Attachment parenting, or AP, is an approach to child-rearing intended to forge
strong, secure attachments
between parents and children.
For many parents, this approach feels intuitive. And anthropological research suggests that some parenting practices--such as baby-wearing and co-sleeping--have deep roots in our evolutionary past (Konner 2005).
But does AP really make a difference?
Not surprisingly, it depends on how you define your terms.
Here I ignore politics, the "attachment parenting movement," and various romantic or religious notions about "natural" parenting.
Instead, I review the scientific research that supports physical closeness, sensitivity, and responsiveness in parents. For information about books, websites, and organizations that offer support to parents committed to these principles, click here.
Attachment parenting practices
AP is often associated with a set of practices, including
• Breastfeeding on cue
• Extended breastfeeding (i.e., continued breastfeeding after infancy)
• Baby-carrying or "baby-wearing"
• Nurturing touch (including skin-to-skin “kangaroo care” for infants)
• Being responsive to baby’s cries
• Being sensitive and responsive to your child’s emotions (e.g., by helping your child cope with her
In addition, I suspect that
mind-minded parenting may promote secure attachments.
However, proponents of AP--like William and Martha Sears, who coined the term “attachment parenting”--note that there is no checklist of rules that parents must follow to qualify as “attachment parents” (Sears and Sears 2001).
Medical conditions or family circumstances may prevent parents from carrying out every AP practice. What’s really important, argues these authors, is sensitive, responsive parenting-— understanding and addressing your child’s needs in an affectionate way (Landry et al 2006).
Similarly, the founders of Attachment Parenting International argue that that attachment parenting is really about adapting a few general principles--like providing kids with a consistent, loving, primary caregiver--to the particular needs of your family.
This is not the same as being overly-protective. By definition, securely-attached kids are not overly clingy or helpless. They are the kids who feel confident to explore the world on their own. They can do this because they trust that their parents will be there for them (Mercer 2006).
The scientific case for attachment parenting
Advocates of attachment parenting make two major claims:
1. Sensitive, responsive parenting leads kids to form secure attachments, and
2. Securely-attached kids are healthier and happier
Some writers have attempted to support these claims with studies of extremely deprived infants (both human and nonhuman). For instance, research demonstrates that kids who are terribly neglected and abused—like children raised in the infamous Romanian orphanages—suffer neurocognitive impairment and socio-emotional problems (Chugani et al 2001).
While such research confirms that chronic stress and trauma are bad for the brain, it’s a stretch to cite these studies as proof that attachment parenting is superior to “mainstream” Western parenting. As a result, some critics have argued that the attachment parenting movement is based on overblown or fallacious claims (Hayes 1998; Warner 2006).
This is unfortunate, because there is a lot of scientific evidence supporting the idea that secure attachments and responsive parenting benefit kids. Here’s a sample.
The link between attachment parenting practices and secure attachment
Several aspects of responsive parenting have been associated with the development of secure attachments. These include:
• High-quality communication. A study of Dogon mothers in Mali found that the quality of communication between mother and infant was associated with more secure attachment relationships (True et al 2001).
• Maternal sensitivity during infant play. A study of premature infants reports that infants whose mothers were unresponsive or more controlling during playtime were more likely to be insecurely attached (Fuertes et al 2006). Securely-attached infants were more likely to have mothers who were sensitive to their children’s’ interests and needs (Fuertes et al 2006).
• Insight into a child’s mental and emotional states. A study of mothers and their 12 month old infants reports that mothers who showed greater insight about their babies’ psychological experiences were rated as more sensitive and were more likely to have securely-attached infants (Koren-Karie 2002). Another study reports that mothers who showed a more accurate understanding of their infants’ mental states at 6 months were more likely to have securely-attached infants at 12 months (Meins et al 2001).
• Sensitivity to an infant’s distress. A recent study analyzing data collected by National Institute of Child Health and Human Development (NICHD) reports that American mothers who showed greater sensitivity to their infants’ distress at 6 months were more likely to have securely attached toddlers at 15 months (McElwain and Booth-Laforce 2006).
• Baby-wearing. An experimental study randomly assigned American mothers of low socioeconomic status to either wear their newborns in soft baby carriers or to carry their babies in portable infant seats. At 13 months, babies in the soft-carrier group were more likely to be securely-attached to their mothers (Anisfeld et al 1990).
• Emotional availability. Research suggests a link between secure attachment and emotional availability—being open to discuss emotions, and being ready to respond sensitively and appropriately to the emotions of others (Easterbrooks et al 2000). An Israeli study observed mothers interacting with their infants and found that moms rated as more emotionally available were more likely to have securely attached children (Ziv et al 2000). In addition, secure attachment relationships may promote emotional availability in kids (see below).
How secure attachments and attachment parenting practices benefit kids
Secure attachments promote independence
As noted above, securely-attached children are more likely to explore on their own (Mercer 2006).
Secure attachments promote emotional availability
Researchers at Tufts University followed 45 mother-child pairs from infancy to age 7. They found that infants who were securely-attached during infancy were more likely to demonstrate emotional availability at age 7 (Easterbrooks et al 2000).
Emotionally supportive parenting promotes better moods and better emotional coping
A study of American kids, aged 9-11 years, evaluated their ability to cope with their emotions in school and at home. Kids with secure attachment relationships--and greater levels of maternal support--showed “higher levels of positive mood, more constructive coping, and better regulation of emotion in the classroom.” (Kerns et al 2007).
Another study found that parents who were responsive to their children's distress had kids who were better at regulating their own, negative emotions (Davidov and Grusec 1996). The same study found that maternal warmth was associated with better regulation of positive emotions.
Attachment parenting contributes to a child's moral development
Researchers report that kids who engaged in mutually responsive, positive interactions with their mothers during the toddler and preschool years had more developed consciences when they reach school age (Kochanska and Murray 2000). These kids were also more likely to comply with adult instructions.
Another study found that kids with more responsive mothers exhibited more empathy and prosocial behavior (Davidov and Grusec 1996).
Attachment parenting practices buffer children from the effects of toxic stress
As I note in this article about stress in babies, there is a lot we can do to keep babies calm and happy. It's true for older children too. But do these things make a big difference? I think they so, particularly for children who are very sensitive, emotionally reactive, anxious, or exposed to high levels of environmental stress.
For example, there is compelling evidence that skin-to-skin contact benefits young infants.
In one study comparing two groups of preterm infants, researchers found that children who'd received skin-to-skin contact in the first weeks postpartum had developed, by age 10, more healthy stress response systems, improved sleep patterns, and better cognitive control (Feldman et al 2014).
In another recent study, newborns at high risk for developing abnormal stress responses showed no evidence of such problems at 7 months -- not if their mothers reported giving their babies lots of caresses (Sharp et al 2012).
Co-sleeping may also reduce stress. Researchers have reported that British children (aged 3-8) who slept in
their parents’ rooms showed lower daily levels of the stress hormone
cortisol (Waynforth 2007). In a study of Dutch infants, co-sleeping babies experienced lower spikes in the stress hormone cortisol when they were subjected to psychologically distressing situations (Beijers et al 2013). And an experiment testing newborns' responses to bathing found that, compared to co-sleepers, babies who slept alone experienced sharper spikes in cortisol levels (Tollenaar et al 2012).
But perhaps the most dramatic evidence comes from research that measures emotional sensitivity and responsiveness. As I note in this article, people who grow up in poverty experience high levels of stress, and may therefore be at high risk of developing stress-related diseases, atherosclerosis, autoimmune disorders, and cancer. But studies suggest that kids who have highly nurturing parents are protected from these risks.
The advantage may begin early in life. One study reports that infants of more sensitive mothers had lower baseline levels of the stress hormone cortisol (Blair et al 2006). Other research, which I discuss in this blog post, suggests that babies with "difficult" temperaments may turn into particularly well-adjusted kids if they receive warm, sensitive parenting (Stright et al 2008; Pluess and Belsky 2010).
And recently, researchers have found evidence that warm, sensitive parenting protects young children from brain-shrinking stress. Joan Luby and her colleagues found that poverty-stressed kids with warm, positive, emotionally-supportive parents had better brain development. Unlike peers with less sensitive parents, these kids developed normal-sized hippocampi and amygdale—brain structures that play a key role in spatial learning, memory consolidation, stress reactivity, and the processing of emotion (Luby et al 2013).
Finally, positive discipline may help kids cope better with stress. One study of kids living in highly-stressed urban settings found that parents who identified themselves as practitioners of positive discipline were more likely to have children who were stress-resilient (Wyman et al 1991).
Attachment parenting is associated with fewer behavior problems
A study of French-Canadian children (aged 5-9 years) found that kids who were securely-attached showed fewer internalizing and externalizing behavior problems (Moss et al 1998).
Another, experimental study reports that children living in stressed families (characterized by marital conflict and frequent daily hassles) showed fewer overactive problem behaviors if their parents had been trained in positive parenting and sensitive discipline techniques (van Zeijl et al 2006).
More recently, a longitudinal study tracking the development of 544 babies found that children with more sensitive mothers were less likely to experience executive function problems (including problems with attention, focus, and impulse control) when they were four years old (Kok et al 2013).
Breastfeeding is associated with fewer infections and allergies
Breastfeeding, particularly long-term or extended breastfeeding, appears to protect children from infections and the development of allergies. A recent study of Qatari children reports that children breastfed for more than 6 months had a reduced risk of allergic diseases and ear infections than kids who were breastfed for less than 6 months (Bener et al 2007).
Similar results have been reported in a variety of international studies of breastfeeding (Kramer and Kakuma 2006; Minitti et al 2014).
Attachment parenting practices are associated with higher IQ and academic performance
You might have heard that breastfeeding boosts a child’s IQ-—if, like
90% of the population, he carries the FADS2 gene (Caspi et al 2007).
That result hasn't been replicated, so the jury is still out. But meanwhile there are hints that other attachment parenting practices are linked with higher intellectual achievement.
A British study of 36 middle-class mothers and their three-year-olds found that securely-attached children scored 12 points higher on the Stanford-Binet intelligence test than did insecurely attached children (Crandell and Hobson 1999).
Another study tracking 108 French-Canadian children found that kids who were securely-attached at age 6 scored higher on communication, cognitive engagement, and motivation to master new skills at age 8 (Moss et al 1998).
Of course, correlation doesn't prove causation. It might be that smarter kids have an easier time forming secure attachments.
But there are also experimental studies reporting a link between responsive parenting and cognitive development. In these experiments, some mothers were randomly assigned to receive training in responsive parenting techniques. The infants of trained mothers showed greater growth in cognitive skills than did the infants of control moms (Landry et al 2003; 2006).
Unproven claims and unanswered questions
Baby-wearing and crying
As noted above, baby-wearing may be associated with higher rates of secure attachment. It also may help prevent plagiocephaly, the flattening of the back of the head caused by leaving babies on their backs for extended periods (Littlefield 2003).
But does baby-wearing reduce crying?
it seems that it should. However, with the exception of one study
conducted in 1986 (Hunziger and Barr 1986), there isn’t much scientific
evidence to support the idea. For example, a 1995 study reports that
“supplemental carrying” of infants had little effect on crying rates (St
James-Roberts et al 1995). Possibly, results depend on the temperament
of the individual infant. For an overview of research about crying, see this Parenting Science guide.
"Mind-mindness"...the crucial factor?
"Mind-minded" parents treat their children--no matter how young-- as individuals with minds, feelings, thoughts, and beliefs of their own.
Psychologist Elizabeth Meins and her colleagues have shown that mind-minded parenting is linked with with the development of stronger empathy and perspective-taking skills in children.
It's also linked with more secure attachment relationships. In one longitudinal study, mind-minded parenting at 6 months was correlated with more secure attachments at 12 months. Indeed, mind-minded parenting was a better predictor of secure attachment than were any other variables, including "responsive, sensitive parenting" (Meins et al 2001).
This makes me wonder. Is mind-mindedness the true foundation of attachment parenting? For more information, check out this article.
References: Attachment parenting
Anisfeld E, Casper V, Nozyce M, and Cunningham N. 1990. Does infant carrying promote attachment? An experimental study of the effects of increased physical contact on the development of attachment. Child Dev. 61(5):1617-27.
Beijers R, Riksen-Walraven JM, and de Weerth C. 2012. Cortisol regulation in 12-month-old human infants: associations with the infants' early history of breastfeeding and co-sleeping. Stress. 16(3):267-77.
Bener A, Ehlayel MS, Alsowaidi S, and Sabbah A. 2007. Role of breast feeding in primary prevention of asthma and allergic diseases in a traditional society. Eur Ann Allergy Clin Immunol. 39(10):337-43.
Blair C, Granger D, Willoughby M, and Kivlighan K. 2006. Maternal sensitivity is related to hypothalamic-pituitary-adrenal axis stress reactivity and regulation in response to emotion challenge in 6-month-old infants. Ann N Y Acad Sci. 1094:263-7.
Caspi A, Williams B, Kim-Cohen J, Craig IW, Milne BJ, Poulton R, Schalkwyk LC, Taylor A, Werts H, and Moffitt TE. 2007. Moderation of breastfeeding effects on the IQ by genetic variation in fatty acid metabolism. Proceedings of the National Academy of Sciences. 104(47):18860-5. Epub 2007 Nov 5.
Chugani HT, Behen ME, Muzik O, Juhász C, Nagy F, and Chugani DC. 2001. Local brain functional activity following early deprivation: a study of postinstitutionalized Romanian orphans. Neuroimage. 14(6):1290-301.
Crandell LE and Hobson RP. 1999. Individual differences in young children's IQ: a social-developmental perspective. J Child Psychol Psychiatry. 40(3):455-64.
Davidov M and Grusec JE. 2006. Untangling the links of parental responsiveness to distress and warmth to child outcomes. Child Dev. 77(1):44-58.
Easterbrooks MA, Biesecker G, and Lyons-Ruth K. 2000. Infancy predictors of emotional availability in middle childhood: the roles of attachment security and maternal depressive symptomatology. Attach Hum Dev. 2(2):170-87.
Feldman R, Rosenthal Z, Eidelman AI. 2014. Maternal-preterm skin-to-skin contact enhances child physiologic organization and cognitive control across the first 10 years of life. Biol Psychiatry. 75(1):56-64.
Fuertes M, Santos PL, Beeghly M, and Tronick E. 2006. More than maternal sensitivity shapes attachment: infant coping and temperament. Ann N Y Acad Sci. 1094:292-6.
Hays, Sharon (1998). The Fallacious Assumptions and Unrealistic Prescriptions of Attachment Theory: A Comment on "Parents' Socioemotional Investment in Children Journal of Marriage and the Family 60 (3):782-790
Kramer MS and Kakuma R. 2002. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev. (1):CD003517.
Kerns KA, Abraham MM, Schlegelmilch A, and Morgan TA. 2007.Mother-child attachment in later middle childhood: assessment approaches and associations with mood and emotion regulation. Attach Hum Dev. 9(1):33-53.
Kochanska G and Murray KT. 2000. Mother-child mutually responsive orientation and conscience development: from toddler to early school age. Child Development, Vol. 71(2): 417-431.
Kok R, Lucassen N, Bakermans-Kranenburg MJ, van Ijzendoorn MH, Ghassabian A, Roza SJ, Govaert P, Jaddoe VW, Hofman A, Verhulst FC, Tiemeier H. 2013. Parenting, corpus callosum, and executive function in preschool children. Child Neuropsychol. 2013 Sep 13. [Epub ahead of print]
Konner M. 2005. Hunter-gatherer infancy and childhood: The !Kung and others. In: Hunter-gatherer childhoods: Evolutionary, developmental and cultural perpectives. BS Hewlett and ME Lamb (eds). New Brunswick: Transaction Publishers.
Koren-Karie N, Oppenheim D, Dolev S, Sher E, and Etzion-Carasso A. 2002. Mothers' insightfulness regarding their infants' internal experience: relations with maternal sensitivity and infant attachment. Dev Psychol. 38(4):534-42.
Landry SH, Smith KE, and Swank PR. 2003. The importance of parenting during early childhood for school-age development. Dev Neuropsychol. 24(2-3):559-91.
Landry SH, Smith KE, Swank PR. 2006. Responsive parenting: establishing early foundations for social, communication, and independent problem-solving skills. Dev Psychol. 42(4):627-42.
Littlefield TR. 2003. Car Seats, Infant Carriers, and Swings: Their Role in Deformational Plagiocephaly. Journal of Prosthetics & Orthotics 15 (3): 102-106.
Luby J, Belden A, Botteron K, Marrus N, Harms MP, Babb C, Nishino T, and Barch D. 2013. The effects of poverty on childhood brain development: the mediating effect of caregiving and stressful life events. JAMA Pediatr. 167(12):1135-42
McElwain NL and Booth-Laforce C. 2006. Maternal sensitivity to infant distress and nondistress as predictors of infant-mother attachment security. J Fam Psychol. 20(2):247-55.
Meins E, Fernyhough C, Fradley E, and Tuckey M. 2001. Rethinking maternal sensitivity: Mothers’ comments on infants’ mental processes predict security of attachment at 12 months. Journal of Child Psychology and Psychiatry and Allied Discipline 42: 637-648.
Mercer J. 2006. Understanding Attachment: Parenting, Child Care, and Emotional Development. Westport, CT: Praeger.
Meins E, Fernyhough C, Fradley E, and Tuckey M. 2001.Rethinking maternal sensitivity: mothers' comments on infants' mental processes predict security of attachment at 12 months. J Child Psychol Psychiatry. 42(5):637-48.
Minniti F, Comberiati P, Munblit D, Piacentini GL, Antoniazzi E, Zanoni L, Boner AL, Peroni DG. 2014. Breast-Milk Characteristics Protecting Against Allergy. Endocr Metab Immune Disord Drug Targets. 2014 Jan 21. [Epub ahead of print]
Moss E, Rousseau D, Parent S, St-Laurent D, and Saintonge J. 1998. Correlates of attachment at school age: maternal reported stress, mother-child interaction, and behavior problems.Child Dev. 69(5):1390-405.
Pluess M and Belsky J. 2010. Differential susceptibility to parenting and quality child care. Dev Psychol. 46(2):379-90.
O'Brien M, Nader PR, Houts RM, Bradley R, Friedman SL, Belsky J, and Susman E. 2007. The ecology of childhood overweight: a 12-year longitudinal analysis.Int J Obes (Lond). 31(9):1469-78. Epub 2007 Apr 3.
Posada G, Gao Y, Wu F, Posada R, Tascon M, Schoelmerich A, Sagi A, Kondo-Ikemura K, Haaland W, and Synnevaag B. 1995. The Secure-Base Phenomenon across Cultures: Children's Behavior, Mothers' Preferences, and Experts' Concepts. Monographs of the Society for Research in Child Development, Vol. 60, No. 2/3, Caregiving, Cultural, and Cognitive Perspectives on Secure-Base Behavior and Working Models: New Growing Points of Attachment Theory and Research (1995), pp. 27-48.
Sears W and Sears M. 2001. The Attachment Parenting Book : A Commonsense Guide to Understanding and Nurturing Your Baby. First edition. New York: Little, Brown and company.
Schore AN. 2001. Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation, and Infant Mental Health. Infant Mental Health Journal 22, 1-2: 7-66.
Steele M, Steele H and Johansson M. 2002. Maternal predictors of children's social cognition: an attachment perspective. J Child Psychol Psychiatry. 43(7):861-72.
Stright AD, Gallagher KC, and Kelley K. 2008. Infant temperament moderates relations between maternal parenting in early childhood and children's adjustment in first grade. Child Dev. 79(1):186-200.
True MM, Pisani L, and Oumar F. 2001.Infant-mother attachment among the Dogon of Mali.Child Dev. 72(5):1451-66.
Uvnas Moberg K. 2003. The oxytocin factor. Cambridge, MA: deCapo Press.
Walsh TM, McGrath PJ, and Symons DK. 2008. Attachment dimensions and young children's response to pain. Pain Res Manag. 13(1):33-40.
Warner, Judith. 2005. Perfect Madness: Motherhood in the Age of Anxiety. Riverhead.
Waynforth D. 2007. The influence of parent-infant cosleeping, nursing, and childcare on cortisol and SIgA immunity in a sample of British children. Dev Psychobiol. 49(6):640-8.
Wyman PA, Cowen EL, Work WC, and Parker GR. 1991. Developmental and family milieu correlates of resilience in urban children who have experienced major life stress.Am J Community Psychol. 19(3):405-26.
Van Zeijl J, Mesman J, Van IJzendoorn MH, Bakermans-Kranenburg MJ, Juffer F, Stolk MN, Koot HM, and Alink LR. 2006. Attachment-based intervention for enhancing sensitive discipline in mothers of 1- to 3-year-old children at risk for externalizing behavior problems: a randomized controlled trial. J Consult Clin Psychol. 74(6):994-1005.
Ziv Y, Aviezer O, Gini M, Sagi A, Koren-Karie N. 2000. Emotional availability in the mother-infant dyad as related to the quality of infant-mother attachment relationship.Attach Hum Dev. 2(2):149-69.
For other, fully-referenced articles about issues related to attachment parenting, browse the Parenting Science index on the left side of the screen.
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