![]() But when the stress response is prolonged and not eased by caregiver support, it becomes toxic to the brain and other organ systems, according to a report co-authored by Garner et al., and published in Pediatrics. The fight-or-flight response, in which stress hormones rise and inflammation increases, is healthy and crucial for survival. ![]() When stress is positive or tolerable - a child gets an immunization or starts day care - the proverbial “fight-or-flight response” kicks in temporarily. There’s that common denominator of the physiologic stress response,” he explains. “Whether the adversity is catastrophic or more routine and mundane, the effect on the body is similar. Family circumstances that were considered routine - such as divorce or separation, parental mental illness or substance abuse, or growing up in poverty - are anything but. But now “people are beginning to realize that there is a spectrum of childhood adversity,” says Garner. He explains that experts in developmental science have long understood that catastrophic events, such as experiencing or witnessing trauma, have negative effects on children. “This is a rapidly evolving field,” says Andrew Garner, MD, PhD, FAAP, a primary care pediatrician at University Hospitals Medical Practices in Cleveland. Toxic stress has gained attention in recent years as advances in the areas of epigenetics, neuroscience, and life-course science have all pointed to it as a source of poor outcomes for children and adults. A child who routinely suffers abuse, neglect, or other forms of hardship, such as poverty, may be at risk for this harmful form of stress. A concept developed by the National Scientific Council on the Developing Child, toxic stress describes the body’s response to negative events or experiences that are either powerful, repeated, or prolonged. The term “toxic stress” refers to stress that is not only overwhelming to a child but also not alleviated by the buffering of supportive adults. “Over time, without intervention, toxic stress will lead to an increase in adverse health outcomes that would last a lifetime for these children.” What is toxic stress? Left unchecked, toxic stress in early childhood strains the stress response system and even alters the developing brain. “Toxic stress is the prolonged experience of significant adversity,” says Monica Ordway, PhD, APRN, PNP-BC, Assistant Professor at Yale School of Nursing (YSN). Over time, the lack of nurturing in the face of adversity in childhood can contribute to “toxic stress” - a harmful level of stress that can affect the child’s well-being well into adulthood. While a warm, supportive response can help the baby calm down and feel secure, a distant or angry reaction leaves the child to fend for herself in a scary world. ![]() How a mother responds to her baby’s cries can make a big difference in the child’s ability to learn, develop, and thrive. This story originally appeared in the Fall 2015 issue of Yale Nursing Matters.
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