Attachment Parenting International
As stated in the December 7, 2009 issue’s A-Z year of health review, "B" is for babies--we happily agree. More than ever, families are employing the evidenced-based research and their own instincts to parent in a way that is much healthier for babies, during their infancy and throughout their lives. Babies raised with Attachment Parenting International's (API) Eight Principles of Attachment Parenting benefit from care that is proven to result in strong, connected, well-adjusted children and adults and contributors to society. Included in these Principles is API's Principle to Ensure Safe Sleep, Physically and Emotionally.
Contrary to the very unfortunate and detrimental advice on sleep in Time magazine, API's Principle outlines the need to be responsive to children during the night and not to brush aside their needs as inconsequential to them or to their development in the name of "tough love." The magazine and this proponents’ advice is framed in such a way to alarm parents into unfounded fears about their children being poor sleepers if they respond in loving ways such as rocking their child, breastfeeding, or lying down with the child. We know, in fact, that these practices are not only healthy for the child, but, for the very short period of a child’s life that needs are met in this way, parent and child benefit.
Even adults in familiar places naturally fear being alone in the dark. A healthy fear response drives us to seek the closeness and safety of loved ones. This reaction is no mistake: closeness—especially touch--physiologically helps us return to a calm, functional, thinking, "rational" state. Children are acutely susceptible to these fears, especially at nighttime when they are most likely to be alone in the dark. Neuroscience now reveals that developing brains are not yet capable of resolving these overwhelming and fearful feelings alone. Needless to say, bodies and brains aroused to fight or flee cannot sleep.
Science indicates that a comforting nighttime approach helps children achieve healthy sleep habits. Research and the experience of parents throughout the ages have proven that effective nighttime parenting includes prompt, calm response, as well as holding, cuddling and soothing touch. "Tough love" sleep tactics, resulting in distressing separations, may change the visible behaviors. The state of distress is only suppressed and unresolved and may cause ongoing sleep difficulties or be transformed into other anxieties or behaviors.
Children learn best when we consistently respond to them humanely with loving, (if tired) arms, and with understanding and a genuine desire to help them feel safe and secure. In the blink of an eye, it's all but a dream for us, but the legacy of our responses has a lasting and profound effect.
We pray no one takes to heart this advice you have quite surprisingly chosen to publish, all the more in the midst of the availability of substantial quality parenting information. This advice goes against parents’ good instincts to care for their very young child in the ways their inner knowing tells them to. It's unfortunate to have this misinformation published right as we are on the cusp of leaving behind some very tragic and ill-informed parenting advice from many years past that are still present in our society. It is vital that we make this transition and that we work together to support parents with a goal to affect a more compassionate world--and no more decades from hell. It's a shame we have been set back by Time.
For quality research, understanding, information and support on nighttime parenting and more we recommend The Attached Family magazine and the AttachmentParenting.org website with a number of experts and resources mentioned, including our definitive book on parenting, Attached at the Heart.
The parenting community is dismayed at this poor advice and believes this magazine should hold to its standards to provide information that has not been widely disproved and rejected by parents and experts, and that, in fact, is detrimental to our very youngest.
We implore Time to urgently correct this harmful information in such a way to command even greater attention than received by the original article. Our children are worth it, and so are their parents.
Executive Director, Attachment Parenting International
Barbara Nicholson and Lysa Parker
Founders, Attachment Parenting International
P.S. Per your making of the cover video, your technology for the cover was indeed impressive. We believe you could employ similar creativity to creating a cover that did not require making toddlers miserable--the desperation of the children was so very apparent.
This is how we have responded. If you would like to add your response, please send it to firstname.lastname@example.org, Samantha Gray (API Executive Director), and Janet Jendron (API Board of Directors President).
I'm writing in response to your article in the December 7 issue entitled "The Year in Health, A to Z. B is for Babies." I respectfully but passionately disagree with the statements and research cited to support the notion that babies who fall asleep alone, sleep much better. A vast body of research contradicts this premise.
Research from Canada shows that infants who receive parental attention following waking and crying return to sleep more readily than those receiving delayed attention or whose signals receive no parental response. (Ranson, K.E., & Urichuk, L.J., The effect of parent-child attachment relationships on child biopsychosocial outcomes: a review. Early Child Development and Care, 178,129-53). Dr. William Sears, renowned pediatrician and author of many parenting books, explains the psychology and physiology of infant sleep in his web article at http://www.askdrsears.com/HTML/7/T070200.ASP. He stresses the physiological importance of parenting children to sleep, in order to create a sleep environment that helps a baby through the vulnerable periods of light sleep and reenter deep sleep without fully awakening. He shows why encouraging a baby to sleep too deeply, too soon, may not be in the best survival or developmental interest of the baby.
Dr. James J. McKenna, Director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, is a world-renowned expert on infant sleep. Among many other principles that support co-sleeping, his extensive body of research shows that infants are born with only 25% of their adult brain volumes. This means that infants are neurologically the most immature infant primate of all, the slowest developing and most reliant on adults for the longest period of time, in order to get psychological regulation and support.
Many, many research studies show that stress hormones are lower in mothers and babies who sleep near each other, especially cortisol, which is essential for a baby's healthy growth. The physiology of babies who sleep near parents is more stable, including temperatures, heart rhythms, and fewer long pauses in breathing. In long-term follow-up studies of infants who slept with parents and those who slept alone, the children who co-slept were happier, less anxious, had higher self-esteem, were less likely to be afraid of sleep, had fewer behavioral problems, tended to be more comfortable with intimacy, and were generally more independent as adults. (Reite, M. and J.P. Capitanio, "On the nature of social separation and social attachment", The psychobiology of attachment and separation, New York: Academic Press, 1985, p. 228-238)
Please re-evaluate the information presented with such conviction in "The Year in Health, A to Z. B is for Babies." Your readers have the right to know of the latest reliable research concerning babies sleeping near their parents and of healthy parent/child attachment. Decisions about infant sleep are critically important. Please consider providing your readers with the research collected by Attachment Parenting International on our web site, shown below.
Babies and their feelings matter. Human relationships are built from how we are treated as babies. Positive societal connections are a direct result of healthy attachment within families. I hope Time Magazine will use your considerable influence to treat this issue seriously and help make a positive impact on our world.
President, Board of Directors, Attachment Parenting International
623 Timberlake Drive
Chapin SC 29036
To the editor at Time,
In the recent issue of Time entitled The Year In Health 2009, under B for Babies unqualified advise on childhood sleep is given that likely will cause more harm than good. With all due respect, Jodi Mindell and other parents are perfectly welcome to put their children “three feet away” from them and to ignore the infant child's needs for comfort and frequent breast feedings, if that is what is consistent with their goals and ideals as parents, but it has nothing to do with what other people may want, think and define as being helpful, or what might actually be in the best interest of any particular child, or even, any particular parent. Such a simplistic and dogmatic generalization cannot be permitted to pass as some well-established larger principle of human life or, in this case, the only definition of healthy childhood and family sleep patterns for all, or even for most human beings. A large body of peer-reviewed scientific research from the US, UK, Australia, New Zealand, and elsewhere leads to quite different conclusions regarding the risks and benefits of infants being near their caregivers during sleep and what constitutes "normal" and "healthy" infant sleep.
Generally, such unqualified recommendations are not especially useful both within and across diverse populations of families and often prove detrimental because they distort and misrepresent legitimate, alternative, and exceptionally common practices such as sleeping closer than "three feet" (a seemingly arbitrary distinction) to children. However well intentioned such sweeping recommendations are, they remain confounded by social judgments that assume all parents need and want the same thing (they do not) and that all children are the same (they are not). Moreover, solitary childhood sleep models that promote these forms of separation, sleep consolidation as early in infancy as possible, and rigidly constrained and scheduled nighttime feedings fail to step outside the realm of ethnocentric western pediatric medical recommendations, which were constructed over the last century with little consideration of the evolved biology of infants and children , to consider the full spectrum of "normal" human behavior. Such a consideration leads us to recognize that recommendations such as Dr. Mindell's are in fact largely incongruent with the needs of human infants and children and thus the practices of most human cultures. Indeed, Dr. Mindell's recommendations seek to normalize the idea of infants sleeping in a separate room, i.e. "bringing [the infants] into the parents' bedroom," which blatantly conflicts the recommendations from health care organizations, such as the American Academy of Pediatrics. Frequent nighttime awakenings and feedings are only "problematic" when they are framed initially as pathological, rather than the normal human infant sleep pattern.
On a very basic level, human breastmilk composition (relatively low in fat and protein, high in carbohydrates) dictates that human infants evolved to be fed every few hours at minimum, much like other species in which infants are carried by or are in close proximity to their mothers nearly constantly during infancy. Rather than being a remedy for long-term child sleep issues, imposing separation, lack of physical contact and comfort, and few nighttime feedings on infants likely contributes to the fact that 20-40% of children in our culture allegedly have behavioral sleep “problems to” solve. This recent cultural idea that all infants and children should sleep alone with as little breastfeeding (when babies) and parental intervention as is possible perhaps explains why western parents are seemingly the most exhausted, the least satisfied, and continually the most disappointed as regards their children's sleep than any parents on the planet. It also explains why infants, who refuse to read the cultural memos and whose biological legacies prevent them from complying with them anyway, make their parents so. To suggest that children should sleep alone and untouched is illogical in light of human biology and is impractical, besides. Such a strategy creates the very opposite context in which healthy human emotions and development, including those associated with optimal childhood sleep and parental experiences, evolved.
James J. McKenna Ph.D. 1,2
Lee T. Gettler 2,3
1 Department of Anthropology and
Director, 2 Mother-Baby Behavioral Sleep Laboratory
University of Notre Dame
Notre Dame, IN 46556
3 Department of Anthropology
Evanston, IL 60208
In response to your article I wish to provide some insights based upon my forty years of experience as a pediatrician, father of eight, author of 38 books on parenting and Assistant Professor of Pediatrics as University of California, Irvine. Rather than issuing rules or cautions about being “over attached” concerning nighttime parenting we should be encouraging parents to sleep safely and closely with their babies. In my experience and that of others who have thoroughly researched the issue of co-sleeping, namely Dr. James McKenna, babies who sleep close to their parents sleep physiologically healthier and a mutual trust develops between parents and child. When it comes to working out the right sleeping arrangement I advise individual parents to simply work out the best arrangement that gets all family members the best sleep, rather than give them worrisome rules. For example, concerning the cry-it-out advice (which is physiologically harmful to baby’s neurological development and creates a distance between mother and baby) I advise them: When in doubt how to respond get behind the eyes of your baby and ask yourself, If I were my baby how would I want my mother / father to respond? You’ll always get it right. Remember, we have an epidemic of insomnia in this country necessitating a mushrooming of sleep disorder clinics. When babies start out life with a healthy sleep attitude, that sleep is a pleasant state to enter and a fear-less state to remain in they’re more likely to grow up with a healthy sleep attitude and both children and their parents will sleep better later on.
William Sears, M.D.
As a parenting author, journalist, parent educator, and the mother of a son with unique needs, I was stunned to read Jodi Mindell's recommendations to parents of babies that they keep babies separate to ensure good sleep habits. This information is highly disturbing for two reasons:
First, extensive research has shown that proximity, physical contact, movement, and attuned responsiveness between parent and baby promotes brain growth, especially in the mid-prefrontal cortex which is responsible for nine functions including empathy, body and mood regulation and the ability to extinguish or alleviate fear. Keeping a baby near at night and responding to his cues and cries promotes the brain growth necessary for healthy future self-regulation as a child develops.
Secondly, does any of us know which baby will be the one in 150 boys who is diagnosed with autism by second grade, according to the CDC? Millions of children in the U.S. are diagnosed on the autism spectrum, including pervasive development disorder (PDD-NOS), Asperger's Syndrome and Non-Verbal Learning Disorder (NLD). The SPD Foundation indicates that 1 in 20 children in this country experiences symptoms of sensory processing disorder (SPD) significant enough to affect their ability to participate in daily life. My son, who slept fitfully since birth, was diagnosed at the age of five. He told us his bed was moving one night even while he lay under the covers. He described symptoms of vertigo, dizziness, as we later discovered vision processing difficulties, and his need for deep physical compression.
For any baby, early life experience with an attuned, responsive parent is the hallmark of security, trust, and abiding relationship, naturally laying the foundation for healthy sleep experiences in older years. But, for babies who cannot settle easily, who feel assaulted by light, sound, vibration, or other sensory stimuli, anxiety is already heightened both emotionally and physiologically. For these countless babies, the practice of keeping baby separate and teaching him to sleep on his own through sleep training methods is absolutely devastating to the already sympathetically anxious baby who does not have sufficient integrative fibers and neural connections nor the myelination in his nervous system to cope with "crying it out" and parent separation at night, and can consequently affect his brain chemistry and neural development in profoundly negative ways.
In the 21st century, we cannot afford to be extolling the alleged virtues and benefits of parent-baby separation and sleep training to millions of new parents, when, now more than ever before, we have incontrovertible neuroscience and attachment research which disproves this theory and practice beyond any doubt.
Author, "Let the Baby Drive" (St. Martin's Press, 2004)
Founder of KnowBetterParent and WYSH, LLC
As a parenting counselor and author, I couldn't disagree more with the conclusions in "The Year in Health, A to Z. B is for Babies."
A child who is lovingly cared for during the night as well as the day receives constant reassurance of love and support, instead of having feelings of fear, anger, and abandonment night after night. Children whose legitimate need to be held through the night are met by loving parents, will become adults who cope well with the inevitable stresses life brings. As the writer John Holt put it so eloquently, having feelings of love and safety in early life, far from "spoiling" a child, is like "money in the bank": a fund of trust, self-esteem and inner security they can draw on throughout life's challenges.
Children may be small in size, but they are as fully human as we are, and as deserving as we are to be trusted to know what they need, and to have their voices heard.
"Tough love" is tough, all right, but it has nothing to do with love.
Jan Hunt, M.Sc., Director of The Natural Child
Author of The Natural Child and A Gift for Baby
In response to your article in the December 7 issue entitled "The Year in Health, A to Z. B is for Babies." We'd like to share thoughts an concerns from our perspective at Infant Massage USA. Cross-cultural studies have demonstrated that in societies where infants are held, massaged, rocked, breastfed and carried, adults are less aggressive and violent, more cooperative and compassionate. Dr. Mindell is ignoring nearly 100 years of credible research findings that negate this "smart and healthy science" that your magazine so claims. Dr. Mindell's report further ignores some of the the most respected leaders in child and family wellness our world has to offer: Drs. Margaret Meade (landmark anthropologist), John Bowlby (the father of attachment), Allan Schore (Professor - Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, and at the UCLA Center for Culture, Brain, and Development), William Sears (The Baby Book and father of Attachment Parenting), Bruce Perry (internationally-recognized authority on children in crisis) and the work of many others who, thousands of research citations later, have repeatedly confirmed that how children are cared for influences how they grow up to care for others, for themselves and, one day, their own children.
"20 million people were infected by a virus that caused anxiety, impulsivity, aggression, sleep problems, depression, respiratory and heart problems, vulnerability to substance abuse, antisocial and criminal behavior, retardation and school failure, we would consider it an urgent public health crisis.
Yet, in the United States alone, there are more than 20 million abused, neglected and traumatized children vulnerable to these problems. Our society has yet to recognize this epidemic, let alone develop an immunization strategy." Bruce Perry, MD, PhD
It seems that Dr. Mindell needs a good cry and a good hug from a good person, so that she may be reminded that she is not alone in this world of uncertainties. Furthermore, it seems that Time Magazine needs to re-examine their sense of responsibility in the quality of information offered to families who rely on you for reliable guidance. Here is an opportunity to empower families in their roles as caregivers and nurturers - to help them realize their child's innate potentials for compassion and empathy - to be the kind of citizens our world needs. Please reconsider the impact a message like this can have for future generations.
Suzanne P. Reese
Certified Educator of Infant Massage and International Trainer
Certified Educator of Infant Massage and International Trainer
Infant Massage USA
7481 Huntsman Blvd #635
Springfield, VA 22153
703-455-3455 or 800-497-5996
Psychologist Jodi Mindell's opinion does not hold true for - dare I say - most babies. Emerging from the womb into a bright, loud, cold environment is unsettling for babies and the very best place for them to feel safety and comfort is in mother's arms and at her breast. Keeping baby isolated for sleep trains baby that mother is not there for him unless it's convenient for her. This is not the way to build trust, to form a lifetime bond between mother and baby. Crying raises cortisol levels - the stress hormone - and studies show that elevated cortisol levels cause other health problems. Read The Continuum Concept and the anthropological literature of Dr. James McKenna. Keeping baby close allows everyone to sleep restfully, lowers stress, builds trust, and allows baby to grow in independence at his own rate, resulting in a more secure child. I'm glad I kept my babies close.