"Crying It Out": Acceptable -- or Abuse?

One of the most primitive, innate reactions any mom has is to comfort her crying child. But as we've talked about here before, many babies can tolerate -- and thrive -- with some crying, when their parents thoughtfully decide why and when that might be necessary.

That's why articles like this leave me mystified -- especially when they come from one of my shrink colleagues.  Her bottom line is that CIO is dangerous. She trots out all the old arguments, hailing the Dr. Sears "science" behind her claims, and providing one of the most common misinterpretations of infant research. She makes the mistake that clinical research findings about abused and maltreated babies -- babies who were pervasively denied their needs over the long-term -- should be applied to NORMAL babies in NORMAL families.

The fact is, there is no evidence whatsoever that occasional CIO in typically developing babies causes any damage. PERIOD.

More importantly, there IS evidence that severely sleep-deprived mothers are at much higher risk of developing an already common --and dangerous -- condition: postpartum depression. And PPD certainly CAN lead to long-term damage to both baby -- and the entire family. CIO is a method that, when implemented thoughtfully, can often lead to improved sleep (and health and happiness) for everyone.

Firebombs like those thrown in the Psychology Today article only make the burden heavier on moms. What a shame.

Aloha as always,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

PS: Wow, what a response! After commenting here, please also see the comments developing over at the Fussy Baby Site.

Sudden Fears in 12 to 15-Month-Old Babies

Let me tell you about a cool conversation I had the other day with my Infant Research/Rock Star Guru, Professor Joseph Campos (at UC Berkeley).  He helped me understand more about a funky phenomenon I've written about here before: The Weird, Wacky, Sudden Fears of the 12 -- 15-month old. You know: Crazy fears of the bath, bizarre fears of mustached men, and other kooky things like Fear of Flowers (I kid you not -- I've heard 'em all -- many from my own kids). As I've said before, these sudden fears are NORMAL -- but now I understand a little more about WHY.

It's a combination of what I've already written about here -- adjusting to the exciting (and scary) new world of mobility, as well as an inborn fear of sudden, unexpected unfamiliarity. Babies this age tend to freak when they see something that looks out of place -- a man with facial hair (if they're used to clean-shaven guys), dogs that suddenly bark loudly, or things that move in unexpected, uncontrollable directions (like flowers in the breeze). Turns out that adult chimpanzees also have similar fears. Interestingly, our toddlers grow out of these fears -- chimps do not. Rapidly developing baby brains are starting to compare "familiar" to "unfamiliar". It's likely protective -- which is especially needed now that the baby is toddling around, away from parents.

Sudden baby fears are also related to a similar parent frustration at this age: Resistance to car seats, strollers, changing tables, high chairs, or any similar baby-jail. Why? Because they remove the element of control from your little one -- and CONTROL is what helps to decrease baby's fears.

So here's how to cope with those intense and sometimes inexplicable fears in your young toddler: Give her as much control as possible (given safety factors, and of course your need to do other stuff, too.) Fear of the unknown and unexpected is always best soothed with CONTROL. Let baby approach (or avoid) fascinating/scary things (or people) at her own pace. Explain to her when it's time to get into the car seat -- and let her try to negotiate herself into it, if possible. (She just might do it, if you give her a minute to think it through.) Take the pressure off if she's feeling shy or fearful. And most of all: DON'T WORRY. Weird toddler fears mean nothing about future psychological adjustment (and the more YOU freak out about her fears, the more SHE'LL freak out about them.)

But on the flip side: If baby needs to get into the car seat NOW, or if she MUST have a bath tonight -- that's OK, too. Explain it to her. "I know you don't want a bath, but you have enchiladas in your hair, honey. I promise to make this as fast as possible, then we'll be all done." Be supportive and understanding -- but shampoo away. You won't do any psychological harm. The trick is to give her the general message that, WHEN POSSIBLE, you'll give her as much control as you can. But sometimes the grown-ups have to be in charge (and that's a good lesson, too).

The good news is this: These fears almost always dissipate by 18 months of age. (Then you'll be on to bigger and better things -- like Full On Temper Tantrums.) Whee!

Aloha,

Dr. Heather The BabyShrink Mom of Four and Parenting Expert

Breastfeeding & Bottle Feeding: Dealing With A "Bottle Strike" By Your Baby

A common parenting problem: The Baby Refuses a Bottle -- And Mom Works (or otherwise can't always be with the baby). Here are some tips: Prevention and Practice. If you expect her to take a bottle intermittently, you've got to keep up the practice. Have her take a bottle at least every 1-2 days -- even if Mom will be with her -- to keep up her familiarity with it (and prevent problems when you DO need to leave her). I can't emphasize this enough. DON'T PANIC. I know Baby is hungry and fussy, but this too shall pass. The more stressed out you are about it, the more the problem will be reinforced. Stay calm, keep trying, and Baby will eventually accept the bottle again. In the meantime, arrange your schedule so you can nurse, but keep trying with the bottle. Often, Dads, sitters and grandmas have better luck with the bottle than Mom will. We Moms often have trouble trusting that anyone might possibly substitute for us, but this is a sure sign it's time to let go. Offer a bottle to Baby when she's asleep. She's more likely to accept the bottle when drowsy or sleeping. Experiment with different bottles and nipples, but don't blow Baby's college savings on this technique. It often doesn't work -- but worth a try. Babies who refuse one nipple will often accept the same one just a few hours or days later. Don't try to "force feed" in any way. This will start a struggle that you can't win. Offer -- repeatedly -- over different times of the day, different temperatures, and by different people. If she refuses -- immediately take it away for at least a couple of hours -- and don't get aggravated. She'll pick up on your frustration, and a negative cycle will begin. Have Dad, Grandma, Sitter, or Sibling offer the bottle when Mom is COMPLETELY OUT OF THE HOUSE. Babies smell Mom, and will wait her out if they sense she's nearby! And of course, make sure there's no thrush, teething pain, tummy trouble, allergies, or other medical problem interfering. "Bottle Strikes" (or their cousin, the "Nursing Strike") are very common. Just when you're sure Baby will never take the bottle again (or nurse again), you're likely to be surprised. Hang in there!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Child Development: Why Your 9-Month-Old Baby Is So Difficult All Of A Sudden

I had an amazing conversation with one of the world's foremost infant researchers last week, Dr. Joseph Campos. He's at Berkeley, where he's churned out tons of scientifically rigorous studies about the developmental changes in infancy. He's come up with some transformative ideas about babies, the upshot of one being that crawling causes your baby to become your little social partner, for the first time. No longer just a passive lump in the social world, now she's able to start to understand some of what's going on inside your mind. She understands how important you are to her, and seeks your emotional support, presence and encouragement as she starts to scoot out into the world under her own power. She now gets reassurance from your presence and your emotions -- your facial expressions and body language -- not just from physically holding her. Super Cute, and Super Challenging

The flip side of this is that it also causes clinginess, fussiness, and sleep problems -- some of the major complaints of parents at this stage. Turns out, crawling out into the wide world is fascinating -- and terrifying. Your little adventurer gets it now -- that as much as she wants to venture out on her own, she desperately needs you, and is panicked that she'll lose you somewhere along the way. As Dr. Campos said to me, the baby's drive for independence is equally matched by her fear of it.

So to you fellow parents of 9 to 12-month-old babies out there: I know it can be a challenging, difficult stage. Your little bug seems content to scramble around the house one minute, then wails in panic the next. What used to be stable sleep habits are now in a shambles. Feeding --and nursing -- has become an unpredictable struggle -- and separations are exceptionally difficult. And forget diaper changes! What a wrestling match! Immmobility is the enemy to her now -- being restrained in any way is bound to be a fight. High chairs, strollers and car seats are demon baby torture devices. They keep her from exploring her brave new world.

What to do? Re-think your daily tasks with this knowledge in mind. Everything will take a little longer, as your baby goes through this unpredictable (but temporary) stage. Some days she may need you constantly. But don't worry -- when you've finally reached the end of your rope with your little Clingon, she'll start to feel "refueled", and venture out again -- allowing you to catch up on that laundry and email. And make sure you get some help with nighttime wakenings -- you'll need extra rest too, since you're up again with a fussy baby -- but don't forget to reinforce the sleep routines that have worked well in the past. She'll eventually remember what her job is, at night -- and now that her memory is better, she can hold on to her internal image of you a bit longer, giving her some comfort, despite being away from you to sleep. Feel some reassurance knowing that the earlier -- and stronger -- your baby shows separation anxiety, the sooner it resolves. Lots of parental support and understanding help her get through this challenging -- but remarkable -- stage.

Dr. Campos was generous and encouraging in my BabyShrink book-writing project, and I had a blast geeking out with him, picking his brain about the amazing new developmental capacities in normal 9-month-old babies. What a great experience! Now, please excuse me -- I've got a 9-month-old baby clinging to my leg.

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Sleep & Nap Issues: Got a New Baby? How to Manage The Sleep Deprivation

Boy, am I tired. You'd think I'd get used to the lack of sleep by now -- this is our fourth child, after all. But the crushing effects of sleep deprivation continue to be the hardest part of parenting, for me. I could change diapers and nurse and even chase toddlers all day long, if I could just GET SOME SLEEP. But this baby is just like her siblings, and she sleeps sporadically at best. At 4 months of age, she sometimes awakens once or twice at night -- but more often three or four times -- to nurse and be comforted. I've got 3 other kids, a day job, and you, dear reader, to keep me more than busy. I'm tired. IMG00341

When I had our first child, I had secret visions of the wonderful sleep-inducer that I'd be. "Babies need sleep, and so do parents. I'll get the baby to sleep." Somehow, I thought I could use my super-shrink powers to calm, soothe, or hypnotize her to sleep.

I was wrong. Our first didn't sleep reliably through the night until she was four. FOUR!

Since psych grad school, oddly, is completely unhelpful in the preparation for parenthood, I sought out and read every single "Baby Sleep" book out there. All the major titles. I tried everything, religiously. Didn't work.

And in the process, I got more and more sleep deprived myself.

There's not much recognition out there that parents' sleep deprivation often goes on for a really long time, and despite how difficult that is, it's actually quite normal and typical for a baby to be up a lot at night for several months, and even beyond. I was doing some research for this post and I found something really annoying -- most articles only address the FIRST MONTH of how to survive with a newborn. The implication is that things really improve in the sleep department after that first month of your baby's life. AS IF! In the first month, you're getting by on adrenaline, grandma's help, and that extra sympathy and interest everyone still has in the new baby. It actually gets WORSE after that first month; you lose most of those extra perks, the baby STILL doesn't sleep very well, and you're slowly but surely losing your mind from the accumulated lack of sleep.

And of course there ARE some babies who sleep beautifully from very early on. (But parents of THOSE babies aren't reading this post, are they?) It makes those of us with crummy sleepers feel there must be something wrong with my baby; or, there must be something wrong with my parenting. The urge to compare our babies to other babies is just too tempting. Not recommended, but hard to avoid.

When Your Baby Starts to Sleep Better...and then Regresses It's also easy to worry that "something is wrong" when your baby seems to be sleeping better....then all of a sudden is back to waking several times a night. Please know that regression is normal in many developmental areas, especially in early childhood. Sleep is no exception. My second-born slept a good NINE hour stretch from the age of 9 weeks until the age of five months. Then he started trying to roll over, and he roused himself several times a night with his new-found pursuit. After prematurely congratulating myself that we finally had a decent little sleeper, I just about lost it when he regressed back to waking several times each night again. Just as you get used to being up all night with a newborn, you also quickly get used to regular sleep again. And when your baby regresses and you have to go BACK AGAIN to being up and down all night, it somehow feels WORSE than when you were used to it before. "Of Course, MY Baby Sleeps Through the Night!" Another thing that happens is that we compare our experiences to other parents'. That's a mistake, because PARENTS LIE. Not all parents, but enough of them DO get caught up in the game of comparing kids that you end up getting some pretty skewed information. And for some reason, the misinformation also comes from other parenting "resources", which are often misleading. Even most pediatricians have little sympathy for our sleep deprivation. After all, most of these doctors take overnight call and had to be awake for their residency training for a couple of days at a time for years, so sleep deprivation is a relative term for them. And when your pediatrician says you can expect your baby to "sleep through the night" at 12 weeks of age, guess what she means? Sleeping a 6-hour stretch (sometimes, at least), is considered "normal". But in my book, that's not sleeping through the night, especially when most babies that age want to go down for the night at around 7 or 8 pm. By the time YOU get to bed, the nighttime rounds are just beginning.

The WORST advice you get is to "sleep when the baby sleeps". Well, DUH. But it's not that easy, is it? Babies' sleep cycles can sometimes be so unpredictable that they have their best stretch of sleep smack in the middle of the day, when you need to shop, cook, do stuff with your other kids, and otherwise live your life. Waking up every hour or two in the middle of the night is often more the reality for many young babies.

And I don't know about you, but it's impossible for me to sleep "on command". OK, baby's asleep now, ready, get set...SLEEP! It doesn't happen that way, does it? There are biochemical reasons for that. Once we're awake for far too long, or we're awakened one too many times at night, our bodies start to produce hormones to keep us awake. That's when you get that hyper, wired, "I-know-I-should-be-sleepy-but-I'm-wide-awake!" feeling at 3 am.

You might think that I'm going to give you some fabulous secrets for getting your baby to sleep. Sorry, folks -- sleep is one of the things you can't "make" your child do -- along with other bodily functions like eating and pooping. And if I had found the holy grail of making a baby sleep through the night, I would be a very rich Baby Shrink indeed. The truth is, nobody's done that. But I have come up with some tips, over the years, from both my experience as a shrink and as a mom, for how to SURVIVE the sleep deprivation that most of us experience with babies:

How to Survive Baby-Induced Sleep-Deprivation In order to be safe behind the wheel of a car and to keep your body (and mind) relatively healthy, you MUST get at least adequate sleep a couple of times a week. Consider this a Doctor's Order: GET HELP so that you can at least 1) sleep in at least 2 mornings a week, complete with eye shade and ear plugs so that you don't feel like you're "listening" for the baby, and 2) get at least a 90 minute break most afternoons when you can lie down and rest (and hopefully sleep). If you're a first-timer, it might not be easy to trust anybody to care for your Babe, even if you're eyes are crossing from lack of sleep. But you MUST force yourself allow a trusted person to help you. Not easy to arrange? I know. Essential for your health and well-being? YES.

Get some exercise -- preferably outside -- for at least a few minutes each day. I know it feels impossible when you're wiped out, but there really is a magical effect in taking even a few minutes' brisk walk. Getting outside in the sun will also help to re-set your circadian rhythms, which are being hammered by your 24/7 schedule. I promise, you'll feel better. You might also be able to sleep better when you get an opportunity later on.

Learn meditation and breathing techniques to calm the stress hormones that keep you awake when you should be sleeping. Any "mindfulness", prayer, yoga, or other meditative technique that focuses on breathing will work. If you feel hyper and over-tired, even TEN SECONDS of mindful breathing will help you slow down and feel better. But do strive for 15 minutes a day in order to get your stress hormones under control. This will help you to sleep better when you DO have a chance.

Don't obsess over how little sleep you're getting. Believe me, I've been there -- staring at the digital numbers on my bedside clock, getting madder by the minute about yet another night of lousy sleep, up and down with the baby. The less sleep you get, the more upset you become, and a vicious cycle begins. Don't obsess about it. Let it go. Tell yourself: Oh well, another late night. This is something I can look back on later in life and laugh about. I know I feel beyond exhausted right now, but this too will pass. And if you can't sleep, then read or watch TV. Just give yourself a break about it.

Don't compare the amount of sleep you're getting now to how much sleep you USED to get or need. I know you used to sleep in until noon, and you couldn't function with less than 8 hours before this, yadda yadda. But your body has changed -- you're a parent now, and things ARE different. Yes, your body needs sleep, but you're also pretty good at adapting to less sleep -- at least for the short term. It feels impossible to "roll with it", but that's what you've got to do.

Don't be afraid of the "Cry It Out" method for your baby -- once she's old enough. I think you can safely start that at about 9 months of age for most babies -- after they have sufficiently developed the memory skills to remember that you'll be coming back eventually, despite being left to cry (and sleep). Before then, you can (of course, with your pediatrician's blessing), allow baby to fuss, grunt and make noise before rushing to get her; many babies are NOISY sleepers (another reason for them to sleep in their own rooms), and don't actually need to be picked up. Try to learn the difference between "grunty-noisy-baby-sleep" noises and actual "come feed or comfort me" noises.

And finally, try to adopt a bit of a Zen attitude about all of this. Because your crushing sense of exhaustion will quickly dissipate one day, sooner or later, as your baby naturally develops a better capacity to sleep at night. Then you'll be on to the next parenting challenge. So pace yourself. Our oldest is almost 9 and I still almost cry in relief as I check in on her, in a deep sleep, late at night. How can they grow this fast? (Cue the music to "Sunrise, Sunset".) Is this the baby that so challenged my sense of order in the world, simply because she wasn't a great sleeper for the first few years of her life? And here she is, a beautiful, intelligent, happy third grader, reliably sleeping from 8 pm to 7 am every day. Development is a magical thing, people. We parents can only provide love, structure, safety, support and guidance to shape these fabulous creatures that are our children, while the amazing processes of "growing up" happen before our (sleep deprived) eyes. We can't "make" them sleep, but we can't "make" them roll over, sit, stand, speak, and run, either. So step back for a minute to bask in the miraculous glow of your child's growth and development. It's a beautiful thing! I hope this helped. And now, please excuse me while I try to get some sleep!

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Here's another post on babies and the normal range of their sleep patterns.

Attachment Parenting: More Discussion On Its Pros And Cons

There's an interesting discussion that's taking place on several sites simultaneously, and rather than responding to comments down below one of my more recent Attachment Parenting posts, I thought I'd highlight the discussion here, since lots of us are interested. Many of us are confused when we read parenting advice by "gurus" like Dr. Sears (who coined the term "Attachment Parenting"), because it makes us wonder whether we're doing a terrible disservice to our children if we use some form of "Cry It Out", DON'T co-sleep, engage in "babywearing", or do "extended breastfeeding". Poor Susanna came over to BabyShrink, after feeling scolded by AP proponents when she tried the "Cry It Out" (CIO) approach in a desperate attempt to get her son to sleep. We've continued to discuss the issues, with Annie at PhDinParenting bravely supporting her beliefs here, and elsewhere.

Annie left a link on a fascinating, very thorough anthropological review article looking at aspects of "natural parenting" worldwide. If you've got the time to read through the 82 page document -- go for it. Seriously, it's extremely interesting. I certainly find very little to quarrel with in the report. Perhaps Annie doesn't realize it, but here at BabyShrink we agree that responsive, "tuned-in" parenting is crucial in child development, and that physical -- and emotional -- contact, and very involved care, is an essential component in the ultimate well-being of a child. And that the lessons learned from in-depth study of attachment -- via well-accepted research -- informs our approach and intentions.

But the research review that Annie showed us mainly focuses on the young infants we ALL agree need to have close, physical contact and deeply involved parenting. It doesn't extend much to a discussion of toddlers and preschoolers, which is the group most often asked about at BabyShrink. It also doesn't tell us that the "Attachment Parenting" approach is somehow BETTER than the "Good Enough" parenting we strive for.

My beef is with those who take excellent research, and make unwarranted generalizations about it. The research shows us that excessive crying and non-responsive parenting is bad for the development of babies. --Well, duh. The research does NOT say, for instance, that a certain amount of crying, in the service of getting an older baby or toddler to sleep through the night, in their crib -- is a bad thing.

The bottom line here is that I'm against any sort of "holier than thou" parenting approach that doesn't respect individual differences in babies' temperaments and family circumstances. Good Enough is GOOD ENOUGH -- and there's research to support THAT. You don't have to be a perfect parent, and in fact in trying, you can make everyone nuts. There are far too many parents out there on "information overload", worried that they are daily making bad decisions for their kids, and in the process, not learning to trust their own best instincts as parents. You know your child best. I've always said to take what I say, or what any "expert" advises, with a grain of salt. Take what makes sense, leave the rest, and improvise from there.

Do I think Attachment Parenting can be applied with excellent results? Of course. Are there AP parents who are doing a fantastic job? Absolutely. But there is a vocal AP minority who insist on spreading the "gospel" to those of us who don't appreciate the prosteletyzing -- and whose children are turning out pretty great, thank you very much.

FOR MORE OF DR. HEATHER'S THOUGHTS ON ATTACHMENT PARENTING, SEE THIS POST, AND THIS ONE TOO. IT'S BECOME A HEATED TOPIC!

Dr. Heather The BabyShrink Mom of Four, Parenting Expert

Attachment Parenting: Is It Bad for the Child?

Dear Dr. Heather, Does breastfeeding past 2 years of age encourage dependency? I know a child who is still breastfeeding and has become very whiny and attached to her mother. The mother is making no effort to wean the child. Is this type of emotional attachment healthy for the child? She still wakes up to nurse during the night and sleeps in the parent’s bed.

Thanks,

Concerned about a child

Dear "Concerned",

This is a polarizing issue that tends to bring out strong opinions. There is a community that promotes an approach called "Attachment Parenting", based on the work of well-known pediatrician and author William Sears, MD, and one of they key tenets of this approach says that "extended breastfeeding" (past the age of two years) is recommended and important to the development of a child to promote a solid sense of safety and security. However, their key tenets are only based loosely on well-known child development research, and Attachment Parenting certainly has it's critics.

One of the things I do like about Attachment Parenting (AP) is it's understanding of the cultural differences that exist in families around the world, and the promotion of various ways of raising a family that can resonate more fully with various non-Western cultures. For instance, many Asians traditionally -- and happily -- share a family bed, or a family bedroom, as is suggested by AP. I also like the fact that AP promotes the reliance on the family's own resources to know what is best for their children; we don't have to rely on outside "experts" for everything. AP is also well-known for it's insistence that the attachment between infant and mother is essential to the development of a healthy baby, both physically and emotionally. That message sometimes gets lost, or diluted, in Western cultures.

The problem I have with AP is that it's adherents often tend to be quite orthodox in their beliefs. I myself have been sternly lectured for simply using a stroller (as opposed to "baby-wearing", another AP belief), as well as for using a bottle to feed my baby in public. Of course, this is the opposite of the intolerant demagogues who criticize breastfeeding in public -- it's their shared judgmental strictness that bothers me most.

The other concern I have is that it takes a blanket, "one-size-fits-all" approach to all children. Some babies don't want to be held all the time. Some babies need time without physical contact to "decompress" from all that physical stimulation. Some babies don't do well breastfeeding either, and many babies sleep better when they're not disturbed by the direct physical contact of their parents. And your approach to raising your babies has to be dependent, at least partially, on the unique constitution of those babies. You've seen me write about sensory differences here at BabyShrink, and I know far too many babies who have these quirks and preferences to be comfortable giving a blanket statement about "baby-wearing", breastfeeding, or co-sleeping. In our family, only 1 of our 3 children enjoyed being held all the time; the other two needed "time-outs" from direct physical contact in order to look around and "process" all of that physical contact. They (and I) both felt better for a little break now and again, and I used bouncy seats, strollers and cribs regularly for these breaks. It simply isn't fair to criticize parents who accurately judge the needs of their babies to include a little "down time", or to make them afraid that they risk their child's optimal development if they use a stroller or have their crib in their own room.

If you've read other BabyShrink posts, you won't be surprised to hear me say that I strongly support the uniqueness of each individual family to best decide the individual needs of each of their unique babies. And to that end, I say that if it works for a family to have a family bed, or for mom to breastfeed for over two years, I'm not going to criticize that. However, I have met many families who suffer negative consequences of making those decisions, but stick with them in the false belief that it's what's best for their children. Often, an AP family will come to see me for a problem related to the development of their toddler. When I start to gather more information, guess what? Mom is exhausted, usually because she has been unable to sleep through the night since the day her baby was born; she's often still nursing several times a night. And her husband is grumpy because he can't get any "alone time" with his wife, and he's sick of being kicked through the night by a toddler who gets bigger by the day. So mom is beyond exhausted, dad is frustrated and distant, and the toddler becomes the focus of the problem. Everyone suffers in this scenario. In this situation, my advice often includes the suggestion to transition the toddler into his own bed, in his own room, to restore some balance in the lives of the couple. The relationship needs attention, too! If the parents don't have a strong relationship, the development of the child will surely suffer. And if the child needs to sleep in his own bed, and be weaned from breastfeeding, that is a small price to pay if it serves the purpose of bringing the parents back into a more harmonious relationship.

So, "Concerned" reader, I can't say that "extended breastfeeding" will hurt the development of the child, without knowing all the other factors in the family. It remains the responsibility of the family to determine what's best for them -- and for their child. But I certainly don't promote Attachment Parenting as the "be-all, end-all" guide to what's best for your child. Only you can decide that!

Aloha, Dr. Heather The BabyShrink Mom of Four, Parenting Expert AND MAKE SURE YOU CHECK OUT THE COMMENTS TO THIS POST FOR AN EXTENDED, INTERESTING DISCUSSION AMONG READERS!

AND DON'T MISS ANOTHER ONE OF MY ATTACHMENT PARENTING POSTS HERE PLUS THIS POST AS WELL -- IT'S BECOME A POPULAR TOPIC!!

Breastfeeding & Bottle Feeding: The “Good-Enough Mother”: Are Breasts Required?

Dear BabyShrink,

I fully intended on breastfeeding my first baby. But after trying hard for six weeks, we had to give up. We had 3 lactation specialists, moms, friends, and my doctor helping. But my baby was not gaining weight and crying all the time. I just never made more than a half-ounce of milk at a time, despite pumping and nursing all day (and night). But the specialists all told me to keep trying. That eventually, I would make more milk. I never did, and I could not stand to know that she was hungry. I had to feed her!

Feeding my baby formula felt like a failure as a mom. But she is developing into a wonderful and healthy little girl. Now that I am expecting my second baby, I still think back to that time and I worry about it. It makes me so depressed that I still get teary-eyed every time I think of trying to nurse again. All my friends and my sister were able to nurse. Why not me? People are urging me to try it, but I just can’t go through that again. I was so stressed out at a time I wanted to be enjoying my new baby. Now I will have a toddler to care for as well.

How do I handle this? Any thoughts are appreciated.

Sign me,

Anonymous in Atlanta

Dear, Dear Anonymous Mom,

I asked you if I could post this letter because so many moms out there are experiencing this same thing right now. Terrible guilt and angst because of being unable (or unwilling, for what can be excellent reasons) to breastfeed their babies. Let me say this immediately: as a psychologist, I want you to be as happy and stress-free as possible during the early months with your baby. Your baby’s development and happiness depends very much on YOUR emotional state at that crucial time. If breastfeeding is causing you too much strain and guilt…it’s just not worth it.

OK, I said it! Let the breastfeeding police come and take me away. But it has to be said.

Some of you are about to get angry at me. So before that happens, let me state a few things as fact:

Breastmilk has absolute advantages, nutritionally, over formula

Nursing has been shown to be beneficial in many ways, to both mother and baby

I support the ability of Moms to nurse their kids anywhere at any time

I nursed our four kids

But the pressure to breastfeed can be harmful to many Moms. It’s hurting some of you (and by extension, your babies). While I accept the fact that some Moms simply may not understand the benefits and simplicity of breastfeeding, and I do wish more Moms would at least try it out, I don’t accept the patronizing (matronizing?) attitude that often goes along with judging Moms for their choice not to nurse…or their physical inability to do so.

As a licensed psychologist, I also see many Moms who feel inadequate, uncertain, and self-critical because of society’s pressure to breastfeed. They in turn transmit those feelings to their babies.

Although we are told that virtually all mothers can (and should) nurse their babies, consider the following real-life examples of Moms who simply can’t breastfeed: The Moms who, like Anonymous above, went through several lactation specialists, medications, and weeks of stress, only to find her breasts simply won’t produce milk (and her baby wasn’t gaining weight)

The Moms who need to take medicine for postpartum depression (or other life-threatening illness) and want to protect their babies from the medication

The Moms who have no breasts, or inadequate breast tissue, either because of an accident, illness, surgery or congenital condition

These are cases where Moms CANNOT breastfeed. Yet in each case, these Moms are criticized and judged by others who have the nerve to ask them, “Why aren’t you breastfeeding?”

But I must maintain that there are also situations where Moms CHOOSE NOT to breastfeed, and that choice must be respected. Who are we to judge the choices other parents make about feeding their babies? Who are we to impose our decisions on them?

I would rather see a happy mom and baby with a bottle of formula than a stressed out mom (and baby) struggling through nursing. To me, the most important thing is that Mom feels comfortable in her decisions as a parent. If Mom is happy, everyone’s happy. I actually stole the term "Good Enough Mother" from one of my shrink heroes, Dr. Donald Winnicott. He was the first to say, "back in the day", that you should not strive to be a perfect parent....just a good enough parent. If you want to get the scoop on him, read more here. (It's a little technical, but if you're into psychology, Winnicott is a classic.)

And it extends to the “I’m a better parent than you” kind of competitiveness that continues beyond the baby stage. Who’s toddler is smarter/cuter/faster/going to the “better” preschool? Who is watching the least TV? Who has the better diet?

Our expectations of being “Good Enough” mothers have gotten completely out of whack. And the very strong pressure to breastfeed our babies does not help.

Again, this is all about expectations. It’s important for parents to have realistic expectations of their parenting. Parenting decisions have to be made with the best interests of both parent and child in mind. Breast or bottle? Your choice is best.

If you're struggling with this issue and want to talk personally with me about it, I'd love to help you. Hit the "Parent Coaching" button, or email me at BabyShrink@gmail.com to arrange a Skype, phone, or in-person appointment.

Aloha,

Dr. Heather The BabyShrink Mom of Four, Parenting Expert