Response to Maria and Lauren's letters in Kindred

This is a response to responses to my articles in Kindred (in the Aware Parenting articles section here) - "Book Review: Raising Drug-Free Kids: 100 Tips for Parents", and "Presence - Emotional wellbeing as a preventative for drug use (Understanding control patterns)."  Maria and Lauren's letters can be found after my response, for those who did not read them in Kindred.

Dear Maria and Lauren,

I celebrate our shared desire to contribute to babies and children, even though we have very different ways of seeing the most optimal way to do this.  I appreciate that we all have solid reasons for believing what we do, and respect your beliefs and choices.  I’d like to explain more about how I perceive Aware Parenting.

Maria, when you say, “Letting a baby cry in arms may lead to not breastfeeding on demand, which may interfere with the breastfeeding relationship, especially during the first year of life,” and Lauren, when you say, “Whenever a human is under stress, at any age, we rely more heavily on others to help re-regulate us and bring us to equilibrium.  Relationships are key to doing this in a healthy way.  And while this seems to be what the author is suggesting, she simultaneously undermines that for every breastfeeding dyad,” and, “To unilaterally smash a relational paradigm of breastfeeding and make it the same as bottle feeding is utterly ridiculous,” I hear you deeply honouring the breastfeeding relationship.  Aware Parenting also celebrates and advocates breast-feeding, and the close connection it brings between mother and baby.  However, breast-feeding is not the only way for a mother to give her full presence to her baby.

When a mother watches her baby closely to ascertain whether he is hungry, or has another immediate need, or has some feelings to express, she can respond accordingly; including feeding him when he is hungry, holding him close to meet his need for closeness, and listening to him when he is simply upset.  She can be fully present and connected with him in all these ways and more.  I have spoken to more than a hundred parents practising Aware Parenting, and I have not heard any say that the breastfeeding relationship has been adversely affected.  To the contrary, the majority talk about how being present with their baby’s feelings has enriched the relationship between them, including breastfeeding.

Maria, you say, “If the baby does not want the breast (or is bottle-fed and not hungry), then a cuddle is great, but not otherwise.”  In Aware Parenting, the aim is to carefully observe a baby’s behaviour to ascertain whether he has an immediate need.  Only once these have been ruled out will a parent simply give her loving presence whilst the baby cries.  For example, if a baby comes on and off the breast (and it is not an issue of milk supply or a stuffed-up nose), it could be that he is saying that he is not hungry but has some feelings to express.  But if a mother doesn’t think that babies have feelings that need to be heard, she might keep trying to stop the crying – by continuing to offer the breast, even if the baby comes off many times, or turns his head.  A baby will soon learn to deal with his feelings the way his parents do, so if he is fed when he is upset, he learns that feeding is what is wanted of him when he is upset. Once this happens, it becomes much more difficult to tell whether he is hungry or needing to express some feelings.

Lauren, I hear that you find Aware Parenting troubling personally and professionally and that it initially troubled you on a “gut level.”  In contrast, as soon as I found out about Aware Parenting, it resonated with me completely, and all I had learnt as a psychotherapist and Research Fellow in infant development.  It continues to meet my needs for clarity, contribution and understanding, both as a parent and as an Aware Parenting Instructor.  My professional experience highlighted the importance of accurate mirroring of internal states for a baby and child’s self-development.  When we understand what our baby or child is feeling, and respond specifically to that, the child experiences congruence between his inner states and the mirroring he receives.  His personality develops to match his true self.  He also learns, for example, the difference between a sensation of hunger and feeling upset.  Aware Parenting encourages parents to observe the fine details of our baby and child’s behaviour.  Eye contact, tension in the body, behaviour whilst feeding, the amount of movement during sleep, and their responses to other children and ourselves, all give us clues to their feeling states.

Maria, you say, “I fully agree with the fact that babies and children need to be heard, loved, empathised with and respected.”  However, I think that if we respond to all of their feelings by feeding them, or any other repeated way, they will not experience empathy as much as if we are able to be present with their feelings.

Maria, you wrote, “When any human being or any age cries, there is a need which is being expressed there.  The key is in trying to understand what it is.”  If you count the need to be heard, to express our selves, and to receive empathy, then I would agree with you. In Aware Parenting, the key is always trying to work out why a baby or child cries, but knowing that, like adults, they have real feelings that need to be heard, understood, and empathised with.

Many parents have told me that they see the difference in their babies after a cry in arms – much more eye contact, in that buddha-type gaze way, more relaxed bodies, more smiling and laughing, and more relaxed bodies both during the day and when sleeping.  Parents tell me that children regularly given the opportunity to express upset feelings are able to concentrate for long periods, and enjoy being gentle, close and cooperative with other children and adults.

Lauren, you say that distracting a small child to prevent “meltdown” is humane.  Evidence from hundreds of parents practising Aware Parenting and Parenting By Connection show that children lovingly listened to whilst they have a tantrum, become relaxed, warm, and present once the chunk of feelings have been expressed.  Many people worry that babies and children cannot manage strong feelings, like when you use the word “overwhelming”.  We live in a culture that fears strong feelings, and I think that if we as parents believe that our babies and children are not able to feel many of their own feelings (with our loving support), they will come to believe that to be true.  In contrast, when we trust that they can safely feel their feelings if we are being present and close with them, then they remain comfortable with the ebb and flow of sensations that move through their bodies.

The importance of close observation of our children’s behaviour in Aware Parenting relates to comments you both made – Maria, you talk about night waking.  Aware Parenting advocates co-sleeping, and it’s not just about the number of times a baby wakes at night, but also, are their bodies relaxed during the night and day, do they make plenty of eye contact, do they cuddle up when held without being fed or rocked, do they laugh and smile a lot?  Lauren, when you talk about breast-feeding when upset, “There is no indication that this is dissociative.”  If a mother feeds her baby when he is upset and not hungry, she can then observe his behaviour.  Does he make more eye contact, does he smile a lot whilst looking at her, does he mould into her arms with a relaxed body when he is awake and not feeding?  She can also observe his behaviour after a cry in arms, looking at the same things.  These will help her work out whether the baby is more present, and available for connection, or less (indicating the possibility of dissociation), when fed frequently for comfort.

Lauren, I had a very different interpretation to you of Aletha’s journey of Aware Parenting and the connection she made between unhealed stress and night-time waking.   On page 115 of The Aware Baby, she does not mention a run of exhaustion of not being able to take it anymore.  She does talk about working out why her son was waking up from 2-6 times a night from 6 months onwards.  As I read there, she did not say that he “learned to sleep” at 23 months by her holding him at night without feeding him.  Instead, she chose not to feed him to sleep in the evening, instead being present with him and holding him in her arms.  His expressing his feelings and releasing his stress at the end of each day helped him to feel calm enough to sleep through the night.

Maria, you said, “I cannot support the view that it (breastfeeding) would lead to an addiction per se,” and Lauren, you said, “there is not one shred of evidence that would point to, for example, use of breastfeeding for comfort to lead to alcohol use when upset.”  The chart in the article was designed to show how control patterns can change or develop, rather than saying that they always do so in those ways.  So, Lauren, when you talked of a three year old needing to be jiggled, what I was aiming to show in the chart was that control patterns change with age – and always jiggling a baby when he is upset might lead to him learning to move and run about when he is upset as a three-year-old.  Few three-year-olds need jiggling, and few teenagers suck their thumbs – but they may do other things to hold feelings at bay.

When we know how much babies and children are learning from us all the time, doesn’t it make sense to hold in mind the possibility that if we always stop our baby’s upset feelings, and generally distract our child when they are upset, that they will learn that feelings are to be avoided and feared, and might find ways of avoiding feeling them?

I can understand that some parents feel reticence and concern hearing about babies and children crying, when of course we want our children to be happy and fulfilled.  However, over and over again, I have seen that when parents clearly see how much more present, relaxed, happy, and available for connection their baby or child is after crying with support, they feel confident that such expression is a vital need.

Most of all, I love hearing about the joy and connection which parents practising Aware Parenting tell me about.  I thought you might be interested to hear some of their experiences.  You can read them at www.parentingwithpresence.net - go to “Aware Parenting Stories.”

Warmly,

Marion Badenoch Rose





Maria's letter

Raising drug-free kids
I have been an avid reader of Kindred for the last two years, and during this time I've always felt inspired by the contents of its pages. So I was quite surprised to find some information within a couple of articles in the last issue [Sept-Nov 2008, Vol 27] which did not follow what I had interpreted as part of Kindred's philosophy until now.
The first one, entitled ‘Presence’, showed a table in which breast/bottle feeding for comfort would lead to eating when upset, which could then lead to drinking alcohol when upset. Breast and bottle are NOT the same. Non-nutritive sucking, which occurs at intervals with nutritive sucking while breastfeeding and does not happen while bottlefeeding, plays a fundamental role in the normal neurological development of the child. While non-nutritive sucking happens (which a lot of children do when upset and comforted by the breast, especially older children), there is no actual ‘eating’. And even when the child does get breastmilk, this is not the only (or main) source of comfort: the mother's presence is inseparable from her breast. Breastfeeding is the most ancient, evolutionary devised way to calm a baby's cry, and I cannot support the view that it would lead to an addiction per se.

In the same article, the view that ‘all crying means there is an unmet need’ is viewed as a fallacy. I must also disagree with this statement. When any human being from any age cries, there is a need which is being expressed there. The key is in trying to understand what it is...

The author also sees ‘frequent night wakings in babies older than six months’ as ‘difficult behaviour’. If a baby older than six months sleeps in another room and is calling for his mother (the only safe place as far as he's concerned), this is normal infant survival behaviour. If the baby is asleep with mum and wakes to breastfeed, or because he is teething, uncomfortable, etc., this is also, not difficult, but normal behaviour. What are frequent night wakings? How many, according to the author, are ‘too many’, and specified by who?

In the second article, ‘Raising Drug-Free Kids: 100 Tips for Parents’, it is argued that from ‘birth to age 3’ babies should never be left to cry alone -which I fully agree with for any age-, but parents are encouraged to use the ‘crying-in-arms’ approach. I am extremely worried about this bit of information. Letting a baby cry in arms may lead to not breastfeeding on demand, which may interfere with the breastfeeding relationship, especially during the first year of life. While it is true that babies can give other clues for feeding well before crying, a hungry and overtired baby might only be able to express his hunger through crying. I think that advising a mother to let a baby cry in arms is against the very maternal instinct of nurturing her child through breastfeeding. If the baby does not want the breast (or is bottlefed and not hungry), a cuddle is great, but not otherwise.

I fully agree with the fact that babies and children need to be heard, loved, empathized with, and respected if we want to give them a fair chance of not resorting to external substitutes for internal wellbeing. However, Aletha Solter's approach is definitely not for me.

Maria Jose Lopez

email


Lauren's letter
My concerns are about the Nurturing your Child's Emotional Wellbeing article (and to some extent the Raising Drug-Free Kids piece written by the same author) [Sept-Nov 2008, Vol 27]. I have read a good bit of Solter's work and the 
Aware Baby stuff and initially it only troubled me on a gut level. But as the years have passed and my professional skills have deepened and I've learned more about attachment, regulation and neurology, it now troubles me greatly not only on that instinctive level but on all the professional levels too. 

My main issue lies in the notion that breastfeeding a child when upset (so for comfort) causes a baby to 'enter into a kind of trance' and for that period of time 'she doesn't feel the upset but is also disconnected from joyful feelings...’ Not  only do I not think this is evidence-based, I think it is completely contrary to the evidence and utterly confuses the relational paradigm of breastfeeding with the nutritional paradigm of formula feeding. On a regulatory level, science has shown us that breastfeeding when upset (which, by the way, can sometimes mean the ingestion of NO milk/food as you know), regulates a baby's body.  When babies are tested for blood saturation and heart rates after having blood drawn and then after that are given to mum to feed for comfort and re-tested, their bodies go from very disregulated and stressed to an immediate state of  oxygen saturation to normal levels and regular heart rate. There is no indication that this is dissociative. It is regulative. As Siegel, Schore and scores of others show us, humans progress from needing their physiological and emotional states regulated for them, to having them co-created to self-regulating. They also show us that whenever a human is under stress, at any age, we rely more heavily on others to help re-regulate us and bring us to equilibrium. Relationships are the key to doing this in a healthy way. And while this seems to be what the author is suggesting, she simultaneously undermines that for every breastfeeding dyad.

My further concern lies in the proverbial 'long bows' she draws between the early 'control patterns' and the later ones. Despite what many may think, the field of addiction is not monolithic and many have done deep and holistic research into the pathways to addiction of all kinds.

While most would argue that regulatory issues are at the heart of addictive behaviours, there is not one shred of evidence that would point to, for example, use of breastfeeding for comfort to lead to alcohol use when upset. The problems with this idea of 'control patterns' are many, but my first concern is that there aren't even any developmental markers given alongside this theory. 

Another example used is 'jiggling or rocking when upset' yet for a brand new infant we know that movement is soothing and regulating (it is in part why wearing your baby works so well). Now if your baby misses the developmental window to move beyond that and is still needing to be jiggled when three years old, that is a pattern that is potentially concerning. But it is about age-appropriate, individually-determined, incremental skills-building in the area of regulation. 

Last example: distraction when upset is seen as problematic. Yet for the small child, without the emotional, cognitive and verbal skills to 'hold' overwhelming feelings and process them, distraction (especially when the upsetting issue is small but could escalate into meltdown) can not only helpful, but humane.

I find it particularly potent that when I read Solter's book she came upon this theory of holding her baby in the night but not feeding the baby (and hence the baby learned to sleep) at the end of a long run of exhaustion and not being able to take it any more. In many ways, this one aspect of her work is at odds with much of her other work and it stands out to me as something invented and inconsistent with evidence. That is not to say that I am fundamentally opposed to night weaning or that children can't have 'bad habits' created around feeding that need support to move on from. But to unilaterally smash a relational paradigm of breastfeeding and make it the same as bottle feeding is utterly ridiculous.

I share because it feels important and because I adore your magazine.

Lauren Porter

Centre for Attachment, New Zealand