Attachment Parenting
The 4 Principles Of Attachment Parenting And Why They Work - American Psychological Association
Attachment
parenting
Attachment parenting (AP) is a parenting philosophy that proposes methods aiming to promote the attachment of parent and infant not only by maximal parental empathy and responsiveness but also by continuous bodily closeness and touch.[1] The term attachment parenting was coined by the American pediatrician William Sears. There is no conclusive body of research that shows Sears’ approach to be superior to "mainstream parenting".[2][3] Contents 1.0 History Attachment parenting is only one of many responsiveness and love-oriented parenting philosophies that entered the pedagogical mainstream after World War II, and it owes many of its ideas to older teachings, such as Benjamin Spock's influential handbook Baby and Child Care (1946). Spock had mothers advised to raise their infants according to their own common sense and with plenty of physical contact – a guideline that radically broke with the preceding doctrines of L. Emmett Holt and John B. Watson; the book became a bestseller, and Spock's new child rearing concept greatly influenced the upbringing of the post-war generations. Thirty years later, Jean Liedloff caused a stir by a "continuum concept" that she presented to the public in a book of the same title (1975). In Venezuela, Liedhoff had studied Ye'kuana people, and later she recommended to Western mothers to nurse and to wear their infants and to share their bed with them. She argued that infants, speaking in terms of evolution, have not arrived in the modernity yet, so that today's way of child care – with bottle feeding, use of cribs and baby carriages, etc. – does not meet their needs.[4] Later, authors such as Sharon Heller and Meredith Small contributed further ethnopediatric insights.[5] In 1984, developmental psychologist Aletha Solter published her book The Aware Baby about a parenting philosophy that advocates attachment, extended breastfeeding and abstinence from punishment, similarly to what William Sears later wrote; however, the point that Solter stressed most was an encouragement of the child's emotional expression in order to heal stress and trauma.[6] In the 1990s, T. Berry Brazelton invigorated the discussion. He contributed new research about the capacity of even newborn infants to express themselves and their emotions, sensitized parents for these signals, and encouraged them – just like Spock – to follow their own judgment.[7] William Sears came to the term "attachment parenting" in 1982 by reading Liedloff.[8] Initially, he referred to his new philosophy as "the new continuum concept" and "immersion mothering".[9] When he published his book Creative Parenting in 1982, the concept was largely elaborate already. The "7 Baby-Bs" were not explicitly presented as a canon yet, but as basic elements of a new parenting philosophy they were distinctly clear even at that early point.[10] In 1985, William Sears and his wife Martha Sears began to link the concept – ex post – with attachment theory which they had begun to recognize at that time.[11] From then on, they used the term "attachment parenting".[12] [...] I realized we needed to change the term to something more positive, so we came up with AP, since the Attachment Theory literature was so well researched and documented, by John Bowlby and others. — Martha Sears[13] In 1993, William Sears and Martha Sears published The Baby Book which became the first comprehensive manual for AP-parents and which was occasionally dubbed "the attachment parenting bible".[14] The first attachment parenting organization, Attachment Parenting International, formed in 1994 in Alpharetta, Georgia and was founded by Lysa Parker and Barbara Nicholson.[15] The first book that carried the term attachment parenting in the title was written by Tammy Frissell-Deppe, a mother who gave an account of her personal experiences and of those of her friends and acquaintances.[16] In 1999, blogger Katie Allison Granju followed with another book,[17] to which William Sears contributed a foreword, before he, together with Martha Sears, published his own work, The Attachment Parenting Book in 2001. All three books stood – with their opposition against a crude behavioristic infant anthropology – in the tradition of Spock, but radicalized the concept of a contingency-oriented parenting on the one hand, and incorporated Liedloff's idea of an instinct-guided resp. "natural" childrearing on the other hand. In the same year as Sears and Sears' Attachment Parenting Book, Jan Hunt published her essay collection The Natural Child. Parenting from the Heart. Hunt who sees herself as a child advocate, campaigned in this book not only for attachment parenting, but also for unschooling.[18] A more recent AP proponent is parenting advisor Naomi Aldort, who published her book Raising Our Children, Raising Ourselves in 2006.[19] Like before him the founders of attachment theory, Mary Ainsworth in particular, William Sears teaches that a strong mother-child-attachment emerges from contingency, that is of emotional attunement of mother and child, which again is based on the mother's sensitivity. Since the mother "reads" the signals of her infant, Sears speaks in this context of "babyreading".[20] Another metaphor that he uses is "to be in the groove".[21] William Sears strongly believes in the existence of child rearing practices that support "babyreading" and that augment maternal sensitivity.[22] The methods of attachment parenting include seven practices/principles that according to Sears form a "synergetic" ensemble and that are based on the child's "biological needs".[23] Sears refers to those principles as "7 Baby Bs":[24]
Until 1999, Sears named only five Baby Bs. The last two were only added in 2001 with the publication of the Attachment Parenting Book.[25] Birth bonding: Mother with newborn William Sears postulates the existence of a brief time slot immediately after birth during which the newborn is in a "quiet alert state" and particularly accessible for bonding. He refers to this birth bonding as "imprinting" and bases himself on a study by Drs. Marshall Klaus and John Kennell from 1967; however, Klaus and Kennell later modified their original assumptions, including the one cited by Sears.[26] Sears advises women to abstain from analgesics during childbirth, since those drug the child, too, and according to Sears interfere with the birth bonding.[27] William Sears argues that breastfeeding greatly accommodates mother-child-attachment because it triggers the release of oxytocin in the mother which supports her emotional bonding with the child, notably in the first ten days after childbirth.[28] In opposition to bottle feeding which tends to being done in three to four hour intervals, breastfeeding enables the mother, too, to perceive the child's moods and needs exactly.[29] Since the half-life period of the hormones prolactin and oxytocin (which promote bonding) are very short, Sears recommends to breastfeed very frequently, newborns in particular (8 to 12 times a day).[30] He claims that the hours between 1 am and 6 am are the most beneficial for breastfeeding.[31] In general, Sears argues that breastfeeding is beneficial for the health of both child and mother.[32] He claims that infants up to six months should be exclusively fed with breast milk, since he believes that, at that age, children are allergic to all other foods.[33] William and Martha Sears advise mothers to breastfeed every child for 1–4 years:[34] While breastfeeding for only a few months is the cultural norm for Western Society, what we know about breastfeeding in primitive cultures and weaning times for other mammals that human infants were designed to breastfeed for several years.— Bill Sears, Martha Sears[35] William Sears advocates extended breastfeeding, since he is convinced that breastfeeding supports attachment even of older children and that it is a valid instrument to comfort older children or to bring mother and child together on turbulent days.[36] Neither does he object nighttime breastfeeding of toddlers.[37] As early as in 1992, Norma Jane Bumgarner had campaigned for extended breastfeeding.[38] Sears’ recommendations are in accordance with the WHO guidelines on breastfeeding, which recommend exclusive breastfeeding in the first six months and complementary breastfeeding in the first two years for all countries.[39] Since breastfeeding studies are, for ethical reasons, never conducted as randomized controlled trials, critics have repeatedly suspected that studies may have produced the superiority of breastfeeding as an artifact. Both the physical, emotional and mental development of children and the preferences of women for a feeding method are strongly determined by socioeconomical factors such as the mother's ethnicity, social class, and education. If researchers go without randomization and turn a blind eye to those possible alternative factors, they fundamentally run a risk to falsely credit the feeding method for effects of socioeconomical factors.[40] A loophole from this problem was first presented by Cynthia G. Colen (Ohio State University), who successfully factored out socioeconomical determinants by comparing siblings only; her study demonstrated that formula fed children showed only minimal differences to their breastfed siblings, insofar as their physical, emotional and mental thriving was concerned.[41] William Sears' assumptions about the benefit of breastfeeding for the attachment have been studied. In 2006, John R. Britton and a research team (Kaiser Permanente) found that highly sensitive mothers are more likely than less sensitive mothers to breastfeed and to breastfeed over a long time period. However, the study showed no effect of the feeding method on the attachment quality.[42] Sears advises mothers to wear infants on the body as many hours during the day as possible, for example in a sling.[43] He argues that this practice makes the child happy and allows the mother to involve the child into everything she does and never to lose sight of the child.[44] He advises working mothers to wear the child at least 4–5 hours every night in order to make good for her absence during the day.[45] In 1990, a research team from New York revealed in a randomized study that children of lower class mothers who to the age of 13 months spent a lot of time in a child carrier on their mother's body showed significantly more frequently a secure attachment as defined by Ainsworth than the control group children, who spend more time in an infant seat.[46] For middle-class families, an equivalent study doesn't exist yet. Sears argues furthermore that babywearing exercises the child's sense of balance; since a child who is worn on the mother's experiences more of her conversations, he believes that babywearing is also beneficial for the child's language acquisition.[47] However, there are not studies that confirm such effects. It is undisputed that babywearing can calm children down. Infants cry the most at the age of six weeks; in 1986, a research team at McGill University showed in a randomized study that infants of that age cried significantly less if their parents wore them a lot on the body during the day.[48] Sears recommends babywearing for the purpose of settling a baby to sleep, too.[49] He approves on the use of a sling up to the age of three, since childwearing can also be used to calm a misbehaving toddler down.[50] Other pediatricians find it disputable to wear children beyond the age of nine months permanently on the body, arguing that this is against the child's natural desire for autonomy.[51] William Sears states that any sleeping arrangement that a family practices is acceptable as long as it works; but he advises mother to sleep close to the child.[52] He thinks of co-sleeping as the ideal arrangement and refers to it as the nighttime equivalent of babywearing: co-sleeping supports, in his opinion, the mother-child-attachment, makes breastfeeding more convenient, and prevents not only separation anxiety, but SIDS, too.[53] Sears is convinced that mother and child, in spite of frequent nighttime breastfeeding, have the best sleep when they sleep close together.[54] He is also convinced that due to the extra nighttime feedings, a child that sleeps close to the mother thrives better than a child "crying, alone, behind bars".[55] Moreover, Katie Allison Granju argued that co-sleeping is beneficial for children, too, because it gives children a vivid notion of the concept of bedtime.[56] The idea of co-sleeping was not new in modern Western societies; as early as in 1976, Tine Thevenin had campaigned for the "family bed".[57] Sears doesn't see a problem when a three-year-old still shares their mother's bed every night.[58] He doesn't even object if a child is in the habit of spending the whole night with her mother's nipple in her mouth, except when the mother really feels uncomfortable.[59] Sears advises working mothers to co-sleep on all accounts in order to compensate the child for her daytime absence.[60] Sudden infant death syndrome (SIDS) is a very rare incident; it occurs in less than ½ per mill of all infants. James J. McKenna has discovered that co-sleeping mothers and infants not only synchronize their sleep-wake-rhythm, but their breathing, too; he therefore reasons that co-sleeping lowers the SIDS risk.[61] Nonetheless, studies that investigate SIDS directly have shown that permanent co-sleeping rather raises the SIDS risk than lowering it; it is worth noting that in the study, the increased risk of SIDS occurred in infants younger than four months when the parents were especially tired, had consumed alcohol, were smokers, slept on a sofa, or the baby was in a duvet. Otherwise, no increased risk was associated with bed sharing.[62] The U.S. Consumer Product Safety Commission also warns against co-sleeping.[63] Attachment Parenting International issued a response which stated that the data referenced in the Consumer Product Safety Commission statement were unreliable, and that co-sponsors of the campaign had created a conflict of interest.[64] The American Academy of Pediatrics' policy on SIDS prevention opposes bed-sharing with infants, although room-sharing is encouraged.[65] In general, research doesn't confirm an advantage of co-sleeping over separate beds. A meta study from Israel has pointed out in 2000 that sleeping aids such as pacifiers and teddy bears significantly improve the child's sleep, while co-sleeping and frequent nighttime breastfeeding if anything hinder the formation of wholesome sleeping patterns.[66] Co-sleeping mothers breastfeed three times as frequently during the night as mothers who have their bed for themselves.[67] The most important factor for a child to get a good sleep proved to be the mother's emotional accessibility, not her permanent physical closeness.[66] "Crying is an attachment tool" William Sears determines crying as the child's pivotal mean of self-expression.[68] Parents are challenged to "read" the crying – which is initially generalized – and to provide the child with empathic feedback in order to help them to differentiate and elaborate the repertoire of their signals gradually.[69] Furthermore, he recommends prevention of crying: parents are advised not only to practice breastfeeding, babywearing and co-sleeping as much as possible, but also to get into the habit of properly responding to the early warning signals so that crying doesn't happen in the first place.[70] Likewise, parents must teach their child that some trivial occasions are no cause for alarm at all.[71] In general, Sears argues that infants should never be left crying because this would harm them.[72] But as early as in 1962, T. Berry Brazelton had shown in a study that a certain amount of crying in young infants does not indicate emotional or physical problems, but is to be considered normal and harmless.[73] William Sears names two reasons why infants should not undergo sleep training: he believes that infant training hardens the mother emotionally and that children who underwent such training don't sleep better but merely resign and become apathic, a state that he refers to as "shutdown syndrome", although a condition of this name doesn't exist in DSM or ICD.[74] Frissell-Deppe and Granju believe that sleep training is traumatic for children.[75] Sears argues that advocates of sleep training are professionally incompetent and merely business oriented, and that there is no scientific proof that sleep training is beneficial for children.[76] For parents and particularly for mothers, attachment parenting is more strenuous and demanding than most other present-day ways of parenting, placing high responsibility on them without allowing for a support network of helpful friends or family. William Sears is fully aware of the arduousness of the methods.[77] He suggests a whole package of measures that aim to prevent an emotional burnout of the mother, like the prioritization and delegation of duties and responsibilities, streamlining of daily routines, and collaboration between both parents.[78] Sears advises mothers to turn to a psychotherapist if necessary, but to stick to attachment parenting at all costs.[79] Sears finds the burden of attachment parenting just and reasonable, and describes the opponents of this philosophy as "authoritarian males ... caught up in their role of advice giver".[80] Granju, too, takes a swipe at "the male dominated 'scientific' childcare guidance". She argues that the low reputation that breastfeeding, namely extended breastfeeding in the Western world has, arises from a sexualization of the female breast: from the perspective of a sexistic society, the breast "belongs" to men, not to children.[81] Mayim Bialik, too, considers attachment a feminist option, since it constitutes an alternative to the – male dominated – superiority of physicians who traditionally shaped the spheres of pregnancy, childbirth, and motherhood.[82] Since attachment parenting poses a considerable challenge to the reconcilability of motherhood and female career, the philosophy has been greatly criticized, most notably in the context of the attachment parenting controversy from 2012. Sears states that in attachment families, parents and children practice a highly developed and sophisticated type of communication that makes it unnecessary for parents to use practices such as scolding; often, all it takes is a mere frown. He is convinced that children who trust their parents are cooperative and don't resist parental guidance.[83] He therefore recommends positive discipline.[84] But in contrast to many AP parents, he isn’t fundamentally opposed to confrontative methods (firm, corrective response), and he gives high significance to child obedience and conscience.[85] Sears is a decided advocate for authoritative parenting.[86] As studies have shown, it is indeed possible to use discipline strategies that are sensitive[87] and, therefore, one should not equate discipline and insensitive caregiving. Like Benjamin Spock before them, William and Martha Sears consider their parenting philosophy as a common sense and instinct-guided ad hoc way of parenting.[88] In contrast to Spock who derived his ideas in a straight line from Freud’s psychoanalysis, the Searses in fact didn’t start out from a theory; even the tie to attachment theory was only engineered ex post, when the philosophy was already largely complete. Apart from Liedloff’s rather eclectic thoughts, they came to their ideas mainly from their own personal impressions:[89] Our ideas about attachment parenting are based on thirty-plus years of parenting our own eight children and observing moms and dads whose parenting choices seemed to make sense and whose children we liked. We have witnessed the effects this approach to parenting has on children.— Bill Sears, Martha Sears[35] Despite the lack of a consistent theory, William and Martha Sears consider attachment parenting scientifically proven: AP is not only common sense, it’s supported by science.— Bill Sears, Martha Sears[90] Their belief in such scientific proof doesn’t hinder the Searses to advise AP parents not to engage in discussions with AP critics.[91] They also favor some science while they refuse other: Science says: Good Science Backs AP.— Bill Sears, Martha Sears[80] Fundamental terms and criticism Critics consider a lack of a consistent theoretical foundation – notably the lack of precise definitions of the fundamental terms – a shortcoming of the attachment parenting concept.[92] The concept of mutual emotional fine-tuning has been known in psychology since Franz Mesmer, who introduced it under the term "rapport", before Freud adopted it for psychoanalysis. In relation to the mother-child-tie, behaviorists and developmental psychologists rather speak of "contingency" today; Daniel Stern coined the term "attunement", too. For Williams Sears, attachment parenting is a kind of parenting that is radically characterized by maternal responsivity. For that, he adopted Mary Ainsworth’s term of "maternal sensitivity": The woman directs her attention completely on the child ("babyreading") and responds continuously to every signal that the child sends; the result is a state of harmony between mother and child that leads to mutual attachment.[93] Sears believes that the maternal "tuning-in" begins during pregnancy already.[94] Within the framework of infant cognitive development studies, the child's attachment to the parents has been well researched. As early as in the late 1940s, Donald Winnicott gave a detailed account of the development of the child's attachment; at the latest after the sixth month, healthy children begin to disengage from the mother-child symbiosis quite normally. However, it was Margaret Mahler who gave the most accurate description of the attachment development during the first three years. William Sears’ publications reveal no knowledge of this relevant literature. Sears’ use of the term "attachment" is merely colloquial. He applies it synonymously with terms like trust, harmony, closeness, bonding, love bonds, and connection: "Attachment describes the whole caregiving relationship between mother or father and baby."[95] He mentions that attachment emerges from contingency, but in his further accounts, he never differentiates between attachment and contingency. The readers must therefore assume that attachment is a deeply vulnerable state that never stabilizes and that requires constant reestablishment through incessant sensitivity.[96] Later in the book, in contradiction to his own preceding statements, Sears reassures adoptive parents: "Don't worry about the attachment your child may have ’missed’ in foster care. Infants are extremely resilient."[97] The establishment of a secure mother-child attachment is the declared and pivotal goal of attachment parenting. In numerous scientific studies, the normal development of attachment has been well documented. The same applies for deviant or pathological developments. Problematic or disturbed attachment has been described in three contexts:
William Sears uses the terms "lesser quality of attachment", "insecure attachment", and "non-attachment" synonymously. His formulations don't reveal which kind of problematic attachment is meant: reactive attachment disorder (ICD), disorganized attachment (Ainsworth) or the two forms of insecure attachment (Ainsworth).[104] Still in 1982, he mentioned "diseases of non-attachment" not referring to the attachment theorists Bowlby and Ainsworth, but to Selma Fraiberg, a psychoanalyst who studied blindly born children in the 1970s.[105] Due to the vague description of problematic attachment, Sears and AP organisations who use his criteria have been reproached to produce a high rate of false positives.[106] The same applies to definitions of attachment therapy, a concept that frequently appears to be partially overlapping with attachment parenting.[107] Attachment parenting supporters have distanced themselves from attachment therapy, notably from its methods, but not from its diagnostic criteria.[108] Sears offers a discrimination between (good) attachment and (bad) enmeshment, but again without explaining to his readers how exactly they can identify the difference.[109] There is no conclusive body of research that shows Sears’ approach to be superior to "mainstream parenting".[2] In field studies in Uganda, Ainsworth has observed that sometimes even children who spend plenty of time with their mothers and who were breastfed on cue, developed signs of insecure attachment; she concluded that it is not the quantity of mother-child interaction that determines the attachment type, but the quality. It is, therefore, not practices like co-sleeping, babywearing or feeding on cue that Ainsworth identifies as the crucial determinant for a secure attachment, but the maternal sensitivity.[110] The theoretical starting point of attachment parenting – the idea of contingency – would suggest a concept of the infant as a creature who is essentially defined by their feelings and communication. William Sears, though, defines infants even more essentially by their needs.[111] Need is therefore another basic term; attachment parenting means quintessentially to attend to the child's needs.[112] As early as in the 1940s, psychologists such as Abraham Maslow shaped detailed models of the human needs; ever since, scientists have made a clear distinction between needs on the one hand and desires on the other hand. In 2000, T. Berry Brazelton, a pioneer in the field of newborn psychology, and child psychiatrist Stanley Greenspan published their book The Irreducible Needs of Children, in which they re-assessed the term for pediatrics. When the Searses published their Attachment Parenting Book one year later, they responded neither to Maslow nor to Brazelton and Greenspan, but used the word need merely in a colloquial sense. Although they stressed that parents must distinguish between needs and desires of children, in particular of older children, they denied their readers a guideline of how to tell needs and desires apart.[113] With a view to infants, they believe that needs and desires are plainly identical.[114] In general, they use both terms synonymously.[115] With a view to toddlers, they often phrase it: a child is not ready yet (to do without breastfeeding, without co-sleeping, etc.); but even in contexts like these, they speak of needs, too.[116] Opponents of attachment parenting have questioned that the behavior of a 3½ year old who still demands to nurse can actually be classified as a need. Most likely the child is seeking consolation. To give a child comfort is an important parental responsibility; but parents are just as well liable to teach their child to take heart by their own power.[117] Stress has been surveyed and documented in many studies. The theoretical foundation was created in the 1960s by Richard Lazarus. In 1974, Hans Selye introduced the differentiation between distress and eustress, and in 1984, psychoanalyst Heinz Kohut proposed the concept of optimal frustration; Kohut postulated that the harmony between parents and child needs some well allotted disruption in order to empower the child to develop a healthy personality.[118] In resilience psychology, too, there is broad agreement today that it harms children if their parents keep any stress away from them indiscriminately; by doing so, they suggest to the child that everyday problems are painful and overall to be avoided.[119] Even though stress is one of the fundamental terms of attachment parenting, William Sears’ publications don't reveal acquaintance with pertinent literature about this topic.[117] Sears links stress and distress with the release of cortisol, but uses both terms synonymously and in a purely colloquial sense. He refers the term to any uncomfortable or frustrating state which makes the child cry – a signal which AP mothers are supposed to carefully attend to since stress sickens the child.[120] On the other hand, Sears advises mothers not to overreact and to teach the child imperturbation ("Caribbean approach").[121] He leaves it up to the parents to decide which type of response individual situations ask for. For parenting, any fuzziness of the term stress as well as of the term need have far-reaching consequences. If it is assumed that any crying of the child indicates harmful stress and that any of his demands indicate a true need, parents are bound to confuse rapport, sensitivity, responsivity, emotional availability, and wise protection with behaviors that, from an educational standpoint, are highly dysfunctional and that William Sears mostly wouldn't agree with himself:
Instinct is another basic term of attachment parenting. The Searses describe attachment parenting as the natural, biological, intuitive and spontaneous behavior of mothers who rely on their instincts, sixth sense, inner wisdom or common sense.[126] They attribute even motherliness itself to instincts,[127] whereas they attest men a reduced instinct for children's needs.[128] Instinct theory developed in the 1930s within the framework of ethology. It owes its basic ideas to William McDougall among others, and its elaboration mainly to Konrad Lorenz and Nikolaas Tinbergen. Lorenz believed that instincts are physiological processes, and assumed they could be described as neuronal circuitry in the brain. But already Arnold Gehlen had disputed that humans still have much instinct at their disposal; for him, plasticity and learning aptitude outranked instinct.[129] In today's research, the term instinct is regarded as obsolete.[130] Recent studies have demonstrated that motherly behavior is not inbred but biologically and socially determined.[131] It is partly triggered by oxytocin, partly learned.[132] William Sears' writings show no knowledge of this current state of research. The Searses use the word instinct in a purely colloquial sense and synonymous with terms like hormonal and natural;[126] as an antipole of instinct and nature, they identify the things that "childcare advisors" say.[133] If you were on an island, and you had no mothers-in-law, no psychologists, no doctors around, no experts, this is what you would naturally and instinctively do to give your baby the best investment you'll ever give.— William Sears, Martha Sears[23] William Sears, who owes his formative impressions to Jean Liefloff, points to mammals, primates, "other", "primitive", and "traditional cultures", namely on Bali and in Zambia.[134] Developmental psychologist Heidi Keller who comparatively researched the mother-child relationship in a large bandwidth of cultures, disputes that attachment parenting can be described as a return to a "natural motherliness", like many supporters advertise it. Keller doesn't rank attachment parenting as a counteragent to the high-tech world, but asserts that it "paradoxically fits optimally into a society of individualists and lone warriors how we experience it in the Western world". Many of the methods that the representatives of attachment parenting attribute to the evolutionary history of life don't actually play the major role in non-western cultures that is attributed to them. In Cameroon for example, children are actually carried in a sling initially, but then have to learn to sit and to walk much earlier than European and North American children; rather than to cultivate affectionate eye contact, mothers blow into their children's face in order to get them out of the habit of making eye contact.[135] Even in the United States, there are minority groups which can be classified as highly "traditional", none of them practicing attachment parenting. Amish mothers for example co-sleep with their infants, but only for the first several months;[136] they never let their infants and toddlers out of view, but they don't wear them while they are working.[137] From very early on, Amish children are raised to serve God, family, and community rather than to express their own needs.[138] The infants of orthodox Jews traditionally sleep in cradles.[139] In communities where there is no eruv, Jewish parents are not allowed to carry their children about on Shabbat.[140] Native Americans traditionally used cradleboards which could be worn, but which involved minimal physical touch of mother and child. Optimal development of the child As Suzanne M. Cox (Northwestern University) has pointed out, neither attachment theory nor attachment parenting offer a general outline of the optimal development of the child, which could be used to empirically measure the efficacy of attachment parenting.[141] The Searses promise parenting results such as increased independence, confidence, health, physical growth, improved development of the motor and language skills, good manners, conscientiousness, social competence, sense of justice, altruism, sensitivity, empathy, concentration, self-control, and intelligence.[142] However, there is no conclusive evidence from empirical research that supports such claims.[141] The ultimate target of child rearing is, according to Sears, happiness.[125] Similar to the German catholic Albert Wunsch, Sears therefore ranks among those parenting advisors whose philosophies reflect stray aspects of their religious beliefs, but result in a purely worldly target. In the year of the publication of the Attachment Parenting Book, Wendy Mogel, by contrast, suggested her own very influential concept of character education that was straightforwardly based on her Jewish faith (The Blessings of a Skinned Knee, 2001). Attachment parenting is particularly popular among educated urban women in Western countries, who are interested in ecological and social issues.[135] In the United States, parenting tips of well-known people like the actresses Mayim Bialik and Alicia Silverstone contributed to the popularity of the philosophy.[143] Many North American Women are organized in support groups of Attachment Parenting International (API), the movement's umbrella organization, in which Martha Sears serves as a board member.[144] In Canada, there are further AP organizations such as the Attachment Parenting Canada Association (Calgary);[145] even some public health organizations promote attachment parenting.[146] William Sears has close ties to the international La Leche League (LLL) which feature him as a conference speaker and published several of his books.[147] In LLL groups, many mothers get in touch with attachment parenting for the first time.[148] There are also attachment parenting organizations in Australia and in New Zealand. In Europe, Attachment Parenting Europe (APEU, in Lelystad, Netherlands) campaigns for attachment parenting; in the Dutch language the philosophy is referred to as natuurlijk ouderschap (natural parenthood). This organization keeps liaisons to representatives in Belgium, Denmark, Germany, Ireland, Italy, Norway, the United Kingdom, and Switzerland.[149] In 2012, there were 30 AP groups in England and Wales.[150] In Germany, there are independent AP institutions in several cities.[151] Hamburg, the movement's central point in Germany, hosted a first Attachment Parenting Congress in 2014, under the patronage of Federal Minister of Family Affairs, Manuela Schwesig.[152] A second one has been announced for 2016.[153] In Austria and Switzerland there exist a small number of AP institutions, too.[154] In Sweden, fantasy and science fiction writer Jorun Modén solicits attachment parenting, which she refers to as nära föräldraskap (proximal parenthood).[155] In France where the philosophy is dubbed as maternage intensif or maternage proximal, the movement has virtually no followers;[156] due to the success of the Napoleonic education reforms, the French traditionally have a deeply rooted belief that educated child care specialists educate children at least as well as mothers do.[157] Since 2012, there has been a controversy about Sears' positions which has been mostly carried out in the English-speaking world. It began in 2012 with a cover picture on Time magazine that showed a Californian mother breastfeeding her almost 4-year-old. In the accompanying article The Man Who Remade Motherhood, journalist Kate Pickert argued that even if William Sears' positions are much less radical than those of his followers, they are misogynic and give mothers a chronically guilty conscience, and that they frequently disagree with relevant research results.[158] The cover picture and article became the starting point of agitated disputes in many media. At the same time, attachment parenting attracted attention of sociologists like Ellie Lee, Charlotte Faircloth, Jan Macvarish, and Frank Furedi who described the phenomenon an example of 21st century Parental Determinism. As early as in 1996, sociologist Sharon Hays had described the sociocultural phenomenon of an Intensive Mothering; with attachment parenting, this phenomenon finally became tangible and recognizable.[159] In 2004, media critic Susan J. Douglas and philosopher Meredith W. Michaels followed with their account of a New Momism.[160] Time cover picture and article The Time magazine cover picture and article were published May 21, 2012.[161] Pickert described how parents who follow Sears tend to take opinions that are much more radical than Sears himself.[162] Nevertheless, many parents catch from Sears' books an outlook that Pickert jestingly describes as a "post-traumatic Sears disorder": a severe sense of insufficiency that seems to appear in particular in such mothers who want to follow Sears' advice, for the sake of their children's mental health, but cannot, e.g. because they can't afford to be stay-at-home-moms.[158] Katha Pollitt referred to attachment parenting as a fad.[163] Parents who follow the philosophy have been reproached as acting according to their own helplessness and unsatisfied emotional neediness which may be the true reasons for their decision to incessantly pacify their child by breastfeeding and babywearing even into toddlerhood, as the belief that the child actually needs all that permanent intimacy for their healthy development is only a subterfuge.[164] Emma Jenner argued that parents who are in the habit of stereotypically attending to each of the child's signals with physical proximity will not learn to perceive the child's needs in the full extent of their bandwidth and complexity.[165] Katie Allison Granju, who advocates attachment parenting and who published comprehensive guidelines for AP parents, offers a different perspective. She characterizes attachment parenting as not just a parenting style, but "a completely fulfilling way of life".[166] Sociologist Jan Macvarish (University of Kent), a pioneer in the recent field of parenting culture study, described how AP parents utilize their parenting philosophy as a strategy of individualization, as a way to find personal identity and to join a group of congenial adults. Macvarish even speaks of parental tribalism. According to Macvarish, it is characteristic for such choices that they are much more angled towards the parents' self-perception than towards the child's needs.[167] Sociologist Charlotte Faircloth, too, considers attachment parenting a strategy that women pursue in order to gain and to express personal identity.[168] Child-rearing and lifestyle preferences of AP parents Multiple authors have stated that many parents choose attachment parenting as part of an individualization strategy and as a statement of personal identity and of social affiliation. This assumption is supported by the observation that most AP parents show further distinctive parenting and life style preferences that are based on a particular set of attitudes (notably: a striving for naturalness), which, however, are mostly not directly tied to the declared goal of attachment parenting:[169]
Some practices and preferences of AP parents are prevalent only in North America:
The Sears encourage some of these practices explicitly, for example non-smoking, healthy and home-prepared food, no circumcision, but don't comment on how they are supposed to be linked to the core ideas of attachment parenting.[186] Only in the case of positive discipline, the link is quite obvious.[187] In his Complete Book of Christian Parenting and Child Care (1997), William Sears opposes maternal occupation, because he is convinced that it harms the child:[162] [Some] mothers choose to go back to their jobs quickly simply because they don't understand how disruptive that is to the well-being of their babies. So many babies in our culture are not being cared for in the way God designed, and we as a nation are paying the price.— William Sears, The Complete Book of Christian Parenting and Child Care (1997) Any form of intensive, obsessive mothering has, as Katha Pollitt stated, devastating consequences for the equality of treatment of women in the society.[163] In France, Élisabeth Badinter argued that over-parenting, obsession with washable diapers and organic, home made infant food, and parenting practices as the ones recommended by Sears, with breastfeeding into toddlerhood, bring women inevitably back into outdated patterns of gender role. In the United States, Badinter's book The Conflict: How Modern Motherhood Undermines the Status of Women (2010) had a partially critical reception, because there is no publicly paid childcare leave in this country, and many women consider it a luxury to be able to be a stay-at-home-mom during the child's first years.[189] Still, gynecologist Amy Tuteur (formerly Harvard Medical School) stated that attachment parenting amounts to a new subjection of the woman's body under social control – a trend that is more than questionable in the face to the hard-fought achievements of women's movement.[190] As Erica Jong observed, the rise of attachment parenting followed a surge of glamourized motherhood of popular stars (Angelina Jolie, Madonna, Gisele Bündchen) in the mass media. She stated that the effort to model exceptional children under sacrifice of the parent's own well-being transformed motherhood into a "highly competitive race"; all attempts of women to radically monopolize their parental responsibilities very much accommodate right-wing politics.[191] A "culture of total motherhood" In her 2005 book Perfect Madness. Motherhood in the Age of Anxiety, Judith Warner, too, described how attachment parenting has taken a strong influence on mainstream parenting and how it has established a "culture of total motherhood"; due to these cultural changes, mothers are convinced today that they have to instantly attend to every need of their children in order to protect them from the risk of lifelong abandonment issues.[192] As early as in 1996, sociologist Sharon Hays wrote about a newly formed "ideology of intensive mothering". Characteristic of this ideology is the tendency to impose parenting responsibility primarily on mothers and to favor a kind of parenting that is child-centered, expert-guided, emotionally absorbing, labour- and financially intensive. Hays saw the motives for the overloading of motherhood in the idealistic endeavor to cure an overly egoistical and competitive society through a counterbalancing principle of altruistic motherliness. But according to Hays, any kind of "intensive motherhood" that systematically privileges children's needs over mothers' needs happens without fail to the economical and personal disadvantage of mothers.[193] In 2014, a team of researchers at the University of Mary Washington showed in a study that mothers endorsing the belief that parenting is challenging (e.g. "It is harder to be a good mother than to be a corporate executive"), which is associated with intensive motherhood, have statistically more signs of depression[194] Fathers in attachment parenting Dr. Sears has taken an adamant stance against fathers being primary caregivers in attachment parenting. On his website, he claims that fathers should "help" by supporting mothers and creating an environment which allows the mother to devote herself to the baby.[195] Sears has claimed infants have a natural preference for a mother in the early years;[195] although, little scientific literature actually supports this conjecture since these studies are typically done in situations were the mother is the primary caregiver and not the father. It is biased to say that infants have a "natural" preference for the mother when their mother is the one who is their primary caregiver; a more correct statement would be that infants have a attachment preference for the parent who is their primary caregiver. Studies have found that between 5 and 20% of children actually have a primary attachment with their father.[196][197][198] One specific caregiving activity in which Sears claims fathers should be supportive rather than primary is feeding.[195] Breastfeeding includes nutritional benefits which are undeniable, but the main reason breastfeeding is promoted in attachment parenting is for the mother-child bonding through skin to skin contact and intimacy; however, the benefits of skin to skin contact and intimacy are still present for fathers.[199] Dr. Sigmund Freud theorized that infants tend to prefer mothers since it is the mother who fulfill's the infant's oral needs;[200] however, if the father is fulfilling this need, it would be reasonable to assume that attachment would form with the father. Through what is called "bottle nursing", fathers and other caregivers who cannot breastfeed hold the infant touching their bare torso and feed gently and intimately, focusing their attention on the baby. Other common mother-child AP practices, such as bonding after birth and co-sleeping, may also be equally beneficial for fathers.[201][202] 1. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 2f, 5, 8–10, 110. ISBN 978-0-316-77809-1. 2. Hays, Sharon (1998). "The Fallacious Assumptions and Unrealistic Prescriptions of Attachment Theory: A Comment on 'Parents' Socioemotional Investment in Children'". Journal of Marriage and Family. 60 (3): 782–90. doi:10.2307/353546. JSTOR 353546. 3. Tuteur, Amy (April 2020). "Trauma and attachment: Does attachment parenting promote attachment?". Skeptical Inquirer. 44 (2): 52. 4. "Understanding The Continuum Concept". Retrieved 2015-01-15. 5. Small, Meredith F. (1999). Our Babies, Ourselves. How Biology and Culture Shape the Way We Parent. New York: Anchor Books.; Heller, Sharon (1997). The vital touch : how intimate contact with your baby leads to happier, healthier development. New York, NY: Henry Holt. 6. Solter, Aletha Jauch (1984). The Aware Baby. Goleta, CA: Shining Star Press.; "Aware Parenting Institute". Retrieved 2016-03-10. 7. "At 95, Brazelton shares 'A Life Caring for Children'". USA Today. 2013-05-01. Retrieved 2015-01-16. 8. Sears, William (1983) [1982]. Creative parenting : how to use the new continuum concept to raise children successfully from birth through adolescence (pocket book ed.). New York: Dodd, Mead & Company. 9. Sears, William (1983) [1982]. Creative parenting: How to use the new continuum concept to raise children successfully from birth to adolescence (pocket book ed.). New York: Dodd, Mead & Company. pp. 87, 164, 166, 174, 176, 181ff, 184, 238f. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 112. ISBN 978-0-316-77809-1. 10. Sears, William (1983) [1982]. Creative parenting: How to use the new continuum concept to raise children successfully from birth to adolescence (pocket book ed.). New York: Dodd, Mead & Company. ISBN 978-0-396-08264-4. 11. Only since 1987 Sears' writings explicitly refer to John Bowlby's and Mary Ainsworth's writings. Sears, William (1987). Growing together: A parent's guide to baby's first year. Franklin Park, IL: La Leche League International. 12. Sears, William (1985). Christian Parenting and Child Care. Nashville: T. Nelson. 13. "How did attachment parenting originate?". Retrieved 2016-01-20.; Nicholson, Barbara; Parker, Lysa (2013). Attached at the Heart. Eight Proven Parenting Principles for Raising Connected and Compassionate Children. Deerfield Beach, FL: Health Communications. pp. 27. ISBN 978-0-7573-1745-3. 14. Sears, William; Sears, Martha (1993). The baby book : everything you need to know about your baby : from birth to age two. Boston: Little, Brown. "What attachment parenting really means". Retrieved 2016-03-15.; "Babies Pooping Over Garbage Cans and Hypnotized Toddlers: A Guide to Progressive Parenting". Archived from the original on 2016-03-25. Retrieved 2016-03-15. 15. Arnall, Judy. "Attachment Parenting 101" (PDF). Retrieved 2016-03-09.; "Barbara Nicholson, Lysa Parker". Retrieved 2016-03-09. 16. Frissell-Deppe, Tammy (1998). Every Parent's Guide to Attachment Parenting: Getting back to basic instincts!. Dracut, MA: J.E.D. Publishing. ISBN 978-0-9666341-4-3. 17. Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. Pocket Books. ISBN 978-0-671-02762-9. 18. "The Natural Child Project". 19. Aldort, Naomi (2006). Raising Our Children, Raising Ourselves: Transforming parent-child relationships from reaction and struggle to freedom, power and joy. Borthell, WA: Book Publishers Network. ISBN 978-1887542326. "Naomi Aldort's web site". Retrieved 2016-03-23. 20. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 5–9. ISBN 978-0-316-77809-1. 21. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 18. ISBN 978-0-316-77809-1. 22. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 5, 7. ISBN 978-0-316-77809-1. 23. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 27. ISBN 978-0-316-77809-1. 24. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 5f, 11. ISBN 978-0-316-77809-1. 25. Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. New York, NY: Pocket Books. pp. xix. ISBN 978-0-671-02762-9. 26. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. pp. 47ff, 52, 54, 183. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 36–47. ISBN 978-0-316-77809-1.; Klaus, Marshall H.; Kennell, John H. (1976). Maternal-Infant Bonding: The Impact of Early Separation or Loss on Family Development. St. Louis: C.V. Mosby. Sears names the wrong book title; "John Kennell, Advocate of Infant Bonding, Dies at 91". The New York Times. 2013-09-21. Retrieved 2016-01-15. 27. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 51. ISBN 978-0-396-08264-4.; Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. New York, NY: Pocket Books. pp. 58. ISBN 978-0-671-02762-9. 28. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 96, 188. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 53–56. ISBN 978-0-316-77809-1. 29. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 56–58. ISBN 978-0-316-77809-1. 30. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 55f, 60, 120f. ISBN 978-0-316-77809-1. 31. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 57. ISBN 978-0-316-77809-1. 32. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 54f. ISBN 978-0-316-77809-1. 33. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 142. ISBN 978-0-316-77809-1. 34. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 120. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 64. ISBN 978-0-316-77809-1.; Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. New York, NY: Pocket Books. pp. 290ff. ISBN 978-0-671-02762-9. 35. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 62. ISBN 978-0-316-77809-1. 36. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 62f. ISBN 978-0-316-77809-1. 37. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 99. ISBN 978-0-316-77809-1. 38.Bumgarner, Norma Jane (1992). Mothering your nursing toddler. Franklin Park, Illinois: La Leche League International. 39. "WHO: Breastfeeding". Retrieved 2016-02-22. 40. "Are the benefits of breastfeeding oversold?". 2009-12-17. Retrieved 2015-02-15.; Wolf, Joan B. (2007). "Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign". Journal of Health Politics, Policy and Law. 32 (4): 595–636. doi:10.1215/03616878-2007-018. PMID 17639013. Retrieved 2015-02-15. 41. Colen, Cynthia G.; Ramey, David M. (2014). "Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons". Social Science & Medicine. 109: 55–65. doi:10.1016/j.socscimed.2014.01.027. PMC 4077166. PMID 24698713. 42. Britton, John R.; Britton, Helen L.; Gronwaldt, Virginia (November 2006), "Breastfeeding, Sensitivity, and Attachment", Pediatrics, 118 (5): e1436-43, doi:10.1542/peds.2005-2916, PMID 17079544, S2CID 10044918 43. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 65. ISBN 978-0-316-77809-1.; Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 78. ISBN 978-0-396-08264-4. 44. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 65, 67f, 70–78. ISBN 978-0-316-77809-1. 45. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 133, 139f. ISBN 978-0-316-77809-1. 46.Anisfeld, E.; Casper, V.; Nozyce, M.; Cunningham, N. (1990). "Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment". Child Development. 61 (5): 1617–1627. doi:10.2307/1130769. JSTOR 1130769. PMID 2245751. 47. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 71f. ISBN 978-0-316-77809-1. 48. Hunziker, U.A.; Barr, R.G. (May 1986). "Increased carrying reduces infant crying: a randomized controlled trial". Pediatrics. 77 (5): 641–648. PMID 3517799. 49. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 78. ISBN 978-0-316-77809-1. 50. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 69. ISBN 978-0-316-77809-1. 51. "Die fix gebundenen Kinder". 2012-05-19. Retrieved 2015-01-27. 52. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 78, 173. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 91. ISBN 978-0-316-77809-1. 53. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 173. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 90, 92–95, 102. ISBN 978-0-316-77809-1. 54. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 92–94. ISBN 978-0-316-77809-1. 55. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 93f. ISBN 978-0-316-77809-1. 56. Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. New York, NY: Pocket Books. pp. 188f. ISBN 978-0-671-02762-9. 57. Thevenin, Tine (1987) [1976]. The Family Bed. Wayne, NJ: Avery Pub. Group. 58. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 174. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 95, 97. ISBN 978-0-316-77809-1. 59. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 110. ISBN 978-0-316-77809-1. 60. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 133, 139. ISBN 978-0-316-77809-1. 61. McKenna, James J. (1990). "Sleep and arousal patterns of co-sleeping human mother/infant pairs: A preliminary physiological study with implications for the study of sudden infant death syndrome (SIDS)". American Journal of Physical Anthropology. 83 (3): 331–347. doi:10.1002/ajpa.1330830307. PMID 2252080. 62. Blair, P.S. (1999). "Babies sleeping with parents: case-control study of factors influencing the risk of the sudden infant death syndrome : Cot death—the story so far". British Medical Journal. 319 (7223): 1457–1462. doi:10.1136/bmj.319.7223.1457. PMC 28288. PMID 10582925. 63. CPSC Warns Against Placing Babies in Adult Beds; Study finds 64 deaths each year from suffocation and strangulation Archived 2006-06-18 at the Wayback Machine, Consumer Product Safety Commission, September 29, 1999 64. "Attachment parenting international calls on government to delay campaign warning parents not to sleep with their babies". Attachment Parenting International. Archived from the original on 2013-08-07. Retrieved 2014-01-14. 65. Kemp, James S.; Unger, Benjamin; Wilkins, Davida; Psara, Rose M.; Ledbetter, Terrance L.; Graham, Michael A.; Case, Mary; Thach, Bradley T. (2000). "Unsafe Sleep Practices and an Analysis of Bedsharing Among Infants Dying Suddenly and Unexpectedly: Results of a Four-Year, Population-Based, Death-Scene Investigation Study of Sudden Infant Death Syndrome and Related Deaths". Pediatrics. 106 (3): e41. doi:10.1542/peds.106.3.e41. PMID 10969125. 66. Benhamou, Isabelle (2000). "Sleep Disorders of Early Childhood: A Review". Israel Journal of Psychiatry and Related Sciences. 37 (3): 190–196. 67.McKenna, James (1994). "Experimental studies of infant-parent co-sleeping: mutual physiological and behavioral influences and their relevance to SIDS (sudden infant death syndrome)". Early Human Development. 38 (3): 187–201. doi:10.1016/0378-3782(94)90211-9. PMID 7821263. 68. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 81. ISBN 978-0-316-77809-1. 69. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 81f. ISBN 978-0-316-77809-1. 70. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 82f. ISBN 978-0-316-77809-1. 71. Sears names the method of playing bagatelles down the "Caribbean approach"; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 83f, 88. ISBN 978-0-316-77809-1. 72. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. p. 165, 169. ISBN 978-0-396-08264-4.; "Why do babies cry". Retrieved 2015-01-29. 73. Brazelton, T. Berry (April 1962). "Crying in Infancy". Pediatrics. 29 (4): 579–88. PMID 13872677. 74. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 121ff, 126f. ISBN 978-0-316-77809-1. 75. Frissell-Deppe, Tammy (1998). Every Parent's Guide to Attachment Parenting: Getting back to basic instincts!. Dracut, MA: J.E.D. Publishing. p. 51. ISBN 978-0-9666341-4-3.; Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. New York, NY: Pocket Books. pp. 214. ISBN 978-0-671-02762-9. 76. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 120, 124. ISBN 978-0-316-77809-1. 77. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 107. ISBN 978-0-316-77809-1.; compare Frissell-Deppe, Tammy (1998). Every Parent's Guide to Attachment Parenting: Getting back to basic instincts!. Dracut, MA: J.E.D. Publishing. pp. introduction. ISBN 978-0-9666341-4-3. 78. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 107–110, 112–117, 143ff. ISBN 978-0-316-77809-1. 79. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 109, 117f. ISBN 978-0-316-77809-1. 80. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 120. ISBN 978-0-316-77809-1. 81. Granju, Katie Allison; Kennedy, Betsy (1999). Attachment Parenting: Instinctive Care for Your Baby and Young Child. New York, NY: Pocket Books. pp. 268, 304. ISBN 978-0-671-02762-9. 82. "Attachment Parenting Is Feminism". The New York Times. 2012-05-01. Retrieved 2015-01-20. 83. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. pp. 215, 236ff. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 152. ISBN 978-0-316-77809-1.; "10 Ways Attachment Parenting Discipline is Easier". Retrieved 2015-01-29. 84. Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 2. ISBN 978-0-316-77809-1. 85. "Healthy discipline for children". Retrieved 2015-01-29.; Sears, William; Sears, Martha (1995). The Discipline Book: Everything You Need to Know to Have a Better-Behaved Child From Birth to Age Ten.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 17–21, 29. ISBN 978-0-316-77809-1. 86. Sears, William (1983) [1982]. Creative Parenting: How to use the new continuum concept to raise children successfully from birth to adolescence. New York: Dodd, Mead & Company. pp. 237f. ISBN 978-0-396-08264-4.; Sears, Bill; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York, Boston: Little, Brown and Company. pp. 106. ISBN 978-0-316-77809-1. 87. Van Zeijl, J.; Mesman, J.; Van Ijzendoorn, M.H.; Bakermans-Kranenburg, M. J.; Juffer, F.; Stolk, M. N.; Alink, L. R. (2006). "Attachment-based intervention for enhancing sensitive discipline in mothers of 1-to 3-year-old children at risk for externalizing behavior problems: a randomized controlled trial" (PDF). Journal of Consulting and Clinical Psychology. 74 (6): 994–1005. doi:10.1037/0022-006x.74.6.994. hdl:1871/34105. PMID 17154730. 88. Sears, William; Sears, Martha (2001). The Attachment Parenting Book: A Commonsense Guide to Understanding and Nurturing Your Baby. New York: Hachette. p. 5. 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The Cultural Contradictions of Motherhood. Yale University Press. ISBN 978-0-300-07652-3. "The Cultural Contradictions of Motherhood". Retrieved 2016-02-23. The Cultural Contradictions of Motherhood. Retrieved 2015-01-25. Douglas, Susan. "Understanding parenting culture (video)". 194. Rizzo, Kathryn M.; Schiffrin, Holly H.; Liss, Miriam (July 2012). "Insight into the parenthood paradox: mental health outcomes of intensive mothering". Journal of Child and Family Studies. 22 (5): 614–620. doi:10.1007/s10826-012-9615-z. S2CID 143619309. Retrieved 2015-01-24. 195. Sears, Dr Bill. "AP Fathering". Ask Dr Sears. Retrieved 2019-04-10. 196. Ainsworth, M.D.S. (1967). Infancy in Uganda: Infant care and the growth of attachment.Baltimore: Johns Hopkins University Press. 197. Freeman, H.; Brown, B.B. (2001). "Primary attachment to parents and peers during adolescence: Differences by attachment style". Journal of Youth and Adolescence. 30 (6): 655–674. doi:10.1023/a:1012200511045. S2CID 35110543. 198. Trinke, S.J.; Bartholomew, K. (1997). "Hierarchies of attachment relationships in young adulthood". Journal of Social and Personal Relationships. 14 (5): 603–625. doi:10.1177/0265407597145002. S2CID 145076407. 199. Morelius, Evalotte; He, Hong-Gu; Shorey, Shefaly (2016-09-01). "Skin-to-skin contact by fathers and the impact on infant and paternal outcomes: an integrative review". Midwifery. 40: 207–217. doi:10.1016/j.midw.2016.07.007. ISSN 0266-6138. PMID 27476026. 200. Shaffer, D. (2008). Social and personality development. (6th ed.). Belmont, CA: WADSWORTH CENGAGE Learning. 201. Ball, H. Ball, Helen L. (2006). "Parent-Infant Bed-sharing Behavior: effects of feeding type, and presence of father." Human Nature: an interdisciplinary biosocial perspective, 17(3): 301-316. 202. Markham, Derek (2009-10-05). "Co-Sleeping with Baby: Attachment Parenting for Dads". Natural Papa. Retrieved 2019-04-10.
Sears, Martha; Sears, William (1997). Complete Book of Christian Parenting and Child Care: A Medical and Moral Guide to Raising Happy Healthy Children The Benefits of Attachment
Parenting for Infants and Children: A Behavioral
Developmental View What is Attachment
Parenting? A close attachment after birth and beyond allows the natural, biological attachment-promoting behaviors of the infant and the intuitive, biological, caregiving qualities of the mother to come together. Both members of this biological pair get off to the right start at a time when the infant is most needy and the mother is most ready to nurture. Bonding is a series of steps in your lifelong growing together with your child. What does Attachment Parenting look like? Attachment Parenting is nothing new and certainly not a trend. It is the way parenting has been done for most of human history and, in most cases, will come intuitively to new mothers and fathers. It is important to remember that Attachment Parenting is an approach rather than a set of rules, so while birth bonding, breastfeeding, baby wearing and safe co-sleeping are encouraged in this style of parenting, the benefits of Attachment Parenting are not exclusive to those who are able to do all of these things. The principles of Attachment Parenting are being responsive and sensitive to your baby’s needs, nurturing your child through touch, and creating a bond that allows the child’s needs to be easily deciphered and cared for. What are the benefits of Attachment Parenting? There are numerous benefits of Attachment Parenting for the child, the parents, and the child-parent connection. A responsive and sensitive parenting style can promote brain development in infants, reduce the risk of SIDS, lead to a better understanding of your child’s mental and emotional states, reduce the likelihood of behavioral problems, promote socio-emotional development and much more. And find more helpful information in
The Attachment Parenting Book from the Sears
Parenting Library.
Source: https://www.askdrsears.com/topics/parenting/attachment-parenting/ Is getting
rid of hospital nurseries unfair to new moms? When I had my first baby, it went well, all things considered. I was induced at noon, gave birth 15 hours later in the wee hours of the morning, and my beautiful little boy went right on my chest, snuggling in and latching. I remember him just gazing up at me endlessly, taking in my face. Eventually we were moved to a private room, and I went to a breastfeeding lesson just down the hall, before the grandparents arrived to meet him. Through all the commotion, my blissed-out baby boy slept soundly, swaddled in the bassinet beside me, just like I’d imagined he would. That night, I sent my husband home, after watching him restlessly toss and turn on the recliner in our room. (He’s 6’4".) “You go home, check on the house, get some rest, and come back in the morning,” I said. “I’ve got this!” Cue the narrator: I did not, in fact, have this. My baby, like many, “woke up” on night two—he was alert, hungry and very pissed off about not being his warm, snug womb. He cried incessantly unless I stood up and swayed him, back and forth, back and forth, back and forth. (This “night two” phenomenon—where the baby becomes more alert, and the mom’s milk hasn’t come in yet—is so well known that it was actually written up in the booklet the hospital had given us after birth, but I had been too distracted to read it.) After an hour or two of the swaying, I decided I needed a break and walked out to the nursing station to hand off the baby. To my surprise, the nurse I found didn’t take him—instead, she gave me a warm blanket to swaddle him in, patted me on the shoulder, and said, “you’re doing all the right things.” So I returned to my room. It was now 30 hours and a labour away from the last time I’d really slept, I was bleeding profusely, and I was again swaying my little baby, back and forth, back and forth, back and forth, back and forth. The shadow from the hall lights flickered on and off of his face, and he blinked up at me, silent, but very awake. A thought hit me: Was this what motherhood was going to be? Me, doing whatever this baby needed, no matter the mental-health costs to me? (Spoiler alert: Yes—for the next little while at least.) When I told my own mom about all this, she was shocked at how different my experience was from how she was treated when she’d given birth to me, in the 1980s. Back then, she’d stayed in the hospital for five days, and every night the nurses whisked me away to the nursery so she could rest, bringing me back to breastfeed twice. When they got home, my parents gave me a bottle of formula every night, just in case my mom wasn’t making enough breast milk. This generational switch has happened in response to mounting evidence that supports what’s called “rooming in”—where mom and baby are kept in the same room—and promoting exclusive breastfeeding. That means more support and encouragement around breastfeeding, not having nurseries available to healthy infants, and a lot of grumpy babies on night two. During COVID-19, it’s also gotten harder: most hospitals allow birthing people only one support person, and no visitors. That often means moms can’t have a doula, or your own mom, as well as a spouse. At times, COVID restrictions have also dictated that both mom and their partner are not allowed to even leave the hospital room—no going to grab food, no smoke breaks, no in and out privileges. The pandemic has also raised the bar for when a baby would be sent to the nursery or taken care of at a nurses’ station. Postpartum people are also getting sent home from the hospital faster—the average stay has dropped by 30 per cent since the pandemic began. The Baby-Friendly Hospital Initiative, which was started by the World Health Organization in 1992, has also helped push these changes forward, well before the coronavirus hit. Twenty-nine hospitals across Canada are certified as “baby friendly,” meaning they follow the 10 rules set out by the WHO, including training staff to help mothers breastfeed, ensuring moms are told the benefits of breastfeeding, rooming in, not giving pacifiers, encouraging feeding on demand, and doing skin-to-skin after birth. And hospitals with this designation have to refuse money from formula companies, refrain from advertising formula, and cannot offer it unless it’s medically necessary. This could be seen as shifting birth back to where it should be: not unnecessarily separating moms and babies, and supporting breastfeeding as the default way to feed a baby. Many moms love it, in fact. When I asked for thoughts on a few Facebook groups for parents, one mom replied, “You try and take my child out of my room after giving birth and I’ll wrestle you to the ground, grannie panties and all!” Another said that after doing a lot of research while pregnant, she went to her doctor with a list of evidence-based requests, like doing skin-to-skin, and was reassured to hear that they were all standard at the hospital she was going to. But others, like me, have a more mixed experience. Alli Glydon, a mom from Calgary, is one. When she gave birth, she had a scheduled C-section because her baby was breech. She ended up having a reaction to the spinal block they gave her, and was violently ill for eight hours afterwards. Then, she had trouble breastfeeding, and the nurses encouraged her to wake up every couple of hours to hand-express a few drops of colostrum to give her baby. She would later find out that her baby had a tongue tie, small mouth and high palate, which was why nursing was so difficult. Additionally, Glydon had low supply and Reynaud’s syndrome, which can make nursing incredibly painful. “My daughter was obviously hungry—she was rooting and wouldn’t latch at all—and I couldn’t hand express anything beyond one to two drops of colostrum. The nurses were taken aback when I asked for formula, and it took a long time to come—like more than 30 minutes,” she says. “I felt like I had to beg for it.” Talia Bender, a mom in Vancouver, also had a negative experience. After a 25-hour labour, she was moved into a room with her baby. That night, when she was on her own (her husband was home with their older kids), she was exhausted and nursing the baby when they both fell asleep. “The nurse came in and yelled at me, saying, ‘This is so unsafe,’” she says. “And it’s like, I can hardly walk, I just pushed a watermelon out of my vagina, and we both fell asleep because I’m so exhausted. And you weren’t here!” Bender says she feels like leaving moms alone like this, postpartum, is abnormal. “When you think about birth in the past, you had midwives and your family and a support system; all the women would be there to hold the baby, and let the new mother recover,” she says. “Now we have hospital births and families live all over the place, and there’s so much pressure on the new mother, and so much disregard for the recovery process.” The question of whether the Baby-Friendly Initiative has gone too far has been making headlines lately thanks in part to a U.S. organization called Fed is Best. Founded in 2016, Fed is Best argues that hospitals are encouraging breastfeeding over health, and putting babies at risk of dehydration, jaundice, hypoglycemia (low blood sugar) and hyponatremia (low sodium). “There are billions of infants who require formula at some point during their first year of life,” says Fed is Best co-founder and physician Christie del Castillo-Hegyi. “To hide that and give parents an illusion that exclusive breastfeeding is possible, natural, easy and ideal for all infants, without any evidence, and no parsing out or informed consent of the harms—it has created a public health catastrophe,” she says. Through its website, Fed is Best collects and publicizes stories like that of Landon, a healthy baby who died at 19 days old of cardiac arrest from not eating enough. “If I had given him just one bottle, he would still be alive,” reads the heartbreaking headline on the story. In a 2016 JAMA Pediatrics publication, paediatrician Joel Bass also raised concerns about the unexpected consequences of rigidly enforced baby-friendly practices, including the focus on strict breastfeeding exclusivity. Bass says every hospital should have a nursery for healthy babies, so moms have the option to send their babies there to rest, and that offering a small amount of formula in the early days of life isn’t likely to impact breastfeeding success. He also points out that while many breastfeeding-friendly hospitals still discourage pacifier use, newer evidence shows that it doesn’t interfere with breastfeeding—and may even encourage it—and that putting babies to sleep with a pacifier can help prevent Sudden Infant Death Syndrome (SIDS). But others point out that the Baby-Friendly Initiative does allow for formula when medically necessary. “There are babies that need formula—there are medical reasons for supplementation—and it’s perfectly fine,” says Hiltrud Dawson, a nurse and lactation consultant who works for the Baby-Friendly Initiative of Ontario. “I believe that babies are given formula when needed.” It’s also important to remember that when it comes to following up with babies who are losing weight after they leave the hospital, Canada has a much better safety net than the U.S. does, says Merilee Brockway, a registered nurse and lactation consultant who studies the effects of human milk on babies. That includes babies seeing their doctor or a public health nurse within a week after leaving the hospital—that’s when a newborn is weighed and professionals help parents make sure breastfeeding is on track. (Baby Landon, she points out, was 19 days old when he died, so the system failure was in the follow-up care, not on the maternity ward.) Because of the time crunch in getting mothers home, parents are also not always sent home with enough information, says Dawson. In response, her group helped create a card with information for new moms about how to make sure their baby is getting enough— including how many wet diapers they should look for, the change in baby’s poop, and that their babies should gain weight from day four onwards. They should also have a strong cry, be active, and wake easily. If your baby is getting enough, there do seem to be benefits to not offering any formula at all, says Brockway—even if this isn’t exactly helpful information for new parents who are already stressed enough about exclusive breastfeeding (EBF). “We can see significant differences in the gut microbiome after even one formula supplementation,” she says. Researchers have indeed found a connection between the gut microbiome and issues like asthma and obesity—but there isn’t enough research yet to confirm exactly how that connection works, or how much formula-feeding would affect it. Brockway adds that there is also lots of evidence about how mom’s mental health is important to raising a happy, healthy baby—and that if mom is really suffering under the strain of trying to breastfeed, that can be reason enough to supplement. And she says some health-care professionals can be a bit “fanatical” about encouraging moms to breastfeed. She would like to see the mantras of “breast is best” and “fed is best” replaced by a new one: “informed is best.” “We have really high
breastfeeding intention rates and breastfeeding initiation
rates in Canada. Most moms want to breastfeed. But
breastfeeding can be really hard, and if you have a
difficult labour, or if mom’s sick, it gets to be
really really difficult,” she says. “We need to be
able to say, ‘Are we forcing mom to carry on this
path?’ We need to respect maternal autonomy.” A vacuum or
forceps delivery could be riskier than a C-section for mom
and baby. It seems that most of dificult births rely on forceps still. "Among moms who had mid-pelvic forceps deliveries, 19 percent experienced third- or fourth-degree tearing and, for those who had vacuum deliveries, 12 percent had the same result." This isn’t to say that Caesarean
sections are risk-free—the postpartum infection rate
was higher for women who had C-sections, for
example—but it’s helpful for women to understand
the comparative risks for all options. “A woman who
undergoes Caesarean delivery is very well aware that she is
going to have a scar at the end of it,” says Muraca.
“Whereas a woman who undergoes a mid-pelvic forceps or
vacuum delivery is not informed that she has up to a one in
five chance of ending up with a third- or fourth-degree
severe perineal tear.” Are "natural"
childbirth and attachment parenting bad for moms? Amy Tuteur’s controversial new book, Push Back: Guilt in the Age of Natural Parenting, is a takedown of attachment parenting and our culture’s emphasis on so-called “natural,” drug-free childbirth. Known online as The Skeptical OB, the Harvard-educated former-OB/GYN-turned-author has no time for what she says are the anti-female and elitist tenets of the alternative birthing and natural parenting movements: At best, it’s a bunch of pseudo-scientific hooey; at worst, it’s a plot to roll gender equality back a half-century or two. Maybe that sounds extreme, but more than anything, Tuteur argues that we need to get over the notion that there is one superior parenting philosophy… and maybe ditch the idea of having a “parenting philosophy” altogether. (See, “Are we the worst generation of parents ever?”) We spoke with Tuteur about the trouble with competitive breastfeeding, how judgy moms are the new mean girls and why the “good old days” of natural childbirth were anything but. Natural parenting was initially introduced as a movement to give women agency over their own birthing experience, instead of treating it like an illness or medical problem, which is obviously a good thing. Where did it all go wrong? It’s true that the movement came along at the height of patriarchal medicine, when women had almost no power. Childbirth seemed like an obvious arena to seek progress, since these women were not actually sick. The original goals were for a woman to be allowed to remain awake during childbirth [instead of being put under general anesthesia for the entire labour]; to have her wishes respected; and to have a support person—generally her husband—allowed in the room during labour. The movement was instrumental in giving women control over their childbirth experience, but by the early ’80s almost everything it set out to do had been accomplished. Those behind the movement could have declared victory and gone home, but instead they moved the goal posts—they made it about the superiority of natural childbirth, breastfeeding and many of the behaviours associated with attachment parenting. The fetishizing of the so-called natural is, you say, largely the domain of the more privileged classes. Certainly, you have to get to a certain level of privilege in order to look back longingly on the natural. If you’re a single mother working full-time, there is no way you can be a successful parent based on these standards. There was a time when all childbirth was natural and everybody breastfed and everybody did all of these things that are now associated with attachment parenting, and it sucked. It was really bad. Babies and mothers died in droves, women were terribly oppressed. We now have what is called a “paleo-fantasy” about what life in nature was really like, and there’s this effort to recapture something that actually never really happened. You describe many of the key tenets of natural parenting—the reverence for breastfeeding and attachment parenting—as deeply anti-feminist. How so? This isn’t something I realized right away. I first began researching “natural parenting” because people kept asking me about it on my “Ask an OBGYN” message board. The first thing I noticed was that there is absolutely no science behind any of it. So why are people embracing it? What is the purpose? And then you look at the history, which is really ironic, because natural parenting was started by a guy. Grantly Dick-Read [a leading early proponent, in the early- to mid-1900s, and author of Childbirth Without Fear] was a British eugenicist who was obsessed with the issue of what he called race suicide—white women of the higher classes weren’t having enough babies. He thought that was partly because they were getting out in the wider world and seeking political and economic rights. For the first time, some women in some cultures were allowed to get educations, to have careers, to have their own bank accounts. A seismic shift like that doesn’t happen without a certain amount of push-back. On the right we see religious fundamentalism, which is all about putting women back into the home, and then on the left we see the rise of “natural parenting.” So then the movement is explicitly trying to push back female progress? It’s not just a side effect? It’s a Trojan Horse! We’ll take away women’s rights in the larger world by convincing them to be empowered by childbirth and breastfeeding. There are women out there who now insist that they are. It reminds me of an example from Betty Friedan’s book The Feminine Mystique, where she identified that women [in the late 1950s and early 1960s] were competing over who had the whitest laundry. If you’re competing over who has the whitest laundry, you’re not going to be bothering any men for political power. And now new mothers are competing with each other over who had a drug-free labour, who breastfeeds the longest and who can spend the most hours babywearing? Exactly. That’s not to say that any of these choices are a problem in and of themselves. I think I make it clear in the book that these are choices that I also made when my children were small. All of my children were born vaginally; I breastfed; we had a family bed policy and I carried my children around a lot, but I wasn’t empowered by it. So it’s not about the behaviour so much as the pressure to behave in one way or another? Yes. I made certain choices as a parent, but I didn’t think I was making the only right choice, or even the best choice. I wasn’t practicing a parenting philosophy—I was doing what worked for me and my family at the time. There is a chapter in your book called “Natural Childbirth Advocates: Whitesplainin’ Birth to Everyone Else.” How does race play in? Natural childbirth advocacy is almost exclusively restricted to Western, white women of privileged class. One of the things I remember from when I was practicing obstetrics is that women from other cultures heard about natural childbirth and they were like, “You have got to be kidding me!” Did you ever see that movie Babies, the documentary where they followed four different babies from different parts of the world? It was super cute, but one of the things I found out afterward is that the mother from San Francisco had a home birth, but there were complications and they ended up in the hospital. While the mother from Mongolia, in order to agree to be part of the filming, her demand was that they pay for her birth in the hospital. Home births are certainly a trendy option these days. You say they are more dangerous than people understand. The essence of the natural childbirth movement and of contemporary midwifery in most places is that childbirth is inherently safe. The problem is, it’s inherently dangerous. In the field of obstetrics, we’ve been too successful for our own good, which is part of why people have this misconception. In many provinces in Canada, midwifery is a more mainstream and very regulated field. Yes, I’m actually working on a piece right now about how home birthing can be safe in Canada and not in the US, and it’s about regulating and standards. In the United States, where I live, we have the second-class midwives—the certified professional midwife, who isn’t really a midwife at all, she’s a layperson. They call themselves experts in “normal births,” but as I say in the book, that’s like having a meteorologist who’s an expert in sunny weather. Who needs that? In your book you call out the judgy mommies. Who are they and why are they so judgmental? It’s like the mean girls from elementary school grew up, but they’re still patrolling on the playground or at the Mommy and Me groups. It’s this whole “sancti-mommy” phenomenon: People who wouldn’t in a million years come up to you and talk about something as personal as whether you use pads or tampons now have no problem asking, “Oh, I see you have a baby—did you have a vaginal birth or a C-section?” Any theories on why parents—and particularly mothers—feel the need to compare themselves to other parents, or feel smug about their parenting choices? Parenting is really hard. You’re very vulnerable and you don’t know if you’re doing a good job. As a parent, you don’t get much feedback, like a letter grade or a review from your boss. Instead, we made up a completely arbitrary way of judging parenting—standards that are easy for some of us to meet simply by chance in many cases. And then, because one group met those standards, they declared that they’re better moms than everybody else. It makes me think of designer handbags: I like them, and sometimes I buy them, even though they’re ridiculously expensive, but at no point do I think I’m a better person because I carry one. This is designer parenting. It’s supposed to mark you as better, when in fact it’s worse. The worst thing about natural parenting is that it’s all about creating this exceptional child that you can brag about—and children become accessories. And everybody wants the latest Prada. Right. Exactly. And it’s not that having the Prada bag is bad—it just doesn’t make you superior. Source: www.todaysparent.com/family/parenting/attachment-parenting-bad-for-moms/ Why Attachment
Parenting Is Not the Same as Secure Attachment In the months leading up to birth, a pregnant woman begins to read about childrearing, including a book called Attachment Parenting by pediatrician William Sears and registered nurse Martha Sears. They advocate for a collection of seven practices they call the Baby Bs: “birth bonding, breastfeeding, baby-wearing, bedding close to the baby, belief in the baby’s cry, balance and boundaries, and beware of baby trainers.” The pregnant woman finds their ideas compelling, and so decides to embrace this style of “attachment parenting.” But nothing goes according to plan. She begins delivery at home with a midwife, but when the labor doesn’t proceed, she’s taken to the hospital and given a Caesarean section. Influenced by Attachment Parenting, she worries that she has missed a critical bonding experience with her baby. Six weeks later, the mother develops a severe breast infection and reluctantly switches to formula. “Make sure you find some other way to bond with your baby,” her pediatrician cautions, adding to her distress. At night, the mother pulls the baby from his crib into her bed—even though it makes the baby cry. Pretty soon, no one is happy—and the new mother wonders if her child is on the road to insecurity and anxiety. All of these experiences are real; they’ve happened to mothers I know. And as a developmental psychologist, I know this tension between the ideal and the reality is based on a misunderstanding. Home birth, breastfeeding, and co-sleeping all have benefits—but none of them is related to a baby’s secure attachment with her caregiver, nor are they predictive of a baby’s future mental health and development. Simply put, a secure attachment—which does lead to positive child outcomes—is not the same thing as the philosophy called attachment parenting. What is the scientific view of attachment? The term attachment parenting was coined by Sears and Sears to refer to a parenting approach that emphasizes responding sensitively to the needs of babies and children. Many of their ideas come from parenting their own eight children, as well as from their pediatric practice; some are from anthropologists’ observations of indigenous childrearing practices (thought to be more “natural”); and some (like emotional responsiveness) are consistent with research findings. Many parents, myself included, have welcomed the Sears’ guidance for creating warm, loving relationships, especially in contrast to earlier parenting approaches that were more strict, cold, or distant. The implication, though—liberally strewn throughout the Sears’ writing and the precepts of the related international attachment parenting movement—is that the Baby Bs lead to a secure attachment, which is a specific psychological concept based on 60 years of research. Here we come to the problem: their use of the word attachment and the confusion it creates with the scientific notion of attachment theory. Attachment theory has its roots in the work of an English psychiatrist, John Bowlby, who in the 1930s worked with children with emotional problems. He noticed that the troubled children in his care were deprived of affection and had disturbed or nonexistent caregiving. He came to believe that a primary caregiver served as a kind of “psychic organizer” to the child, and that the child needed this warm, intimate influence to develop successfully. According to Bowlby, babies form a “small hierarchy of attachments”: The number has to be small for the baby to learn relevant emotional information, but multiples offer the safety of backups. And it’s a hierarchy for safety, too—in danger, there’s no time to think, so the baby can automatically turn to the person already determined to be the reliable comfort. In the 1950s, Mary Ainsworth joined Bowlby in England. A decade later, back in the United States, she began to diagnose different kinds of relationship patterns between children and their mothers in the second year of life, based on how babies respond to separations and reunions. When babies have a secure attachment, they play and explore freely from the “secure base” of their mother’s presence. When the mother leaves, the baby often becomes distressed, especially when a stranger is nearby. When the mother returns, the baby expresses joy, sometimes from a distance and sometimes reaching to be picked up and held. (Babies vary, depending on their personality and temperament, even within a secure attachment). Though early researchers studied mothers, current research shows that fathers, co-parents, grandparents, babysitters, and even older siblings can be significant attachment figures. Caregivers who foster a secure attachment are responsive, warm, loving, and emotionally available, and as a result babies grow to be confident in the caregiver’s ability to handle feelings. The babies feel free to express their positive and negative feelings openly and don’t develop defenses against the unpleasant ones. Why the confusion about a secure attachment? The Sears’ idea of attachment parenting is not well defined—and certainly has not been scientifically linked to a secure attachment outcome. And this confusion can sow guilt, worry, and misdirection in parents, who (understandably) are not aware of the distinction. “Attachment [in the scientific sense] is a relationship in the service of a baby’s emotion regulation and exploration,” explains Alan Sroufe, a developmental psychologist at the Institute for Child Development at the University of Minnesota, where he and his colleagues have studied the attachment relationship for over 40 years. “It is the deep, abiding confidence a baby has in the availability and responsiveness of the caregiver.” A secure attachment has at least three functions:
“Attachment is not a set of tricks,” continues Sroufe. “These [attachment parenting principles] are all fine things, but they’re not the essential things. There is no evidence that they are predictive of a secure attachment.” Take breastfeeding, for example, touted as key to attachment parenting. Mechanical and insensitive breastfeeding could actually contribute to an insecure attachment, while warm, sensitive, interactive bottle-feeding could help create a secure attachment. It’s not the method of feeding but the quality of the interaction that matters for attachment, says Sroufe. Constant contact, too, can be misunderstood. Certainly, skin-to-skin contact, close physical touch, holding, and carrying are good for infants and can even reduce crying. But again, what matters for attachment is the caregiver’s attunement. Are they stressed or calm? Checked out or engaged? Are they reading the baby’s signals? Attachment parenting advises emotional responsiveness, and this practice aligns best with scientific attachment theory. Babies grow best when their feelings are taken seriously. But well-meaning parents can overdo it, believing they need to meet the child’s every request, which can be exhausting and counterproductive. In contrast, research on secure attachments shows that, in the flow of everyday life, misattunements happen about 70 percent of the time! What is important, researchers say, is that the baby develops a generalized trust that their caregiver will respond and meet their needs, or that when mismatches occur, the caregiver will repair them. This flow of attunements, mismatches, and repairs offers the optimal amount of connection and stress for a baby to develop both confidence and coping skills. “There’s a difference between a ‘tight’ connection and a secure attachment,” Sroufe explains. “A tight attachment—together all the time—might actually be an anxious attachment.” The neurobiology of attachment “Attachment theory is essentially a theory of regulation,” explains Allan Schore, a developmental neuroscientist in the Department of Psychiatry at the UCLA David Geffen School of Medicine. The areas of the brain that process emotional and social information begin to differentiate in the last trimester in-utero (whereas the more “intellectual” regions pick up in the second year of life). By birth, the amygdala, hypothalamus, insula, cingulate cortex, and orbitofrontal cortex—regions important for emotion processing—are present, but the connections among these areas develop in specific patterns over the first years of life. That’s where input from the primary relationship is crucial, organizing the hierarchical circuitry that will process, communicate, and regulate social and emotional information. Synaptic connections are pruned, and epigenetic processes modify the expression of genes that regulate stress, depending on input from the environment. Parents use their own empathy, perspective taking, inference, and intuition to discern the needs of the baby. And the behaviors that parents are inclined to do naturally, like eye contact and face-to-face interaction, baby-talking and holding, are exactly the ones shown to grow the neural regions in the baby that influence emotional life. It is through a “right-brain-to-right-brain” reading of each other that the parent and child synchronize their energy, emotions, and communication. “What a primary caregiver is doing, in being with the child,” explains Schore, “is allowing the child to feel and identify in his own body these different emotional states. By having a caregiver simply ‘be with’ him while he feels emotions and has experiences, the baby learns how to be,” Schore says. And it’s not just about regulating stress. Supporting positive emotional states is equally important to creating a “background state of well-being.” If the caregiver’s emotions are too high, the stimulation could be intrusive to the baby, Schore explains. Too low, and the baby’s “background state” settles at a low or possibly depressive emotional baseline. Just right, from the baby’s point of view, is best. Even then, there’s a lot of leeway. As Schore says: Insecure attachments aren’t created just by a caregiver’s inattention or missteps. They also come from a failure to repair ruptures. Maybe the caregiver is coming in too fast and needs to back off, or maybe the caregiver hasn’t responded and needs to show the baby that she’s there. Either way, repair is possible, and it works. Stress is a part of life, and what we’re trying to do here is to set up a system by which the baby can learn how to cope with stress. How important is attachment? “Nothing is more important than the attachment relationship,” says Sroufe, who, together with colleagues, ran a series of landmark studies to discover the long-term impact of a secure attachment. Over a 35-year period, the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) revealed that the quality of the early attachment reverberated well into later childhood, adolescence, and adulthood, even when temperament and social class were accounted for. One of the most important (and paradoxical) findings was that a secure attachment early in life led to greater independence later, whereas an insecure attachment led children to be more dependent later in life. The MLSRA studies showed that children with a secure attachment history were more likely to develop:
But attachment is not destiny; it depends on what else comes along. A poor start in life, for example, can be repaired in a subsequent relationship with a good mentor, a healthy romance, or constructive therapy. As for my new-mother friends, they’re bonding successfully with their babies, welcoming and enjoying the moments when connection happens. And if you’re concerned about bonding with your own baby, rest assured that you’ll have some help—from your baby. Because regardless of their individual personalities—whether they cry a lot or sleep very little, whether they’re breastfed or bottle-fed—babies invite adults in with their wide-open gaze, their milky scent, and their tiny fingers that curl around your big ones. They let you know what they need. Before you know it, they are lighting
you up with their full-body smiles and pulling you close
with their plump, soft arms. And the sweet elixir of
attachment is underway. This new invention
will change C-sections for the better Besides being numb, being covered in blue drapes and shaking from anaesthesia, the worst part of a C-section is not being able to hold your baby right after giving birth. But thanks to three registered nurses from Virginia, that’s all about to change. Kimberly Jarrelle, Deborah Burbic and Jess Niccoli have created a new surgical drape called the Skin-to-Skin C-Section Drape that allows mom and baby immediate skin-to-skin bonding, thanks to a flap window that the doctor can use to pass the baby through to her. The flap can be resealed immediately, so the surgical environment stays sterile while the doctor stitches mom back up. The first time a mother holds her baby is such a beautiful moment, which is why Jarrelle, Burbic and Niccoli spent three years producing 50 different prototypes before they settled on something that would work. Despite having 50-plus years of labour and delivery experience between them, the three nurses spent numerous hours brainstorming ideas over coffee and referring to a plethora of studies. “When mom gets to hold that baby for the first time on her chest, that experience is just unbelievable,” said Burbic to the Richmond Times-Dispatch. “We were going, ‘How could we make this happen in the operating room?’” According to the article, three
hospitals have already agreed to test out the Skin-to-Skin
C-Section Drape. We’re one step closer to having every
mom experience the immediate baby bonding she so needs. We
love that hospitals, doctors and nurses are making
C-sections less like a scary operation and more like the
birth experience that women imagine. Is it still
safe to swaddle your baby? 12/22/20 When Melissa Romain had her first baby at a Toronto hospital in 2016, the nurses demonstrated how to swaddle him and encouraged her to continue doing it at home. But by the time she had her second baby four years later, things had changed. The nurses swaddled her baby the whole time they were on the maternity ward; then, as she was being discharged, they told her she shouldn’t swaddle at home because it was too dangerous. They said this was because the baby was under closer supervision in the hospital, but Romain says there was plenty of time that she and her baby were alone together in her room. “I was confused and a little frustrated,” says Romain. “Nobody explained why swaddling is no longer a best practice. They just said that this is how it is now.” According to Wendy Hall, a sleep specialist and professor emerita at UBC’s School of Nursing, most hospitals now advise parents not to swaddle. They’re likely following the guidelines of the Registered Nurses Association of Ontario and Perinatal Services BC, who both recommend against it. “We suggest families use sleep sacks instead, because babies move, the blankets [you use to swaddle] can come undone, and if that gets in their face, there is a risk for sure,” says Cynthia Joly, a nurse educator at CHEO in Ottawa. “Unless you’re able to really watch the baby, like during a nap in your arms, we don’t advise that parents swaddle.” The other concerns are that swaddling might lead to overheating; chest infections (because an overly tight swaddle can restrict breathing); and hip dysplasia, a condition in which a baby’s hip joints are loose or partially or fully dislocated. Swaddling also may be linked to sudden infant death syndrome (SIDS), which is not necessarily when a baby rolls over and suffocates, but an unexplained death of a baby under one year old. But this messaging can be confusing for parents who have researched swaddling on their own. Paediatrician Harvey Karp, author of the best-selling Happiest Baby on the Block books, includes swaddling as one of his five key ways to soothe a newborn. (He also markets his own line of swaddles to use.) And other trusted sources, like The American Academy of Pediatrics and the Canadian Paediatric Society, both say swaddling is low risk if practised correctly. “The Canadian Paediatric Society certainly is not against swaddling as long as it’s done properly,” says Janice Heard, a community paediatrician in Calgary and member of the Canadian Paediatric Society’s public education and advisory committee. Swaddling does seem to help newborns sleep longer stretches at night. That’s because it helps calm the Moro reflex, which makes the baby’s arms spring out. “Many babies like that cuddled-up feeling. It’s like being in the womb,” explains Heard. Toronto paediatrician Dina Kulik says to avoid swaddling if you can, but that it’s much better than some other sleep “crutches” parents reach for, like holding a baby all night, using a swing or sleeping with them on the couch. “If they can go down without it, don’t do a swaddle,” she says. “But if the alternative is holding them all night, swaddling is certainly safer than that.” Make sure the swaddle is worn low—around their shoulders, not bunched up at their neck—and fits snugly, because there is a risk that the swaddle will become loose and the fabric could cover the baby’s face and suffocate them. Babies should be dressed lightly underneath a thin swaddle to avoid overheating. If you’re using a Velcro or zip-up swaddle, make sure it’s the right size so your baby’s head doesn’t scooch down into the swaddle as they sleep. And the baby’s hip area should be left loose so there is room for them to bend up and kick out their legs, which helps prevent hip dysplasia. Then, there’s positioning: Always put a swaddled baby to sleep on their back, never on their side or their front, which greatly increase the risk of SIDS. When babies show signs of learning how to roll over, it’s time to ditch the swaddle. Babies who bed-share with a parent should also never be swaddled. “Swaddling and co-sleeping is really not a very good combination,” says Hall. “If a baby is swaddled and ends up face down, they are completely defenceless.” Kulik adds that there are some infants
who shouldn’t be swaddled under any circumstances, such
as babies who are very jaundiced or underweight. If
you’re unsure, ask your healthcare provider for
personalized, up-to-date advice, she says. “Always talk
to your doctor. Every kid is different.”
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