Attachment parenting, detached debate

Time’s titillating cover overshadows article’s substance

Time touched a nerve this week with its provocative cover photo of 26-year-old Jamie Lynne Grumet and her 3-year-old son standing on a chair next to her, nursing her left breast while both stare directly (and unapologetically) at readers.

The underlying story focused on the “attachment parenting” method developed by Dr. William Sears, which advocates prolonged breastfeeding, “baby wearing” (carrying the child in a sling throughout the day), and having babies sleep in parents’ beds. The issue, which appeared on newsstands over the weekend and coincided with Mother’s Day, sparked thousands of responses from news outlets around the world.

Many reported that Time had “reignited” the debate about parenting, and breastfeeding in particular. But that’s not true, at least not judging by the reactions in the mainstream media. What Time reignited is the age-old and somewhat tiresome debate about incendiary magazine covers. Quarreling about whether Time had done good or bad totally overshadowed commentary about the substance of its article, which is unfortunate for anyone interested in learning the basics of the medical community’s current thinking on attachment parenting.

Time’s story, by staff writer Kate Pickert, doesn’t go too deep into the evidence for and against attachment parenting, either. Its focus is Sears, a California pediatrician who wrote the seminal treatise on the method, The Baby Book, in 1992. The 20-year-anniversay peg is a bit weak and Sears is no stranger to the media, but Time contended that, “For all the book’s popularity and influence, surprisingly little is known about the author.”

From there, the piece delved into Sears and his wife’s childhoods and their own child-rearing practices, arguing that attachment parenting is “rooted” in their upbringing and that “Sears’ views are less extreme than his critics (and even many of his followers) realize.”

Pickert doesn’t go easy on Sears, however, mentioning right away that “a lot of people might” call his philosophy crazy. She also dissects in detail one of his more controversial theories—that allowing babies to “cry-it-out” can cause brain damage. According to Pickert:

Sears cites a number of academic studies to back up his point. A close look at the research, however, does not actually provide evidence that bouts of crying associated with sleep training affect brain development. Several papers Sears cites involved studies of rats. At least one looked at babies who suffered from cases of severe neglect or trauma… Other research showed that babies who cry excessively are more likely to suffer from, for example, attention-deficit/hyperactivity disorder, but it’s not clear if they cry because of underlying neurological problems that later manifest as ADHD or whether the crying causes ADHD.

Pickert stresses that “the science on attachment is also easily misunderstood and misused.” While there is evidence that children without “consistent relationships with parents” can suffer developmental and emotional problems, there is “no science to show” that babies who are fed formula, pushed in strollers, or sleep in bassinets “will turn out any different from children raised via the attachment method.”

Sidebars in the story went into a little more detail.

“Bed sharing can be deadly,” science reporter Jeffrey Kluger emphasized in one. “A sleeping adult can crush or suffocate a baby; the risk of SIDS increases as well.” But Sears is largely in sync with the medical community in stating that it’s fine for mothers to breastfeed “into toddlerhood.” The American Academy of Pediatrics (AAP) and the US Surgeon General encourage mothers to breast-feed exclusively for six months, introducing solid foods after that while continuing to nurse “one year or longer or as mutually desired by mother and infant,” parenting reporter Bonnie Rochman reported in another sidebar.

That was about it for the science in Time’s story—adequate, if not ample. But the thousands of commentators who responded to the piece made nothing of it. It took half an hour of searching to find this helpful information (relegated to an online sidebar) from BBC health and science reporter James Gallagher:

• No government or international body has a recommended upper age limit on when a mother should stop breast feeding her child
• The World Health Organization (WHO) says there are a range of health benefits for exclusively breast feeding babies for the first six months
• After that the WHO suggests a combination of foods, fluids and breast milk up to the age of two “or beyond”
• Dr Mary Fewtrell, who specialises in childhood nutrition at University College London, said that there isn’t any research into the health benefits of continuing to breastfeed children up until school age
• She said that “even for the health benefits of breastfeeding beyond a year or 18 months, there is little research” and that this was far more a social than a nutritional issue

A much more thorough and fascinating history of the breastfeeding debate appeared in the March issue of Harper’s. The magazine published an essay by Elisabeth Badinter, adapted from her upcoming book about “how modern motherhood undermines the status of women.” Titled, “The Tyranny of Breast-feeding,” it’s an account of the rise in influence of La Leche League, an international organization formed in the late 1950s, which advocates on-demand breastfeeding for as long a child wants.

The essay described how the league slowly but surely won the support of major national and international organizations worldwide, from the American Medical Association and American Academy of Pediatrics to the World Health Organization and UNICEF. And Badinter made no secret of her misgivings about that effort, describing it as an ideological “crusade” for “increasingly dictatorial and restrictive” practices, waged by “breast-feeding militants.”

While acknowledging that “a mother’s milk is perfectly adapted to the child’s digestive system and developmental needs [and that] it reinforces natural immunities and reduces the risk of allergies,” Badinter cast a skeptical eye on the growing list of advantages attributed to breast feeding:

Some studies claim that breast-feeding reduces the risk of sudden infant death syndrome, type 1 and 2 diabetes, lymphoma, leukemia, childhood Hodgkin’s disease, obesity, hypercholesterolemia, asthma, even multiple sclerosis. Others have tried to demonstrate that breast-fed children show better cognitive development … Some of these advantages—enhanced immunity, for example—require that breast-feeding continue for three to six months. Others have little basis in scientific data.

According to Badinter, “the Society of French Pediatrics has published the most objective report on the subject, pointing out areas of uncertainty and bias.”

That kind of information is useful to readers who know nothing, or next to nothing, about the current medical consensus surrounding parenting, attached or otherwise. Unfortunately, the science discussed in Time and Harper’s was absent from the outcry of the last few days.

A spirited discussion about the latest research on parenting no doubt occurred on parenting blogs and forums, but anybody who is unfamiliar with that corner of the cyberwoods and lacks the inclination to wander in—a reasonable position—would be at a loss. In the mainstream media all anybody seemed to care about as whether or not an attractive young woman suckling her son was too much for the cover of a national newsweekly.

That debate—about the line between effective and exploitative—matters, too, but certainly not as much as the one about how to raise a healthy kid. The critics missed that.

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Curtis Brainard writes on science and environment reporting. Follow him on Twitter @cbrainard. Tags: , , , ,