Category Archives: 1. Pregnancy & Birth

Fertility and conception, pregnancy, childbirth, and the early postpartum period.

API Parenting Support Survey: Parents Crave Local Support

A 2009 online survey by Attachment Parenting International revealed that parents around the world are hungry for support and education in their Attachment Parenting choices. Results from the survey clarify API’s role in providing this support.

This API survey was conducted to gather anecdotal information and feedback from established API supporters. API was pleased to have more than 100 responses from busy parents in the brief timeframe.

The key point disclosed through the survey is that parents want to see API have more of a local presence. Parents very much appreciate all of API’s resources, but it is the local peer support that they crave. Moving
stories and more in-depth feedback is included in “How has API Helped You” at the end of this summary.

Read the full report here: http://www.attachmentparenting.org/pdfs/API2009ParentingSupportSurveyReport.pdf

Interaction and Relationships in Breastfeeding Families: Interview with Dr. Keren Epstein-Gilboa

By Rita Brhel, managing editor and attachment parenting resource leader (API)

Having nursed one child and not the other, I can say with confidence that there is something truly magical about the breastfeeding relationship. So much more than a transfer of nutrients from mother to baby, the act of breastfeeding touches on each of the Eight Principles of Parenting from nurturing touch and safe sleep to consistent care and personal balance. Breastfeeding is, as Attachment Parenting International co-founders Barbara Nicholson and Lysa Parker write in their book, Attached at the Heart, the very model of an attachment bond.

author Keren Gilboa-EpsteinAnd as Dr. Keren Epstein-Gilboa of Toronto, Ontario, Canada, explains through a new book intended for professionals working with new parents — Interaction and Relationships in Breastfeeding Families: Implications for Practice — the choice to breastfeed positively impacts much more than the attachment bond between mother and baby, but also among all members of the family unit, from siblings to the father, even after the breastfed baby has weaned.

A nurse psychotherapist with a long list of credentials behind her name (PhD, MEd, BSN, RN, FACCE, LCCE, IBCLC, RLC), Keren has been working with new parents and families with young children for the past 25 years as a counselor, lactation consultant, childbirth educator and birth supporter, researcher, and preschool teacher. She is also well published in scientific journals and other publications on topics ranging from pregnancy and birth to breastfeeding and early parenting. Interaction and Relationships in Breastfeeding Families was borne out of Keren’s own clinical and research experiences.

I devoured the information presented in this book. It reveals to the reader the psychological aspects of breastfeeding on the whole family, not just through the intimacy between mother and baby but how breastfeeding literally shapes family development and promotes sensitive interactions between all family members. And then, it follows up with implications for the professionals working with young families. Interaction and Relationships in Breastfeeding Families also gives another dimension to breastfeeding education for lactation consultants, counselors, and others who work with new parents in their transition to family life.

RITA: Keren, how did you first become interested in Attachment Parenting?

KEREN: My experience as a nursing mother is the basis of my interest in Attachment Parenting and interactions in breastfeeding. I parented in a style that might be defined as Attachment Parenting without knowing that there was a name associated with this behavior. My own experiences taught me the importance of mothering in tune with child needs, including cue-based breastfeeding into early childhood. I also learned how this style of breastfeeding and parenting seems to be misunderstood and is criticized by others.

RITA: What led you to write your book?

Interactions and Relationships in Breastfeeding FamiliesKEREN: Insights from my personal experience influence my clinical work and research interests. My aim is to increase the understanding and respect for physiologically based nursing and associated parenting through research. I use recognized theories of development to clarify and validate behaviors in my writing. The material in Interactions and Relationships in Breastfeeding Families reflects my first study on maternal-infant interaction during breastfeeding that was published in a peer-reviewed journal of psychology in 1993. Later training as a family therapist demonstrated to me how important it is to look at the entire family in order to understand more about the interchanges between the nursing mother and child. In 2006, I completed a study that used a family systems approach to describe the entire nursing family. The results of this study are described in my book.

RITA: How do you hope for your book to benefit families?

KEREN: I hope to help families in two ways:

  1. By providing them with information about themselves that will hopefully normalize their experience and fortify their behaviors
  2. By enriching families’ interactions with professionals by describing physiologically based breastfeeding patterns and associated parenting to services providers.

I talk about the feelings that might arise for those providing services to families whose lifestyles and attitudes might differ from their own view of family life. Many services providers in Western contexts criticize cue-based nursing, nursing into early childhood, and ongoing respect for children’s needs for closeness. I believe that helping services providers’ recognize their bias may enrich their ability to listen to and to provide optimal information to families.

RITA: How does your book fit into API’s Eight Principles of Parenting?

KEREN: I think that the work Attachment Parenting International does is very important!

My book demonstrates how families apply many of the Principles of Attachment Parenting to real life and also discusses the implications of this style of parent-child interaction for parent development, positive child outcome, and family function:

  • Preparing for Pregnancy, Birth, and Parenting — The book demonstrates that parents’ attitude toward birth affects their nursing behaviors.
  • Feeding with Love and Respect — Most of the families described in the book see birth and breastfeeding as a part of a physiological continuum, and this seems to facilitate cue-based nursing. Physiologically and cue-based nursing implies that parents respect and respond to infants’ and older nursing children’s needs and signals for nursing. The practice that parents get responding to infants and children’s cues for nursing seems to enhance the development of a parenting style that respects children’s needs and focuses on responding to children’s signals.
  • Responding with Sensitivity — This responsive style of interaction is called sensitive or attuned parenting in the literature and appears to contribute to healthy child development. Cue-based and child-focused parenting also implies that parents suit their interactions to children’s individual characteristic and evolving capacities.
  • Using Nurturing Touch and Ensuring Safe Sleep — The sensitive parenting style associated with cue-based actions through nursing in infancy carried on into other behaviors, including children’s needs for proximity and touch at all hours. Most of the families respond to their children’s needs for closeness by holding, carrying, and sleeping with or near their children. Children’s changing needs for proximity are respected and responded in an individual manner.
  • Practicing Positive Discipline — Open communication, sharing, and parents’ capacity to tolerate children’s unique needs, including in difficult situations, seems to be the central means that parents use to guide children.
  • Providing Consistent and Loving Care — Sensitive tactile interactions evolve into a warm communication style that helps parents meet their children’s changing developmental needs. Parents see their children as individuals, enabling them to suit interventions to the specific needs of each child.
  • Striving for Personal and Family Balance — Open communication and reverence for all of their children’s needs seem to help parents establish and also restore balance to the family system. Parents share joint values and alter couple interactions to reflect infants and children’s changing needs. Older children’s experiences of being heard seem to help them tolerate younger siblings’ needs and also enrich their capacity to understand others – an important tool contributing to family function.

RITA: What tips do you have for parents seeking a closer bond with their baby?

KEREN: Parents should use nursing as a method of learning how to read and respond to babies’ signals. The physiological and psychological meaning of nursing for infants prompts them to cue frequently to nurse. Parents may learn about their child and parenting by observing, interpreting, and responding to children’s cues for nursing. Cues include signs of readiness to commence and finish a nursing session. In addition, women in particular learn how to mother by interacting with their babies during the nursing sessions. Men internalize sensitive fathering by participating in cue reading for nursing, by observing mothers, and also by matching their supportive actions to the changing needs of the nursing dyad. Both parents may use the touch associated with nursing to learn more about sensitive parenting.

RITA: Thank you, Keren, for your time and insights. Do you have any closing thoughts you’d like to share?

KEREN: I go back to my reasons for studying and writing about breastfeeding families and issues related to an Attachment Parenting style: I want to help strengthen parents and enable them to see birth and nursing as normal, rather than medically owned events. I hope to help parents feel comfortable responding to their infants’ and children’s cues, and to feel that their role as parents is important. One might recall that an important insight that I brought from my parenting experience to my clinical and research work was that professionals misunderstood cue-based nursing and parenting. Hence, I also directed my book towards professionals and dealt with the bias that they might have toward cue-based breastfeeding into early childhood and associated parenting. I hope that parents will tell their health care and other professional services providers about the book and encourage them to read it.

The Breastfeeding Father

By Jarold Johnston, CNM, IBCLC

BreastfeedingDad’s job is to take over the job of the lactation consultant when the family goes home from the hospital. The father is who will be available to answer questions at 3 a.m.

Many mothers struggle with confidence when breastfeeding: They doubt the baby’s desire to breastfeed, they doubt their family’s support for breastfeeding, and most of all, they doubt themselves and their ability to breastfeed. A new mother struggles with confidence almost every day, and her shaky confidence is easily destroyed by a doubting father. When you say something foolish like, “I don’t know, Honey, maybe we need to give him a bottle,” you have just damaged your family’s chances at breastfeeding success.

So, if you’ve come this far, you’re still with me and it’s time to learn how to breastfeed. Continue reading

#1 on the Breastfeeding Team –> Daddy

By Jarold Johnston, CNM, IBCLC

fatherAs a midwife, lactation consultant, and father of seven beautiful breastfed babies, I’m often asked to share my perspectives with new parents. First, let me say, I have found through personal and professional practice that almost everything is hard the first few days or weeks with a new baby — and breastfeeding is no different.

You will do yourself a favor if you prepare for the challenges by learning all you can before your progeny is born. I encourage you to talk to your health care provider, lactation consultant, and especially friends who have successfully breastfed for more than six months. Learning from successful and experienced breastfeeding friends is a good way to get honest, accurate information and avoid the myths that make breastfeeding so very challenging. I warn you to ignore the advice of couples who failed at breastfeeding, as their perspectives, while honest, may not always be accurate.

Before we can talk about your role in breastfeeding, we have to first answer the most fundamental question: Why would anyone want to breastfeed? In the old days, we used to talk about the benefits of breastfeeding and you will still hear some people mention it, but not me. Believe it or not, breastfeeding doesn’t make your baby bigger, stronger, faster, or smarter. Breastfeeding doesn’t make him super-human, it just makes him human. Continue reading

The Danger of Pharmaceuticals

By Adrienne Carmack, MD

Danger of PharmaceuticalsIn April 2005, Rani Jamieson gave birth to a healthy baby boy, Tariq. She was given Tylenol #3, a medication containing acetaminophen and codeine, for postpartum pain. She took two pills twice a day, less than the prescribed amount, and cut this dose in half two days later after experiencing fatigue and constipation. She was told it was safe to take this medication while breastfeeding, and did so.

When he was seven days old, Tariq became excessively sleepy and had trouble breastfeeding. His mom began pumping and froze her extra breastmilk while continuing to nurse. She brought Tariq in to see his pediatrician when he was 11 days old for poor feeding; the pediatrician noted he had regained his birth weight and nothing further was done. On his 13th day of life, Tariq became unresponsive. When the ambulance crew arrived, he was already dead. Six months later, an autopsy showed a deadly overdose of the codeine his mother had been taking.

Codeine is generally regarded as a safe medication for use by breastfeeding moms immediately postpartum. In 2001, the American Academy of Pediatrics issued a report stating that codeine had not been reported as causing signs or symptoms of problems in breastfed infants and that it had no effect on lactation. It was included in a list of medications “usually compatible with breastfeeding.” Actually, several reports of apnea in infants whose mothers were taking codeine had been previously reported, in 1993 and 1984, according to a study published in the January 2007 issue of Canadian Family Physician.

Even today, the Academy of Breastfeeding Medicine, a breastfeeding advocacy organization, reports that codeine is generally a suitable choice for postpartum pain. In their report on pain control in breastfeeding mothers, they advise limiting doses of pain medications to the minimum amount necessary and suggest that nonpharmacologic means of pain control such as hypnotherapy may be better. However, they ultimately conclude that codeine is generally safe because it has been widely used by millions of women worldwide.

How can a medication that has been safely used in millions also be dangerous enough to kill a newborn baby, even when used at lower doses than the standards recommended? Scientists have recently begun studying the role of genetic variations in drug reactions. They have found that individuals with certain forms of genes are more likely to metabolize drugs in ways that lead to higher side effects. For example, the chemotherapy drug cisplatin causes hearing loss in some of the people who receive it, particularly children. However, until recently, no one knew why this was. It’s now been shown that certain forms of genes are responsible for this side effect, as published in the September 2007 issue of American Journal of Human Genetics.

For codeine, the answer lies in a gene called CYP2D6. Those with a certain form of this gene metabolize codeine very rapidly. Codeine works as a pain medication after it is metabolized to morphine, which then acts on pain receptors in the body. Those who metabolize codeine very rapidly end up with very high levels of morphine in their bodies very quickly. In the case of Tariq, his mother had symptoms early on, suggesting that she was a “fast-metabolizer” of codeine. Tariq was found to have morphine levels of 90 ng/mL, much higher than the level usually seen in infants receiving intravenous morphine, about 12 ng/mL. Rani’s frozen breastmilk contained 87 ng/mL of morphine.

Why, before codeine was deemed safe for the infants of nursing mothers, weren’t morphine levels in breastmilk studied? They were. A study published in The Journal of Human Lactation in 1993 measured the levels of morphine in the blood and milk of seven mothers taking codeine and in the blood of their infants. The levels of morphine in the infant’s blood never exceeded 2.2 ng/mL, which is generally considered a safe level, and is much lower than the levels found in Tariq’s blood.

Claims of medication safety are usually made after drugs have been tested in uniform populations at standard dosages, not in diverse populations that represent our society. In the case of CYP2D6 gene variations, the fast-metabolizer form occurs in up to 29 of every 100 people, depending on ethnicity, as published in the Canadian Family Physician study. It’s easy to see how measuring the levels of morphine in the milk of seven mothers of an ethnicity with a 1% rate of genes causing fast metabolism of morphine would be unlikely to include a mother with this variation. Had the study been done in mothers of Ethiopian descent, who have the highest chance of having this form of the gene, the researchers likely would have seen very high levels of morphine in the milk of at least one of the mothers.

Given these facts, it is likely that millions of infants worldwide go through their first days of life sedated and drowsy, while their mothers are reassured that the medication they are taking is harmless. Many new moms, unfamiliar with an infant’s behavior, may not recognize that their babies’ behavior is unusual. If they do worry and seek medical care, many doctors would fail to recognize the symptoms as a drug effect. One can only surmise the effects of this early drug exposure on brain development.

Genetic mutations such as this also account for other side effects of medications. For example, the CYP2D6 gene is also important in how the body handles another pain medication, tramadol. Those with the gene variation causing rapid metabolism are much more likely to experience nausea than those who do not. Half of rapid metabolizers develop nausea, compared to only 9% of those who are able to metabolize tramadol completely, according to a study published in the February 2008 issue of Journal of Clinical Psychopharmacology. Similarly, individuals with this form of the gene who take codeine have a 91% chance of becoming excessively sleepy with the medication, compared to 50% of those without it. Those who metabolize codeine very rapidly have 50% higher levels of morphine in their systems.

This new understanding of the role genes play in the way our bodies process drugs illustrates the reasons why pharmaceuticals that seem safe can still be very dangerous. Since this report was published, some strategies that have been recommended are using medications such as ibuprofen instead of codeine in breastfeeding mothers, using codeine for a shorter time after the baby is born, or even performing genetic studies in all mothers to determine if it is safe for them to use codeine while breastfeeding. These strategies are flawed. Simply reducing or changing the pain medication used is not likely to be effective in controlling a mother’s pain. Carrying out mass genetic screening would be extremely costly and time-consuming.

Not only are these strategies impractical, they fail to address the real issue. Pharmaceuticals are dangerous. Reports indicate that adverse drug events occur in 67 of every 1,000 hospitalized patients and are fatal in 3.2 of every 1,000 patients, according to a study published in the April 1998 issue of Journal of the American Medical Association. Worse, 95 of every 1,000 hospitalized children experiences an adverse drug event. Of every 1,000 children admitted to the hospital, 20.9 are admitted because of drug reactions. Almost half of these are life-threatening reactions. It’s estimated that 14.6 of every 1,000 children who are not hospitalized will experience an adverse drug reaction, as published in the July 2001 issue of British Journal of Clinical Pharmacology. According to the United States Food and Drug Administration, if these rates are accurate, adverse drug reactions are the fourth-leading cause of death in the United States. Even when drugs are thought to be safe for many years, using them can still have devastating consequences.

The best strategy, one that isn’t commonly proposed, is simply avoiding medications in the first place. Medications are widely overused. In the case of postpartum pain, choosing a natural childbirth, with alternate methods of pain control if needed, provides the safest environment for the baby. This option avoids the risks of codeine in particular and also lets women avoid all of the drug effects that are not yet understood and can’t be predicted. If a mother does feel that taking a medication is important for her health or that of her child, she should diligently watch for any side effects. Mothers are wise to listen to their bodies and to not hesitate to seek alternate treatments if concerning symptoms occur while taking a drug.

Some mothers who chose to avoid drugs while pregnant and breastfeeding do so because they are aware of studies showing the harms this can cause to their infants. Most, however, likely are led to this choice by their innate wisdom. The choice to have a natural childbirth is often criticized as unnecessary because of claims that drugs such as codeine are safe. The new understanding of genetic variations provides evidence that the instincts of mothers who choose to avoid these situations should be trusted.

Mothers who are in a situation where they are offered pharmaceutical treatments should carefully weigh the potential, unknown risks of taking these medications. Because the effects a drug will have on one individual cannot be predicted by what has happened in others, one cannot be too cautious in making this decision. As with many parenting decisions, the choice to use pharmaceuticals cannot be taken lightly. It is prudent for all individuals, but especially nursing mothers and growing children, to avoid these potentially toxic chemicals whenever possible.

An Attached C-section

By Catherine McTamaney, EdD, society and education lecturer at Vanderbilt University, Nashville, Tennessee USA

Catherine MctamaneyIt never occurred to me that anything might go wrong.

My partner and I had asked all the big questions as we got ready for the birth of our son. We’d prepared ourselves both physically and spiritually for what we expected to be a smooth, beautiful childbirth assisted by our midwife. It just never occurred to me that we would need anything besides each other to welcome our child into this world.

Okay, okay. I can hear the knowing chuckling of mothers everywhere. Yes, we should have known better. But we didn’t. We were first-timers.

The day before our son was born, a check-up indicated far less movement in utero than our midwife felt was healthy. Because we knew the baby would be large, Deborah recommended a c-section, and we resigned ourselves to surgery.

I didn’t want to sacrifice rooming-in with the baby, however, and the hospital had never tried a rooming-in with a C-section family before. Deborah phoned ahead to let them know of our request. The first nurse we spoke with said she felt it was unwise and that my recovery would be hindered. We asked Deborah to keep calling. She reached the head nurse for the ward, promised that either my partner or another family member would always be with me, and was given the go-ahead for us to room in.

From the moment we were admitted to the hospital, we were the knowing subjects of an unusual experiment. One of our nurses believed strongly in Attachment Parenting and was an enthusiastic supporter. Another believed just as strongly that my body would not heal properly if I were under the additional responsibility of caring for my child. Each of us, naysayers and supporters, waited to prove ourselves right.

On April 22, my son was born, weighing 10 lbs. 15 oz. and healthy as could be, in a delivery room crowded with my midwife, the perionatalogist performing the surgery, a team from intensive care, the delivery nurses, the recovery nurses, the neonatal nurse, and, somewhere in the crowd, my partner and me. Not certain of how to combine a c-section and nonseparation, the hospital had simply sent everyone from their own departments into surgery with us. And so our quiet, natural birth turned into a fabulous, well-attended party, complete with a local Nashville radio station playing in the background. My partner was able to be with our son while my surgery was completed, then brought him to my arms, where he lay comfortably sleeping as my stitches were tied.

From that moment, our son never left us. All the necessary tests were performed in our room. He was bathed, measured, and clothed within my reach. He nursed easily and on demand; I had no engorgement and my milk came in less than 30 hours after surgery. I walked unassisted the morning after his birth. I had little pain or discomfort around my incision, which healed beautifully. I listened to my own body, ate when I was hungry, walked when I needed movement, and never noticed myself healing because I was too busy attending to my child.

Mothering is an obviously generative process, but it is just as importantly regenerative. I had an exceptionally easy recovery from my surgery, and I believe the reason is that it is very difficult to focus on and perpetuate our own pain when we’re admiring our children. I did not have time to think about whether I hurt, because I had a new child to care for. I did not have time to fear mothering, because I had to mother. And the overwhelming joy, the pure and incomparable wonder, the love that makes you smile so hard tears are forced from your eyes, shadowed any discomfort I might have felt. I don’t claim not to have had pain — but I know I didn’t notice it.

On the day we were discharged from the hospital, a day earlier than expected, I was required to attend an orientation meeting. Sitting in a classroom across from the nursery, I watched a young mother pushing a plastic hospital bassinet in which a tiny pink bundle slept. At her side was an older woman, probably her own mother. They stopped at the door to the nursery and pushed it open with the far end of the bassinet. The young mother motioned with one hand to the nurses inside, then she and her mother turned and walked back down the hall.

She never said goodbye to her child, never kissed her or patted her head. She didn’t tuck the blanket in before she left or stop to catch one more glimpse of those tiny fingers. She was already disconnected from the life she’d had within her only a day before. I wondered how different that family might be if, instead of offering drop-in childcare, the hospital had offered instead a supportive environment for attachment. An opportunity was lost, as that family detached, to protect and nurture the bond of mother and child that nature requires of us while we are pregnant, and hospitals so easily regulate out of us once our babies are born.

In retrospect, I believe the reason my partner and I were so blasé about birth classes was because, although we never articulated it, there exists a trust between us that our love for our child would guide us. It is a promise that we have, in turn, given to our son — not that we would make no mistakes, but that we would be guided by love. We didn’t choose Attachment Parenting because we had done long research about its benefits; we chose it because, when we knew our son was coming, we couldn’t bear the thought of not being with him all the time. We didn’t choose to sleep as a family because of scientific research on cosleeping; we chose it because we loved the way our son felt beside us.

How joyous, then, that our instincts, our love for our child, led us to the best practice! We needed the support of our doctors to welcome our child safely into this world, to overcome the practical limits of my own body. But this experience has taught me that, however limited my physical being, my spirit is strong. My spirit heals. My spirit mothers. And when I look down at my happy little scar smiling up at me from across my belly, I know we still had a natural birth. We’ve kept our promise.

Breastfeeding while Pregnant

By Debbie Page, RN, IBCLC, CEIM, director of TheNewBornBaby.com

breastfeeding while pregnantMany women find themselves pregnant while they are still enjoying a nursing relationship with their child. It doesn’t typically occur during the first six months, as long as you and your child are together most of the time and the child is exclusively nursing, but it can happen any time. Your child may be seven months or two years old when you discover you are pregnant. Should pregnancy be the reason to wean? For most mothers, the answer is a resounding no!

Babies need to breastfeed for years, not months, so continuing to breastfeed while pregnant could be the very best thing for your nursling. You will want to discuss this with your partner and your midwife/doctor. In Western cultures, the social norm is to breastfeed for a few weeks to a few months and certainly not during pregnancy. You may very likely have family members and friends pressure you to wean. Only you can make that decision. Educate yourself so you can base your decision on facts, not emotions. Embrace your freedom as a woman and mother to make the decisions you feel are best for your children and your family.

You and your family will have a lot to ponder about as you arrive at your decision. You may decide to continue nursing and set periodic goals for re-evaluating.

Is It Safe to Breastfeed While Pregnant?

There are two situations to consider:

  1. How are your pregnancies? If you carried your pregnancies to term without a threat of premature labor, then you are fine to continue breastfeeding. If not, you need to make sure your midwife/doctor is fine with your plan. If it is OK for you to have sex during pregnancy, it is safe to keep breastfeeding. Some doctors are concerned that the nipple stimulation of breastfeeding will cause premature contraction, but the medical literature does not support that theory. Nipple stimulation causes a release of oxytocin, which triggers the milk to let down. The synthetic form of oxytocin, Pitocin, is used to induce or augment labor. The amount of oxytocin released during orgasm is more than with breastfeeding, so the chances are slim to none that breastfeeding would put you into preterm labor.
  2. Are you well nourished? While you are pregnant, your body will draw from your stored nutrients to support your unborn child. You will continue to make high quality milk during pregnancy, but you will need to increase your calorie intake and your vitamins and minerals. Eat well, drink enough fluids, and make sure you gain the expected amount during your pregnancy. Women who are malnourished should not breastfeed during pregnancy. Vegan, anemic, or dairy-free moms need to pay special attention to their nutrition even if they are not pregnant, but especially if pregnant and breastfeeding.

Will My Older Child Get the Proper Nutrition?

Because your milk production may dwindle about halfway through your pregnancy, you may need to supplement a child whose sole source of nutrition is breastfeeding.

Not everyone will experience reduced milk supply, however. When Hilary Flower wrote her book, Adventures in Tandem Nursing, 30% of 200 mothers she had interviewed did not report a decrease in their production while they tandem-nursed.

What Other Ways Will Pregnancy Alter My Milk?

The taste of your milk will change, and some nurslings do not care for the new taste of Mommy’s milk.

At some point, your milk will revert to colostrum. This is still fine for your child and there is no need to worry that she will use it all up. Your breasts will keep replenishing the colostrum. Once you deliver, your production of colostrum will increase to provide plenty for the new baby.

How Does It Feel to Breastfeed While Pregnant?

Some women find it irritating or become restless when they nurse while pregnant. Hormonal changes are probably the culprit.

The hormones of pregnancy may also cause nipple tenderness. The tenderness may increase with the decrease of milk production.

For some women, morning sickness or nausea increase with nursing; for others, it decreases. If you experience more nausea, try altering your nursing schedule.

What About Weaning During Pregnancy?

You may decide that you want to wean before you deliver. This is fine. Giving some thought to this before you choose to breastfeed during pregnancy can help you emotionally if this does happen.

Some children will wean when the milk production dwindles or because the taste of the milk changes. Again, preparing for this possibility before it happens can ease the loss of your nursing relationship with this child.

Is Organic Really Healthier?

By Rita Brhel, managing editor and attachment parenting resource leader (API)

Is organic scientifically healthier?Georgia Jones isn’t accustomed to addressing a crowd as knowledgeable about food as are many attached parents. An University of Nebraska-Lincoln nutrition professor, Jones spends much of her classroom time educating people about the very basics of what they put in their bodies.

“My students don’t come with an understanding of food,” she said. “Food for my students comes out of a box, a pan. If I told my students to go make a chocolate cake, they wouldn’t have a clue.”

But many families involved in Attachment Parenting are smart about their food. They understand the importance of knowing where their food comes from and how it was produced. These consumers choose to eat food without chemicals, because they realize that organic is superior to conventionally raised food. Or, is it?

Background on the Organic Food Industry

Organic food, a $14 billion industry, is the fastest-growing segment of the food industry, Jones said. National surveys show that two-thirds of Americans have purchased organic food at some point during the last 12 months.

“Organic food started as mostly a niche market, years ago,” Jones said. During especially the last decade, organic foods, farmers markets, and local food networks have spread rapidly into the mainstream consumer market. “Organic food is no longer a niche market,” she said.

Consumer demand for organic food is on the rise for a number of reasons, including food safety issues, such as an avoidance of pesticides and genetically modified organisms (GMOs); a concern for the environment; and because organic food is often fresher and tastier than conventionally grown food, Jones said. But the number-one reason is an increased awareness of the link between food and health.

“There was a time in this country when we forgot that food actually has a purpose in our health, that it is for nourishment,” Jones said. “Now, we’ve moved into an area that I call ‘beyond nutritional eating,’ where we are using food to try to prevent and heal disease.”

That organic food is free of pesticides and GMOs and comes from environmentally friendly farms and gardens are safe assumptions – each documented through federally regulated certification programs. Shocking as it may be, however, there is no certainty that organic food, while its safety is certainly more accountable, is actually more nutritious than conventionally grown food, Jones said.

A New Era in Food Science

Consumers often confuse food safety and nutrition. Food-borne illnesses, pesticides, and GMO allergens are food safety concerns. Nutrition refers specifically to the content of macro- and micronutrients within food. Traditional nutrition centers on macronutrients, which include protein, carbohydrates, and fats; vitamins; and minerals. Micronutrients include substances such as phytochemicals and phytonutrients that were long thought to have no effect on human health. Research now shows that these micronutrients, also known as secondary metabolites, are extremely beneficial in boosting the immune system, protecting the body from cancer-causing free radicals, killing disease-causing pathogens, and more. “This is a new area [for science],” Jones said.

One phytonutrient receiving a lot of attention from nutritionists are flavonoids, which are found in very high amounts in blueberries but also in a variety of colorful fruits and vegetables. Flavonoids are known to protect against heart disease, cancer, and age-related diseases such as dementia. “You want to eat plenty of fruits and plenty of vegetables,” Jones said. “Something else is, you want to eat plenty of color. This is a key part of nutrition and is not getting enough attention.”

Activated by environmental stress, flavonoids are produced by the plant as a defense mechanism against UV-B radiation and disease stress. “These secondary metabolites aren’t there for us. We just reap the benefits,” Jones said. “They’re actually there to protect the plant.”

Organic Plants Contain More Secondary Metabolites

To determine whether organically raised plants are more nutritious than conventionally raised plants, science is going back to how plants are raised and focusing on the formation of secondary metabolites — the phytonutrients — which are chemicals produced by a plant grown in less-than-ideal conditions. Organically raised plants are subject to more pest and weather stress than conventionally raised plants, which are protected by chemical pesticides, GMO varieties, and commercial fertilizer application. As a result of this added stress, an organically raised plant produces secondary metabolites to provide added protection, as well as to quicken maturation and seed development.

But Theories Are Not Proof

Although organic foods do tend to contain more secondary metabolites, “there are a number of reasons why scientists aren’t coming out and saying this is the better way,” Jones said. There are still too many unknowns in the formation of secondary metabolites, including specific environmental factors, soil properties, and crop management practices that affect the formation of these micronutrients. Plus, there are two crucial questions that must be answered first:

  1. Do organic plant products contain more or less of certain nutrients, minerals, vitamins, and secondary metabolites than conventional plant products?
  2. To what extent are nutrients, minerals, vitamins, and secondary metabolites beneficial or harmful to human health?

Much of the problem with being unable to give a definite answer to the question of whether organic food is more nutrition relates to the type of research that has been conducted on the relationship between secondary metabolites and organically raised food. Most of the studies seek out theories, such as epidemiological studies that link food to health through statistics, retail food analysis, and other studies that are purely observational. Observational studies look for patterns, but they can’t prove a theory. For example, an observational study may find that people who eat oranges tend not to develop cancer but there aren’t any scientific data to prove that oranges prevent cancer. “Just because something organic is statistically different doesn’t mean it’s biologically different,” Jones said.

Below are a number of observational studies related to organic nutrition, each with promising theories:

  • Organic ketchup contains more lycopene than conventional and store brands, and fast food ketchup (Ishida and Chapman, 2009).
  • Flavanoids are significantly higher in tomatoes raised with organic practices such as crop rotation for pest control and organic matter for fertilizer, than in tomatoes raised with herbicides and pesticides and commercial fertilizer (Mitchell et al, 2007).
  • Animals fed with organic feeds have fewer stillbirths than those fed with conventional feeds (Williams, 2002; Bourn and Prescott, 2003).
  • Antioxidant compounds are higher in peaches and pears raised organically than conventionally, and vitamin E is higher in organic pears than conventional pears (Carbonaro, et al, 2002).
  • Organic food products have higher levels of vitamin C and lower levels of nitrates than conventional food products (Bourn and Prescott, 2002).

A follow-up human or animal study must be used to prove any theories found. Human studies are the most influential but are particularly difficult to do. “You can control what a rat does, but you can’t control what a human does,” Jones said. “You have to consider not only diet but lifestyle. You can’t eat organic and drink or smoke all day. … You also have to consider, with human studies, that diseases progress over a lifespan, not just one or two years.”

The Most Promising Study

By and large, the observational study most supportive of the theory that organic food is nutritionally superior to conventional foods was conducted in 2001 among Okinawans, the people living on the southern-most Japanese island of Okinawa.

“They have the longest lifespan of any group alive,” Jones said. Okinawans live to be an average of 81.2 years old, followed by the Japanese at 79.9 years, Hong Kong at 79.1 years, and Sweden at 79.0 years. The United States has the 18th longest lifespan of the world’s societies, at 76.8 years.

Okinawans also experience a delayed aging process and minimized debilitating diseases in the elder years. “These people are healthier longer than (Americans) are,” Jones said, despite U.S. medical advancements superior to that of the Okinawans. The average cholesterol level in the Okinawa centenarian is 102.4 mg/dL, and high blood pressure exists in only 1.5% of the centenarian population, she said.

There are several aspects of the Okinawan diet that differ dramatically from the Western diet. Okinawans have never developed a taste for salt, so “they don’t eat a lot of processed foods,” Jones said. Their flavonoid consumption is six times higher than the Japanese or Canadians, who are next on the list. And the Okinawan diet contains the highest lycopene content of all of the world’s diets. The Okinawan diet has since been called the Longevity Diet, because it improves physical strength, prevents illness, and maintains overall health.

“They look at medicine as food,” Jones said. “They’re really looking at food in a different manner than we do.”

Using the Okinawan study, consumers of organic foods can safely assume that, yes, organic is nutritionally superior to conventional foods, Jones said. But, she warned, this is only a guess until the research proves it so — although it’s a guess that many consumers are confident to say is truth.

Current Trends in the Organic Sector

Consumer interest in organic foods continued to grow last year. Highlights from 2008 consumer use surveys include:

  • Research from The Natural Marketing Institute reveals that consumers are increasingly incorporating organic products into their lifestyles. Total household penetration across six product categories has risen from 57% in 2006 to 59% in 2007. The research also showed that the number of core users has increased from 16% in 2006 to 18% in 2007.
  • Consumer interest in buying environmentally friendly products and organic food remains high among Northwest natural and organic product consumers despite tough economic times and rising food and energy prices. Research by Mambo Sprouts Marketing showed that consumers in Washington and Oregon see buying “green” as a priority: 92% of consumers reported buying the same (54%) or more (38%) environmentally friendly products compared to the prior six months. Rather than cutting out such products, consumers report they are using money-saving strategies, such as coupons, stocking up on sales, and cooking meals at home to stretch their grocery dollars.
  • 69% of U.S. adult consumers buy organic products at least occasionally, according to The Hartman Group report, The Many Faces of Organic 2008. Furthermore, about 28% of organic consumers (about 19% adults) are weekly organic users. Organic categories of high interest to consumers are dairy, fruit and vegetables, prepared foods, meats, breads, and juices.
  • A Harris Interactive online survey conducted for Whole Foods Market showed that, despite rising food prices, 79% of consumers do not want to compromise on food quality and 70% continue to buy the same amount of natural and organic foods. Findings also showed two out of three adults prefer to buy natural or organic products if prices are comparable to those of non-organic products. Overall, the survey found that 74% of adults purchase natural or organic foods, with 20% saying that more than one-fourth of all the groceries they buy are natural or organic. In addition, 66% of adults would like to find ways to buy natural or organic foods within their budget.

API’s Role in Shaping Parenting: Highlights from the 2009 API Think Tank Event in Nashville, TN

By Rita Brhel, managing editor and attachment parenting resource leader (API)

API's 15th AnniversaryIn an unprecedented move, Attachment Parenting International gathered eight brilliant minds in Attachment Parenting for the organization’s 15th Anniversary Celebration gathering the last weekend of August in Nashville, Tennessee, USA. Never before had all these parenting experts appeared together at an event open to the public. For the hundreds of parents, students, and professionals sitting in the seats of Belmont University’s Troutt Theatre the afternoon of Saturday, August 29, 2009, the “Making an Impact Now: Creating a Sustainable Legacy for Children” Think Tank Event proved truly to be a once-in-a-lifetime opportunity.

Moderator Lu Hanessian, author of Let the Baby Drive, founder of WYSH, host of API Live! teleseminars, and member of API’s Board of Directors, introduced the panel of speakers, each walking from behind the stage curtain to sit on chairs arranged in a semi circle under a six-foot banner proclaiming API’s anniversary theme: “Growing More Attached.” Making up the panel were:

  • Martha Sears, RN – nurse and lactation consultant, La Leche League leader, mother to eight children, co-author of 25 parenting books, and member of API’s Advisory Board and Editorial Review Board.
  • William Sears, MD – pediatrician and pediatrics professor at the University of California’s Irvine School of Medicine, father to eight children, and author or co-author to more than 40 parenting books, and member of API’s Advisory Board.
  • Ina May Gaskin, MA, CPM – midwife, founder and director of the Farm Midwifery Center in Tennessee, and author of two childbirth books.
  • Mary Ann Cahill – co-founder and former director of La Leche League International, mother of nine children, and author of a parenting book.
  • Isabelle Fox, PhD – psychotherapist, author of two parenting books, mother, and member of API’s Advisory Board.
  • James McKenna, PhD – anthropologist, professor, and director at Notre Dame University’s the Mother-Baby Behavioral Sleep Lab, author of three infant sleep books, and member of API’s Advisory Board.
  • Barbara Nicholson, MEd – founder of API, mother to four children, co-author of Attached at the Heart, and member of API’s Board of Directors, Editorial Review Board, and Research Group.
  • Lysa Parker, MS, CFLE – founder and former director of API, certified family life educator, mother to two children, co-author of Attached at the Heart, co-leader of API of Huntsville/Madison, and member of API’s Board of Directors, Editorial Review Board, and Research Group.

“This is quite an illustrious panel!” Hanessian said. Special tribute was paid to Nicholson and Parker, for “without you two ladies sitting at the table 15 years ago and commiserating about the future, we would not be here,” Hanessian said before launching into a discussion that could have easily lasted longer than the two hours allotted.

Congratulations, Barbara and Lysa!
Barbara Nicholson and Lysa Parker, API’s co-founders, were surprised during the Think Tank Event with recognition for API’s first Award  for Contribution to Parenting going to an AP-minded individual(s) who truly made a difference on parenting. The award was presented by Martha Sears and Dr. William Sears.

Said Dr. Sears of the award recipients: “There are few people – and we really know a lot of people – who I look back on and say, they really made a difference.”

Hanessian opened the Think Tank Event through a series of questions exploring the theme, “Making an Impact Now: Creating a Sustainable Legacy for Children.” To sum it up, she wondered on behalf of parents worldwide what parenting for the future means for the choices parents are making everyday in their homes?

But first, how did API come to be?

API in the Beginning

API, like any effective organization, was borne out a need: “I realized when I had my first child, how few supports there were,” Parker said.

She found new mother support in her local La Leche League, which described a different way of parenting than much of mainstream promoted – one that resonated with her sense of self and where she gravitated toward in her parenting approach. “I think that was a miracle moment for me,” Parker said.

Through the years, Parker and Nicholson saw a need for this parenting approach to get into the reach of more parents. As special education teachers, they encountered children labeled with emotional and behavioral issues and learning disabilities who were, rather, in need of connection with an adult attachment figure. “A lot of problems weren’t really a learning problem but an attachment problem,” Nicholson said.

Read the entire history of API’s founding in the special Attached at the Heart issue of The Attached Family magazine, available at www.attachmentparenting.org/attachedattheheart/journal_aath.pdf.

Ultimately, API came to be as a way to better educate and support attached families, but Attachment Parenting was around long before 15 years ago. Martha Sears and Dr. William Sears, called the Father of Attachment Parenting (AP), coined the term years before API was founded. But the parenting principles that make up AP didn’t start with the Sears.

“In my first year of practice, a wise professor said to me: Surround yourself with very wise mothers,” said Dr. Sears, who is celebrating his 40th year of pediatrics practice this year. “That was my first introduction to Attachment Parenting.”

Empowering Parents

“I worry most about the disempowerment of parents,”  said Dr. McKenna.

“We live in a culture of fear,” Hanessian agreed.

API strives to give the power of parenting back to the mother and father, so that they know how to make the best decisions for their children and family despite the sometimes ill-informed and biased advice offered not only by friends and family members but also by medical and other childcare professionals.

“Take back the power,” Parker said. “For far too long, people in the culture have dictated how we should raise our baby, how we should have our baby.”

Gaskin explained how this empowering of parents best happens when advocated for early – at birth. By choosing a midwife, new parents can ensure that the mother and baby can likely be together from labor and delivery forward. By starting as early as possible in keeping parents with their child, their parenting journey pushes forward with connection being considered “normal.”

Parents’ naturally gravitate toward connection, when not influenced by outside forces. What API advocates is for parents to follow that intuition.

“Our fourth child is the one who taught me about intuition,” three decades ago, Martha Sears said, adding that the first three babies were so-called easy babies – or, in other words as McKenna explained, this fourth child would be one of the babies who aren’t as convenient for parents as they wish they would be. This fourth baby required Martha Sears to cosleep in order for her to get some sleep. Although she was following her intuition, it was a scary time for her because the mainstream culture did not support this sleeping arrangement at all. Sears had to learn how to listen to her baby and trust her intuition despite what was popular in parenting advice at the time.

“Thirty years ago! Isn’t that unbelievable that we’re still plagued by that doubt?” Hanessian exclaimed.

What API does is to help parents realize that they are the experts in their child’s care and that, as humans, we are driven toward connection with one another, especially between parent and child. In Western culture, especially, this often means that how they feel toward childrearing doesn’t quite jive with the mainstream advice. API first empowers parents by allowing them the freedom to look beyond mainstream parenting advice to that connection-building that just feels good and right within themselves.

But the key to helping parents pursue this intuitive parenting style is showing the overwhelming research that support AP and API’s Eight Principles of Parenting. Martha Sears agreed, giving an example of the need to show parents the research discrediting cry-it-out sleep training.

Armed with research, API has helped to turn the tide. Parents are now able to find AP resources to support them in their parenting journey. Even in the mainstream culture, more and more experts are saying for parents to listen to their babies.

There are still challenges, though. Western culture is driven by a working population and both parents in most families work outside the home. Dr. Fox recalled a point in her practice when the family dynamic had noticeably changed – when parents were unable to describe the history of their child’s behavioral problems for which Fox had been called to assess and repair, even unable to provide basic childcare facts such as the child’s fears or the potty training technique used. What she found was that the children she most often saw with behavioral issues were those who did not have a consistent caregiver in the early years of life.

That’s why API is so important, Nicholson said – to get these observations, and complementary research, out to parents to show them the long-term effects of nurturing parenting.

This change in parenting practice among the mainstream culture takes time. As Dr. Sears pointed out, parents have been practicing AP for more than 40 years, and while Western culture is incorporating more AP principles into mainstream parenting advice than ever before, AP is still a long ways from widespread acceptance.

Cahill, one of seven women who co-founded La Leche League International 53 years ago, agreed that cultural change does take time. The reason is, parents want to be “good” parents and it can be difficult for a mother or father to sort through the advice they receive from literally every person they encounter, whether the pediatrician, a teacher, a clergyman, a family member or friend, or even by observing what other parents model at the park or grocery store.

“When I had my first baby, I wanted to be the best mother. I wanted to breastfeed,” Cahill said. “And I utterly failed.”

But what she came to realize is that she didn’t fail; instead, society failed her. She didn’t receive any support for breastfeeding. That’s the value of API – a source of support .

Dr. Fox agreed, saying that it’s common for parents to attend childbirth education classes but that they don’t often attend parenting classes until they have a problem they need help with. “Mothers need help with childbirth, but they also need help with [at least] the first year,” she said.

‘Good’ Parenting vs. Good Parenting

That “good” parent myth is also fueled by the voices parents hear in their heads from how their own parents had raised them, Fox said. “We hear our own parents’ voices, and we hear that parent’s voice be critical to us.” Without being aware of the power of those voices, parents will judge how “good” they are by how well they following their own parents’ paths.

“In the beginning, I had to overcome some deficits myself,” Martha Sears explained. Her mother had spanked and practiced other non-AP approaches. She struggled, like many parents must, against that voice in her head that conflicted with her intuition in terms of discipline and communication. In the end – at the point of decision making – all parents either make the choice to do what their parents did with them, or they change through education, support, and often intense emotional work.

Martha Sears said it’s important for parents to keep the future goal in mind: “Remember that you are raising someone else’s future mother or future father. It’s important to get yourself emotionally healthy, so that you can give that gift to your children that keeps on giving.”

Among API’s Eight Principles of Parenting is Preparing for Pregnancy, Birth, and Parenting. Through this principle, API is able to empower people early in their parenting journey – which ultimately makes the challenges of raising children, discipline and communication, easier in the long-term, said Martha Sears. “When you can find a solid way to connect with your children early, you have fewer problems [later],” she said.

“This organization [API] is the only one in existence, except La Leche League, where parents can learn that and that teaches this foundation of attachment,” Martha Sears said.

It can be difficult for parents to sort out their own voice from all the other voices they hear. So, how can parents sort out which voices – whether from their own parents or another outside influence, including API – aligns best with their need for connection with their child?

Today’s Western society is the only culture in history that needs to read a book to know how to parent, said Dr. McKenna. Books are wonderful, but the best teachers are other parents – those experienced in AP. Let’s look at what the expert parents said at the Think Tank Event in response to some of the most confusing areas of parenting.

Discipline

Dr. Bill Sears offered a quick reflective question he learned from his wife, Martha, that parents can ask themselves whenever encountered with a tense situation: “If I were my child, how would I want my mother or father to react?”

“Get behind the eyes of your child. Do you yell, do you spank, do you use sarcasm, do you hug? If you ask yourself that question, and answer truthfully, you’ll always get it right.”

Sleep

Someone, at some point, decided that parenting should shut off at night, said Dr. McKenna. Instead of regarding their baby’s cries as a way of communication, they regarded it a non-communicating noise that the baby makes. What makes crying irritating is when parents fail to see the value in it. A crying baby indicates a need and opportunity for attachment-building.

“Does your baby sleep through the night yet?” is among the most frequently asked questions of the newborn period and can make parents feel guilty if their baby isn’t sleeping through the night – as if they are not “good” parents, Dr. McKenna said.

“Sleep is very relational,” Dr. McKenna said. Crying is natural; it’s a sign that attachment exists, that the baby is seeking the parent out and wants the parent close. Dr. McKenna gave this sample reply for the next time someone asks whether Baby is sleeping through the night yet: “Not only does my baby not sleep through the night, he protests and cries loudly when I’m not there – and isn’t that wonderful? He knows when he’s in danger and isn’t afraid to say so!”

If mainstream society regards a baby who wakes and cries during the night as having a sleep problem, the question is why only half the babies have “sleep problems” and not the full 100 percent, Dr. McKenna said. Why  are some of the babies not crying, when crying means there is an attachment bond?

What makes nighttime parenting so difficult is because parents want their sleep and losing sleep is hard. But, “it [parenting] isn’t always going to be easy anyway, because life is like that,” Dr. McKenna said. Even the most informative, well-practiced AP parent can have difficulties in parenting – and infant sleep – if they are caring for a high-needs baby.

Dr. Sears chimed in with a story of a couple who he first saw with their newborn baby and later saw when their baby was three months old. Shorty after birth, the baby was a healthy, happy child and the parents seemed inclined to AP. But, at the three months, the baby wasn’t gaining well and had floppy muscle tone and the parents seemed disconnected.

What had changed? The parents, overwhelmed with their baby’s erratic sleep pattern, had taken a cry-it-out sleep training class. At three months, while the baby was considered “good” in that he slept through the night, the baby’s health was failing in what Dr. Sears refers to as “shut down syndrome” – the baby’s lack of emotional connection with his parents caused him to shut down mentally and physically. It’s a rather common example of the effect that non-AP sleep practices can have on children.

“Beware of baby trainers, because I can tell you, from my practice, it’s a short-term gain by a long-term loss,” Dr. Sears said.

Balance

“This [parenting] is a tough job, and there are a lot of tired moms,” Nicholson said. “What a baby needs is a happy, rested mother.”

Fathers, she said, need to give their wives and partners support – not advice – to ensure that she doesn’t get overwhelmed and is able to find balance between taking care of the child and herself.

But balance is more than self-care; it’s also about healing the emotional wounds left from their own childhoods. “You can’t value someone unless you value yourself,” Dr. McKenna said.

In Utero Bonding

Connection begins even before the baby is born. Nicholson spoke about the importance of parents learning about conscious birth, starting their parenting journey of education and smart choices early. Mothers and babies are not supposed to be separated after birth, Gaskin agreed.

Gaskin recommended that mothers take the time to revel in the baby growing inside them. She suggested mothers focus more on the baby moving and kicking than getting caught up in the technology surrounding pregnancy, such as ultrasounds which unnecessarily distracts some parents.

Consistent and Loving Care

“Babies are ingenious in figuring out who really does what for them,” said Dr. McKenna. Whether this is the mother, father, grandparent, or childcare provider, the baby’s main attachment bond will develop with the primary caregiver. “Our species would not have been successful without significant caregivers,” he added.

That’s why, “what is so important is that mothers have to be there,” said Dr. Fox, who explained that, in all families, one parent should stay at home full-time for the first few years of the child’s life. Often, this is the mother, but more and more, the father is taking on this role in many families. “Fathers can just as well stay home, too,” Dr. McKenna said.

Lately, “fathers are taking more of a role,” Gaskin agreed. “When dads aren’t afraid of babies, I think that’s something very good because that connection is likely to continue.”

Dr. McKenna mentioned the term, “tandem parenting,” in which both the mother and the father share in the care of their child to the point where both are primary attachment figures. This is a new concept, as it has long been thought that a child can only have one primary attachment figure and that the next closest relation would be a secondary attachment figure. The primary attachment preference is based on the father’s behavior toward the baby, not a biological connection.

There is great value in tandem parenting, not only in the benefit to the child who can rely on both parents and to the mother who can take a break here and there, but also to the father himself. When fathers help with their children, their hormone levels fluctuate, Dr. McKenna said. Their oxytocin levels increase and testerone decreases. It’s an actual change in biochemistry.

But, especially with the economic pressures of today’s society, many families are unable to afford one parent to stay at home, so does this mean that they can’t AP? It’s harder for dual-income parents, but certainly possible, Parker said. What they need to do is to focus on reconnecting every day once the parent comes home from work. Hanessian recommended reconnection through cosleeping. Dr. Sears mentioned nursing mothers using breast pumps to be able to continue breastfeeding after they return to work.

“My mother was a single mother juggling two jobs, and what I remember about my mother is that she did the best she could in a less-than-ideal situation,” said Dr. Sears, explaining that while it’s best that a parent is able to stay at home with the children, if it can’t happen, the focus of the parent should be on cultivating that connection as much as possible when together with the child. Children can grow up in situations that are hard but be OK because the memories they have are of happiness and togetherness and connection.

Another way for dual-income parents and single parents is by striving for one, consistent caregiver and being careful about caregiver “roulette,” in which the child’s caregiver is frequently changing. It’s extremely important that a child is able to form a strong, long-lasting primary attachment bond with a caregiver, even if not the parent, and this can only happen with one, consistent caregiver relationship in a childcare situation. Without the formation of a primary attachment bond, as in the case of a child who has many different caregivers, that child will be unable to form healthy attachments and maintain relationships.

Although there are some families who truly cannot afford to have one parent stay at home, Dr. Fox said most families, if they made it a priority, could pull the resources together to do this. More and more jobs are allowing parents to work at home, and the Internet allows parents to more easily start an at-home business, or a family financial budget can help parents adjust to the lifestyle that goes with a lower cost of living.

“You are really needed for the first two years of a baby’s life,” Dr. Fox said. “We go out to borrow money for a house or a car; think about saving that money to stay at home with your baby. It’s not that long.”

What is Good Parenting?

The goal of what mainstream culture considers “good” parenting is how to raise children that won’t embarrass the parents. What API strives to do is to support parents in raising children who grow up connected – that is who are emotionally healthy and able to form strong relationships with others, who want to make good decisions based on their own sense of self and values, and who are empathic and compassionate.

So, how do parents go about doing this?

Dr. Fox explained that AP is based on what is known as the Three Ps:

  1. Protection – that the child feels protected and cared for.
  2. Proximity – that the child is physically and emotionally close with the parent.
  3. Predictability – that the parent is consistent in childcare.

“With protection, proximity, and predictability comes a growing sense of trust and a growing sense of the world’s a pretty good place,” said Dr. Fox.

Dr. McKenna said AP is about parents being conscious of the way they are raising their children. “We tend to think of birth as Independence Day,” he said. “Not that it’s not important, but we’ve overdone it.” Parenting cannot stop at childbirth.

The emphasis placed on childbirth in society needs to spread beyond into childhood; the reason being, babies and children are always developing, always learning. For example, the tastebuds don’t form until the last few weeks of pregnancy, which is why a child tends to like the foods his mother ate during the last part of her pregnancy. And apnea-prone babies can lose up to 70% of their apnea spells by being placed next to teddy bears with a breathing motion. “Every sensory modality that baby has is being regulated by the mother [or father],” said Dr. McKenna.

Dr. Sears said AP is about getting to the basics of relationships in a culture that where the basics can easily be lost in technology. “We’re talking about a low-tech style of parenting in a high-tech world,” Dr. Sears said. He told of a woman in saw in his practice who commented that while she couldn’t afford to buy her son everything that other children had, she could afford to give her son herself.

Dr. Sears also said AP is about parents enjoying parenthood. “Revel in it,” he said.

Highlights from Responses  to Audience Questions

Q: Does AP help autistic children?

Nicholson said that in her research, AP was definitely helpful in building connection between an autistic child and his family members .

Dr. Sears said: “If you were to ask me to write a prescription, I’d write ‘Attachment Parenting,’” because autism is a disorder of the brain and Attachment Parenting directly affects the way the brain develops.

Q: How exactly do you form an attachment bond with your child?

Cahill explained that an attachment is established and maintained by the parent meeting the emotional needs of the child. “All the things you’re doing, it creates this parental antennae,” she said and that antennae – or that sense of knowing what your child needs – develops over time.

Q: How can we change the mainstream perspective on cosleeping?

“Never be afraid to say, this is what you do and that you sleep with your baby,” said Dr. McKenna. “We really need to talk, as individuals, about our choices in positive ways.”

Q: How can we deal with the criticism of babies and toddlers not sleeping through the night?

“Here’s the deal: You’re the best sleep expert in your family,” said Dr. McKenna, adding that there are a number of reasons why young children may not be sleeping through the night but the standard that they should be sleeping through the night is unfounded. Every child is different, and comparing one child to another one isn’t effective in evaluating sleep issues.

Q: What does AP look like in an older child?

“If I had to sum up the long-term effect of Attachment Parenting in one word, it would be: empathy – kids who care,” said Dr. Sears. “If I had to sum up the long-term effect of not doing Attachment Parenting: lack of empathy – kids who don’t care.”

Q: Is there an education approach that is more AP than others?

Nicholson, whose children have homeschooled and attended public school and others, said that API does not endorse any particular education option. However, there is an AP way in selection an education option: “Look at each child and see where are their interests and where are they developmentally?” And, if there is only one option and it doesn’t seem to be a good fit for your child, communicate that you share in her frustration and work to problem-solve to make the situation more ideal.

Bonding Begins in Utero…for Fathers, Too

By Rita Brhel, managing editor and attachment parenting resource leader (API)

Fathers bonding in uteroPregnancy is an amazing time of bonding between a mother and her baby, especially during a first pregnancy. There is no way to describe what hearing the heartbeat or feeling a movement for the first time feels like. Watching her belly grow and grow, the months pass by, perhaps an ultrasound or two giving a glimpse into the womb, and then the transformative power of labor and childbirth – pregnancy is an amazing journey for a new mother.

And for a new father, as he watches his unborn child’s mother’s belly grow, places his hand on her belly, and gets to feel a kick here and there. Childbirth is just as transformative for the father. At one moment, the baby is little more than a dream and, the next, the baby is here! Birth is a joyful event, but it can also be confusing for a new father. He doesn’t have the hormonal drive to attach to the new baby like the mother has, and with so much of the mother’s time wrapped up with caring for the baby, the father can feel a little lost in his role at first.

There are a number of ways fathers can connect with the new baby after birth. What works in a lot of families is asking the father to take on a certain baby care task, such as giving baths, supporting the breastfeeding mother, or filling bottles. But, even then, it can take a while for the father to feel a special connection with this new family member who, at first, only seems to take more and more energy and time without giving much in return.

Fathers who concentrate on bonding with their baby in utero may be able to make the adjustment to fatherhood after the baby’s birth a little easier. Here are a few tips for fathers: Continue reading