David Barker is one of those intuitive scientists, a latterday Alexander Fleming who is able to follow up on a chance observation to develop a theory of fundamental importance.  He knows his stuff, he has a prepared mind and the imagination to see the possibilities of a chance observation.

Barker is an epidemiologist.  He became interested in the geographical variation of mortality from so called life style diseases, bronchitis, ischaemic heart disease, stroke, diabetes in various parts of the country and observed that this was related to poverty, impaired nutrition and high infant mortality.   Although nutrition had improved over the years, it  did not seem to prevent death from these diseases.  Barker wondered whether infant mortality and death from life style diseases were somehow connected.  In Hertfordshire, they had kept meticulous records of birth weight from early in the last century.  Barker found that those individuals born underweight and who remained  underweight at one year of age, were much more likely to die of  cardiovascular disease later in life.  These early observations were confirmed in Preston, Burnley, Wakefield and other areas of the UK and also in children born during the Dutch famine of 1944-5.  So was there something about the early intrauterine environment that programmed the infant along a track to life threatening disease?  Subsequent observations showed that low birth weight was often associated with big placentas, but what did that imply?   Did the placenta adapt in some way to try to extract nutrients from the mother or did it hypertrophy to produce growth factors?  Was it the placenta that programmed the infant to conserve nutrients? 

If Barker’s hypothesis has any relevance, it must be in regions like India, Arabia or the Southern Seas, where there is a veritable epidemic of premature diabetes and heart disease.  In India, scientists have found that even in areas where people had a very healthy life style with low fat high vegetable diets and lots of exercise, people still died early of diabetes and heart disease.  Birth weight was low but as they developed children remained thin but had a very high percentage of body fat and early signs of a tendency to diabetes – the thin-fat infants. They had concluded that this tendency was related to micronutrient deficiency and are doing a study in which they are supplementing the diets of pregnant women and comparing their infants with un-supplemented mothers.    

 The foetus is not just inert and passive.  It reacts to stimuli.  Scientists have shown that shaking a rattle by the mother’s abdomen, even through the mother is listening to something else through headphones, produces an alarm response in the some foetuses.  And some mothers will testify how their baby will be calmed by music or even beat time to the rhythm.  There is also evidence that maternal stress may produce a nervous baby and this tendency will continue throughout life. 

‘A day or two old and they’ve already got a personality; this one lies there as stiff as a mummy – a regular banker, the next one is throwing himself all over the place happy as a young horse, the next is Miss Dreary, already worried about her hemline.’    

                                                                     Margaret, scene 10, Broken Glass by Arthur Miller.

Show me the baby and I will show you the man or the woman. 

There is even data to show that male babies born to mothers who survived the bombing and shelling of Berlin, were more likely to become gay. 

The data suggest that neonatal stress can rest the hypothalamo-pituitary-adrenal axis and render the rats more sensitive to stress and therefore more susceptible to stress related but otherwise unexplained illness.  The conditions of one pregnancy may be different from another.  Anxious and busy mothers may beget twitchy babies.

This doesn’t deny the influence of genetics nor the subsequent effects of life events and life style.  Genetics provides the potential to respond to a particular environment in a particular way.  Early life experience will enhance or reduce that tendency and the environment later in life will either realise that life script or suppress it.  So malnutrition early in life will cause a person to over-consume nutrients and store them as fat, increasing the risk of cardiovascular disease and diabetes.  In the same way, emotional deprivation may cause a person to be wary and needy, so that they have less tolerance of solitude and more emotional tension and illness.   Psychotherapy is there to help those people afflicted whose developmental limitations have left vulnerable to the viscissitudes of life.  

So Barker’s hypothesis exhibits the truism that whatever happens to us makes us the person we are and life is like a tree,  the things that influence us early in our existence affect how we grow and develop much more that the events that occur later in life.