If you haven’t seen the May 21, 2012, cover of Time Magazine, take a look. Standing on a short chair is a young boy who looks like he could be 4 years old (he is alleged to be younger) suckling his mother’s left breast. She is a willowy blond who looks as though she is on a short break from a fashion magazine shoot. Regardless of your perspective, it is a striking image.
The cover story, "Are You Mom Enough?" addresses the phenomenon known variously as "attachment parenting" or "extreme mothering." If you practice in or around San Francisco, you are probably painfully aware of this trend. However, if your office is in Topeka you may not have dealt with a family who is practicing full contact attachment parenting ... yet. But I am sure you have dealt with parents whose style of parenting doesn’t quite sync with your own. How should a pediatrician deal with these discrepancies?
There has been a lot written and said about how pediatricians deal with the parents who choose to delay or decline immunizations. But when the differences in parenting style appear to lack the gravity of immunization choice, is this just a matter of different strokes for different folks? Should we maintain a professional silence and be content with sharing (HIPAA compliant, of course) anonymous anecdotes with our spouses? Or should we speak up and tactfully present an alternate strategy for parenting in a specific situation even though we may not have been asked for an opinion on the subject?
As the years have rolled by, I have broadened my view of how parenting should happen. Watching my brother-in-law and his wife raise their four children has been part of this education. Their decisions on activities, time management, and toy selection have been significantly different from those my wife and I had made. None of their decisions placed my nieces and nephews in danger, but they just weren’t the ones I would have made. Occasionally, when I was asked for an opinion, I would decline to offer one because they had already embarked on a path so different from the one I would have suggested that turning the ship around would have been difficult, if not impossible. The bottom line is that 20 years later, their children are growing into productive and considerate adults that I am proud to claim as nieces and nephews.
Although in general my views on parenting style have softened, there are some areas that have hardened. And some of these put me in conflict with attachment parenting advocates. I will admit that at some level seeing a 2½-year-old nursing makes me feel uncomfortable. But if that works for that family, I can accept it. The problem is that for every mother who can successfully allow nursing to occupy such a large chunk of her life, there are scores who have spent 1 or 2 years of their lives dangerously sleep deprived.
There are too many benefits of breastfeeding to include in this 500-word column. But mothers must not become human pacifiers. It may have worked when we were hunter-gatherers. But most families today can’t afford the flexibility that would allow a mother to be available to nurse her baby to sleep whenever the child is tired. In our society, when a mother’s breast becomes the primary comfort and sleep aid, something has to give and it is usually the mother’s sleep needs. Sleep-deprived mothers are usually not happy people. The evidence is mounting on the toll that depression takes on the health of the entire family.
So I continue to gently coach new mothers to try strategies that will allow them and their babies to enjoy the benefits of breastfeeding, and avoid the traps that can make parenting less enjoyable and effective.
Dr. Wilkoff practices general pediatrics in a multispecialty group practice in Brunswick, Maine. E-mail him at pdnews@elsevier.com.