Will identifying ‘bad mother’ neurons prevent deaths such as Baby P’s, or condemn women before they even give birth?

March 26, 2010

As a little girl, Sian Busby was told that her great-grandmother had drowned her twin daughters when they were just a week old. Years later, when she became a mother, Sian was haunted by the notion that she might have inherited the same “bad mother gene”.

“My feelings of inadequacy and panic as a new mother were compounded by this sense that I might have a genetic predisposition towards infanticide or abusive behaviour,” she says. This in turn drove her to infanticidal fantasies and severe postnatal depression: “I felt completely overwhelmed by the task of mothering and at my lowest points the thought of putting a pillow over my baby’s head did flit across my mind. On those occasions, the knowledge of what my great-grandmother had done made me fear that I might actually be capable of doing the same.”

As bad mothers dominate headlines — from Tracey Connelly, Baby P’s mother, to this week’s tragic story of a ten-month-old boy who starved to death while he lay in his pram at his mother’s flat in North London — neurological research from the United States raises the question of whether a bad mother switch in the brain can be detected, and if so, whether neglectful or abusive behaviour could be prevented.

According to scientists at Richmond University in Virginia, women develop a set of “maternal neurons” that operate like “bad mother/good mother” switches in the brain. Using brain-scanning techniques, they have identified a cluster of brain cells, created during pregnancy and “switched on” after birth, that appear to correlate with good or bad parenting behaviours.

“We believe that a certain number of these ‘maternal neurons’ need to be ‘switched on’ for good mothering to take place,” explains Professor Craig Kinsley, whose research has so far been limited to rodents and small mammals. “Our research showed that the mothers with fewer than this number of ‘maternal neurons’ tended to neglect or abuse their offspring, while those animals with the lowest numbers actually savaged or killed their own young.”

Similar techniques could soon be used to identify human mothers with the capacity to abuse their children. A team at Yale University is already using brain scans to study the areas of the brain that drive good and bad mothering: “We have identified certain areas of the brain where there is a correlation between the level of neuron activity and measures of ‘adequate’ and ‘inadequate’ parenting,” says Professor James Swain.

If it all sounds a bit like something from the film Minority Report (where Tom Cruise goes around arresting people for crimes they are predestined to commit), Swain insists that it wouldn’t be a case of “scan your brain and take your baby away” — rather, “bad mother brain scanning could provide a means of targeting and working with ‘high-risk’ mothers in order to prevent abusive patterns of behaviour before they even started.”

Not everyone is behind the idea. Sian Busby believes that such measures could create a self-fulfilling prophecy. “My own experience has taught me how damaging a sense of innate culpability can be. Because I thought I had inherited the capacity to be a cruel mother, I became consumed by fear that I might do something to my baby. The notion that it was somehow out of my control was terrifying and unhelpful. Moreover, it prevented me from seeking the support I needed.”

Professor Alison Fleming, director of the Centre for the Study of the Psychobiology of Maternal Behaviour at the University of Toronto, agrees: “There is no single factor that determines maternal behaviour,” he says. “The idea that a woman’s brain is ‘hard-wired’ in such a way that she will abuse her children and that it is not within her power to refrain from doing wrong is based on a misunderstanding of neuro-anatomy. All behaviour is dictated by the brain, but the brain is formed in interaction with our environment.”

Fleming is also concerned that the new research into maternal neurons could be used to argue diminished responsibility for those who abuse their children: “It’s perfectly possible to be a good mother with ‘bad genes’ — or ‘bad brain cells’ for that matter — just as it is possible to be neglectful, abusive or inadequate with good ones.”

Professor Kinsley disagrees: “We are all a slave to our brain function. An abusive mother has something malfunctioning in the brain so, in that respect, her behaviour is beyond her control.” When it comes to studying the brain, questions of “bad” and “good” need to be replaced with notions of “broken” and “fixed”, says Kinsley. “But it’s not a question of whether we excuse a certain behaviour. The aim of our research is to identify brain malfunctions so we can work towards fixing them.”

But is it possible to fix or rewire a brain? “Of course it is,” says Kinsley. “Just because a certain pattern of behaviour has a neuro-anatomical determinant does not mean that it is not possible to alter it. The brain is incredibly ‘plastic’, constantly responding to the environment and capable of incredible change.” According to Kinsley, new mothers whose brain scans identified them as having inadequate numbers of maternal neurons could be targeted with counselling or nurse visiting programmes. “Such interventions would help to kickstart more maternal neurons, switching on circuits in the brain responsible for healthy, sensitive parenting behaviour.”

Liz Harman is a family nurse from Derby who is involved in the Family Nurse Partnership (FNP) programe, which targets mothers from high-risk backgrounds. “Mothers on the FNP receive 64 home visits from a community nurse for the first two years of the child’s life,” she says. “Results from a 15-year pilot study of a similar programme in the US showed that targeted families had 48 per cent less incidence of child abuse and neglect. The idea is not to stigmatise these mothers and make them feel like bad parents; it’s to empower them, to give them the tools they need to be great mums.”

Early intervention is key, says Harman: “We start working with mums from 16 weeks into their pregnancy. After 28 weeks, it’s too late. The window during which they are open to this kind of intervention has closed.”

Until now, Kinsley’s maternal neuron work and Swain’s neuro-imaging studies have focused only on new mothers: too late for intervention models to work, according to the FNP model. But Alison Fleming believes that, “while there are sensitive periods during which interventions are most effective, that does not mean that later interventions cannot also effect change, given enough time.”

Sian Busby thinks that a lack of support was one of the factors that drove her great-grandmother to kill her twin daughters. “When I was pregnant with my second son, I felt compelled to try to understand what drove this woman, who had been a warm and loving mother of three, to kill her new born babies.” In the course of her research Sian learnt that she had in fact given birth to triplets, but one had been stillborn and there was a risk that the remaining twins might have suffered brain damage.

“Crucially, just a few days after the birth my great-grandmother was left alone. The woman who was supposed to be attending her that day didn’t turn up because her husband returned from the trenches, and my great-grandfather was away. Perhaps if she had been given the support she needed at that crucial time, things would have worked out very differently.”

Sian’s research made her ensure that she had a strong support network in place after the birth of her second son. “I think there comes a moment in every mother’s day when she would happily throw her child in the dustbin, but usually something stops her. I don’t believe that has anything to do with genes.”

The “Mommy Brain” researchers, Kinsley and Swain, hope that their work will one day protect children such as Baby P. “Greater understanding of the neural mechanics of maternal behaviour should help us to understand what causes mothers to harm their children. Then we can develop programmes to prevent abuse occuring in the first place.”

http://women.timesonline.co.uk/tol/life_and_style/women/families/article7076033.ece

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