My wife was in the operating room getting prepped for the caesarean section. I sat outside waiting for the call to come join the team of eight, including an OB/GYN, a medical resident, numerous nurses and even a few volunteers.
I heard steps coming down the hallway. A man in surgical greens approached me. He had a confident demeanor.
“Are you Brennan?”
“Yes.” I replied hesitantly.
“Perfect. Let’s have a birthday party.”
And with that comment – pushed the doors open to expose the operating room in its entirety.
I was led up to Jessica’s face. There was a large sheet shielding everything below her naval. I was there to support her for the surgery.
After nine minutes, we heard a cry. One of the nurses yelled, “Hey Dad, picture time.”
I stood up and snapped the first photo of our child within 5 seconds of her taking her first breath.
To put this experience in perspective, it was only a generation ago that my father had to barter with the OB/GYN to even be in the room for my arrival, let alone be encouraged to take a photo.
The hospital experience of new parents has certainly changed within a generation. The length of the hospital stay following a C-section has dropped from seven days to two. Mothers no longer receive foot massages during their stay. Fathers are not allowed to smoke celebratory cigars in the hospital. Breast feeding is exclusively promoted. The newborn baby is immediately given to the mother and father, not taken away for 24-hour monitoring. The waxy substance covering a child (vernix) is not washed off, but left to absorb into the skin as it is a natural moisturizer. Sadly, drinking a pint of dark beer to promote lactation is no longer encouraged.
Even the swaddling technique has evolved. Our nurse advised us against a tight swaddle as this would increase the risk of over-heating the baby and instead showed us a looser technique that would allow the baby to be cooler.
It would have probably turned out this way regardless, but that advice has made the regulation of our baby’s temperature a constant source of anxiety. Many of our conversations begin with, “Do you think she’s too hot/cold?”
Newborn children are poorly insulated and cannot shiver to generate heat like adults can – so the fact that we were warned against the baby being too hot instead of too cold seemed counter intuitive.
However, newborns are endowed with a specialized collection of cells called brown adipose tissue (BAT), which is exquisitely designed to generate heat. Research has shown that BAT is a primary factor in the maintenance of infant core body temperature and makes up ~5% of a newborn’s body mass. BAT has a mechanism in place that pulls fat and carbohydrate through the metabolic pathways and generates heat as a by-product. Therefore, because newborns have an inherent heat generating strategy in place, a tight swaddle to ensure the baby’s warmth is not as necessary as once thought.
As I read further into the subject of brown adipose tissue and infants, I came across some interesting ideas.
There are ethnic differences in BAT content, and these differences may offer clues into our ancient past and highlight the power of natural selection.
The hypothesis goes like this: As our ancestors moved out of Africa (approx. 120,000 years ago) and migrated north, the colder climate selected for survival adaptations that allowed newborns to defend their body temperature and avoid hypothermia. One of these evolutionary adaptations was an increase in BAT content. Infants with enough BAT to generate heat could survive cold climates and live to procreate and pass on the genes encoding the increase in BAT.
Recent scientific papers lend support to this hypothesis as there is some evidence that people from cold climates (eg. northern Canada) have higher BAT content vs. people from hot climates (eg. Ethiopia).
Therefore, the evolutionary adaptation of increased BAT may have played a significant role in the survival of infants born in cold environments. Considering the indigenous people of this country emigrated from Siberia across the Bering land bridge, and the European settlers were from cooler climates, much of Canada’s population may be indebted to this specialized tissue.
By Brennan Smith, PhD
