The Universal Needs of Early Childhood
How do we show our kids they matter?
I am not sure we need science to tell us this, but the science is clear, early childhood is a tremendously important time of life. The quality of interactions with caring adults and the environment shape cognitive and emotional development throughout life. From birth to age three, a young child’s brain is making at least one million synapses (connections between nerve cells) per second. Engaged caretaking at this time creates the fertile ground for human flourishing. We intuitively know some traumatic events (family violence, neglect, poverty, separation from a caregiver, etc.) have long-term impacts and try to avoid them. However, there are other parenting practices that are more common and culturally encouraged that run counter to our biology and the care our children evolved to receive.
Similar to maternal needs during the postpartum period, which we discussed last week, there are specific aspects of care that young children need to thrive. Dr. Darcia Narvaez identified these cross-cultural needs by studying small band hunter-gatherers, whose living conditions are the closest to those under which our bodies evolved. I first learned of these needs in the book The Myth of Normal, by Gabor Mate (which I highly recommend by the way).
The following are the seven universal needs of the young child:
Soothing perinatal experience
Prompt responsiveness to the needs of the infant and prevention of distress
Extensive touch and constant physical presence, including touch with movement
Frequent, infant-initiated breastfeeding for two to five years
A community of multiple, warm, responsive adult caregivers
A climate of positive social support for mother and infant
Creative free play in nature with multi-aged mates
Anyone who has ever been pregnant knows, there is more that you cannot control than you can control regarding how much stress you experience during pregnancy and birth. For example, I suspect that the physiologic stress of working several strings of night shifts in early pregnancy contributed to one of my miscarriages. The research backs this up. Likewise, I have no idea what the impact of climbing up on the bed to put someone’s dislocated hip back in place while pregnant or the impact of a high-stress delivery of someone else’s baby while pregnant is on the hormonal environment of a fetus. Short of quitting my job, these are unavoidable stresses. I’m sure most other pregnant people have their own stories of family, financial, or health stresses, not to mention those who were pregnant during COVID or other health crises, are refugees, or pregnant during war. Certainly manage or avoid stress to the extent that you can in pregnancy. On the other hand, trying to control things you cannot control is a recipe for more stress.
Dr. Narvaez advocates for a naturalistic birth in a birthing center. The smells, lighting, and sounds of the hospital environment definitely don’t bear much resemblance to the natural environment where our forebears gave birth. On the other hand, the death of the mother and baby were ever-present concerns, so one wonders if there can ever be a best of both worlds approach. If a birth center is where you feel relaxed and safe, I think it is a reasonable decision. The data about whether birth center birth is comparably safe to hospital birth (at least in the US) remains controversial. However, the data that hospitals perform more unnecessary testing and treatment (e.g. induction, C-section, fetal monitoring) is stronger.
As a physician, I have spent about half of my adult life in hospitals. I am very comfortable in the hospital setting and knowing the many things that could go wrong, felt safer with immediate access to an operating room if I needed one. I also knew I would be plagued by “what if” questions if I had a bad outcome outside of the hospital. I was most comfortable trying to avoid unnecessary interventions by working with a midwife in the hospital setting. All of which is to say that a soothing perinatal experience may look quite different from person to person. The key components of a good birth are feeling that you are involved in decision making, listened to, and respected by your care team.
It is important to remember that it is not only the mother undergoing stress during labor. The baby also goes through “an unparalleled life stressor” in the birth process. There are some key stressors to avoid:
Separating mom from baby
Painful procedures
Bright lights, loud noises, strong smells, rough touches
Environmental toxins
In fact, research shows “increased pain sensitivity, decreased immune system functioning, increased avoidance behavior, and social hypervigilance are all possible outcomes of untreated pain in early infancy.” These are long-term impacts because this is such a crucial time in development.
As a person who simultaneously loved to be in control and didn’t trust her own authority, I read a LOT of parenting books in my oldest daughter’s first year of life. The strangest thing I read and really the only one that I immediately, intuitively knew was wrong was the idea that, “your young child is trying to manipulate you”. It goes without saying that your child is trying to learn how to communicate her needs and desires to you. Her survival depends upon that. That would be like saying that I am manipulating my hosts if I learn the language of a country I am visiting so I can ask for food and water. On the other hand, if you don’t respond to your baby’s cues until the baby is crying, it is true that they will learn that crying is the way to get their needs met. If I went to that country but could only get food and water if I shouted, I would gradually jump to shouting much more quickly. Again, this is not manipulation.
This concept of “manipulation” relates strongly to many attitudes in US culture regarding responding to the needs of the infant and maintaining a physical touch connection with the infant. Some well-meaning friends or grandparents may discourage picking up a crying child so you don’t “get wrapped around their little finger” or that you need to punish a child for temper tantrums or your child will learn to control you. This does not fit with the developmental stage of a child under 3, who expresses their attachment to a caregiver physically and needs physical contact with a caregiver to feel safe. However, this is where having that community of multiple, warm, responsive caregivers is so crucial. In my experience, the physicality of parenting, and the constant touch that your children crave, particularly if you are breastfeeding becomes overwhelming, without other caring adults to provide that touch break, that continuous physical contact can lead to resentment. In this case, it can be important to accept where you are and the help that you have and accept the least worst option. For example, if trying to cook dinner with your baby in the baby carrier is filling you with rage, putting the baby in a swing or jumper is probably the healthier way to go. I think we are often more comfortable with absolutes, but when we are operating in a mode where compromise is the only option, relying on what you know of yourself and your child are the best guides in finding the right balance.
Responding to the needs of a baby are vital to their development. Ignoring a crying baby results in delayed communication, decreased problem solving skills, decreased personal-social skills (possibly because mirror neurons do not develop appropriately), interferes with development of the cerebellum, which impacts gross and fine motor development. In fact, meeting a child’s dependency needs through touch, responsiveness, and breastfeeding is one of the key ways for them to achieve independence.
Breastfeeding is an area where word and deed are quite mismatched in the culture at large. For all the people who say “breast is best”, there is not a lot of support in the “real world” to actually make it happen. I didn’t consider what a truly breastfeeding friendly employer would look like until I was working in Uganda. There, a colleague’s nanny brought the baby into the hospital every few hours, whenever the baby needed to be fed. To be honest, as an American, that possibility had never crossed my mind.
I breastfed my daughters for about three years each. I had trouble finding statistics about what percentage of American moms are still breastfeeding when their child is 3, but this chart, from Kelly Mom suggests that about 5% of moms are still breastfeeding at 18 months, so I’m guessing it’s probably about 1-2% at most. I was very fortunate, breastfeeding came easily to me and the most stressful part was trying to figure out when and how to pump while working as the only doctor in an ER. I didn’t have to worry about where, because I had an office. I didn’t have to worry about resentment from colleagues because I wasn’t doing “my share”, because I was the only person in the hospital that could do my job, so I just had to scramble to catch up when I got back. However, it’s different from working in a clinic, or in most other environments, where you could just schedule your 11:30 appointment or meeting as pumping time. I developed a mental algorithm where if I had a break in patient care and I had not pumped in the last 2 hours, I would pump because I was not sure when I would have a chance next. Then, I would eat because I was breastfeeding and I was ravenous. Then, I would catch up on charts, but usually there would be more new work to do by then. My point is, that in order to do that, you need an extraordinary amount of things working in your favor, it is not something the average person, with the average job and the average amount of support can “just do” because “breast is best’. However, like many of the needs we are not meeting for our moms and babies, there are some incredibly important benefits if we can create a culture that supports extended breastfeeding:
It is a valuable source of nutrition and disease protection as long as breastfeeding continues
Children ages 1-3 who breastfeed have fewer illnesses, less severe illnesses, and lower mortality than those who do not
There is a correlation between duration of breastfeeding and cognitive achievement and social development
Last week, I talked a lot about the climate of social support for mothers and young children, so I won’t belabor that here. However, I do want to emphasize that we tend to underestimate our young child’s physical capabilities, but overestimate their emotional capabilities. Children are just starting to develop self-control around 3.5 to 4 years old. In other words, expecting a parent to convince their 2 year old to “get it together” in the grocery store, is not realistic, not family-friendly, and adds an unhelpful dose of unnecessary shame to their day.
Lastly, our neighborhoods, our childcare, and our schools are absolutely not set up to facilitate creative free-play in nature with multi-aged peers. My daughter gets to interact with her 5th grade buddy about 2-3 times per school year. This is the extent of her interaction with multi-aged peers in the school system. Have you tried to track down kids in your neighborhood to play with? It is shockingly difficult, they are all at dance, or soccer, or swimming lessons, or gymnastics, or I don’t know what. These multi-aged groups in nature are so developmentally important. Here are a few of the benefits:
Builds confidence
Promotes creativity and imagination
Teaches responsibility
Activates more senses
Encourages movement that increases wellbeing
Reduces stress and fatigue
Improved risk management skills
Improved academic skills including communication, decision making, and negotiation
Like last week, I think it is really important to say again that many of these ideal practices are not realistic for people in our culture right now. Some of these practices may be possible, but would drive you nuts or provoke resentment if you are trying to provide a whole village worth of care as a parenting dyad or single parent. Infants as young as one month old can pick up on parental emotions like depression and anger. This means that practically speaking, it may be better to relax one’s attachment parenting practices a bit if they are causing you to feel resentment. In my work in the ER, I see wide varieties of parenting practices and skill-levels. Upon returning to work after having my oldest daughter, I realized quickly that what my kids need most from me is that I give a shit, but really what they need to know is that we all give a shit. How do we show our kids they matter to us?
I’d love to know more about your experiences with this as both child and adult.
So, how do we show our kids (meaning the kids in our communities, not necessarily our biological kids) that they matter to us?
How responsive to your needs were the adults in your life when you were a young child? How did that level of responsiveness impact you?
Did you receive a lot of physical touch as a young child? What is your relationship to physical touch now?
What was your experience with breastfeeding? What were the barriers you faced?
Can you describe a time you received social support as a parent? How about a time you were not supported? This is a totally amazing story of parental support and I will give you a money-back guarantee that it is worth the 12 minutes of your life you spend watching it.
Did you have a lot of time for free play in nature?