IF YOU pick up your child every time she cries, she will whimper and whine simply to get your attention. Never sleep with the baby because you will surely roll over and suffocate him. Newborn infants need rigorous schedules to be content; breast feed only every two hours. A good mother must spend hours every day talking with her child to encourage mental development.
New parents are deluged with advice from paediatricians, childcare experts and just about anybody on the street who stops to peek into the pram. What few parents realise is that most of these rules, these laws of infant care, have little scientific credibility. But that may change if proponents of a new brand of research into childcare, called “ethnopaediatrics”, have their way. This group of anthropologists, paediatricians and child development researchers seeks to discover exactly how different styles of parenting across the globe affect the biology, growth, health and survival of infants. The researchers also aim to explain how those cultural differences come to be; how they are forged from social expectations about children, as well as varying perceptions of child health and disease. For instance, in Guatemala, mothers of zinc-deprived babies were alarmed at how alert their infants became after taking zinc supplements. In these women’s experience, such alertness was a sign of illness.
Making sense of every variation in childcare across the globe will be no easy task. But with one-third of the world’s population currently under the age of 15 the need to do so has never been greater, says Carol Worthman, an anthropologist at Emory University in Atlanta, Georgia. Expanding research into Western parenting practices is no answer, say the researchers, because most of these children live in developing countries where parental values differ from those in the West. Foisting Western beliefs on the rest of the world is definitely not on the ethnopaediatrics agenda. Worthman and her fellow researchers believe there is no one “right” way to rear infants – but there are ways that are out of tune with their local needs. It is the aim of ethnopaediatrics to identify parental practices that conflict with the needs of the infants.
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Newborn babies are the same the world over. Their reflexes have been honed by millions of years of evolution so that they instinctively know when to sleep, when to eat and how to cry out to signal their needs. But the way these needs are met varies hugely from one society to another. From the moment babies start interacting with their mothers, they become members of fast-changing modern societies, often quite unlike those that babies adapted to through evolution. Childcare in every society aims to shape babies into the type of children – and eventually adults – valued by that culture. Different societies have different expectations. Stimulating infants with incessant chatter, for example, might be a good idea in the socially assertive West, but less necessary in other societies.
And societies are not static. What was good for one generation of parents may be considered bad practice by the next. “In many cases, cultural development has contributed to the survival and wellbeing of babies,” says James McKenna, an anthropologist at Pomona College in Claremont, California. “But it’s important to realise that the changes cultures make might not be equally good across the board.” And so understanding exactly how culture, and varying parenting practices, affect the health and survival of infants becomes essential.
Controversy over infant care is at its height where breast feeding is concerned. The use of formula became standard practice in most developed nations after the Second World War. Bottle feeding was seen as better for babies and less trouble for mothers. And many assumed that bottle feeding was responsible for the decrease in infant mortality during this time rather than improvements in nutrition and healthcare. Culturally, bottle feeding came to symbolise “modern” while breast feeding seemed primitive, and was soon considered socially offensive. The flaw in that view became all too clear when industrialised nations encouraged women in developing nations to shun the breast and open cans of soya milk instead. Places like sub-Saharan Africa and Bangladesh, where sanitation and medical care are inadequate, suffered a sharp increase in infant mortality.
The bottle feeding trend has had other, more subtle effects on infant wellbeing that ethnopaediatricians are just beginning to document. Ronald Barr, a paediatrician and child development researcher at McGill University in Montreal, has studied the pattern of crying and fretting among babies from different cultures. He found that the infants of !Kung San hunter-gatherers in Botswana whimper for only a few seconds at a time while Western infants cry for much longer. !Kung San infants feed relatively frequently – for a few minutes every quarter hour – so maintaining an even blood sugar level. Western babies, by contrast, “pulse” feed in long bouts separated by hours. Barr wanted to see if this could be contributing to the distinct crying patterns.
Barr gave Western newborns an extra feed of either milk or sugar-laced water between their normal feeds. They stopped crying for several minutes and it was not just the act of picking them up that calmed them. A few drops of something sweet on the tongue and an unhappy newborn instantly stops crying for up to five minutes. Barr concludes that infants are sensitive to different feeding methods – continuous food is a possible key to contentment. But he stresses that neither practice is “correct” in the biological sense.
Even in sleep, contrasting views of how children should behave set one culture against another. Sara Harkness, a child development expert from Pennsylvania State University, describes the accepted view in the West: “Sleep is so basic that we expect it to look universally the same – that babies will naturally sleep through the night at four months of age.” But this sleeping norm is a figment of our cultural imagination.
In a comparative study, Harkness and her colleague Charles Super found that Kipsigis infants from Kenya normally wake up several times a night while babies in Los Angeles conform to their parents’ expectations and start to sleep through the night when they are a few months old. Even in cultures that are superficially similar, “ethno-theories” guide parenting. In a second study, Harkness and Super showed that Dutch children go to bed earlier and stay asleep on average two hours longer than American children. “The Dutch parents loved to talk about how important regularity is to children,” says Harkness. “In contrast, the American parents we interviewed continually talked about developing the children’s individual potential and maximising the intense relationship between parent and child. The organisation of sleep was a reflection of their different ethno-theories.”
None of these approaches to sleep is harmful to children. But other sleep researchers have highlighted cultural attitudes to sleep that could be. In the West, infants usually sleep alone in a cot or bed in a separate room from their parents. According to McKenna, this practice is based on a series of myths that ultimately serve parents, not babies. Some Western parents fear they will roll over and suffocate their babies, yet this does not happen in the many societies worldwide where co-sleeping is the norm. Other parents fear their kids will develop an unhealthy psychological dependence. There is no evidence that this is true – indeed, quite the reverse. Now McKenna has shown that babies may benefit physiologically from sleeping next to a parent for the night.
Night watch
With sleep expert Sarah Mosko at the Irvine Sleep Laboratory in the University of California, McKenna recruits mothers and their babies to find out just what goes on when the lights go out. Wires are taped to their heads, hands and abdomens to monitor how vital signs such as heart rate and breathing change as they sleep. Meanwhile, a video camera captures shifts in body movement. Scratchy lines on a polygraph sketch a dance between mothers and babies – when baby or mother wakes, the other sleeper does too, and when mother moves from one level of sleep to another, baby follows. The video tapes show mothers and babies sleeping face to face, sharing breaths. More poignantly, sleeping mothers unconsciously reach out and comfort their shifting bundles. This dreaming tango, McKenna believes, evolved to help human infants recover from sleep apnoeas – those fleeting moments during sleep when all of us stop breathing. He contends that babies essentially “learn to breath” during the night as they are aroused by mother’s movements and are triggered to take breaths from her exhaled CO2.
McKenna’s ideas go even further. “The infant’s evolutionary history, and just about every psychological study of infants, reveals that they are designed to respond favourably to sensory stimulation,” he says. This suggests to McKenna that the idea of monitoring a sleeping baby through an intercom is all wrong. Instead, we should switch the amplifiers to let sleeping babies listen to family noises. “Babies’ heart rates and breathing are known to change and be positively affected by listening to mother speak, laugh or sing,” he says. “Family noises promote healthy infant sleep.”
Research by anthropologist Mark Flinn from the University of Missouri seems to confirm that children are especially sensitive to their family environment. For the past eight years he has been tracking the stress levels of children in a rural village on the Caribbean island of Dominica. Once his young subjects are used to the idea, it is easy to get them to spit into a cup. This gives Flinn and his collaborator, Barry England of the University of Michigan Hospitals, a window into the children’s health. They analyse the saliva for the hormone hydrocortisone, which signals stress, and for chemicals produced by the immune system that point to infection. “We’ve found that children have a threefold increase in the probability of coming down with an upper respiratory infection within seven days of having a high stress event,” says Flinn.
And children are most affected by stress generated within the family. Flinn found that children living with step-parents and unrelated carers have higher hydrocortisone levels than those living with their biological family. More telling, the hydrocortisone levels actually track family upheaval. “In one family with three children, the parents had a fight, the mother left, and we saw a rise in hydrocortisone levels in the children over the next few days,” describes Flinn.
Seen from an evolutionary perspective, this type of response makes sense. Flinn believes that successful social interactions are more important than basic skills like hunting. “That’s where the mental chess game is,” he says, “and those are the things that probably have the most important impact on survival and reproduction.” Younger members of our species are especially sensitive to this kind of stress because childhood is the period when we learn the crucial social rules that help us stay alive and lead a normal life.
The right stuff
But the definition of “normal” is culturally based. What is good parenting in one society is not always best for children from another. Two studies by Robert LeVine of Harvard University highlight this point. The Gusii people of southwest Kenya live in polygamous marriages. Each wife tends her own household and an agricultural plot which feeds her family. Women bear 10 children on average. Babies are carried at all times, they sleep with their mothers and breast feed on demand until they are about 17 months old. Then mothers return full time to the fields, leaving their toddlers in the care of older sisters and brothers, some as young as 5 years old.
The Gusii way is to protect the infant from danger, keep it calm and produce a compliant child who slips easily into a sibling hierarchy. Mothers respond immediately to distress signals from infants by soothing them physically. But they do not often talk to babies or encourage them to express their emotions. In contrast, Le Vine found, American white middle-class mothers from Cambridge, Massachusetts do not hold their infants as much as the Gusii mothers do. But American mothers constantly interact with their infants verbally and visually. The Western way is to engage the child. By encouraging social interaction and exploration the parent tries to train an infant to respond to periods of learning in the future.
Both models have attained the status of “common sense” in their culture, and yet neither is right or wrong outside its environmental and social context. For example, when Gusii mothers were shown videos of American mothers responding to infant cries, they were shocked at how slow the mothers were to comfort their children. On the other hand, no American mother would let a five-year-old look after her toddler.
Every culture’s righteous attitude about parenting rests on the notion that early childcare dramatically moulds personality and temperament. Yet in the end, it seems, even the best laid plans of parents and societies are thwarted by the innate flexibility of the human spirit. Western kids brought up to be independent may return home as adults, and Gusii kids raised without intense verbal prompting by their parents make the grade in Western-style classrooms.