth. They have often talked about how quiet and alert I was and how calmly I looked around with my big blue eyes. Babies enter a state of alertness and exploratory behavior during this first hour that does not occur again to the same extent for several weeks (28)Klaus, M. H. and J. H. Kennell (1976). Maternal-infant bonding. St. Louis, Mosby. It’s part of a sensitive period that babies experience right after birth if their mothers haven’t been medicated and they are given the time with their parents. My parents both speak lovingly of that special, magical experience. This was clearly a period of parent-infant bonding.
My Mother’s Experiences of Physical Separation (PS)
Soon afterwards, however, my mother developed a spinal headache, which is an intensely painful complication that can occur following an epidural and is associated with nausea and difficulty moving, sitting or standing (all of which intensify the symptoms) (ES7). She was too sick to lift her head off the pillow and this probably lasted a few days (PS1). My mom remembers having difficulty conveying what she needed to the nurse during that period because of the language barrier (ES8?). Being in pain and unable to raise her head, she would also have been unable to hold or be with me during that time (PS1 or 2).
Unsuccessful Breastfeeding as an Indicator of a Bonding Interruption
When my mother recovered and tried to breast-feed it “didn’t work.” It turns out that difficulty breastfeeding is a common characteristic of non-bonding events and suggests that even though bonding with my parents occurred immediately after my birth, it was interrupted by a period of significant pain and physical separation.
Other Emotional Separation in the First Two Years
My sibling was born 15 months after me. My mom has described feeling overwhelmed, alone and depressed living in a foreign country with 2 children under the age of 2 while her husband worked full time (ES9). And then her father died when I was 18 months old (ES10). This would have likely affected her ability to bond to both of us.
Common Risk for Diabetes, Asthma, ME/CFS and more?
As I’ve described in the first post of this series, stressful events in pregnancy, birth and infancy are also risk factors for type 1 diabetes.
Gisela Dahlquist, a Swedish diabetes researcher suspects the common denominators among these risk factors are that they are all stressful and all increase risk for mother-baby separation.
The research I discovered linking diabetes, asthma and stress in early life pointed me in a direction that was completely different from what I had learned as a physician.
Research showed that there was a deep intelligence at work in natural events such as pregnancy and birth. One in which deep, biological impulses for connection and bonding guide not only behavior and relationships, but that also influence physiology, as well as emotional and physical health.
The science, along with learning from my personal experiences with my health, started changing how I thought.
The suggestions by diabetes researchers that early life events initiate risk or predispose certain individuals to risk seemed just as applicable to asthma.
Given the similarity in risk factors for asthma and type 1 diabetes (prenatal stress, maternal illness, illness in the baby, premature birth, cesarean sections, maternal-infant separation etc), I wondered whether early events were risk factors for other chronic illnesses as well.
When I looked at the research in inflammatory bowel disease (IBD – which includes ulcerative colitis and Crohn’s), which is also frequently diagnosed in childhood, I found risk was also increased with difficult prenatal, birth and early life events. I’ve since found studies showing increased risk from prenatal and perinatal events for most of the chronic illnesses I’ve researched.
I wondered whether my mother’s experiences of bonding disruptions had influenced my risk for chronic fatigue in addition to asthma.
What I was discovering was profoundly inspiring. It was also empowering. And motivating.
The Research Made Me Question Everything
The studies I learned about made me question everything I’d been taught about health and chronic illness in my medical training.
It also made me wonder if there was a way to heal my asthma and possibly even my ME/CFS, and more.
If healing maternal-infant bonding disruptions could cure asthma in kids, could similar approaches improve or heal asthma in adults?
Could such tools be effective in treating other childhood diseases with similar risk factors, such as type 1 diabetes?
Could early treatment be used to prevent asthma? Or type 1 diabetes? Or other chronic illnesses?
Could such an approach be something to consider for the treatment of chronic illness in adults?
Is chronic illness truly, as I had been wondering, the result of an intelligent process gone awry?
I’ll tell you more about my next set of discoveries in upcoming posts, starting with a 2004 study that explains the mechanisms of how treating a mother for a bonding disruption may help heal her child.
I’ve also written about the latest research showing how the cell danger response can trigger the onset of chronic diseases using an example of ME/CFS.
How To Work With Your Asthma or Your Child’s Asthma (Books & Resources)
To learn more about the research and how healing happens, read how Tony treats asthmatic kids and their moms in his book The Mother and Child Reunion.
You can also read more about Tony’s work and research on his website AsthmaBusters. Or contact him with questions or for a DVD he has developed for therapists wanting to learn how to implement the tools he has refined over the years (29)Madrid, A. Asthma and Bonding: Helping children with asthma by strengthening the Maternal-Infant Bond (therapist edition). Monte Rio, Tony Madrid. You can find many of his articles on his other website about bonding.
The book Maternal-Infant Bonding, by Marshal Klaus and John Kennell (1976) remains a remarkably relevant book to learn about bonding and the effects of early relationships even now, 40 years later.
If you wonder about potential links between adverse babyhood experiences and asthma – whether you are the parent of a child with asthma or have asthma yourself, take a look at the resources and therapies for healing trauma in this post on different types of therapies.
If you are an adult with asthma, healing effects of early life experiences and parent-child relationships may help your symptoms even if the process takes much more time than it does for young children. Working with the effects of different types of environmental stressors using these 10 tools can also help.
My own asthma is no longer active following in-depth work over a period of many years. I may still get wheezy when I get a cold or other upper respiratory tract infection, but symptoms are rare at other times.
Adverse Babyhood Experiences and Chronic Illness 1.0: A Subset of ACEs (Free ABE Fact Sheets & Checklist)
Post 1: What if Chronic Illness is an Intelligent Process Gone Awry?
Post 3: Early Life Experiences Alter Genes, Shape Perceptions of Threat and Affect Risk for Chronic Illness
Post 4: Short recap of the first 4 posts on How events in pregnancy, birth and infancy affect risk for chronic illness
Adverse Babyhood Experiences (ABEs): An Overview with Fact Sheets
Want to learn more? This series describes how stressful events in pregnancy, birth and infancy increase risk for type 1 diabetes (#1) and asthma (#2 – this post). One mechanism is that they cause emotional or physical separation between moms and babies. Such effects can alter gene expression (#3) to increase risk for chronic disease (#4). These epigenetic changes are also seen in PTSD and have been shown to be reversible when healing PTSD. Therapies for working with the effects of adverse life events are helping me make sense of as well as recover from ME/CFS and asthma. Maybe similar approaches for healing the effects of early adverse events, as described in today’s post, can be helpful for prevention and treatment of other chronic diseases such as type 1 diabetes and more. If you’ve had a difficult birth or other adverse early experiences it does not mean you will develop a chronic disease. Risk appears to require additional exposure to adverse childhood experiences and adverse events later in life. This information is not easy to find despite many good research studies, in part because links between stress, trauma and chronic illness have long been mistakenly dismissed (#5). Another big reason is that psychosomatic medicine promotes the inaccurate and outdated view that all effects of trauma are psychological.
|↑1||Mead, V. P. (2007). Timing, Bonding, and Trauma: Applications from experience-dependent maturation and traumatic stress provide insights for understanding environmental origins of disease. Advances in Psychology Research. A. M. Columbus, Nova Science Publishers. 49: 1-80|
|↑2||Madrid, A. (2010). The Mother and Child Reunion: Repairing the broken bond. Monte Rio, Lulu Press, p. 11|
|↑3||Madrid, A. and D. Pennington (2000). “Maternal-infant bonding and asthma.” Journal of Prenatal and Perinatal Psychology and Health 14(3-4)(Spring): 279-289, p. 285|
|↑4||Madrid, A. (2010). The Mother and Child Reunion: Repairing the broken bond. Monte Rio, Lulu Press, p. 12|
|↑5||Madrid, A. and D. Pennington (2000). “Maternal-infant bonding and asthma.” Journal of Prenatal and Perinatal Psychology and Health 14(3-4 (Spring): 279-289, p. 285|
|↑6, ↑28||Klaus, M. H. and J. H. Kennell (1976). Maternal-infant bonding. St. Louis, Mosby|
|↑7||Klaus, M. H. and J. H. Kennell (1976). Maternal-infant bonding. St. Louis, Mosby, p17|
|↑8||Grayson, J. (2016). Unlatched: The Evolution of Breastfeeding and the Making of a Controversy. New York, Harper Paperbacks, p. 161|
|↑9||Kennell, J. H. and M. H. Klaus (1998). “Bonding: recent observations that alter perinatal care.” Pediatr Rev 19(1): 4-12|
|↑10, ↑15, ↑16||Moore, E. R., et al. (2012). “Early skin-to-skin contact for mothers and their healthy newborn infants.” Cochrane Database Syst Rev(5): CD003519|
|↑11||Charpak, N., et al. (2016). “Twenty-year Follow-up of Kangaroo Mother Care Versus Traditional Care.” Pediatrics Abstract. Full Text|
|↑12||Hofer, M. A. (1994). “Early relationships as regulators of infant physiology and behavior.” Acta Paediatr Suppl 397: 9-18|
|↑13||Dahlquist, G. and B. Kallen (1992). “Maternal-child blood group incompatability and other perinatal events increase the risk for early-onset type 1 (insulin-dependent) diabetes mellitus.” Diabetologia 35(7): 671-675|
|↑14||Dahlquist, G. and B. Kallen (1997). “Early neonatal events and the disease incidence in nonobese diabetic mice.” Pediatr Res 42(4): 489-491|
|↑17||Madrid, A., et al. (2012). “The Mother and Child Reunion Bonding Therapy: The Four Part Repair.” Journal of Prenatal and Perinatal Psychology and Health 26(3), p. 166|
|↑18||Madrid, A., et al. (2006). “Repairing failures in bonding through EMDR.” Clinical Case Series 5(4): 271-286, p. 273|
|↑19||Madrid, A. (2005/2006). “Helping children with asthma by repairing maternal-infant bonding problems.” Am J Clin Hypn 48(3-4): 199-211, citing Pennington, R. (1991). Events associated with maternal-infant bonding deficits and severity of pediatric asthma, The Professional School of Psychology, San Francisco|
|↑20||Madrid, A. and M. Schwartz (1991). “Maternal-infant Bonding and Pediatric Asthma: an Initial Investigation.” The Pre and Perinatal Psychology Journal 5(1): 347-358|
|↑21, ↑23, ↑24||Madrid, A. (2005/2006). “Helping children with asthma by repairing maternal-infant bonding problems.” Am J Clin Hypn 48(3-4): 199-211|
|↑22||Madrid, 1991, p. 351|
|↑25||I have been unable to find where I read this case study|
|↑26||Madrid, A., et al. (2012). “The Mother and Child Reunion Bonding Therapy: The Four Part Repair.” Journal of Prenatal and Perinatal Psychology and Health 26(3)|
|↑27||Madrid, A., et al. (2012). “The Mother and Child Reunion Bonding Therapy: The Four Part Repair.” Journal of Prenatal and Perinatal Psychology and Health 26(3|
|↑29||Madrid, A. Asthma and Bonding: Helping children with asthma by strengthening the Maternal-Infant Bond (therapist edition). Monte Rio, Tony Madrid|
Great article. I work as a psychologist mostly with adolescents and adults. I was amazed when I first heard about Tony Madrid’s work and I am very interested in reading more on this website.
Veronique Mead, MD, MA says
I was amazed too. It makes a huge difference in understanding symptoms in kids and adults, and it’s often really validating for them too. Best to you in your work!
Thank you for pulling together so much of what I’ve been pondering and studying regarding trauma and chronic illnesses. It’s great to find so much important information pulling all the pieces together in one place. I’m
My mother was under extreme stress in her 3rd trimester while carrying me. I was her second pregnancy. My father, a dentist, contracted Polio from a patient carrier in December 1954 not long before Christmas.
In February 1955 he was getting out of the iron lung and receiving inpatient physical therapy. My mother smoked during her pregnancy to relieve stress of raising my older brother alone, carrying her second child, and loss of her mate and income.
My father was the breadwinner as was typical in the 50s.
Two weeks before I was due my mother was induced at a hospital several hours from Los Angeles where my father was being treated. He was to be released in two weeks and my mother had to deliver me not only because of that but because she had beginning toxemia in that last semester of her pregnancy.
I was left at the Catholic Hospital where I was born and the nuns took care of me for the first two weeks of my life while my mother search for a house in LA to move us all into so that my father could continue to receive outpatient physical therapy.
I was diagnosed with CFS after a chemical exposure at my work as a chemist in medical device manufacturing in 1986. In the 90s after a mountain bike accident I develop fibromyalgia. At the time the chronic fatigue was quiescent.
A free month I was diagnosed with a neurogenic bladder defect and had no nerves on 1/4 of my bladder. From that point on I traveled to Los Angeles on a regular basis from the Imperial Valley, CA to receive urological care and gad 2 minor surgeries and 1 major surgery at age 9.
It wasn’t until 2007 during a relationship break up did I learned that I had a form of PTSD. I believe that all of these events contributed to that including some epigenetic trauma passed down through my mom from her childhood.
in 2007 two days after Christmas my younger brother a very well-respected pharmacist within a VA hospital system suicided.
In 2016 I had major surgery to remove an ovary and a fallopian tube that was cystic to rule out ovarian cancer. Fortunately it was benign the laproscopic surgery went well. However a few months later I developed full blown MECFS.
Any improvements I had between us 2007 and 2018 are largely due to trauma thetapy including TRE, Bioenergetics, EMDR and ither trauma therapies. Also a clean diet, some supplementation, TCM herbs and acupuncture. Acupuncture and other modalities actually kept me working full-time from 1986 until 2008.
I have a long history of trauma not necessarily related to an abusive or violent childhood but due to well I now know are other forms of trauma.
I’d also say that there’s a lot of medical trauma that happens in patients with MECFS and Fibromyalgia because we’re off and not believed by healthcare providers.
Now I’m a retired clinical laboratory clinician turned Holistic Health Practitioner focusing on trauma recovery using different energy medicine modalities and other tools I’ve learned on my own journey.
Veronique Mead, MD, MA says
I’m so sorry for your losses – your brother, the accumulation of traumas, being sick for so many years,… You have put your story together in such an eloquent, “big picture,” articulate and poignant way. The work you have done through it all shines clearly in how you express these difficult situations with what feels like compassion for yourself as well as for the multigenerational components.
Thank you so much for sharing along with the tools that have made such a significant difference in your ability to keep working through it all and through your healing journey.
Everything we hear from others’ journeys, like your own, feels so helpful for all of us – the context, the triggers, the tools, the subtlety, the losses, the recoveries, the tone in which you can present it all …. It offers hope and encouragement. It also provides examples of the very common experiences of adversity that can affect our health and that have nothing to do with abuse or violence.
How wonderful that you are offering such hard-earned tools, understanding and wisdom in your new career. It’s lovely to meet you here and I wish you all the very best on this ongoing journey and labor of love :-)
Thank you Veronica. Appreciate you taking the time to read and reply.
I find Gillian and her mother’s story intriguing. Do you think that that effect would still have effect long after the child has left home? In other words, could a mother’s self healing work support an adult child’s healing work? I know that family constellations work exists but that’s primarily working with one family member I believe. What would happen if say the mother (who otherwise appeared healthy) were to pursue emotional healing work for herself? Do you think there would be an effect on the adult child?
Veronique Mead, MD, MA says
Yes – the effects from a mother’s experience can continue such that it affects her child’s health into adulthood. Tony’s work has found that healing seems to become more complex as the child gets older (after about age 9yo) and the research I’ve found suggests this may be due to the cumulative effects of other traumas (his thought too). So an adult may be able to heal by either working with their own attachment patterns and / or their mother’s healing work. See Stephan Hausner’s book for some remarkable case stories of adults who have healed when their adult mothers healed (I forget the details and have notes in my book but I’m not currently home).
My own asthma has just about completely resolved through my own attachment work over the past number of years.
I’m not sure what you mean in your reference to the Constellation work being with a single family member – sometimes it’s an entire system that changes, sometimes it’s a process that highlights an issue with one family member and then relates to others,… but one can return and to more constellations to keep healing old patterns (ie: sometimes one session does a great deal and sometimes it takes more). In other words – lots of healing can happen at any age. It can take longer for those of us who are adults, but Stephans’ examples show this isn’t always the case. Hope that helps!
and Tony Madrid’s) is that it can
I’ll look into Hausner’s book. It sounds interesting. I’m encountering a great deal of anger around this today. My mother has very obvious signs of emotional trauma and is very adamant that she’s not going to do anything about it. She also struggles with asthma. It’s frustrating to be a part of such an emotionally unhealthy family when I’m the one showing the symptoms most clearly and the others aren’t even interested in doing their bit to improve things. Too much fear I guess. Sigh! I’ll just have to keep on plugging away on my own!
My comment about family constellations work is that I thought it involved one person exploring their relationship to family members with the help of other (unrelated) group members as surrogate family. Perhaps I’m wrong. Perhaps entire family groups occasionally engage in the process together. I hope your sessions in Germany are going well. Thanks for writing so soon. I hope you didn’t feel pressured.
Veronique Mead, MD, MA says
Yes, read Hausner’s book. One of the most helpful takeaways I have from this work is another level of acceptance and even respect for doing our own work and how family members may not be able to address or heal their own traumas for all kinds of reasons. While it would be wonderful if they did, and could help the next generations a great deal, it is, I believe, a common occurrence.
As for family constellations – the beauty is that we can go as individuals for our own lives / healing / symptoms and what happens for us – which involves our family system being represented in the work – can help unlock / heal / resolve / or clarify issues that can release us to live our own lives more fully. In other words – it helps us heal even if our family members aren’t present / interested or able to do any work ie: it’s a way to address what you mention without family members having to do anything. It therefore gives us more capacity to heal regardless of what others do or don’t or can’t do within the family.
No pressure – just responding as I’m able while here in Germany! Travels went smoothly and it’s beautiful, cool and sunny here. Our workshop starts in about 5 hours :0-)
I just finished reading Stephen Porge’s “Pocket Guide to the PolyVagal Theory” for the second time. I’m seeing the effects of an unsafe social environment in my youth (lots of high stress situations around death and sex for me starting very early) and am focusing my energy on finding safe places at these levels to socialize and heal. I’m also grieving the loss of the childhood dream that if I just worked hard enough or smiled convincingly enough I would get the safety I craved. It’s crystal clear to me now that that was an exercise in futility. It’s painful to realize how strong the resistance to positive change is within my birth family and to let go of such a deeply embedded pattern of behaviour in myself. I hope your workshop goes well and you are able to find a way to release old traumatic memories and find greater safety in your life. Thanks for the lead on Hauser’s work. Cheers, Garth
Veronique Mead, MD, MA says
“Yes!” to your insights Garth!