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    QUESTION:

    What is Attachment Parenting and how does the infant benefit from beingattached? Discuss both the short and long term benefits.

    How does our society regard this way of parenting? Discuss, including

    recommendations.

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    Introduction

    The aim of this literature review is to discuss and explore the

    attachment parenting. Discussion will include how the infant benefits from

    being attached, the short and long term benefits and how our society regards

    attachment parenting. To begin to understand what is attachment parenting

    one must first define what attachment is and the theory behind it that leads to

    attachment parenting.

    Attachment

    Attachment is defined, as a lasting psychological connectedness

    between human beings" (Bowlby, 1982). It can also be defined as a

    relationship that when felt to its deepest degree causes the mother to feel that

    the baby is part of her. This feeling is so strong that, at least in the earlymonths, the attached mother feels complete when she is with her baby and

    feels incomplete if they are apart (Sears, 1987).

    Parenting

    Parenting is defined by Shonkoff and Phillips (2000) as the 'focused

    and differentiated relationship that the young child has with the adult who is

    most emotionally invested in and consistently available to him or her'.

    Attachment Parenting

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    Attachment parenting is a style of parenting that develops an infant or

    child's need for trust, empathy and affection in order to create a secure,

    peaceful and enduring relationship. This style requires a consistent, loving

    and responsive carer, ideally a parent, especially during the child's critical

    first 3-5 years of life (Ezzo & Bucknam, 1995).

    Attachment Theory

    Attachment theory explains how we become secure, first as children

    and later as adults. Attachment theory is based on the belief that the mother-child bond is the essential and primary force in infant development, and thus

    forms the basis of coping, negotiation of relationships, and personality

    development (Bowlby, 1982). Attachment theory provides not only a

    framework for understanding emotional reactions in infants, but also a

    framework for understanding love, loneliness, and grief in adults. In

    comparison, Wikipedia (n.d.) in Sigmund Freud proposed that attachment

    was a consequence of the need to satisfy various drives. Attachment is

    considered a biological system and children are naturally attached to their

    parents because they are social beings, not just because they need other

    people to satisfy drives. Therefore attachment is part of normal child

    development.

    Development of Behaviour

    Bowlby (1973) described four infant behavioural systems:

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    The exploratory system where the infant explores the world around him; the

    affirmative system; where the infant learns to be with others; the

    fear/wariness system, that gradually helps the infant learn about dangers and

    to stay safe; the attachment system that assists the infant to seek proximity to

    their attachment figure and develop a sense of security. He identified the

    attachment system as the most important one of all the four.

    Family

    The family is the basic institutional unit of society primarily

    responsible for the child-rearing functions. When families fail to fulfill this

    responsibility to children everyone suffers. Families are responsible for

    providing physical necessities, emotional support, learning opportunities,

    moral guidance and building self-esteem and resilience (Kumpfer et al

    2002).

    Having a child is one of life's most emotional events. It transforms

    individuals or people as parents in a relationship. During pregnancy parents

    must adapt physically and emotionally to proceed to what is probably the

    greatest responsibility in their lives. Preparation for becoming a parent

    begins long before childbirth. It includes healthy lifestyle choices in all the

    areas of wellness. There is no single framework or model used for teaching

    parents skills or strategies. This has been a controversial area of discussion

    in the early childhood intervention literature, where the emphasis has

    changed from a child-focused to a relationship focused approach ( Kelly &

    Barnard, 1999).

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    One common strategy for coping with changes and challenges during

    pregnancy is to attend antenatal classes and visits. Antenatal classes may

    come in various forms, but all have the same aim - to help prepare parents

    for both the birth, and early parenthood. Antenatal classes should not only

    focus on the help to prepare the mother for labour, birth, and early

    parenthood but also on the communication skills of early attachment

    relationships to assist and motivate the new parents to be more connected

    with their newborn infant and understand more their infants needs.

    Motivated parents can usually be more able to provide a far richer and more

    nurturing social and intellectual environment for their children (Garbarino,

    1992).

    We believe as a group that parents can be served best by sensitive

    leaders during ante-natal classes and visits that willingly help to develop and

    maintain a creative learning environment and encourage participation. Both

    parents must choose to participate (Kaiser& Hancock 2003). Whenever

    possible both parents must attend to these classes and visits as many

    information can be gained by them from these interactions with the health

    care staff and other experienced parents. Like the mother, the father can also

    benefit from knowing what to expect when the mother goes into labour - and

    how to assist in that process.

    Birth Bonding

    Mothers are biologically and genetically designed to nurture their

    babies. A newborn's mother has everything a baby need arms to hold him,

    breasts with human milk to feed and comfort him, a human body to share

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    with him, a person to protect and be there for him. The best way to start a

    relationship with their baby is for the mother and father to be informed and

    be active in their baby's birth. If both parents are present at the birth, and

    there is a positive birth experience, the mother and father are very likely to

    fall deeply in love with their baby (Barker, 1991).

    The decision of parents regarding their childs may depend on how

    they themselves were raised as children, what they observed in other

    families, what they had been taught, and their cultural background. Every

    family is different; a different father and mother each with their own genetic

    inheritance, beliefs, values, background and education. What might work for

    one family does not necessarily work for another. Learning about our early

    attachment relationships with our parents can give us insight into our own

    adult relationships, and especially into our marital relationship. Parents'

    skills and needs vary widely. According to Bowes (2000) a couple normally

    builds their parenteral skills from their own experiences as a child, thus

    becoming a major influence on their own parenting style.

    Shonkoff & Phillips (2000) stated that what young children learn,

    how they react to the events and people around them, and what they expect

    from themselves and others, are deeply affected by their relationships with

    parents, the behaviour of parents, and the environment of the homes in

    which they live'. Both parents must invest in quality time to promote healthy

    relationships, social and emotional development in their young children.

    Failure to do so is both costly to children and society. Being loved, valued

    and understood by those closest in childhood is perhaps the strongest

    protection against our emotional disturbance.

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    Parents not only need to foster a secure attachment with their child,

    but they also require: the personal skills to interact constructively with their

    children, the organizational skills to manage their lives inside and outside

    the home, and the problem-solving skills to address the many challenges that

    children present. Doing this requires co-operation with the childs needs and

    how the child is responding to the world. It also requires support, like child

    care and social networks, and resources that come with economic security.

    The infant and his parents benefit from attachment parenting in various ways both in the short and

    long term.

    Relationship

    With good relationship the parents and their baby, will experience mutual sensitivity, mutual

    giving, and mutual shaping of behaviour, mutual trust, more flexibility, and more lively interactions and

    brings out the best of each other.

    Benefits for Baby

    The baby will feel more trusted, more competent, grows better, feels

    right, acts right, is better organized, learns language more easily, establishes

    healthy independence, learns intimacy and to give and receive love.

    Benefits for Parents

    Parents may become more confident in responding to what levels of

    parenting their baby needs. They will be more sensitive and will be able to

    detect more efficiently their babys cues so then they can respond intuitively

    and flow with babys temperament, can find discipline easily and become

    keen observers of their child. Parents will be able to know their baby's

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    competencies and preferences and will also know what advice to take and

    which to disregard for the benefit of their children (Sears, 1987).

    Babies communicate in various ways for their needs such as body

    movements, facial expressions and crying. Young babies need lots of

    physical contact through mutual giving. Mutual giving is where baby

    enjoyment begins (Sears, 1987). Babies learn to trust when their needs are

    consistently responded immediately and with sensitivity. Building a strong

    attachment with a baby involves not only responding consistently to his

    physical needs but also spending enjoyable time interacting with him and

    thus meeting his physical and emotional needs as well. The baby also needs

    to be handled and caressed frequently in order to thrive.

    Breastfeeding is another important intervention that meets the baby's

    physical and emotional needs. Breastfeeding is more than a physiological

    process. It is a learned activity that involves a dynamic interaction within a

    complex set of social, cultural and experiential factors (National

    Breastfeeding Advisory Committee, 2007). Much of the literature that

    promotes breastfeeding focuses on the physical benefits of the process,

    particularly the transfer of nutrients and immunity. According to Ezzo &

    Bucknam (1995) breastfeeding also has a critical significant role in

    attachment, early brain development and the overall healthy child

    development. Breastfeeding is one way for a mother to nurture an infant by

    responding to his attachment behaviours. It is an attachment practice an

    important practice that the mother can use to develop a deep and lasting

    connection with her child and thus respond to his needs. When the mother

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    breastfeed, she holds and caress her baby, and gives her baby nourishment

    and comfort. The baby, in turn, "gives" good things back to his mother.

    Klaus and Kennell (1976) claims that mothers who have close contact

    (preferably skin-to-skin) with their babies during the first hours and days

    after delivery are more likely to breastfeed their young and they also show

    significant long term differences in mothering behaviour compared with

    those mothers who had a "routine" separation from their babies in maternity

    hospital. While nutrients and antibodies pass to the baby, beneficial

    hormones are released into the mother's body which further enhances her

    mothering behavior. The hormones associated with breastfeeding (prolactin)

    help mothers to feel calm and loving by having a more peaceful parenting.

    Babies and young children will detach themselves from breastfeeding

    when they are ready, and not when the mother decides to stop. It is crucial

    that the mother will be emotionally responsive to her baby's emotional needs

    that are the cornerstone to attachment parenting. Here the father can give

    valuable emotional support to his partner when breastfeeding. In most

    families the primary attachment figure in the early years is the mother, but

    the father also has a crucial role.

    Most of the children are suffering from not having a father-figure at

    home, particularly in their early years of development, where human

    bonding is of prime importance. The role of the father in the early days and

    weeks of the infant is crucial. This is the time where the father will put

    shared care into practice. It assists the father to get to know his new baby

    and is an invaluable time to create a relationship with the baby and establish

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    an active parenting role. According to Granju & Kennedy (1999), like

    mothers sensitive care giving, fathers sensitivity predicts secure

    attachment. It is an effect that becomes stronger through the time the father

    spends with his baby. The father can give his wife or his partner a much

    needed break, and re-integrates the emotional balance between the two.

    During the early weeks after birth, the father can make the effective use of

    his entitled parental leave. Parental leave can positively give the fathers an

    opportunity to build a better relationship with his newborn baby and his

    partner by mutual shaping. By being involved in the shared care of their

    newborn with his partner, the father at this time can also handle any feelings

    of exclusions he may encounter.

    After becoming parents, both partners will never be the same and

    they want the change to be better parents through mutual shaping. An

    example of mutual shaping is well illustrated by how the father and his baby

    learn to talk to each other. A baby's early communication is a language of

    needs. Crying and smiling are the earliest tools used by the baby to

    communicate and reinforce the fathers responses to his needs. As the father

    learns and responds to his baby's language, he may feel that he is regressing

    to the level of his baby. The hard work of looking after the child feels much

    less hard when both parents communicate effectively with each other.

    The father can also help during feeding. If the mother is breastfeeding,

    the father is to try to help as much as possible and provides his wife the

    emotional support she needs such as preparing frequent drinks and healthy

    snacks, as feeding may be difficult at first. If the mother expresses her milk

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    in a jar or the baby is being bottle-fed, the father can play a more active part

    during day and night. Taking turns, particularly with night feeds, which are

    the most exhausting times, will make a big difference to the morale of the

    mother in the future. She may easily feel overwhelmed at the enormity of

    her responsibilities.

    Children who receive trust and confidence through the early touch of

    both parents are more likely to express confidence, security and

    independence as individuals very early in their lives. The father can also

    assist the mother in changing nappies, bathing the baby and soothing away

    inexplicable crying fits. Being involved also means having fun. Playing with

    his new baby, the father will have the opportunity to observe his childs

    rapid development. Apart from being a fascinating moment, it also helps to

    build a stronger relationship.

    The father can also strengthen his relationship with the new baby by

    learning to spend quality time massaging the babys body. It gives him a

    wonderful way to soothe and calm his child. Karen (1994) in her book

    Becoming Attached stated that the father is a role model for his son and in

    an innocent way is also the first romantic figure for his daughter.

    Parents may find out that through all their love, care and affection,

    make their child more mature to focus on his life in the future from a better

    perspective.

    Emotional Needs and Security

    Ainsworth et al (1978) discussed crying as the baby's way of

    communicating that he or she is distressed. A secure infant depends upon

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    his parents when in distress; the parents, in turn, are attuned to the infant's

    needs and can respond in a sensitive, responsible way most of the time.

    Emotional development refers to giving a child an opportunity to love other

    people, to care, to help generously and feel secure. Parents must be

    responsive to their baby's needs with their physical presence (Isabella &

    Belsky, 1990).

    Being loved is achieved through: physical needs, emotional support,

    encouragement, caressing, hugging and touch. Cook (1997) states that some

    emotional needs can be summarized under five A's: affection, acceptance,

    attachment, appreciation and approval. From the time speech develops, he

    adds a sixth - the child sometimes also needs an apology. This can serve to

    restore a relationship when one of his parents makes a mistake. One must

    remember that a child not only needs to be loved but also to feel loved.

    Co-Sleeping

    Co-sleeping has many benefits for both parents and the baby. A good

    way of understanding 'attachment parenting' is to look at the significant issue

    of the family bed. Those who believe in attachment parenting consider it a

    wonderful opportunity to bond with kids and to teach them good sleeping

    behaviour. Parents and infants may sleep well near each other. Pursuant to

    the proximity presence of the mother, babies do not have to fully wake and

    cry to get a response. As a result, mothers can attend to their infant before

    either of them is fully awake (McKenna 1990). Mosenkis (1998) stated that

    it is both normal and healthy for a child to be dependent upon parents until

    he, not his parents, feels safe enough and independent enough to separate.

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    There are also disadvantages associated with co-sleeping.

    Epidemiological knowledge has implicated bed-sharing as a risk factor for

    Sudden Infant Death Syndrome (Mitchell & Thompson, 1995). Several

    retrospective studies of sudden infant deaths have described the hazards of

    bed sharing such as suffocation from overlaying and entrapment (Drago &

    Dannenberg, 1999).

    Therefore, decision making about infant sleep location has become

    controversial for professionals and parents. As health visitors have

    substantial contact with mothers and their infants, they are frequently asked

    for information and advice regarding bed sharing. The information given to

    them must be based on evidence, by labelling a practice as 'safe' or 'unsafe'

    that may put infants at risk. Health visitors have an ethical responsibility to

    provide parents with information based on evidence, and to empower them

    to take decisions about how to provide a safe sleeping environment for their

    baby, irrespective of whether they choose co-sleep or not (Simpson &

    Garpiel, 2002)

    Separation

    Secure attachment can be damaged by long episodes of separation

    between the parents and their child. Parents are the most perfectly attuned

    persons in the childs needs. Klaus & Kennell (1976) proposed that

    separation between a mother and her infant in the first three days of life can

    affect the long-term experience of the child. Being away from him during

    stressful times deprives him or her from the most valuable support and also

    deprives his parents of the chance to further cement their friendship.

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    Long separations can cause their child to go through the stages of

    grief and can affect their childs attachment. If separation is inevitable, the

    parents must willingly help their child to work gradually and then ideally,

    the carer will be one that has a consistent loving attitude and can give

    continuity of care to the baby.

    Discipline

    Discipline provides developmentally appropriate boundaries linked

    with natural or logical consequences, allowing children to mature into a

    secure and successful independence. Parents should treat their children the

    way they want to be treated. Positive discipline is an overarching philosophy

    that helps a child develop a conscience guided by his own internal discipline

    and compassion for others. Positive discipline is rooted in a secure, trusting,

    connected relationship between the parent and child. Discipline, which is

    empathetic, loving and respectful, strengthens the connection between parent

    and child; while harsh or overly-punitive discipline weakens the connection.

    Parents must remember that the ultimate goal of discipline is to help children

    develop a self-control and self-discipline.

    Responding to the Older Child

    Some children enjoy pre-school or other programmes where parents

    are not included, but these are not necessary for child development. Before

    joining one must consider the child's readiness to separate, and the amount

    and type of support provided by adults. Parents must continue to:

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    Nurture a close connection by respecting the child's feelings and trying to

    understand the needs underlying his or her outward behaviours.

    Support explorations by providing a safe environment for discovery and

    remaining close with their child.

    Show interest in the child's activities and participate enthusiastically in

    child - directed play.

    Nurturing Touch and the Older Child

    Human touch and holding is really something we really never grow

    out of. All humans (including children) thrive on touch and the reconnection

    it provides. Observations have shown that babies and children who are

    deprived from touch generally suffer from anxiety and its related disorders

    (Dawes & Harrold 1990). Parents must play games to encourage physical

    closeness. Frequent hugs, snuggling, back rubs and massage all meet the

    older childs need for touch. Teaching adults and children to use gentle

    touch through massage techniques is a good idea. Massage can soothe babieswith colic, help a child unwind before bedtime, and provides opportunity for

    playful interactions that increase the parent-child bonding and to prevent the

    use of hurting touch such as shaking, hitting and spanking children (Dawes

    & Harrold 1990).

    Babies who are born through caesarean section, premature or

    incubated, and who miss out on the massage through the birth canal, need

    even greater amounts of touch and massage. It is believed that fast-birth

    babies might later feel ambiguous about their body and be overly head-

    oriented people (Dawes & Harrold 1990). They would benefit enormously

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    from massage which would bring them back into their bodies and encourage

    them to feel accepted towards their body.

    How does our society regard this way of parenting?

    The family is the basic human community through which persons are

    nurtured and sustained in mutual love, responsibility, respect, and fidelity.

    We affirm the importance of both fathers and mothers for all children.

    Between March and June 1999, Misco International organized the fourth

    wave of the European Values Study. A random sample of 1000 Maltese

    respondents took part. These were asked about the importance of the

    involvement of both the mother and the father in their child development.

    Irrespective of the changing gender roles, respondents were constantly of the

    opinion that a child needs both father and mother to grow up happily (Abela

    1999).

    In a womens activity held on the Womens Day, Marian Theuma

    and Sue Gatt spoke about various issues. Mainly highlighting:

    The need of having the continuous presence of a support person during

    pregnancy, labour and after giving birth for both mother and father.

    The different needs of bonding, warmth, care and breastfeeding that are

    so essential for the development of the security of a child.

    The difficulties women face today in reconciling family and work

    responsibilities which are not allowing motherhood, the fulfilment that

    was possible in the past.

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    The mothers stress at a time when emotional support is so important

    to develop attachment to the baby in a safe environment.

    The importance of parenthood education, to reach out to school

    children and teenage parents.

    A number of solutions at national level were recommended including

    the need of educators specialised in mothering/fathering skills. These

    educators in parenthood together with health professionals should seek ways

    of complementing the services they offer to meet the needs of todays

    parents. (Theuma & Gatt 2002).

    Recommendations

    In order to aim in supporting attachment parenting in todays society,

    one must start from the very beginning; that of re-evaluating the knowledge

    of the general public regarding this issue. Measuring the level of education,

    local traditions and beliefs through questionnaires are all vital and important

    for this aim. This will strengthen all aspects of family and community life by

    building a network which assists parents to meet their obligation to each new

    member of the family and raising healthy, confident children the natural way

    through attachment parenting.

    Health Authorities should start restoring values and of nurturing and

    recognize that all our childrens needs. Professionally run, affordable

    childcare services are therefore necessary to meet the needs of single

    mothers and families where both parents work. The importance of training

    staff at different levels to ensure that children below school age are given

    education care that caters for their needs is imperative.

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    Parenting education may reach the general public through various

    ways. These include verbal information, telephone information, via e-mail,

    written information, videotape, parent-held records and home visiting.

    Mahoney & Wheeden (1997) suggests that standardised verbal

    suggestions are effective in delivering information. Specific and relatively

    simple content should be used. Verbal information alone is insufficient and

    is best accompanied by other education methods such as counselling. Such

    information should be given during ante-natal classes and throughout child

    development. Advice is delivered best by a professional.

    Telephone-based services can be delivered cheaply and are generally

    viewed favourably by parents, including those targeting parents of children

    with specific conditions. The advantages of such service include saving of

    time and money on appointments and easy access for those who live far

    away. Limitations to use this service include poorer and less educated

    families. Booth & Booth (1993), emphasizes that telephone information

    alone has not shown an impact on parenting skills and child functioning, but

    is useful as part of a parent training package combined with other strategies

    such as written material.

    Written material consists of informational handouts. These can be

    effective educational tools, particularly when they are accompanied by a

    personalised approach and advice. This helps to engage parents interest andmotivation.

    Instructional videotapes have been effective and increase parents

    education when shown in situations such as clinic waiting rooms. A

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    combination of video series and verbal discussion groups appear to be most

    effective in achieving such learning.

    Parent-held records enable the parents to monitor their childs

    development throughout his first years. Also this helps in guiding parenting

    skills and preventing or intervening with problematic chid behaviours and

    development. Vaccinations records are also kept by the parents, therefore

    this also motivate them in monitoring their childs health.

    Routine home visiting by health professionals is an effective way of

    delivering non-medical aspects of care (Gross et al. 1995). Home visiting formore substantive family and child problems can also be effective and can

    minimize attrition with families most in need of intervention. Professional

    training of home visitors, and setting defined goals, is associated with

    improved outcomes for children across a range of important developmental

    and social areas. This includes enhanced language, behavioural development

    and decreased child maltreatment. Home visiting also helps in developing a

    personal relationship between the home visitor and the parents, therefore

    helps the goals to be reached.

    Conclusion

    Ante-natal classes are very valuable in the preparatory process of new

    parents, and they must attend these sessions together in order to gain

    experience to be able to care for their new born baby as well to share their

    new experience with other experienced couples. Of equal importance is the

    need for the new parents to reflect deeply on good communication between

    each other so then they can work towards the goal of giving good values to

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    their children. The fruits of good mothering and early nurture are among the

    greatest blessings a person can have in life. In offering these to their infants,

    mothers and fathers are setting patterns of relationships which can be

    creative, mutually rewarding and lasting for the rest of their lives.

    Our children need the best of our strength, our courage, our

    intelligence and our fearlessness. They need our empathy, assertiveness and

    self-confidence. They need the kind of support that only their fathers and

    mothers can provide. What we all need as parents today are the tools, the

    new know-how and new hope and happiness for our children. Therefore, it is

    of the highest importance to hold the highest positive thoughts we can for

    our children.

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