what about attachment parenting?

During my excursion into the world of child development theory, I’ve been acutely aware of one important group I’ve so far overlooked; the advocates of attachment parenting (AP). Attachment parenting is an approach derived from John Bowlby’s theory, but includes practices like extended breastfeeding, ‘babywearing’ (carrying the baby close to the parent’s body), co-sleeping, and a high level of responsiveness to the baby’s needs. I must admit to being sympathetic to AP as an approach; I must also admit (like many other parents) to being something of an attachment parenting backslider. Both my children were in a buggy by the age of six weeks because I couldn’t find a sling that didn’t hurt my back, due to a series of complications I stopped breastfeeding my son at four months, and one child slept happily in bed with me whereas the other simply wouldn’t.

A significant influence in the AP movement is William (‘Dr Bill’) Sears, a paediatrician and author of a number of best-selling parenting books. Dr Sears’ wife Martha is a director of Attachment Parenting International (API), an organization founded in 1994 by Barbara Nicholson a learning disabilities specialist, and Lysa Parker, who also has a background in special education. Parker also worked with La Leche League International, as did four other of the API’s eight directors. (La Leche League was founded in Illinois in 1956 by a group of mothers who wanted to promote breastfeeding, a practice then rapidly dwindling in the USA.)

Dr Bill’s shoes have to an extent been filled by Gordon Neufeld, founder of the Neufeld Institute in Vancouver, Canada. Unsurprisingly, Neufeld’s approach is firmly grounded in attachment theory, with separation, for example, being seen as playing a key role in the ‘epidemic of anxiety’ that apparently afflicts our children. Neufeld’s ideas are very popular, but it’s instructive to read what a group of parents who have used the AP approach with their special needs children have to say here.

Why attachment parenting?

The predominant reasons given for the attachment parenting approach are that it involves ‘instinctive’ and ‘natural’ child-rearing practices that parents have used for thousands of years. In essence this is the same argument used by Bowlby and Bruce Perry in support of their models of child development. I think it’s flawed in two respects. One is that ‘instinctive’ behaviours have also led to the adoption of practices that attachment parenting advocates are unlikely to approve of, such as infanticide, cranial deformation and genital mutilation. You could argue, of course, that such practices might be instinctive but they’re not ‘natural’. Unfortunately, ‘nature’ isn’t always benign either.Throughout human history, infants in hunter-gatherer societies have been at high risk of death from predation, starvation, injury and infection. And if hunter-gatherer societies appear to be healthier than those in the developed world, it’s often because of the price paid by their ancestors and the weaker members of their community. Although AP proponents often advocate as natural a lifestyle as possible, few in the developed world would expect mothers and children to be self-sufficient, live in huts, cook over open fires or fail to take advantage of modern medical interventions if required.

Evidence or belief?

In other words, neither the ‘instinctive’ nor ‘natural’ justifications for attachment parenting provide sufficient evidence to support it. I suspect that rather than AP consisting of practices based on a careful evaluation of the evidence, AP is actually based on a set of beliefs. They’re not unreasonable beliefs; breastfeeding, carrying babies in a sling and being responsive to a child’s needs are highly likely to be of benefit because they optimize nutritional intake and reduce the risk of gastro-intestinal infection, keep the infant warm, comfortable and within the parent’s sight, and increase the likelihood of the child’s needs being responded to promptly. In other words, they are beneficial to the child for good, demonstrable reasons, not because they are ‘instinctive’ or ‘natural’. Other practices are less obviously beneficial; Attachment Parenting International has issued safety guidelines in respect of children sleeping in the parent’s bed, for example, and numerous parents have described attachment parenting resulting in outcomes such as a bad back and sleep deprivation.

Personally, I have no problem with parents basing their parenting approach on a set of beliefs; as long as children aren’t harmed, parents are free to bring up their children as they see fit. They are also entitled to share their beliefs with others and to try to persuade them that those beliefs are right. I don’t even have a problem with practitioners such as Sears or Neufeld advocating a particular approach to child-rearing, because parents and practitioners committed to an approach don’t generally claim to have carried out an exhaustive evaluation of the relevant evidence. It’s usually fairly obvious that they are propagating beliefs and are using evidence selectively to back up their views. What I do find worrying is researchers adopting the same approach. Even though their credentials suggest they are able to evaluate all the relevant evidence in a reasonably objective manner, some follow the same strategy as attachment parenting advocates and base their theoretical models on beliefs backed up with supporting evidence only. What’s also worrying is that an uncritical evaluation of the evidence appears to be acceptable to some peer-reviewed journals.

In a previous post I compared Leo Kanner’s and Bruno Bettelheim’s approaches to the early evidence relating to autism. Kanner’s initial model of autism was based on his evaluation of evidence in the light of contemporary child development theory. As time went by, he repeatedly revised his model as new evidence became available. Bettelheim, by contrast, not only based his model on a belief about the cause of autism (parental behaviour), but also used evidence selectively to support it, and his background in philosophy appears to have persuaded him that this was valid way of handling evidence. I don’t know if Bettelheim’s approach is embedded somehow in the world of child development research, but it keeps cropping up amongst child development researchers. Bowlby’s essential dismissal of genetics and unquestioning acceptance of the idea that the origins of psychiatric disorders are to be found in childhood experiences, contrasts starkly with his painstaking analysis of concepts such as instinctive behaviour and emotion. Allan Schore goes into considerable technical detail about the development of the orbitofrontal cortex, but doesn’t question Bowlby’s model of attachment, or the findings of researchers he uses to support his orbitofrontal model, despite Bowlby’s theory and the function of frontal areas of the brain being the subject of considerable debate. Perry’s discussion of the evolution of human socio-emotional behaviour is pretty speculative, and although on the face of it his brain scan findings are persuasive, digging a little deeper suggests that he hasn’t paid sufficient attention to defining concepts such as neglect, nor to the range of other possible causes of abnormal brain development.

Carrot or stick?

Another issue that’s concerned me is what the attachment model is used for. AP proponents tend to take a resoundingly positive approach to parenting – AP practices are recommended because they are seen as being good for babies and their families and ultimately, society at large. Parents are encouraged to use strategies flexibly and adapt them to their own lifestyles, even though some AP supporters might get a bit over-zealous and risk making parents feel needlessly guilty. When attachment theory filters through into public policy, however, a rather different picture emerges; one in which there’s a real risk of attachment theory being used as a stick with which to beat parents. Poor attachment is blamed for poor health, antisocial behaviour and psychiatric disorders, locating the source of those problems firmly within the family, particularly with parents and notably mothers.

Despite references being made in policy documents and textbooks to Bronfenbrenner’s ecological systems theory, his framework is rarely applied except in the sense of recommending interventions at the community, state or international level to prevent or compensate for the damage caused by poor parenting. So far, I’ve found little consideration given to the possibility that problems manifested by individuals could have causes at all levels, from genes through physiology, to economic, social and cultural pressures at the community, national or international level.

In my next post, I look at a book by a critic of current child development theories, John Bruer’s The Myth of the First Three Years.

Acknowledgement: with grateful thanks to Jennifer Skillen for information about the history of La Leche League.