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An opinion piece

I believe that the vast majority of parents love their kids and do the best they can for them.  Parents might make decisions I don’t like based on bad information, or they might have a different set of beliefs that leads them in another direction.  And parents might make decisions I don’t like on first glance, but that I would make just the same if I were in their position.

I believe that babies and children are amazingly resilient and forgiving.  I think babies have a built-in assumption that their moms are doing everything they can for them.  I think babies have strong attachment and a good bond with stay at home moms, stay at home dads, working moms, working dads, divorced parents, single parents, gay parents, foster parents, extended family, and frequent babysitters, .

It seems to me that babies are most often happy, healthy, and secure, whether their mothers had natural birth or planned c-sections, whether they’re fed mother’s milk from the breast or bottle, donor milk, or formula, whether they sleep with their parents or in a crib, whether they’re circumcised or intact, have their ears pierced or not, wear organic cotton or Wal-mart polyester, eat mostly local vegetables or mass-produced beige foods.

It is my conviction that certain individual choices can introduce more risk than others, but the most important thing is the totality of the child’s life.  Sometimes “risky” choices are necessary to allow for other decisions that offer a better overall outcome.  Also, every parent puts a foot wrong now and then.  Some weeks it will seem like we fail to live up to our own standards every day, but parents keep giving it their best shot, and their kids can tell.

I believe it is wrong to spank children.  Yet I have spanked my children on occasion.

I believe routine infant circumcision is wrong.  I also believe that parents who choose it do so because they believe it’s harmless, healthy, and even necessary.

I believe it is better to exclusively breastfeed babies until 6 months.  For me, it hurt, sometimes to the point of agony, every time I nursed for about 3 months.  I’m glad I managed to endure it, but I wouldn’t have blamed myself for stopping.

I believe the vast majority of moms have the phsyiological capability to breastfeed.  I also believe that many moms still truly can’t breastfeed because of bad information and lack of support on a local and cultural level.

I believe we should nurture, love, and appreciate our children.  And I know all of us are going to lash out and be impatient with our kids at some points, when they’ve pushed us to our limits.

Most of all, I believe that parents and children need plenty of good information and lots of emotional and practical support.  If we want parents to do what we think is best, the most useful approach is one of respect and a presumption of good faith.  If we want people to dismiss our information and continue as they have been, the quickest way to do that is to deliver that information with plenty of condescension, scorn, and contempt.

I don’t have any citations.  I’m not trying to strong arm you into agreeing with me.  It’s just what I believe, and I’m confident enough not to try to make it more.  Maybe Darcia Narvaez could use this model for her next Psychology Today article.  Those who agree with her will still cheer and post links to it.  And those whose behavior she wants to change might actually take her seriously and think about her arguments.

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The Dangers of Being Insulting and Misleading

Darcia Narvaez, PhD, launched quite the volley two days ago with her Psychology Today article, “The Dangers of ‘Crying it Out': Damaging children and their relationships for the longterm.”  Now, if you’re a reader of this blog, your first question might be, “Gee, that seems rather incendiary.  Does this person have a real PhD?”  Given that she’s a psychology professor at Notre Dame, I’m thinking yes.  But that doesn’t disqualify her from being a judgmental ideologue who has only passing acquaintance with honesty!

Introduction

She starts out by poisoning the well, linking “Cry it out” with discredited 19th century exhortations not to touch babies, to withhold love, not to be too kind, and the sentiment that watching and entertaining a baby is a waste of time.  She refers to “Cry it out” without defining the term and also talks about “letting babies cry.”  This vagueness about the very heart of her argument isn’t helpful to her case.  What does she mean by CIO?  Ferber? Weissbluth? Ezzo?  “Letting babies cry” for how long?  Does letting a baby cry for 5 minutes on one occasion “damage children and their relational capacities in many ways for the long term” and make the baby “less intelligent, less healthy but more anxious, uncooperative and alienated”?  Note she doesn’t give any citation as she lobs these firebombs.  She simply says “With neuroscience we can confirm [them].”  This is the debating equivalent of saying, “Increase the Flash Gordon noise and put more science stuff around!”  She’s trying to dress her philosophical opinion piece with science-y trappings without doing, you know, actual science.

Citing . . . herself, she declares that babies only grow when being held, and that basically you should never put your baby down, never mind sleeping apart from them.  Then she states, “There are many longterm effects of undercare or need-neglect in babies.”  While the terms “longterm,” “effects,” “undercare,” and “need-neglect” are left undefined, she has finally, in the fourteenth paragraph of her article about the risks of CIO, cited a scientific study that allegedly demonstrates the risks of CIO.  Well, it’s not an actual study.  It’s a survey of research used to make a public policy argument for early intervention “to provide an optimal environment in the first years of life.”

There are many longterm effects of undercare or need-neglect in babies”

The article by Dawson, Ashman, and Carter, does discuss postnatal stress as an influence on child development.  However, it’s difficult to pin down what is included in the term “stress.”  The authors discuss animal studies where “separation from the mother” causes a surge in cortisol and other hormones.  Unfortunately, some study abstracts don’t tell how long a separation they’re studying (and I can’t afford to buy all the studies!).  And of course that would have a big impact on our concern about the risks of CIO.  However, this one and this one  used a 24 hour separation, and this one used isolation for 6 hours daily during postnatal days 2-20.  The human studies of postnatal stress discuss the level of attachment exhibited by children, compared with their behavior and cortisol levels, but don’t inquire into what might cause poor attachment.  The most damning statement I could come up with was “later attachment security was related to greater maternal responsiveness and lower cortisol baselines,” i.e., maternal responsiveness, as measured during clinic visits, was associated with children showing greater attachment security when they returned for follow-up testing.  Needless to say, mothers who scored high on responsiveness during the day at the clinic might or might not have used CIO in some form at night, at some point.

When they discuss specific circumstances that cause stress for babies, Dawson et. al refer to babies in Romanian orphanages, and those with clinically depressed mothers.  Note that these are serious, long-term, global stressors, not simply a short period of stress, confined to a certain part of the day, for a limited duration.  Other circumstances they cite as influencing child development for the worse are fetal exposure to drugs and alcohol, developmental disabilities such as autism, poor nutrition, and violence.  So by “stress,” they seem to be referring to very long isolation from the mother, or significantly traumatic events and conditions.  There’s no indication that sleep training rises to this level, and Dawson et. al. never make any reference to sleep training or long periods of crying.

Moreover, the Dawson article undermines Narvaez’s confident doom-saying by noting that “the contribution of parenting factors to the development of self-regulatory brain mechanisms that have been hypothesized to relate to affective and attentional disorders is still poorly understood,” and “It needs to be determined whether psycho-biological measures such as neuropsychological performance, cortisol levels, autonomic responses, and brain electrical activity will be useful in identifying children at risk for psychopathology.”

So let’s go back to the statement she linked with this article: “There are many longterm effects of undercare or need-neglect in babies.”   It might more accurately reflect the article to say, “There may be many long-term effects of lengthy separation from the mother, maternal mental illness, and chronic deprivation in an institutional setting, but we’re not yet sure what those effects are, and while we are guessing that certain brain mechanisms relate to emotional and attention disorders, we’re not sure about the details, and we don’t know if or how much parenting affects such mechanisms.”

“What does ‘crying it out’ actually do to the baby and to the dyad?”

We’re told that “neurons die” due to “the toxic hormone cortisol.”  You know, that “toxin” that is needed for proper glucose metabolism, regulation of blood pressure, blood sugar maintenance, immune function, and inflammatory response.  Is it more charitable to assume that Dr. Narvaez is ignorant, thinking that cortisol is unremittingly evil, or that she’s disingenuous, purposely ignoring the beneficial, normal function of cortisol while focusing solely on its effects in cases of chronic stress, when the body is not given the chance to return to baseline after a stressful event?  I’m going to have to go with the latter, seeing as she follows up with the brazenly speculative cry, “Who knows what neurons are not being connected or being wiped out during times of extreme stress?” (That’s a fun game – I’m going to play.  “Who knows how many of my neurons have been wiped out due to reading Dr. N’s screed?”  “Who knows whether contact with her article might have given me an STD?”  “There’s no telling how much my credit score has fallen due to such extensive contact with this text!”  “Who can tell whether you’ll receive a pot of leprechaun gold if you write an angry letter to Psychology Today?”)

Next up, we’re told that “disordered stress reactivity can be established as a pattern for life.”  Again, both citations refer to extreme stress such as child physical and sexual abuse, psychiatric illness, and PTSD.  I admit I’m reading these late at night, but I’m pretty sure neither included “crying for 10 minutes” in their list of catastrophic stressors.

Likewise, when she argues that self-regulation is undermined, she cites a study that does indeed say “Stress during infancy that is severe enough to create insecure attachment has a dissociative effect,” but the stress they’re discussing involves experiences so severe they induce PTSD.

Next she argues that “trust is undermined,” referring to the philosophical work of Erik Erikson and delineating her personal belief that a baby left to cry (presumably for any period) learns to mistrust his caregivers, and the world at large.  Piling fantastic speculation on wild conjecture, she sums up, “And self-confidence is undermined. The child may spend a lifetime trying to fill the inner emptiness.”   Or, not.  Either guess is equally valid.

She is also concerned that “caregiver sensitivity may be harmed.”  Again, this is speculation.  It’s not totally nonsensical – it makes sense that becoming inured to your child’s cries in one instance could make you generally more insensitive.  On the other hand, every mom I’ve talked to who’s tried sleep training has agonized over her baby’s crying, and it’s equally plausible that empathy and good old mom guilt might make a sleep training mother more responsive, doting, and loving at all other times.  It would also make sense that a fatigued mother would be less responsive, while a well-rested mother would have more resources for engagement with her baby.  We’re dealing purely with “what-if” scenarios here, and Narvaez seems to acknowledge that by including the uncharacteristic equivocation “may,” and omitting any citations.

“But isn’t it normal for babies to cry?”

Here Narvaez really lays into parents, setting an impossible standard.  She states that if your baby cries, or even “displays discomfort,” it’s clearly because you are depriving them of something they need.  And she makes sure to remind you that your baby is rapidly growing – implying that your callous deprivation is particularly disastrous and cruel!

She continues, stating that any parent whose baby cries a lot is inexperienced and ignorant.  If only you stupid incompetent parents had researched how to properly soothe a colicky, fussy, or high-needs baby, your infants would hardly cry at all.  Get on that, would you?

Why Narvaez’s article is a double-scoop of obnoxious.

To sum up, this article really irritates me because it combines two things I hate.  First of all, you guys know it irks me when people abuse citations.  What’s billed as a research study supporting their assertion turns out to be an opinion piece or simply doesn’t say what the citing party says it does.  I’m annoyed that to get a real picture of the supposed “science” here, I had to spend hours combing through abstracts and pony up $6 to rent an article.  Narvaez no doubt has greater access to scientific publications than we lowly parents do – is it too much to ask that she not misrepresent what the studies say?

The second thing that makes me twitch is her intrusive, judgmental tone.  I’ll be the first person to present the evidence showing formula feeding is statistically more risky than breastfeeding, or even to opine that routine infant circumcision is unethical.  But I don’t charge into someone’s facebook status about their son’s bris screaming that they’re child abusers.  I don’t post here intimating that formula is “junk food” and accusing bottle-feeding moms of not loving their kids enough, or being ignorant and callous.  I acknowledge that people can choose parenting options that may be demonstrably inferior, all things being equal.  But I don’t live their lives, and I don’t know what factors are interacting to ensure that all things aren’t equal.  I just know that all things aren’t equal for most people, most of the time.  The vast majority of parents love their kids like no tomorrow, and make the best decisions they can given their unique circumstances.  The last thing they need is someone twisting the facts in an effort to make them look uncaring and stupid.

(By the way, that “formula is junk food” concept comes from another of Narvaez’s articles, which inspired a PhD in Parenting post saying that Narvaez was judgmental, vague,  ignorant, and lacking scientific support for her statements, and that she “gives greater legitimacy to the argument that lactivists are cold-hearted, uncaring, uncompassionate, ‘Breastfeeding Nazis.'” Whoa.  When a distinguished lactivist like Annie says you’re exemplary of the meme that lactivists are jerks, you know you’ve gone way overboard with the AP zeal!)

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