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There are three basic assumptions about human nature that are reflected in parenting philosophies. The first is the assumption that a child is born evil by nature and the parent is a disciplinarian and trainer. The goal of parent education is to learn how to direct and control the child's inherent sinful nature and willfulness. This approach maintains that respect must precede love and often accepts physical punishment as appropriate. The main proponents of this parenting style throughout history have been John Wesley, James Dobson and the Puritan tradition. The second approach, espoused by Jean Jacques Rousseau and Thomas Gordon, states that children are inherently good and trains parents as communicators and teachers of human relation skills. The third approach views the child as neutral and the parents as environmental engineers. The child is thought of as a "tabula rasa" (literally a blank tablet) to be shaped by either a good or poor environment. This is the approach of behavior modification and positive reinforcement as taught by John Locke and B. F. Skinner.
In the last few years there has developed a dichotomy between two very distinct parenting styles: one classified as "baby-led", the other as "parent-led". In the parent-led model the family and the marriage are of prime importance, not the child. Order, stability and routine are highly valued. Parents are instructed to "train" their infants to sleep through the night by 8 weeks of age and never to co-sleep. This method claims that the child will be happier, physically and psychological healthier, and more prepared for life's challenges when self discipline is learned early in life. Although the parents' task may initially be hard, schedules and routine will make the parents' lives much easier. It is geared in respect rather than unconditional love.
Although this approach sounds logical, sensible, and very attractive to our "by-the-clock", "daily planner" Western life-style, it breaks down when examined in the light of infant physiology. Sleep physiology, stomach emptying, and brain maturation do not lend themselves to the type of "training" advocated by this approach. In fact, the biologically healthy child will protest being forced to sleep alone in a separate room, be fed at only specific intervals, and left to cry (in the effort not to spoil the child). Psychological research over thirty years ago suggested that infants become more independent and secure if they are attended to promptly and consistently when they cry.
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The alternate approach of baby-led parenting has often been called "attachment parenting". With this approach infants are breastfed on demand, have great flexibility with little or no schedules, are responded to immediately, and often sleep with their parents. Advocates of this method of parenting claim that the child is happier, physically and psychologically healthier, and more prepared for life's challenges when the individual spirit is nourished and supported. Breastfeeding certainly appears much easier and more natural with this approach. However this approach does give a less ordered and predictable life-style for parents. Some individual infants or children may also need more structure.
Co-sleeping (an infant sleeping with his or her parents, especially the mother) is a particular issue of contention between these two approaches. Although Western culture assumes that individuality and appropriate growth and development are predicated on early independence, and that sleeping alone is an early milestone of independence, history and most world cultures do not hold this view.
We are just now learning that infant physiology is designed to work in concert with mother's physiology, necessitating close proximity of mother and infant, both during the day and during sleep. Breastfeeding and co-sleeping are part of the same adaptive complex designed by natural selection over million of years of human evolution. Because human infants are born neurologically immature and develop slowly, continuous contact with the mother served to maximize the chances of infant survival and hence parental reproductive success. Only in the last one to two hundred years, and only in Western industrialized societies, have we come to think of breastfeeding and infant sleep location as two separate phenomenon.
So far evolutionary biology has primarily focused on adult members of the species. Now science is seeking to discover how biology shapes the human species from the very first days of life. Thousands of years ago human infants were usually carried at their mothers' sides, nursing continuously. Is this "best" or appropriate today? It is our responsibility as health care providers to continuously seek and evaluate new information in order to act in the best interests of our patients. We also need to be aware of our own biases and paradigms of thought while we listen carefully to what both science and our hearts tell us. Happy parenting!
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