1. Observation of bath and the massage with hot water to the head of Ghanaian babies.

The temperature of the water in the bucket for the bath could be as high as 65.3 degrees Celsius. The temperature of the soft spot during the massage with the hot towel on it reached between 41 and 42 degrees Celsius. It caused the brain temperature to increase to 39 degrees Celsius at least. This had an immediate effect on the behavior of the babies. The babies screamed from pain or fainted. The women who were interviewed about the behavior of the baby during the massage with the hot water on the head reported on the same kinds of behavior. However, fainting was mistakenly regarded as sleeping by the women. The baby can not sleep under such a condition, but rather faints from the over heating. Screaming from pain indicates a potential damage to the brain of the baby and fainting is the result of an increase in the level of some chemicals in the brain that lead eventually to lack of blood supply to the brain. It does not only result in fainting but also in brain damage.

 

1.1. The harmful effect of hot water or any heat on the head of a baby (based on research in offspring of animals).

Our normal body temperature is between 36 and 37 degrees Celsius. So, what is wrong with a little bit heat on the head of a baby?

Any temperature above 37 degrees Celsius causes the body to be under hyperthermia or over heating. Hyperthermia can be as a result of fever caused by a disease and other internal factors, or by heating the body from outside. Putting hot towel on the head of a baby exposes the head and the brain of the baby to heat. When the temperature of the brain of a baby rises even in 1.5 degrees Celsius and reach 38.5 degrees Celsius, structural and chemical changes happen in the brain:​

• Changes in the differentiation of neurons to their various types.

•  Less migration, expansion and distribution of neurons causes the cortical layer of the different areas in the brain be thinner. The cortical layer is where many cognitive functions happen such as thinking, reasoning, judgment, taking decisions etc. 

• Changes in the destination position of these neurons in the brain.

• Changes in the structure of the neurons and their synapses that can end in their destruction.

• Change in the strength of the synapses result in change in the strength of the connection and communication between neurons.

• Reduction in the blood supply to the brain. It means that less oxygen and nutrients reach the brain. This condition harms the brain. It can also cause fainting.

For more information see "Structural changes under hyperthermia", "Molecular changes under hyperthermia", and "Past research in offspring of animals" pages. 

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2. The harmful effect of the Robb ointment which is applied on the soft spot after the bath.

The ointment contains harmful chemicals to the brain. It is applied on the head of a baby immediately after the bath while the skin is warm. In this condition, the quantity of the chemicals in the Robb ointment that are absorbed into the brain is doubled. Applying the Robb ointment twice a day for two years is a constant interference in the brain development.

It results in: 

• Higher chance that the child would suffer from ADHD (Attention Deficit Hyperactivity Disorder). Thirty percent of Ghanaian pupils suffer from ADHD.

• Disturbance in the distribution and expansion of the neurons.

• Reduction in the speed of communication between the neurons.

• Death of neurons.

For more information see: "Robb ointment effect" page.​

The meaning of all these harmful effects is that the baby would have a smaller brain and he or she will be a slow thinker. 

 

Learning impairments as was observed in Creative Foundation School.

The prominent learning impairments observed among children from rural area that usually passed hot water massage to their heads when they were babies, from Nursery 1 up to Primary 2 in Creative foundation School were as follows: 

• Inability to use both hands: the dominant hand with the support of the non dominant hand to perform a task such as coloring shape on a paper or building with Lego bricks.  As a result of that, the non dominant hand does not support the activity of the dominant hand. Therefore, the dominant hand fails to do the work as demanded (Nursery 1, 2 and Kindergarten 1). 

• Short attention span (all ages).

• Memorizing or repeating without understanding (all ages).

• Basing their reasoning with no connection to their daily life experiences (Kindergarten 2, Primary 1, Primary 2). 

For more details see: "Learning impairments" page.​

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Effect on long term cognition.

The hot water massage and the application of ointments to the head of the baby can affect the infrastructure and the chemical balance of the neural network. Therefore, it would affect the complexity and the organization of the memory and reduce the efficiency of the memory in processing new information. This will lead to impaired leaning capabilities, reciting in place of understanding and wrong decisions making in life. For more details see​: "Memory and learning" page and "Connectionism and Hierarchical models of the neural circuits" page.

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If these two practices are harmful to the brain of a baby, why do Ghanaian mothers practice them?

In Ghanaian traditional knowledge it is believed that as a result of the pressure in the birth canal during delivery of a baby, cracks (sutures) and holes (soft spots, fontanelles) are formed in the skull of the baby. Air enters the head of a baby through these cracks and holes and causes illness. In order to avoid the damage, they believe in, the women use hot water to massage the head of the baby and apply on the head the Robb ointment with the conviction that they are healing the holes, cracks and wounds in the skull. The biggest hole in the head of a baby is the soft spot, anterior fontanelle, or as it is called by the Ghanaian the "breathing place". The movement of the skin on the soft spot gives the wrong impression that air passes through that place into the brain.

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What should be done in order to stop these deeply rooted customs?

There is the need to educate the Ghanaian communities about the real purpose of the sutures (cracks) and the fontanelles (soft spots, holes) in the skull of a baby. They are there not by accident, but this is how the skull of a baby is form already in the womb. During giving birth of a baby, his or her head passes through the birth canal which has a smaller diameter than that of the head of the baby. In addition, the birth canal is surrounded by the pubic bones that form a stiff ring around it. This limits the extent of the expansion of the birth canal. Therefore, the bones of the skull of the head of a baby are not yet fused together. This condition allows the bones temporally to shift and reduce the diameter of the head of a baby in order to allow it to pass through the narrow birth canal without damage. The fact that the bones of the skull will be fused together slowly and not at once, allows the growth of the brain of a baby as he or she grows. All the sutures and fontanelles will be closed naturally. There are no spaces in the skull that air can pass through them because each space (suture or fontanelle) is covered with a connective tissue that does not allow air to pass into the head. The vibration of the biggest fontanelle (the anterior fontanelle or the soft spot), is as a result of the vibration of the blood vessels beneath the skin covering the anterior fontanelle. As the heart pumps the blood forward, it vibrates the blood vessels. If you put one hand on the biggest soft spot, the anterior fontanelle in the head of a baby and the other hand on his or her chest where the heart is, you will feel in both hands the same rhythm of pules. For more details see: "The soft spot" page.

Can we tell the mothers not to use hot water on the head of a baby? What about warm water?  NO!!!

Many times, the instruction from the hospital is not to use very hot water. The women then, lower the temperature of the water. The temperature of lukewarm water is 37 degrees Celsius and the heat that starts to cause changes in the brain is 38.5 degrees Celsius. Since the difference between 37 to 38.5 degrees Celsius is only 1.5 degrees Celsius, detecting the temperature of the water by hand is not sufficient and therefore, not recommended.

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Recommendations:

The instructions to the mothers should be:

1. Do not do any treatment to the head of the baby.

2. Do not massage the head of a baby at all.

3. Do not apply any ointment on the head of a baby.

4. Do not press the head of a baby. Just leave the head by itself. 

5. Wash gently the head of a baby with room temperature water and soap. The head of a baby is not dirty. Do not scrub the head. 

6. If the baby catches cold, he or she sneezes, coughs, or has phlegm in the throat, exposure to cold air can contribute to the illness of the baby. The cold air enters the head through the nose into the cavities of the sinus in the skull, which are located above the nose and under the eyes. The cold air enters the chest into the lungs only through the nose and mouth.  Therefore, you can dress the baby with warm clothes and put a cap on his or her head to keep him or her warm.

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