The first year of life is an important and vulnerable time. Infants are learning a great deal about themselves, their world, and the people in their world. While so much development takes place throughout the first year of life in regard to all four developmental domains, one of the main things infants are concentrating on is forming secure attachments with a few primary caregivers who provide them with consistent, responsive care. This paper will look at some historic theories and figures associated with attachment such as Rene Spitz, Harry Harlow, Erik Erikson, Mary Ainsworth, and John Bowlby. It will then describe some of the contemporary attachment figures and theories that have been deemed developmentally appropriate by many in the field of infant development. After this, some highly considered developmentally inappropriate methods of infant care such as baby training will be looked at with regards to the harmful effects they have on infants and attachment. The paper will conclude with a summary of my own thoughts of the research presented in this paper.
Historical Roots of Attachment
Prior to and on into the 1800s and early 1900s not a great deal of accurate knowledge or research had been gained in attachment. A very common belief held by most people during this time period was that infants’ affection towards their mothers was due to the milk the mothers supplied to them. The people did not believe that infants needed or were capable of giving human love (Karen, 1994). There were three major viewpoints on infants during this time period. The first was that of the eugenics who claimed that infants were genetic constructions, and believed that a perfect human race could be created through not allowing society’s outcasts to reproduce. “The genetic view achieved its greatest respectability in Arnold Gesell, the eminent American pediatrician in developmental psychology, who first brought attention to the child’s inborn maturational timetables” (Karen, 1994, p. 2). Gesell asserted that genetics were in total control of how children turned out no matter the environment in which they were raised.
The second viewpoint of this time period was that of the behaviorists. John Locke appeared centuries before one of the most well-known behaviorist, John B. Watson, and held the belief that children are born “blank slates” and that the environment could completely shape them into the people they would become. They warned that motherly affection toward children was dangerous, and that children should be treated as young adults. Robert Karen (1994) states, “In his famous 1928 book on child rearing, Watson wrote: ‘Treat them as though they were young adults. Dress them, bathe them with care and circumspection. Let your behavior always be objective and kindly firm. Never hug and kiss them, never let them sit on your lap. If you must, kiss them once on the forehead when they say goodnight. Shake hands with them in the morning. Give them a pat on the head if they have made an extraordinary good job of a difficult task’” (p. 3). The behaviorists were perhaps the first “baby trainers” believing that as long as the infant’s physical needs were met within a strict schedule, the infant should not be coddled. Sadly, some people still hold this belief in today’s society as shall be discussed later in this paper.
The third viewpoint which led to the first experiments and the birth of attachment theory was that of the psychoanalysts. Psychoanalysts placed a high importance on loving relationships in the development of healthy social-emotional behaviors in infants and children. Psychoanalysts considered themselves environmentalists like the behaviorists, but felt that the environment should be a very loving and affectionate one. John Bowlby was the main figure in psychoanalysis, and is considered to be the founder of attachment theory (Karen, 1994) as will be discussed a bit later. While Bowlby may have founded attachment theory, it was Rene Spitz’s research on infant hospitalism and Harry Harlow’s experiment with rhesus monkeys that delivered one of the first scientific blows to the common beliefs held by the majority of people of this time.
Rene Spitz- Hospitalism
In the 1940s Rene Spitz did a study on infant hospitalism. A total of 91 infants were placed in the Foundling Home located just outside of the United States. For the first three months of the infants’ lives, they were breastfed by their mothers in the Foundling Home. If an infant’s mother was not available, one of the other mothers would also breastfeed that infant. The infant’s enjoyed the affection given by their mothers during this initial three month period. After three months, all of the infants were separated from their mothers. The infants were cared for by nurses and received high quality physical and medical care. Each nurse was in charge of eight to twelve infants, making it almost impossible for the infants to have any need except for the physical/medical need met. As Spitz (1965) states, “To put it drastically, they got approximately one tenth of the normal affective supplies provided in the usual mother-child relationship” (p. 279). In other words, no love or social support was given to these infants.
It wasn’t long before a rapid decline was seen in the infants’ development. Just after three months of the separation, the infants’ motor development had completely halted, and they became totally passive. They’d stopped crying. The infants just lied on their backs and did not have the motivation to roll over or sit up. “The face became vacuous, eye coordination defective, the expression often imbecile. When mobility reappeared after a while, it took the form of spasmus mutans in some of the children; others showed bizarre finger movements reminiscent of decerebrate or athetotic movements (Spitz, 1945a)” (Spitz, 1965, p. 279). Sadly, these infants were failing to thrive, and were severely stunted in all aspects of development.
By the end of the children’s second year of life, those who had survived, their development was “forty-five percent of the normal” (Spitz, 1965, p. 279). This was after they had been placed back into loving homes. These children had become severely disabled both physically and mentally. Even the children who survived and were checked on again at age four, the majority still could not sit unassisted, walk, or talk (Spitz, 1965). It was a horrific example of how social-emotional depravation severely affects infants. Many of the infants did not survive. The death rates of these children were extremely high compared with other children in institutions in which loving care was provided. According to Spitz (1965), “Of the 91 children originally observed in the Foundling Home, 34 had died by the end of the second year; 57 survived” (p. 281). It was speculated by Spitz that the death rate may have been even higher due to the fact he lost touch with some of these children after the study. It was also noted by Spitz that only two of the infants died of disease (Spitz, 1965).
Spitz wasn’t the only one in the 1940s that observed hospitalism and deaths occurring in institutionalized infants. Hungarian pediatrician, Dr. Emmi Pikler, was noticing much of what Spitz did. She, thus, created a model of care for these infants in order to avoid the devastating effects of hospitalism (Gerber & Johnson, 1998; Hammond, 2009). This paper will look at Dr. Pikler’s work later. First, Harry Harlow’s experiment with the rhesus monkeys was a chance to duplicate Spitz’s study. It shed a great deal of light on infant needs and attachment.
Harry Harlow and the Rhesus Monkeys
In 1958 Harry Harlow conducted a series of experiments with rhesus monkeys in order to try to understand the conditions in which human infants wither away and to come up with some preventive measures. He also wanted to disprove the common idea that infants love their mothers because of the food they provide for their infants. “Regarding mother-love, sociologists and psychologists were in accordance with psychoanalysts: The baby loves the mother because she feeds it. Harlow found this implausible” (Karen, 1994, p. 123). Harlow conducted his research at the University of Wisconsin in Madison. He was the president of the American Psychological Association at the time of his experiments.
Harlow used the rhesus monkeys for his experiments because they were quite similar to human infants. He took eight newborn rhesus monkeys and separated them from their mothers. He raised them in cages outfitted with surrogate mothers which were contraptions inside the cages. In one cage, there was a block of wood covered with soft sponge rubber that had been covered with a terry cloth. Attached to it was a circular face with a light bulb behind it for warmth, and a feeding nipple. In the other cage was a wire mesh with a feeding nipple attached to it. The monkeys spent all of their time with one of the surrogate mothers. Harlow observed that no matter which surrogate mother “fed” the baby monkeys, they spent up to 18 hours a day clinging to the terry cloth mother (Karen, 1994). “The monkeys affectional ties to their cloth mother were sustained even after long separations. And when the infant monkeys were placed in a strange situation, a room filled with a variety of stimuli known to arouse monkey interest, they always rushed initially to the cloth mother when she was available, clung to her until their fear dissipated, and rubbed their bodies against her” (Karen, 1994, p. 124). This clearly demonstrates that monkey and human infants love their mothers for the comfort and love they provide and not for food.
Interestingly, Harlow also found that the infant monkeys preferred the familiar face drawn on the surrogate mother to a new face or no face. Sadly, all of the monkeys in these studies ended up having some devastating social-emotional problems due to not having an actual live mother to give them the love and interaction they needed as infants. They could not easily relate to their peers and raising their offspring proved to be even more difficult with abuse and murder occurring. “Cross and Harlow (1965) reported the syndrome of compulsive behaviors which become ever more severe as partial isolation is prolonged. These maladaptive behaviors include nonnutritional sucking which serves no ordinary purpose, stereotyped circular pacing, fixed and frozen bizarre bodily postures and positions of hand and arm, as well as withdrawal from the environment to the point of complete detachment” (Harlow & Mears, 1979, p. 244). This further disproves the theory that human infants don’t require affection or that it’s dangerous to them. As another well-known psychologist, Erik Erikson points out, infants’ attachment goes much deeper than food or even love, but requires trust.
Erikson’s Theory of Psychosocial Development: Stage 1- Trust versus Mistrust
The first stage of Erikson’s Theory of Psychosocial Development is Trust versus Mistrust. This stage occurs during the first year of the child’s life. Attachment and an infant’s temperament are highly intertwined in this first stage of development. “According to Erikson’s theory (1994), the first year of life is a critical period for the development of a sense of trust. The conflict for the infant involves striking a balance between trust and mistrust. This primary psychosocial task of infancy provides a developmental foundation from which later stages of personality development can emerge… Resolution of the trust/mistrust conflict is manifest in a mature personality by behaviors that basically exhibit trust (of oneself and others) but maintain a healthy amount of skepticism” (Puckett, Black, Wittmer, & Peterson, 2009, p. 159). Erikson (1963) states that “The first demonstration of social trust in the baby is the ease of his feedings, the depth of his sleep, the relaxation of his bowels” (p. 247).
Infants are totally reliant on their parents and caregivers for every aspect of their needs. If their parents and caregivers are responsive and consistently meet their needs, the infants will then develop a trust in their parents and caregivers. Erikson (1963) explained that the way mothers actually cared for their infants is more important in helping infants develop trust than the “absolute quantities of food or demonstrations of love” (p. 249). Infants require consistency in their care. As infants increase their waking hours, they find that more adventures of the senses give way to feelings of familiarity that coincide with feeling good inside. “Forms of comfort, and people associated with them, become as familiar as the gnawing discomfort of the bowels” (Erikson, 1963, p. 247). It is clear that infants quickly adapt and learn the familiarity of the adults who consistently provide them with the responsive, sensitive care that they require.
The infants will also develop a trust in their ability to successfully elicit a response from their parents and caregivers to get their needs met. This inner trust in oneself is just as important to the infant’s well-being as the ability to trust his or her parents and caregivers. As Erikson (1963) states, “The general state of trust, furthermore, implies not only that one has learned to rely on the sameness and continuity of the outer providers, but also that one may trust oneself and the capacity of one’s own organs to cope with urges; and that one is able to consider oneself trustworthy enough so that the providers will not need to be on guard lest they be nipped” (p. 248). This ability to trust in oneself lasts a lifetime as does the ability to trust others. This begins at birth for all infants.
On the other hand, mistrust develops if infants are not responded to consistently and in a sensitive way. Infants then begin to have a mistrust in their parents and caregivers as well as in themselves. They just never know if and when someone will respond to them, or if they will be successful in eliciting a response. This can affect them their entire lives, and can make it much more difficult to successfully resolve the other conflicts in subsequent stages of this theory of psychosocial development. The development of our deepest and most dangerous defense mechanisms, projection and introjection, occurs in the event of mistrust (Erikson, 1963, p. 248). Erikson (1963) goes on to explain that “In introjection we feel and act as if an outer goodness had become an inner certainty. In projection, we experience inner harm as an outer one: we endow significant people with the evil which actually is in us. These two mechanisms, then, projection and introjection, are assumed to be modeled after whatever goes on in infants when they would like to externalize pain and internalize pleasure, an intent which must yield to the testimony of the maturing senses and ultimately of reason” (p. 248-249). In crises of love, trust, and faith, these two mechanisms are often reinstated throughout adulthood which can be characterized as irrational attitudes towards enemies in a great deal of “mature” adults (Erikson, 1963, p. 249).
Therefore, Erikson showed how infants require respectful and responsive care from their mothers as well as other adults in their lives. Being able to trust that their needs will be consistently met by loving adults is very important for infants to create secure attachments. However, Mary Ainsworth noticed that not all attachments created by infants are secure. Ainsworth looked into what happens with infants when they are given loving, responsive care inconsistently.
Mary Ainsworth and the Strange Situation
Mary Ainsworth worked with John Bowlby for a short time at the beginning of her career as they were interested in how maternal deprivation affected infants. They also believed that it was best to study infants and their mothers and/or primary caregivers in natural environments in order to accurately assess emotional and attachment security. However, Ainsworth was interested in studying in the other aspects of the mother-child relationship such as how everyday behaviors of the mother or primary caregiver affected the quality of attachment. She, as many other psychoanalysts of this time period, still initially believed that infants loved their mothers because of the milk they provided to the infants. Ainsworth traveled to Uganda in order to study the infants and mothers. While in Uganda, she became a part of the women’s lives and was an intimate figure of their homes and families. As Ainsworth closely observed the mothers and infants, she quickly noticed that the behaviors toward each other went deeper than just the food that the mothers provided the infants. The following list of behaviors was observed in the infants by Ainsworth during her time in Uganda:
- “Crying when the mother leaves
- Following the mother
- Showing concern for the mother’s whereabouts
- Scrambling over to the mother
- Burying the face in the mother’s lap
- Using the mother as a safe haven when in a strange situation
- Flying to the mother when frightened
- Greeting her through smiling, crowing, clapping, lifting the arms, and general excitement (1967)” (Mooney, 2010, p. 28).
Infants that were securely attached used their mothers as a security base once they became mobile and could explore their environments. These infants could wander away from their mothers to explore the room, but could continuously check in or come back to their mothers when needed. Ainsworth observed variations in culture in regards to how some mothers in Uganda cared for their infants as well as the infant’s development, and these two things affected the mother-child relationship. Mooney (2010), when speaking of Ainsworth’s observations, states, “She noted that many anxious babies seemed to be the offspring of anxious mothers. She noticed that mothers separated from their husbands or families experienced more stress and seemed to pass it on to their infants (1967)” (p. 29). These observations soon led her to label different attachments.
In 1956, Mary Ainsworth and her husband moved back to the United States where she got a position at John Hopkins University. She wanted to try and duplicate her study from Uganda, so she, after much effort, convinced the university to fund her research. She knew that all infants display the same attachment behaviors worldwide, but she began to notice that mothers in the U.S. treated their infants differently than mothers in Uganda. For example, infants in the U.S. were used to having their mothers walk out of the room briefly, whereas in Uganda, infants went everywhere with their mothers and would cry uncontrollably if left even briefly by their mothers (Mooney 2010). Therefore, it was clear to Ainsworth that observing the infants and mothers in their homes would not provide an accurate understanding of mother-child attachment behaviors. Ainsworth and her colleagues set up the Strange Situation on the campus of John Hopkins University.
For the Strange Situation study, a room was set up with engaging toys and materials for the infants to explore. The room had a one way window for observation. There were eight brief episodes in which Ainsworth and her colleagues observed the mother and child’s responses and behaviors. The following is the list of episodes in the order that they occurred:
“1. Mother, baby, & observer enter the room. The observer introduces mother and baby to experimental room, then leaves.
2. Mother & baby. Mother is nonparticipant while baby explores; if necessary, play is stimulated after 2 minutes.
3. Stranger, mother, & baby. Stranger enters. First minute: Stranger silent. Second minute: Stranger converses with mother. Third minute: Stranger approaches baby. After 3 minutes mother leaves unobtrusively.
4. Stranger & baby. First separation episode. Stranger’s behavior is geared to that of the baby.
5. Mother & baby. First reunion episode. Mother greets and/or comforts baby, then tries to settle him again in play. Mother then leaves, saying ‘bye-bye.’
6. Baby alone. Second separation episode.
7. Stranger & baby. Continuation of second separation. Stranger enters and gears her behavior to that of baby.
8. Mother & baby. Second reunion episode. Mother enters, greets baby, then picks him up. Meanwhile stranger leaves unobtrusively” (Ainsworth, Blehan, Waters, & Wall, 1978, p. 37).
Throughout the experiment, observers watched the amount of explorations that the infants engaged in as well as the infants’ responses to being left with and without the stranger and the mother returning. Ainsworth categorized three types of attachments based on the observations of the Strange Situation; secure attachment, anxious-ambivalent attachment, and anxious-avoidant attachment (Mooney 2010). The securely attached infant will use his or her mother as a secure base; interact some with the stranger if the mother is close by and shows approval; and gets upset when his or her mother leaves but is happy and easily comforted when his or her mother returns. The anxious-ambivalent insecurely attached child will show stress and anxiety in unfamiliar places and with strangers, even when the mother is with the child. When the mother leaves the child, he or she becomes extremely anxious, but is resistant to reuniting with the mother. “Some psychologists suggest that it is the result of inconsistent parenting styles. Ainsworth suggests that the parent responds to the child on her own schedule rather than that of the infant” (Mooney, 2010, p. 32).
The anxious-avoidant insecurely attached child shows very little interest in interacting with any adults. These infants show no emotion and have given up on trying to elicit a response from the people in their world. They no longer trust in themselves or their mothers much like the infants that Spitz, Pikler, and Bowlby studied in institutions. “It seems very likely to us that maternal behavior plays a large part in influencing the development of qualitative differences in infant-mother attachment” (Ainsworth, Blehan, Waters, & Wall, 1978, p. 137).
Ainsworth observed that if parents’ behaviors toward their children at a young enough age of the children, a one-year-old insecurely attached child could become a securely attached two-year old child. The Strange Situation redefined the term maternal deprivation to include negative behaviors towards infants in addition to the actual loss of maternal care. Ainsworth (1962) states, “The term ‘maternal deprivation’ has been used also to cover nearly every undesirable kind of interaction between mother and child- rejection, hostility, cruelty, over-indulgence, repressive control, lack of affection and the like” (p. 99). As far as the validness of the Strange Situation to current studies of attachment behaviors, Ainsworth, Blehan, Waters, and Wall (1978) explain that “It is the patterning of behaviors in the strange situation that ‘matches’ the patterning of behaviors at home. Consequently, we conclude that the comparison of strange-situation and home behavior provides justification for viewing the strange-situation classificatory system as having continuing usefulness, and not merely as having being useful as an methodological step toward identification of dimensions of behavior that might be assessed independently” (p. 136). This means that the Strange Situation can continue to be used to study aspects of attachment behaviors.
It is clear that Mary Ainsworth’s work provided a deeper insight into attachment types and behaviors. She went deeper than just the loss of maternal care. John Bowlby was also interested in parental behaviors and how they influenced children. He is considered the father of attachment theory.
John Bowlby: The Father of Attachment Theory
John Bowlby had a nanny with whom he was securely attached during the first four years of his life. He had contact with his parents for an hour a day during tea time. At the age of four, his nanny left his family causing Bowlby to become deeply distraught. A few years later his parents set him away to boarding school as this was the custom in England during this time period for upper middle class families. These two separations from maternal care caused Bowlby to become interested in studying the effects of maternal deprivation on children’s growth and development. After completing his degree at Cambridge University, he began studying at the British Psychoanalytic Institute to become a child psychiatrist. Bowlby disagreed with the Freudian theories that troubled children were struggling with an internal conflict brought on by their fantasies. Instead, he felt children’s troubles could be traced back to what either did or did not happen to them as infants and young children. After Bowlby became a child psychiatrist, he worked with many disturbed children and adolescents where he observed that many of their problems could be linked back to their early childhoods. “Bowlby proposed that often the attitude of a parent toward a child is deeply affected by a result issues from his or her own childhood” (Mooney, 2010, p. 19).
Like Spitz and Pikler, Bowlby studied the effects of hospitalism after World War II as many young children were left as orphans due to the war. He also briefly worked with Mary Ainsworth in studying attachment behaviors in mothers and children. He did not accept the theory that infants love their mothers because of the food they provide them. Harlow and Erikson’s work proved that Bowlby was correct in this thinking. In 1950, in a report published by the World Health Organization, Bowlby (1973) stated, “’What is believed to be essential for mental health is that the infant and young child should experience a warm, intimate and continuous relationship with his mother (or permanent mother-substitute) in which both find satisfaction and enjoyment’ (Bowlby 1951)” (p. xi). It was clear from two-year-olds in which he had observed and created a documentary about had serious adjustment and attachment issues after being placed in a hospital away from their parents, then after months, returning home. They no longer trusted their parents not to leave them (Bowlby 1973).
Bowlby also observed infants’ behaviors that promoted attachment if the infants were responded to appropriately. Bowlby (1982) states, “Apart from crying, which is never easily ignored, an infant often calls persistently and, when attended to, orients to and smiles at his mother or other companion. Later, he greets and approaches her and seeks her attention in a thousand attractive ways” (p. 204). He also noticed that infants are keenly aware of their mothers and/or caregivers whereabouts. Even if the infant is engrossed in his or her own activity, it isn’t long before they notice that their mother or caregiver has left the room and begin to protest. “During his eleventh or twelfth month he becomes able, by noting her behaviour, to anticipate her imminent departure, and starts to protest before she goes” (Bowlby, 1982, p. 204). It is clear that from birth infants behaviors are designed to create social connections with the people around them in order to try and make secure attachments.
This section has created a detailed overview of the main historical figures and theories of attachment. It is quite interesting that these people who did not buy into the first ideas that infants only love their mothers because of food, and that affection could be dangerous to them, all saw the devastating effects maternal deprivation has on infants and children. “Bowlby, in 1951, introduced his timely review of the research evidence by saying: ‘The extent to which these studies, undertaken by people of many nations, varied training and, as often as not, ignorant of each others’ conclusions, confirm and support each other is impressive. What each individual piece of work lacks in thoroughness, scientific reliability, or precision is largely made good by the concordance of the whole’ (p. 15)” (Ainsworth, 1962, p. 97). These research findings pave the way for what is considered currently best practices in promoting secure attachments in infants. The next section of this paper will discuss contemporary attachment figures and theories such as Magda Gerber, Dr. William Sears and Martha Sears, and T. Berry Brazelton.
Contemporary Theories of Attachment
Magda Gerber and the Resources for Infant Educarers (RIE) Approach
The Resources for Infant Educarers (RIE) Approach was founded in the United States in 1977 by Magda Gerber. It originated in Budapest Hungary in 1945 at an orphanage established by pediatrician Dr. Emmi Pikler. Dr. Pikler wanted to try to improve life for infants and toddlers living in orphanages thus creating this respectful approach. The children in the orphanage were there due to their parents being killed or captured in World War II. Also, some of the infants’ mothers died in childbirth. Dr. Pikler wanted a better outcome for these infants and toddlers as they were failing to thrive with many dying despite receiving good medical care. Dr. Pikler observed that when the infants had a few primary caregivers with whom they became securely attached, were able to actively participate in their daily care with the same caregivers who always gave their full attention to the infants during all daily care routines, and were allowed to develop unassisted as well as unrestricted, these infants thrived and were easily transitioned into a family home when adopted at around 3 years of age. The orphanage is still in Budapest, Hungary, and is directed by Anna Tardos, Dr. Emmi Pikler’s daughter. It now also provides care to abused and neglected very young children using the same approach as Dr. Pikler created. This approach was developed further for the U.S. in the 1970s by child development theorists with whom Magda Gerber studied and consulted; Jean Piaget, Erik Erikson, and Dr. Tom Forrest, a United States Pediatrician. Magda Gerber was a student under Dr. Emmi Pikler, and studied the interactions of the adults with the infants and toddlers at the orphanage in Budapest. Magda Gerber was surprised at how Dr. Pikler talked directly to her daughter when she was sick and Dr. Pikler visited her to provide medical care. This was the beginning of a lifelong friendship between Magda Gerber and Dr. Emmi Pikler. Magda received her Master’s degree in early childhood education from the University of Hungary. Then Magda Gerber brought Dr. Emmi Pikler’s approach to the U.S. creating the RIE Approach from it. Magda coined the word educarer because we care while we educate and educate while we care. Magda Gerber worked with many diverse families and with many children with disabilities.
The practices of RIE help promote secure attachments in infants by providing them a few primary caregivers which can be parents and other adults that consistently respond to the infants’ needs. While infants are allowed to cry without being distracted, they are never left to just “cry it out.” Infants are always responded to in a positive and supportive way when they cry. Their needs are consistently met, and their feelings are always acknowledged and validated. As Gerber and Johnson (1998) state, “Our goal is to accept and acknowledge a child’s feelings, though not always the behavior, and allow her to express them” (p. 87). Having the same people care for them also allows the infants and parents or caregivers establish a positive rapport with each other. The adults and infants get to know one another deeply and become in tune with each other. “RIE builds on the foundation of establishing a respectful relationship between the infant and a primary carer, and also with a few other significant adults who form a stable part of a baby’s life. Within this relationship, RIE encourages the adult to become acquainted with the non-verbal infant through sensitive observation of the child’s cues, and to offer both security and freedom to the infant within the relationship” (Petrie & Owen, 2005, p. 55). This clearly does much to aid the formation of secure attachments in infants.
The practices of RIE encourage adults to speak to the infants before doing caregiving routines with them such as diapering, feeding, or bathing. They also advocate adults to be entirely focused on the infants during these daily care routines. Hammond (2009) states that “When an adult speaks quietly about what is happening and waits for a response, the child does not need to be on alert that a change could be coming at any moment unannounced” (p. 13). The infant can learn to trust his or her environment easier if he or she is never taken off guard by sudden changes. “In moments of mindful, respectful, sensitively responsive caregiving, babies receive messages and lessons about what it means to be responded to with kindness and compassion, and this is at the heart of learning about empathy (Eisenberg 1992; Noddings 2003)” (McMullen, Addleman, Fulford, Moore, Sisk, & Zachariah, 2009, p. 22). The RIE practice of talking to the infants and giving them one’s total attention during all daily care activities promotes the development of trust, secure attachment, and empathy because the infants will not be constantly in need of attention from the adults in their lives, and will begin to understand kindness. “In Gerber’s own words, ‘If you pay half attention-which nobody does, it’s usually much less-but let’s say you give half attention all the time, that’s never full attention. Babies are always half hungry. But if you pay full attention a little bit of the time, then you go a long way. That’s what I would recommend: to be fully with a child, then let her be’ (1988)” (Mooney, 2010, p. 40). These RIE practices strongly provide all infants with the high probability of developing trust in their parents and caregivers as well as in themselves. They make it more likely that they will develop secure attachments with their parents and caregivers.
Like the practices of RIE, the practices of Attachment Parenting (AP) created by pediatrician William Sears and his wife, registered nurse, Martha advocate sensitive responsiveness to infants and toddlers. They also recommend a technique called Babywearing which is done in many cultures.
Dr. William and Martha Sears’ Attachment Parenting
Pediatrician William Sears and his wife, Martha who is a registered nurse, created Attachment Parenting (AP) through over 30 years of parenting and observing parents and children in their medical practice. It has been observed by many that children who are attachment parented are more compassionate, caring, responsive, and trusting (Sears & Sears, 2001). There are seven facets that comprise Attachment Parenting, and are known as the “Baby Bs.” They are birth bonding, belief in baby’s cries, breastfeeding, babywearing, bed sharing, balance and boundaries, and beware of baby trainers. As in the RIE Approach, AP is about giving sensitive, responsive care to infants starting at birth. “Attachment Parenting is an approach to raising children rather than a strict set of rules” (Sears & Sears, 2001, p. 2).
One of the “Baby Bs” of AP is birth bonding. The birth of an infant is seen as a very intimate occurrence that is to be shared by the family with as little interference by medical personnel as possible. Whenever medically possible, the infant should be given directly to the mother or father after he or she is born. If mother and infant are medically stable, the family should be given privacy for the first hour after birth to help the parents and infant ease into their new relationships. Dr. Sears and the American Academy of Pediatrics suggest that all post-natal tests and exams can postponed until after the first hour of birth in healthy newborns. While it isn’t an absolute must as far as attachment for newborns and parents to spend their first hour together after birth as medical complications may arise, it has been shown that this practice can soothe infants and parents. Sears and Sears (2001) state, “Studies done by Klaus and Kennell and others have shown that a mother’s early contact with her baby makes a difference to how she cares for her infant” (p. 36). This applies not only to the birth mother but to whomever the infant will be primarily cared by. Even if the infant cannot be immediately placed with his or her parents, it is very important that the infant is given as much human contact as possible. Holding newborns skin-to-skin has been shown to help soothe and regulate their body temperatures, heart rates, and breathing. This is called Kangaroo Care and is often done with premature infants. However, Dr. Sears highly recommends that it be done with all newborns.
Birth bonding also includes breastfeeding the infant in the first hour after birth as well as throughout the entire hospital stay. It is also recommended that the infant room in with the parents, and that the parents do all of the daily care routines with the infant instead of having the nurses do it. Infants that room in with their parents are responded to quicker than they are in the hospital nursery. “Rooming-in newborns cry less because they are more likely to receive a quick and nurturing response to their cries. Mother (or Father) helps them calm down before they have a chance to get really wound up and cry uncontrollably. Babies in a large nursery are sometimes soothed by tape recordings of a human heartbeat or of music” (Sears & Sears, 2001, p. 42). Responding to an infant’s crying is one of the most important aspects of AP.
Belief in infants’ crying is another “Baby B” of AP. This means understanding that crying is an infant’s way of communicating to the adults in his or her world. Dr. Sears recommends responding in some way every time an infant cries; especially with very young infants as they are learning to trust their parents and caregivers. Sears and Sears (2003) state that “Meeting your baby’s needs in the early months means solid communication patterns will develop. With time you can gradually delay your response and gradually your baby will learn to accept waiting a little bit as she learns noncrying language and develops self-help mechanisms” (p. 6-7). As with the RIE Approach, parents and caregivers are encouraged to observe their infants in order to learn their infants’ cues and different cries in order to respond appropriately. For example, Dr. Sears recommends that parents try to respond to very young infant’s pre-cry such as anxious facial expressions, flailing arms, excited breathing, and quivering lips. This teaches young infants that they don’t have to cry full blast to receive a response from their parents and/or caregivers. Dr. Sears, as well as other professionals and parents, has observed that once young infants are crying full blast, it is quite difficult to soothe them. While pre-crying and early crying promotes empathy and responsiveness in adults, as the crying becomes stronger and higher in intensity it becomes grating on the adult’s nerves. This can cause avoidance behaviors in the adult towards the infant. The following chart from The Attachment Parenting Book shows how as intense crying increases, adult responsiveness tends to decrease.
(Sears & Sears, 2001, p. 85).
Early responsiveness has also been shown to decrease infant crying during the second half of the first year. “In 1974 a group of researchers met to review studies on what makes competent children. In analyzing attachment research, they concluded that the more a mother ignores crying in the first half of the first year, the more likely her baby will cry more frequently in the second half” (Sears & Sears, 2001, p. 83). This may be due to the fact that the infant hasn’t learned other forms of communication such as gesturing or babbling due to the unresponsiveness of the mother. They’ve been taught to cry long and hard to get a response. As with the RIE Approach, allowing infants to “cry it out” is not advocated in AP. It is, however, recognized that infants sometimes need to cry in order to expend extra energy. And as infants get older, they must be allowed to self-soothe and problem solve. But the infant should never be ignored, and should always have the adult’s support and reassurance.
Breastfeeding and bed sharing are also “Baby B’s” of Attachment Parenting. The American Academy of Pediatrics recommends that infants are breastfed for the first year of their lives (Gartner & Eidelman, 2005; Sears & Sears, 2003). There are many health benefits for infants are improved vision and hearing, improved oral motor development via the suction required while at the breast, and a higher level of immune system function due to antibodies in the mother’s milk. Sears and Sears (2001) state, “Breastfed babies are protected from many diseases. Breastfeeding is associated with a lower incidence of virtually every kind of infectious disease including bacterial meningitis, urinary tract infection, and infant botulism” (p. 55). Breastfeeding is also associated with a lower incidence of certain kinds of cancers in women such as breast cancer.
No matter whether infants are breastfed or bottle fed, it is very important that infants are fed when they display signs of hunger instead of sticking to a strict feeding schedule. This goes back to helping infants learn to trust that their needs will always be met by the adults caring for them. By feeding infants on cue, infants also learn to accurately read their bodies’ signals for hunger and satiation. “During the early weeks of breastfeeding, mothers should be encouraged to have 8 to 12 feedings at the breast every 24 hours, offering the breast whenever the infant shows early signs of hunger such as increased alertness, physical activity, mouthing, or rooting. Crying is a late indicator of hunger” (Gartner & Eidelman, 2005, p. 499). Feedings should also be a social time for infants and their mothers and/or caregivers. The infant and adult learn to communicate with each other.
While strict schedules are considered to be harmful and even dangerous for infants by many pediatricians and infant specialists, routines help promote attachment in infants and adults. A predictable routine helps the infant to anticipate what will happen next. The infant will also learn the responses certain cues will invoke. “I would like to replace the rigid idea of a schedule with the more flexible concept of a routine or even with the more flowing experience described by the word ‘harmony.’ The more you listen and respond to your baby, the simpler it will be to ease him into a routine that suits both of you” (Sears & Sears, 2003, p. 15). Routines are based on the infant’s and adult’s needs which promotes a healthy, positive adult-child relationship.
Bed sharing is recommended by Dr. Sears in order to make night feedings easier. It has been shown that infants who sleep with their parents sleep better. The infant can be soothed or fed quicker before crying escalates to uncontrollable. It is very important that all hazards such as pillows and blankets have been removed from the area where the infant will be sleeping. It is also important that parents don’t consume alcohol or drugs before sleeping with their infants. The bed should be firmly against the wall. A co-sleeper that attaches to the side of the adult’s bed can also make bed sharing safer. After all hazards have been removed from the sleeping area, research has shown that bed sharing may decrease the risk of infants dying from Sudden Infant Death Syndrome (Sears & Sears, 2001). This may be because sleeping next to an adult helps young infants get their breathing patterns and sleep cycles in synch with the adult’s. However, if bed sharing does not work for the family, it is fine for infants to sleep alone.
Babywearing is another important “Baby B” of Attachment Parenting. Babywearing is practiced in many cultures. Infants are worn on their parents’ and/or caregivers’ bodies throughout the day. This allows infants to be close to the parent or caregiver much of the day. However, it should be balanced with time for the infant to play on the floor. While the infant is being worn, he/she should be talked to about what the adult is doing to provide plenty of spontaneous learning opportunities for the infant. Infants that are worn get a great deal of natural stimulation. It has been shown that wearing infants helps soothe them because they are warm, cradled, and near their primary caregivers.
Unlike one may think, babywearing does not cause motor development delays as restrictive devices can. The reason for this is the gentle motions that infants experience stimulates the vestibular system, “and scientists are finding that this stimulation helps babies breathe and grow better, regulates their physiology, and improves motor development” (Sears & Sears, 2001, p. 70). Another reason babywearing does not cause motor development delays is that infants are constantly making adjustments as the adult moves about (Sears & Sears, 2001). Dr. Sears advises against the use of restrictive devices such as infant swings, bouncy seats, walkers, and exersaucers.
The final two “Baby B’s” of Attachment Parenting are balance and boundaries and beware of baby trainers. These two go together because anything that is taken to extremes can create problems in young children. Older infants and toddlers require boundaries and limits. These help young children to feel safe and secure. For example, securely attached infants and toddlers will often look at their parent or caregiver when they encounter something that they are unsure about. If the adult smiles approvingly, the child will usually continue exploring. If the adult frowns, the child will usually stop exploring. Infants and toddlers need discipline and guidance because they lack self-control. Unfortunately, many people think of discipline and punishment as one and the same. This should not be the case whatsoever. “Webster’s Dictionary describes discipline as ‘training that corrects, molds, or perfects.’ I believe the best and most long-lasting training comes from within. Discipline is first learned externally, based on parental, and then societal expectations” (Gerber & Johnson, 1998, p. 204). Positive guidance strategies such as modeling, redirection, and natural consequences work better to truly teach children more appropriate ways of behaving. For example, if a toddler gets up from the table, then the natural consequence is that he will be finished eating. This is not punishment; it is cause and effect that directly relates to the toddler’s behavior. Baby trainers believe that from the moment infants are born they must be taught that the adult is on charge. Sears and Sears (2001) state that “Baby training is based on a misperception of the parent-child relationship. It presumes that newborns enter the world out to control their parents, and that if you don’t take control first, baby will seize the reins and drive the carriage.” (p. 125).
As the historical and contemporary research cited in this paper shows, there are negative effects on the attachment process; some quite devastating. Like the proponents of the RIE Approach, Dr. Sears and his wife deeply frown upon baby trainers who advocate strict schedules, ignoring infant crying, and the use of physical punishment for infants and toddlers. Dr. Sears implores the importance of understanding the child’s perspective in order to appropriate respond and guide the child. “Authority is vital to discipline, and authority must be based on trust. If an infant can trust his mother to feed him when he’s hungry, he will be more likely as a toddler to listen to her for what to do when, for example, he encounters breakable objects on Grandma’s coffee table” (Sears & Sears, 2001, p. 20). Children raised with respect, responsiveness, and sensitivity of Attachment Parenting are respectful, responsive, and sensitive adults. “This sensitivity carried over into other aspects of life: marriage, job, social relationships, and play. In my experience, sensitivity (in parent and child) is the most outstanding effect of attachment parenting” (Sears & Sears, 2003, p. 17).
Dr. Sears isn’t the only pediatrician to observe that infants thrive when provided with sensitive, responsive, and respectful care. Dr. T. Berry Brazelton has researched and worked with infants and their families for well over 40 years. The following section will describe his research, observations, and approach to infant care.
T. Berry Brazelton’s Touchpoints
Pediatrician T. Berry Brazelton graduated from Columbia University College of Physicians and Surgeons in 1943. He then went to Boston, Massachusetts in order to complete his residency training at General Hospital. After this, he began his pediatrics training at Children’s Hospital. He has worked with many child psychiatrists including Dr. Joshua Sparrow as Dr. Brazelton was interested in the social-emotional side of medicine. Dr. Brazelton created the Brazelton Touchpoints Center in Boston where he works with infants and their families. With the help of Dr. Sparrow, Brazelton has brought his approach to others around the world. Many hospitals, clinics, and child care centers use the Brazelton Approach. His approach is strengths-based and preventive rather than fixing problems. He came up with three types of infants based on their temperament and personality traits: Average, Active, and Quiet. His idea was to let parents know that one infant isn’t better than another due to his or her personality. Every infant is a unique individual.
In 1973 Brazelton created the Neonatal Behavioral Assessment Scale (NBAS). This is used to assess a newborn’s visual, audio, and tactile responses to different stimuli. Brazelton begins by meeting with expectant parents to get to know them and discuss their fears and concerns about the impending arrival of their baby. He wants the parents to feel comfortable with him so that when they go through different touchpoints with their infant, they will be more likely to open up to Brazelton and allow him to guide them. Touchpoints are all the milestones children and parents go through. Brazelton believes it is very important to tell parents what to expect next from their child so they can respond sensitively and appropriately.
Once the baby is born, Dr. Brazelton does the NBAS and other newborn assessments with the parents in the room. Not only does he want to get to know the newborn’s personality, but he wants the parents to see just how competent their newborn is. Brazelton and Sparrow (2006) state, “There is an important mutuality here. Parents seem to have an expectation for the kinds of behavior with which a newborn is equipped. When the baby’s skills and ways of communicating are confirmed, parents gain more confidence in their own ability to understand and care for their infant. Our studies have shown that after such a shared assessment, the mother and the father are significantly more sensitive to their own baby’s behavioral cues at one month, and they remain more responsive throughout the first year” (p. 29). This is an important aspect to creating secure attachments in infants. Brazelton and the parents get a glimpse into the newborn’s temperament, self-soothing skills, and preferred ways of being handled and soothed. Another thing Brazelton does to help parents connect with their newborns is to hold the infant up and talk into the infant’s ear while having the mother talk into the infant’s other ear. The infant always turns toward the mother instead of Brazelton in response to her voice. This makes the mother ecstatic as she realizes that her infant already knows and responds to her. He does the same with the father. 80% of the time the infant will turn toward his or her father’s voice. On the rare occasion that the infant does not turn toward the father, Brazelton subtly helps the infant to do so (Brazelton & Sparrow, 2006).
Dr. Brazelton does not believe that a newborn must be given directly to the mother after birth in order for bonding to occur. Instead, he suggests that the mother be given a choice of being given the infant at birth or after a rest period. The father should be given the same choice. He wants parents to be eager to be with their newborn instead of feeling guilty for wanting to rest after delivering the child. “When the first greeting must be postponed, parents can still become fully attached to their baby. It is very important that expectant parents and those who assist them in childbirth know not only that each family has its own timetable but also that strong, long-term attachment is the goal” (Brazelton & Sparrow, 2006, p. 38). Being ready to respond to their infant’s needs such as feeding and soothing is important for creating secure attachments between infants and their parents and/or caregivers.
As the proponents of RIE and AP, Dr. Brazelton believes that infants should be fed on cue, and that feedings should be a social time for infants and parents or caregivers. He also highly recommends that infants be breastfed. Brazelton and psychologist Kenneth Kaye did a study on infants sucking patterns during feedings. Brazelton and Sparrow (2006) state, “A baby will start out with a short burst of constant sucking. Very quickly, she resorts to a burst-pause pattern. A burst of sucks will be followed by a pause: suck-suck-suck-pause. Psychologist Kenneth Kaye and I studied the pauses to try to understand their significance, for we were aware that babies tended to look around and to listen in these periods…Fifty percent of the pauses are accompanied by a maternal response, and fifty percent go unnoticed…In our study, the baby’s pauses when the mother didn’t respond were significantly shorter than those when she did. In other words, the baby seemed to prolong her pauses to capture social stimuli. We point to this burst-pause pattern in babies to help emphasize the importance of playing with and talking to a baby at feeding time” (p. 41). It is clear from this study that infants need feedings to be more than just food. It is another time for learning and communication between the infant and adult. For this reason, Brazelton states that infants should never be propped with a bottle (Brazelton & Sparrow, 2006).
As previously stated, Brazelton highly recommends that infants be fed on cue instead of making them stick to a strict feeding schedule. He reiterates that crying is a late sign of hunger in infants. Parents and caregivers should feed infants who are in an alert state, are rooting and mouthing, and are bobbing their heads as if looking for a breast or bottle (Brazelton & Sparrow, 2006). Parents and caregivers should also observe the infant in order to his or her different cries and cues, so they can respond appropriately to his or her needs. As infants become older, they can go longer periods between feedings, but it is still very important that infants are fed when they are hungry. This helps infants trust that their needs will always be met by the adults in their lives.
Dr. Brazelton recommends that all daily care routines such as bathing and diapering be times of social interaction between adults and infants. “As we talk about the opportunities for play, I like to point out that diapering and bathing can also be important times for communication. Talking to the baby and kissing her stomach are irresistible accompaniments to diapering. Parents can make it a fun time” (Brazelton & Sparrow, 2006, p. 41). As the proponents of RIE point out, by talking to infants during daily care activities, a sense of mutuality forms between the infant and adult as they accomplish tasks together. This also allows the adult to learn from the child. Infants will let parents and caregivers know when something is right or wrong. The adults need to be sensitive in order to pick up on what the infant is trying to tell them.
When it comes to nighttime routines for infants, Brazelton recommends having consistent bedtime routines, and putting the infant to bed awake but sleepy. He has observed throughout his career that infants tend to sleep lighter and awaken more at night before they are about to achieve major milestones such as rolling, sitting, and walking. Therefore, Brazelton warns parents of this before it occurs. He also discusses the pros and cons of co-sleeping with parents. He understands that for some families co-sleeping is a good choice but not for others. “In cultures where there is a choice, it is not necessary and does not seem fair to push a child out abruptly later. So, the decision should be made in advance, with full awareness of the changing pros and cons of co-sleeping as the child grows. Parents must examine their own biases and consider the long-term consequences of their decision before they make up their minds” (Brazelton & Sparrow, 2006, p. 91). If parents do co-sleep with their infant, Brazelton recommends a slow transition for the child such as setting “up a crib next to the parents’ bed…Parents can then still roll over to pat the child down when he comes up to light sleep” (Brazelton & Sparrow, 2006, p. 156).
Dr. Brazelton, as the proponents of RIE and AP do, believes that while there are times when infants need to cry a bit to learn to calm themselves, they should never be left to “cry it out.” He recommends that parents and caregivers respond in some supportive way to an infant’s cries- even at night. The infant may be learning to sleep through the night and may just need his or her parents to let him or her know that they are there. In this, the infant knows that his or her parents haven’t neglected him in the night. When care is a necessity during the night, it is important that parents are as low-key as possible with the infant in order to teach him or her that nighttime is not a time to play and socialize. If care is not necessary but the child requires some soothing, Brazelton and Sparrow (2006) state, “If you have been taking her out of bed to rock her, don’t; soothe and stroke her with your hand, but leave her in bed (author’s italics). She won’t like it, but she’ll understand. Stand by her crib and tell her that she can and must learn to get herself back to sleep” (p. 390). This is a much more appropriate way of helping infants learn to sleep through the night without allowing them to “cry it out” as many baby trainers recommend.
Dr. Brazelton highly frowns upon the use of physical punishment with children; especially infants and toddlers. He recognizes that older infants as well as toddlers require clear, consistent limits in order to slowly learn self-control. Again, discipline means to teach and to guide children in appropriate behaviors. Spanking does not do this; it controls. “Physical punishment such as hitting or spanking will mean two things to her: one, that you are bigger than she and you can get away with it, and two, that you believe in aggression” (Brazelton & Sparrow, 2006, p. 146). Spanking children causes them to slowly lose their trust in their parents and caregivers. This makes them less likely to listen to parents without the threat of punishment. Discipline, however, has the opposite effect on children. “Discipline is the second most important thing you do for a child. Love comes first, and discipline second. Discipline means teaching, not punishment. The goal is for the child to incorporate her own limits. Each opportunity for discipline becomes a chance for teaching. Hence, after a brief disciplinary maneuver, sit down to comfort and hold her, saying, ‘You can’t do that. I’ll have to stop you until you can learn to stop yourself’” (Brazelton & Sparrow, 2006, p. 147). Brazelton recommends using time-outs not as punishments but to help the child calm down.
This section has described some of the contemporary attachment figures and theories. It is quite clear that they take the historical attachment research into account as much of the contemporary research is a continuation of how secure attachments are formed in infants. Again, the research of the contemporary attachment figures validates each other even if they have slightly different beliefs. The overall consensus is that infants require sensitive, responsive, consistent, and respectful care in order to thrive and create secure attachments to the adults in their lives. This paper will conclude by taking a brief look at baby trainers and failure to thrive.
Given the research I have provided throughout this paper, it is clear that baby training is not only futile, but has been proven dangerous and harmful to infants. Books such as Baby Wise by Gary Ezzo and Robert Bucknam and To Train a Child by Michael and Debi Pearl including some books by Dr. James Dobson recommend putting young infants on strict schedules, parent-directed feedings and sleeping, and using physical punishment with infants and toddlers are based on pure opinion, not research nor a experienced background in child care. They are behaviorist like John B. Watson ad John Locke discussed earlier in this paper who believed affection was dangerous to young children. While today’s behaviorists may not go quite as far as saying affection is dangerous to infants, they have no concrete understanding of infant development or attachment. The American Academy of Pediatrics warns against baby training due its potentially harmful effects. According to the Department of Child and Family Services, it is considered child abuse to hit children under the age of two.
Failure to thrive, Disorganized/Disoriented Attachment, and Reactive Attachment Disorder (RAD) are potential reactions infants may have if they are not provided with sensitive, responsive, respectful, and consistent care from the adults in their lives. These disorders often have long term effects for children. “Children who were maltreated in infancy and were scored as having a disorganized attachment at 1 year continue to be disorganized during early childhood (Barnett, Ganiban, & Cicchetti, 1999). Disorganized children are more likely to display evidence of child behavior problems (disobedience, fighting, withdrawal) and adolescent psychopathology, in particular dissociation (mental confusion, lack of subjective self-awareness, out-of-body experiences, accident proneness) (Carlson, 1998; Lyons-Ruth, Eastbrooks, & Cibelli, 1997)” (Fogel, 2011, p. 327).
In the Disorganized/Disoriented Attachment disorder, infants show severe contradictory behaviors such as smiling but then turning away from the parent, crawling backwards to the parent, and displaying a frozen posture when reunited with the parent. Infants that display this attachment disorder are abused, neglected, and are malnourished. “Because parental behavior in this type of attachment relationship is so disturbed, it is not surprising that infants develop severe and disturbed reactions” (Fogel, 2011, p. 320). Reactive Attachment Disorder (RAD) has two types of patterns. The first type of pattern is called Inhibitions. “The child is excessively inhibited, hypervigilant, or ambivalent and contradictory” (Fogel, 2011, p. 320). This is much like Disorganized/Disoriented Attachment. The second type of behavioral pattern of RAD is Disinhibitions. The child shows no selective attachments and show over familiarity to strangers (Fogel, 2011). RAD stems from not having a consistent, stable caregiver, physical and emotional needs gone unmet, and child abuse and neglect.
This paper has discussed the historical roots of attachment theory in which Rene Spitz, Harry Harlow, Mary Ainsworth, and John Bowlby showed that infants require more than good physical care and food to thrive. It has shown how contemporary attachment theory is highly based on the historical research. This paper shows the devastating effects on infants who are left to emotionally fend for themselves. The affects of baby training and physical punishment on infants and toddlers makes it very clear that infants are vulnerable to the world around them. They deserve nothing but kindness, love, and respect.
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Attachment Theory- Why NOT to Baby Train by Steph is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at whynottrainachild.com.