Martha G. Welch, MD

Specialties:
Psychiatry
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Overview

Martha G. Welch, MD, DFAPA is a Professor of Psychiatry In Pediatrics and In Pathology & Cell Biology at the Columbia University Irving Medical Center, where she also serves as Director of the Nurture Science Program (NSP). She is a Diplomate of the American Board of Psychiatry and Neurology and a Distinguished Fellow of the American Psychiatric Association. Dr. Welch is the 2014 recipient of the Gold Medal for Meritorious Service to College of Physicians & Surgeons (Columbia University), the 2013 recipient of the Physicians & Surgeons Alumni Lifetime Learning Award (Columbia University), and the 2011 honoree for the Columbia University Alumni Medal for Meritorious Service. She also holds an appointment at Karolinska Institute, Stockholm, Sweden as Associate in Pediatrics.

Areas of Expertise / Conditions Treated

  • Pediatric Behavior and Development

Academic Appointments

  • Associate Professor of Psychiatry (in Pediatrics and Pathology & Cell Biology) at CUMC

Hospital Affiliations

  • NewYork-Presbyterian / Columbia University Irving Medical Center

Languages

  • French
  • Spanish

Gender

  • Female

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Credentials & Experience

Education & Training

  • Columbia University College of Physicians and Surgeons
  • Internship: Greenwich Hospital
  • Internship: Albert Einstein College of Medicine -The University Hospital
  • Residency: Albert Einstein College of Medicine -The University Hospital
  • Fellowship: Albert Einstein College of Medicine -The University Hospital

Board Certifications

  • Psychiatry

Research

Dr. Welch’s research at Columbia University––in early childhood development, hormonal signaling, and the visceral brain––has provided the scientific foundation for research and clinical tools used by NICUs and pediatrics departments, including Family Nurture Intervention (FNI) and the Welch Emotional Connection Screen (WECS).

In 2006, Dr. Welch and Dr. Michael Gershon MD co-founded the Columbia University BrainGut Initiative to better understand mother-infant behavioral regulation, and the effects of nurture on child neurodevelopment and mother-child relational health. There, Dr. Welch was the first to locate secretinergic neurons in the forebrain and to demonstrate that secretin activates visceral brain regions. She was also the first to demonstrate the presence of oxytocin receptors in the gut, and its developmental regulation in the enteric nervous system and in the epithelium of the gut during the early postnatal period. Her team was also the first to characterize the role of in-vitro oxytocin stimulation in cell survival and cell death pathways. With Myron Hofer MD and Michael M. Myers PhD, Dr. Welch demonstrated a role of the vagus nerve in potentiating rat pups’ vocalization during separation from their mothers.

Dr. Welch’s animal research, published with collaborators David Ruggiero PhD, Kara Gross Margolis MD, and Michael D Gershon MD, established that a combined administration of oxytocin and secretin can reduce gut inflammation. With Hadassah Tamir PhD and Benjamin Klein MD PhD, Dr. Welch showed that these hormones of nurture play a critical role in gut-brain signaling and function. Her ongoing basic research at NSP continues to investigate the biology of nurture. This research on hormones of nurture, combined with clinical insights from work with children and families, led to Dr. Welch’s breakthrough theory of change: that two people co-modulate each other’s gut-brain vagal signaling and emotional behavior through autonomic co-regulation.

In 2008, Dr. Welch founded the Nurture Science Program at Columbia University Irving Medical Center with Dr. Michael M. Myers. There, Dr. Welch also developed and validated the Welch Emotional Connection Screen (WECS), in order to help clinicians identify the behaviorsof emotional connection and co-regulation. The WECS is a quick, predictive, and actionable research and clinical tool. Where other behavioral and relational health assessments look at each individual, the WECS refocuses the observer on co-regulatory behaviors between two people.

In 2009, Dr. Welch launched a three-year randomized control trial of Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) at Morgan Stanley Children’s Hospital of New York Presbyterian. This groundbreaking clinical intervention combined mutual sensory calming with emotional expression in repeated “calming sessions” guided by trained nurture specialists. The intervention led to significant improvements in: infant cognitive and behavioral development, symptoms of maternal anxiety and depression, and the autonomic regulation of both mothers and babies. With collaborator Stephen Porges, PhD, Dr. Welch has shown that physiological benefits first demonstrated at term age remain up to five years later (as indicated by vagal tone). Currently implemented in multiple hospitals, Family Nurture Care uses FNI’s evidence-based practices to promote mother-child emotional connection and long-lasting positive developmental and emotional-behavioral effects.

Research Interests

  • Exploring the biological mechanisms of nurture using animal models
  • Neonatal and infant Development
  • Testing the family nurture intervention in prematurely born infants and infants aged 0-5 years
  • Welch Emotional Connection Scale, which determines emotional connection between parent and child

Clinical Trials

Dr. Welch currently serves as principal investigator of a multi-site replication of her groundbreaking Family Nurture Intervention (FNI). A randomized control trial comparing FNI with Standard Care (SC) has demonstrated that emotionally connecting mothers and premature infants in the NICU promotes dramatic neurodevelopmental improvements in the infants, and mental well-being of the mothers. Premature infants and their mothers who received this intervention showed significant benefits compared to those who only received SC. FNI babies atnear-to-term age showed robust increases in electroencephalographic (EEG) power in frontal regions of the brain. 18 months later, they had higher scores in language, cognition, and social-emotional development. Moreover, mothers showed more attentive and responsive caregiving during the NICU stay, and 4 months later had lower levels of depression and anxiety. Both mother and child had better physiological regulation, evident out to 5 years post-discharge. FNI in the NICU is the first intervention to show both infant and maternal improvements across multiple domains, both short and long-term, and is now in replication trials in 3 states.

Selected Publications

1. *Welch MG, Tamir H., Gross K.J., Chen J., Anwar M., Gershon M.D. Expression and developmental regulation of oxytocin (OT) and oxytocin receptors (OTR) in the enteric nervous system (ENS) and intestinal epithelium. J Comp Neurol. 2009 Jan 10; 512 (2):256-70. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097117/

2. *Welch MG, Anwar M., Chang C.Y., Gross K.J., Ruggiero D.A., Tamir H., Gershon M.D. Combined administration of secretin and oxytocin inhibits chronic colitis and associated activation of forebrain neurons. Neurogastroenterol Motil. 2010 Jun;22(6):654-e202. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3068601/

3. *Welch MG, Margolis K.G., Li Z., Gershon M.D. Oxytocin regulates gastrointestinal motility, inflammation, macromolecular permeability, and mucosal maintenance in mice. American Journal of Physiol Gastrointestinal and Liver Physiol. 2014 Oct 15;307(8):G848-62. https://pubmed.ncbi.nlm.nih.gov/25147234/

4. Klein B.Y., Tamir H., Hirschberg D.L., Ludwig R.J., Glickstein S.B., Myers M.M., *Welch MG. Oxytocin opposes bacterial endotoxin - Effects on ER-stress signaling in Caco2BB gut cells. Biochem Biophys Acta. 2015 Oct 28;1860(2)402-411. https://pubmed.ncbi.nlm.nih.gov/26520666/

5. Gross Margolis K., Vittorio J., Talavera M., Gluck K., Li Z., Iuga A., Stevanovic K., Saurman V., Israelyan N., Welch MG, Gershon M.D. Enteric Serotonin and Oxytocin: Endogenous Regulation of Severity in a Murine Model of Necrotizing Enterocolitis. Am J Physiol Gastrointest Liver Physiol. 2017 Aug 3;313(5):G386-G398. https://pubmed.ncbi.nlm.nih.gov/28774871/

6. Brunelli S.A., Curley J.P., Gudsnuk K., Champagne F.A., Myers M.M., Hofer M.A., *Welch MG. Variations in maternal behavior in rats selected for infant ultrasonicvocalization in isolation. Horm Behav. 2015 Aug 22;75:78-83. https://pubmed.ncbi.nlm.nih.gov/26306860/

7. Kaidbey J, Ranger M, Myers MM, Anwar M, Ludwig RJ, Schulz A, Barone J, Kolacz J, and *Welch MG. Early Life Maternal Separation and Maternal Behaviour Modulate Acoustic Characteristics of Rat Pup Ultrasonic Vocalizations. Nature: Scientific Reports. 2019. In Press. https://www.nature.com/articles/s41598-019-54800-z

8. *Welch MG, Myers M.M., Grieve P.G., Isler J., Fifer W.P., Sahni R., Hofer M.A., Austin J., Ludwig R.J., Stark R.I. Electroencephalographic activity of preterm infants is increased by Family Nurture Intervention: a Randomized Controlled Trial in the NICU. Clin Neurophysiol. 2014 Apr; 125(4):675-84. https://pubmed.ncbi.nlm.nih.gov/24140072/

9. *Welch MG, Firestein M.R., Austin J., Hane A.A., Stark R.I., Hofer M.A., Garland M., Glickstein, S.B., Brunelli S.B., Ludwig R.J., Myers M.M. Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial. J Psychology and Psychiatry. 2015 Mar 11;56(11):1202-1211. https://pubmed.ncbi.nlm.nih.gov/25763525/

10. Beebe B, Myers MM, Lee SH, Lange A, Ewing J, Rubinchik N, Andrews H, Austin J, Hane A, Margolis AE, Hofer M, Ludwig RJ, *Welch MG. Family nurture intervention for preterm infants facilitates positive mother-infant face-to-face engagement at 4 months. Dev Psychol. 2018 Nov; 54(11):2016-2031. https://pubmed.ncbi.nlm.nih.gov/30284883/

11. *Martha G. Welch, Meeka S. Halperin, Judy Austin, Raymond I. Stark, Myron A. Hofer, Amie A. Hane, Michael M. Myers. Depression and anxiety symptoms of mothers of preterm infants are decreased at 4 months corrected age with Family Nurture Intervention in the NICU, Archives of Women's Mental Health, 2015, https://pubmed.ncbi.nlm.nih.gov/25724391/

12. Amie A Hane, Jasmine N. LaCoursiere, Mai Mitsuyama, Sarah Wieman, Robert J. Ludwig, Katie Y. Kwon, Joy V. Browne, Judy Austin, Michael M. Myers, *Martha G. Welch. The Welch Emotional Connection Screen (WECS): Validation of a Brief Mother-Infant Relational Health Screen, Acta Paediatrica, 2018 https://psychology.williams.edu/files/Hane-et-al.-2018-Acta-WECS-Validation-Paper-.pdf

13. *Martha G. Welch. Calming cycle theory: the role of visceral/autonomic learning in early mother and infant/child behavior and development, Acta Paediatrica, 2016, https://onlinelibrary.wiley.com/doi/full/10.1111/apa.13547

14. S. W. Porges, M. Davila, G. F. Lewis, J. Kolacz, S. Okonmah-Obazee, A. Hane, K. Kwon, R. J. Ludwig, M. M. Myers, *M.G. Welch. Autonomic regulation of preterm infants is enhanced by Family Nurture Intervention, Developmental Psychobiology, 2019, https://onlinelibrary.wiley.com/doi/10.1002/dev.21841

15. Martha G. Welch, J.L. Barone, S. W. Porges, A. A. Hane, K. Y. Kwon, R. J. Ludwig, R. I. Stark, A. L. Surman, J. Kolacz, M. M. Myers, Family nurture intervention in the NICU increases autonomic regulation in mothers and children at 4-5 years of age: Follow-up results from a randomized controlled trial, Plos One, 2020, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236930

16. Robert J. Ludwig, *Martha G. Welch. Darwin's Other Dilemmas and the Theoretical Roots of Emotional Connection Frontiers in Psychology 2019, Darwin’s Other Dilemmas and the Theoretical Roots of Emotional Connection