Monday, March 07, 2011

Reconciling Expectations with Biological Norms

As I have looked through advertising, books, and media in general on the topic of new babies and parenting, I have developed a critical eye in picking out information that is, shall we say, "sugar-coated" and unrealistic. I volunteer as a breastfeeding support counselor, and so I have to be aware of all things baby-related as I may have a mom come to me with questions, and I like to know what she is talking about if she brings up any topics that are baby-related but not directly breastfeeding-related.

Media in our culture presents us with these ideas of what newborns, babies, and young children are like. Often, these ideas are not based in biology, but rather, cultural expectations. Parents over the past few generations have come to expect certain things of their babies due to these non-biologically imposed ideas. As many first-time parents have not spent much, if any, time at all in observation of babies, they turn to parenting magazines and books, most of these presenting mainstream ideas of how babies "should" be.

So I thought I'd come up with a list of the many expectations that are presented to new parents and how they don't always mesh with biology, with how a "real-life" baby will be. Unfortunately, even with knowledge of what a baby is like biologically, there is still enough pressure to conform to societal norms that many parents will still try to go against these biological norms. We are a society of control, and often parents will feel out-of-control when going along with the biological norms of their babies. If their baby is not doing things "the way the book says they should," then parents can feel betrayed, helpless, out-of-control, and as if they are failing. My wish is that all parents could feel confident that not following the mainstream baby-raising advice won't result in ruin for their children. The biological facts were enough to convince me that society's idea of a "good baby" was not accurate and based more on social norms than biology. I don't know what it is about me that made it so that I don't care about being "different" from the norms as portrayed by the media... if it was, I would share it with the parents who want to follow their instincts and the biology of babies but feel pressured by family, friends, and society in general. Self-confidence is part of it, but there has to be more to it than that, because I was never too terribly self-confident as I was growing up.

So, some of the expectations parents may have based on how babies are presented by our media, and the biological realities which cause frustration when babies fail to meet those expectations:

* Culturally-imposed expectation: Young babies eat every 3 hours and sleep in a crib/bassinette contentedly in between feedings.
Biological reality: Newborns have tiny tummies, about the size of their fists. They need to eat frequently, especially in the early weeks if nursing, in order to get enough milk as well as to ensure that there is an adequate supply of milk in the future. Breastmilk digests quickly by design, to ensure that babies eat often. Breastmilk is the biological norm for feeding infants. Babies also are used to being in constant contact with the mother in her womb. Many babies object to being laid down alone frequently and for long periods. Frequent nursing provies frequent skin-to-skin contact, which babies expect biologically.

*Culturally-imposed expectation: Babies need to learn to be independent, to "self-soothe," and to play on their own. They will become "spoiled" if they don't learn this at a young age.
Biological reality: The American culture sees independence as an important trait in adults, and it seems that has carried over into how we treat children from the beginning of their lives. Many parenting magazines and books portray babies as being able to put themselves to sleep, play with their own toys alone, and sit contentedly in various baby devices. However, babies come into this world more helpless than any other mammal. Even baby apes can cling to their mothers' fur, and our babies can't even do that! Babies' brains do about 90% of their growing in the first three years. New connections are being formed constantly. Science tells us that meeting babies' needs consistently helps with the normal wiring of the brain. Babies who are left to "cry it out" alone, which many parents do in trying to get the baby to "sleep better" (more on "sleeping better" in a moment), experience higher levels of the stress hormone cortisol. High levels of cortisol can be damaging to the baby (reference).

Often, mainstream parenting advice says, "But if you hold your baby every time he starts crying, he will control you." But an infant cannot seek to control anyone. He only knows that he is a social creature who feels "right" when he is being held. His biology dictates that he cry when alone - it is a survival mechanism. True, we don't have to worry about a tiger coming after the baby if we set him down in another room, but he doesn't know that we now live in a civilized society where there is no threat of wild animals! His biological makeup remains the same.

When people advise new parents to get their babies to play independently, this is often presented as "entertaining himself." There are mobiles and crib toys and "baby gyms" for babies who cannot yet pick up and manipulate objects. They cannot even pick things up but are expected to "play" by themselves! This can lead to the over-purchase of multiple baby entertainment devices and toys. The thought behind this is that the parents shouldn't set themselves up as the entertainer of the baby, so they should teach babies to do it independently. But biologically, babies don't need to be "entertained" nor do they need to entertain themselves at a young age! Babies learn best when they are allowed to experience in-arms passive observation. The parent can hold the baby or wear him in a sling as he goes about his daily adult tasks - this does not tie him up in "entertaining" the baby, but it serves a valuable purpose: the baby IS "entertained" by this, and in the process he learns what adults do, what life is all about. He learns how things happen in day-to-day life. He is not the center of attention. More information on this can be found in Jean Liedloff's book, The Continuum Concept. Some information about it, as well as two great articles, can be found here. Another excellent read about biological norms of infants is Our Babies, Ourselves by Meredith Small.

* Culturally-imposed expectation: Babies should be able to sleep through the night at a certain age or milestone (such as by 8 weeks, or as soon as they double their birth weight, for instance).
Biological reality: Babies do not sleep like adults. They are designed to wake frequently as a survival mechanism! Not only do they need to eat frequently, but they need to go through shorter sleep cycles to ensure they do not go into too deep a sleep, which is dangerous for babies. If a baby begins sleeping 8-12 hours straight in the early weeks or months, then he is getting less nutrition and is not stimulating his mother's milk supply as frequently, which can lead to too little milk a few months down the road in many instances. Babies are particularly vulnerable during the first six months (especially 2-4 months) to difficulties in rousing themselves from a deep sleep - they are designed to sleep near an adult, whose breathing regulates theirs and keeps them in a lighter sleep state. This is preventative against SIDS. Biologically, a parent should not want their baby to sleep alone for an 8 hour stretch prior to six months of age! Sleeping long stretches is often seen as a baby sleeping "well" or being "a good sleeper." But biologically, it is actually good for the baby to sleep for short stretches! The question of, "Is he a good sleeper?" is so commonly used, and in the wrong context, in our society. Read more at Dr. McKenna's Notre Dame Sleep Laboratory.

* Culturally-imposed expectation: Babies should sleep in cribs on their backs and alone. This is the only safe way for a baby to sleep.
Biological reality: Again, there is the assumption that "good" sleep is done alone. A baby is often given a quiet, separate sleeping space. But as mentioned above, babies who sleep alongside their parents are better able to regulate their breathing and able to nurse more frequently. Sleeping alone is not safer, yet it is sometimes portrayed this way. A nursing mother sleeping next to her baby will not roll over on him unless she is under the influence of drugs or alcohol or has some sort of severe sleep disorder. This of course does not mean that most babies sleeping alone will succumb to SIDS, nor does it mean that a baby sleeping with its mother will never die from SIDS, but the biological makeup of the mother-baby dyad is such that we were designed to sleep in this way. Babies who sleep alongside their mothers nurse often, keeping them in a lighter sleep state for a prolonged period. Have you heard the suggestion from the American Academy of Pediatrics to put a baby to bed with a pacifier to decrease the risk of SIDS? Biologically, the baby has a "pacifier," the mother's breast, for this very reason! Babies nursing in the night alongside their mother often go from back to side frequently during the night, which not only solves the question of which position to put the baby to sleep in, but it prevents against a relatively new issue of "flat-head syndrome," where a baby develops a flattened spot on the back of his head due to lying on his back all night (and this can be exacerbated by use of car seat, infant swings, and not being carried often in an upright position). Biological norms of infant sleep can alleviate the need for many modern-day devices: cribs, pacifiers, helmets to correct severe flat-head syndrome... Putting babies to sleep alone in a separate room is a relatively new experiment in the history of humankind.

* Culturally-imposed expectation: You need to purchase various baby gear items because they will be used frequently and are essential to raising a baby. Some of these items may include: bucket car seat, stroller, baby swing, exersaucer, jumper, crib, pacifiers, bottles...
Biological reality: Advertisers often push these items as essentials when many babies don't care for them at all (much to chagrin of tired/overwhelmed parents who think the baby gadgets might be the key to saving their sanity, and then the gadgets fail to help - how frustrating!). Because of the expectations we have, we think that babies really will like these items, and that there is something "wrong" with them if they don't! The pressure to buy various things for the baby is deeply ingrained: registry lists, baby showers, ads coming to your mailbox (how do they know you are pregnant or have a new baby??), friends who have these items for their babies... Sometimes it is helpful to have a space to safely set the baby, so these items can have their place. But when over-used, babies are passed from station to station to "entertain" them as a substitute for being in the arms of parents. They are not biologically programmed to expect this. Further, most of these devices are only able to be used for a few months before the baby outgrows them.

* Culturally-imposed expectation: Babies must sleep alone and have to "cry-it-out" in order to learn this necessary skill. If they don't, they will never be able to sleep well and alone.
Biological reality: Babies don't sleep like adults. They go through much shorter sleep cycles, and they wake frequently, as mentioned before, as a survival mechanism, because deep sleep is not safe for infants. All children (unless they actually have a medical condition of some sort) will develop more advanced, adult-like sleep habits as they age. Both of mine did. They both slept in my bed, and then in my room, and both now sleep in another room, all night long, and rarely wake up in the night. They just got to that point, and there was no forcing and training and leaving them to cry. I know others who have had the same experience. As much as magazine articles want us to believe that we are "starting a bad habit" and it will never be able to be broken (does "never" mean a few years, or is it actually literal?), it is simply not the case. The sleep development of a baby or toddler will grow and unfold the same way their development will in any other area: talking, walking, etc. Above, there was a link to a Dr. Sears webpage which listed the potential dangers of the "cry it out" method of sleep "training." This method, which most authors and doctors who do advocate for it will at least say to wait until the baby is six months, has no biological basis. The reason it "works" is because babies just give up. They don't "learn" to sleep "better," they just stop trying to get anyone to respond because they know it is hopeless. Parents sometimes hear that you have to leave a baby to "cry it out" so they will develop "good sleep habits," and they assume this just means to leave the baby, as young as a couple weeks old in some cases, to cry for prolonged periods. They don't realize - or don't want to realize, perhaps - that babies are biologically programmed to be near their mothers, day and night. It is okay to be the "sleep aid" for your baby, and it is natural! Cry-it-out, cribs, "loveys," etc. aren't natural, so why is it sometimes assumed that it is healthier for babies to go to sleep in these ways than it is for their mothers to nurse them or their fathers to lay next to them and rub their backs? In fact, babies who are parented to sleep this way are adaptable to different situations - they don't have to be in their own cribs in their own bedrooms in order to fall asleep, nor do they have to "cry it out" in a strange new environment such as a hotel room. Babies who know mom as the way of going to sleep are much easier to travel with. Travelling with my babies has been a joy (well, except the driving with babies who hate the car seat part! ;).

* Culturally-imposed expectation: Babies need to eat jarred baby food purees before they can begin to eat finger foods. Nutritionally, babies also need rice cereal as their first food.
Biological reality: I have done an extensive post on this in the past. Biologically, babies are designed to be fully sustained on their mothers' milk for at least six months to a year. Only after a year does solid food begin to be needed nutritionally. This does not mean that babies cannot try food prior to a year, but that they don't need much of it for nutrition, and it should not be replacing much of their diet of breastmilk. Spoon-feeding of purees does just this. Purees were designed so babies could eat solids earlier than when they'd otherwise be ready developmentally. Babies who can pick up small bits of foods and put it in their own mouths are in control of their own appetite, and they learn how real food smells, feels, and tastes. Solid foods are about learning in this case, not for filling the baby up and replacing breastmilk. It is as easy to throw a banana in the diaper bag as it is to throw in a jar of baby food and a spoon. And the eating process is easier - the adults can enjoy their own food, modelling social and eating behaviors for the baby, rather than having to feed the baby first and then eat later, once their hands are free. This is the way babies were fed for thousands of years, before baby food was introduced.

* Culturally-imposed expectation: Nursing babies must be weaned actively by their mother or they will never wean on their own and will be "mamas boys (or girls)."
Biological reality: All children wean eventually. I don't think there's a case on record of a teenager who was still nursing, much less an adult! ;) As toddlers get older, mothers do add to the weaning process in a natural way, by asking the child who can understand to wait a few minutes to nurse, for instance. The child gradually finds other things that are interesting, tasty, and comforting. In a natural weaning, there is no horror story of the terribly engorged breasts as is sometimes the case in a more abrupt weaning. There is no lamenting the angry outbursts from the young toddler who doesn't understand why he can no longer nurse. If a mother needs to wean earlier than her child would, it can be done gradually over several weeks so as to minimize these uncomfortable possible side effects. Toddler and preschool-aged nursing is biologically normal: worldwide, the average weaning age is somewhere between 2-4 years, and that is even with our low weaning age averaged in!

* Culturally-imposed expectation: Babies have to be on a schedule.
Biological reality: Babies need to eat when hungry, as was stated previously. There is new evidence that women may have different breast capacities, meaning that some women will have to nurse more often in order for their baby to grow and thrive. Just because so-and-so's neighbor's baby only nurses every three or four hours (and sleeps all night and still weighs a ton!), it doesn't mean this will be the case for all mothers and babies. With scheduling of feeding and sleeping (and even "playing!"), it is often times more frustrating to try to do this in the first place. If the baby won't sleep when it is "naptime," or he "doesn't eat enough" at one feeding and so the mother makes him wait until the next scheduled time to "teach him to eat a full meal," then there can be crying and frustration on all ends! Many pieces of advice say that if you don't get your baby on a schedule, he will "control" you. He needs to be on a schedule so you can "get your life back." But talk about being controlled - how is not being able to leave the house at the expense of "the schedule" going to give a parent a feeling of being "in control" anyway? At some point, the schedule can control the parent. And for the baby who does not conform to a schedule despite his parents' efforts, the result is disappointment, resentment, and feelings of failure. But an infant does not have to be on a schedule. If he wakes at night crying a lot due to illness or teething one night, then letting him fall asleep nursing before "naptime" the next day may be quite beneficial to him. Wearing the baby around in a sling allows him to nurse and nap whenever his body urges him to do so. Now, at some point this does get to the point where an older baby or a toddler can benefit from a sleep schedule, in that he doesn't stay up til midnight one day and go to bed at 7 another day... once an older baby becomes distractable and cannot nap easily on the go, then he may need a set "naptime." But for infants, for babies under six months in particular, a sleep schedule is not necessary. Nursing on a schedule also prevents comfort nursing, which is important to babies, who have a biological sucking instinct and do it for comfort.

* Culturally-imposed expectation: You and your baby must spend face-to-face time playing "learning games" using "learning toys." This is the best use of your time spent interacting, and the rest of the time, baby will be in some device such as a swing or crib.
Biological reality: This is one I have picked up on lately, which the fisher-price ads and Pampers/Huggies parenting newsletters (I mean ads) would lead us to believe... that our babies will suffer developmentally if we don't use learning toys and games with them. Biologically, does a baby need a toy that will spout off the ABCs with the touch of a button? Does a child need to experience learning time in order to learn cause and effect? Biologically, a child will learn best by interacting with his natural environment, by hearing adults speaking (because they are near the adults and not in another part of the house with "learning toys"), by observing life happening around him. Yes, we need to interact with our babies to a certain extent, but this is most naturally done by singing and holding and moving and talking, not by sitting on the floor with some Baby Einstein toy. It has become popular to have learning games and DVDs for babies and toddlers, but biologically, these things are not essential - if they were, would our species have made it this far intellectually?

*Culturally-imposed expectation: Babies and toddlers have to have things "done to" them in order for them to learn independence in acquiring new skills. This includes sleeping, eating, toilet training, and others.
Biological reality: This is one reason why we have so many parenting books and magazines. Our society is such that we can't just leave a child to develop, but we have to do it for him. We have to push, or it will "never happen." I am not sure where this idea came from, but biologically, a baby and young child will sleep alone when ready, will eat when hungry, and will stop soiling himself when he develops to the point of finding it unpleasant and inconvenient. When pushed, there may be resistance, so that it no longer becomes about what the child would have done naturally, but a power struggle. And there are children who may have medical or emotional issues which could slow the normal biological development in these areas, such as a child who has sensory issues and certain foods feel wrong to him, causing him to gag and refuse a variety of foods. In these cases, yes, the children may need some adult interference, but not in a forcing way. For the normally-developing child, he will master all these tasks on his own one day. Toileting, eating, dressing himself, weaning... all he needs is the example of older people around him and his natural development will unfold.

I know that there is a lot of overlap in the areas mentioned above. If there was a specific "child-rearing norm" as presented by the popular culture which I have missed, feel free to comment and let me know. I wrote this list in part as I thought back at my first child's babyhood... how I knew she needed to be close to me, instinctually, yet I felt that I needed her to nap alone. "All babies nap alone," the parenting magazines told me. So why couldn't mine? Why did her eyes fly open and the crying begin as soon as she hit the mattress? And she wouldn't lay contentedly alone, so forget about the "put your baby down to nap when she is drowsy but awake" nonsense! But if only parents knew that this is not normal baby behavior - that they don't just sleep and eat whenever and wherever you want them to and fit conveniently into your pre-baby life as if they aren't there to begin with, like the soap opera I used to watch in high school would lead you to believe (in which the young children and babies would make brief appearances so their parents could acknowledge them and then life would go on as if they didn't exist, because they were "sleeping" or "with the nanny"). New parents would be better off if informed that they don't have to "do" things to their infants, that life will be very different than before children, and that the baby will just learn things as life progresses. No need to get neurotic over it, yet this is what I sometimes felt like in the early days with a baby! So, if any future first-time parent is reading this, know that yes, it will be a difficult adjustment. It is hard to let go of the preconceptions and myths and stereotypes and expectations you may have had ahead of time. Your baby may not make his biological needs known as loudly as others, but then again, he might. Knowing what to expect developmentally and biologically can put you at ease so that your expectations don't rule your new life with baby. And he will grow up - it will happen, and faster than you could know. Certainly faster than I thought it would when my first was a baby... I literally sometimes had the illogical thought that nothing would change, that she would never grow into different ways of sleep, eating, etc. But I learned more and more about what babies need and what they are like biologically, and I let it all go and began to relax and to embrace the closeness with my babies. They will grow up and be gone all too soon.


Carrie said...

Crying it out makes my heart hurt every time I think about it! Great post!

My Feminine Mind said...

Love Your post! I see this idea of having to control everything so ingrained in our culture. From having to control the birth experience, rather than letting a woman's body do what it is designed to do, to putting babies on a feeding schedule rather than trusting the baby's own rhythms, or even putting older kids on a "learning schedule" rather than just tying to follow the kids' lead and give them opportunities and resources to follow their curiosities and natural bent. I often wonder how much less stressful and peaceful things could be if we could try to understand what is rather than constantly trying to shape into something else. I try to do this in my own parenting, but it can be so hard because that's not at all the cultural norm!