1. Caring For Babies, Caring For Parents: What Human Infants Really Need And Why James J.McKenna Ph.D. Edmund Joyce Professor of Anthropology Director of Mother-Baby Behavioral Sleep Laboratory University of Notre Dame Saturday Scholar Series

2. Western Perceptions of, and Approaches To, Caring For Baby? Whose baby is it, anyway? How and when did parents give up their rights to make decisions about how they would care for their infants? Or Did we? Do we ..abdicate decision making to outside medical authorities? Why do we seem to care so much that others approve of what we do with our infants? How did Western parents lose their own confidences in how to be a “good” parent?

3. “ It’s not what we know that gets us into trouble….it’s what we know…that just ain’t so! From : Everybody’s Friend (1874) By Josh Billings

4. Infant Care Is A “Moral Good” The kind and nature of parental care is critically judged by community members based on societal values..roles of men, women and children… What’s “good” parenting? What is safe? What problem is worth solving?

5. if... sleeping alone through the night is “good” for babies then “good” babies sleep alone, don’t they?

7. Until recent, western historic periods, no human parents ever asked: Where will my baby sleep, how will I lay my baby down to sleep, and how will I feed my baby? most human parents still don’t!

9. The cultural dismantling of this biological system led to the deaths of thousands of western infants from, SIDS, accidental asphyxiations and/or other SUDI (i.e. from social sleep …to solitary infant sleep-- from breast feeding …to bottle-formula feeding from supine … to prone infant sleep position

11. American Academy Of Pediatrics New SIDS Prevention Recommendations proximate but separate sleep for baby; no side position sleeping; cuddling but no bedsharing pacifers for sleeping infants, after breast feeding is established; more holding and carrying

13. Babyhood …….by Paul Reiser “ Getting your child to sleep becomes a blinding obsession. I myself would often loose sight of the larger picture.What is the actual goal here? Constant sleep? No awake time? Zero consciousness? I mean, we must accept that at some point babies have to be awake.They did not come to the planet just to sleep. Are we determined to get them asleep just so we can get a taste of what life was like before we had a kid? Because, if we are, then why did we have a kid? Just to lie there to look soft and fuzzy? We could have gotten, say, just a peach. A St Bernard? A narcoleptic houseguest? Or why not just a chenille bathrobe? Chenille bathrobes are fuzzy and just lie there”?

16. “… SLEEPING IN YOUR BED CAN MAKE an infant confused and anxious rather than relaxed and reassured. Even a toddler may find this repeated experience overly stimulating” really? R. FERBER (1886,1999) SOLVE YOUR CHILD’S SLEEP PROBLEMS

17. Culture Producing Science Producing Culture: How A Folk Myth Achieved Scientific Validation “ Scientific” validation of solitary infant sleep as “normal” and “healthy” #1: Initial test condition—infant sleeps alone, is bottle fed, and has little or no parental contact #2: Derive measurements of infant sleep under these conditions # 3: Repeat measurements across ages, creating an “infant sleep model” #4: Publish clinical model on what constitutes desirable, healthy infant sleep. #5: To produce “healthy” infant sleep, replicate the test condition

24. Who is the infant? What do infants need and why? Who decides and ..does it matter? ..the behavior of infants is not independent of the theories of human infancy that parents adopt Based on Leon Eisenberg “The Nature of Human Nature” pg 165 (1972)

27. “ For species such as primates, the mother IS the environment.” Sarah Blaffer Hrdy, Mother Nature (1999) Babies Celebrated , Beatrice Fontanel and Claire D’Harcourt, © 1998 Harry N. Abrams, Inc. Nothing an infant can or cannot do makes sense, except in light of mother’s body

32. small biological aside… What is the origin of mammalian breastfeeding Ahhhh … let’s see..?

35. http://www. bfnews . blogspot .com/ (2004) But, is this what we mean when we say….. “ he has a good taste in art” ? Now, this is biology!

37. Maternal behavior among primates extends throughout an extremely long infant and juvenile period, with prolonged periods of physical contact. Orang-Utan

40. Consider the physical intimacy of the maternal-infant relationship … socially and medically obscured by western culture Balinese Mother and infant

42. A major basis of maternal-infant attachment is “contact-comfort” (rather than satiation)… Harry Harlow “ Attachment”: Unfolding, discriminating bond between parent and infant; genetically-based….. Immediate survival and protection from predators is main outcome;

45. Just how ideological is baby care socialization? Consider these “Aboriginal (toy clay dolls ) and mud breasts” Now Available at Toys R Us ? ……(as if!)

53. Breathing mechanical Teddy Bear! (reduces infant apneas by 60%) (Evelyn Thoman 1985)

58. Who Bedshares? “ There are two kinds of people in the world…those who sleep with their children and those who lie about it!” Rob Cordes M.D.

61. Until recent historic periods, no human parents ever asked: Where will my baby sleep, how will I lay my baby down to sleep, how will I feed my baby? most human parents still don’t (Co-sleeping with breast feeding are inevitable and inseparable for most contemporary people)

66. 1.Dis-articulated from mother… No touch; No smells; No sounds No movement; No body heat’ No breadth exchange

68. Diversity of Co-sleeping ( requires taxonomic distinctions) Co-bedding twins (within sensory range) partial, mixed bedsharing with Dad

69. Parent -infant co-sleeping is biologically and psychologically expectable, if not inevitable.

71. What Co-sleeping Looks Like Maori, New Zealand recliner co-sleeping (unsafe) napping desert Aborigine Koala

72. University of Notre Dame Mother-Baby Behavioral Sleep Laboratory first time mothers, at risk teens Research funded by NICHD RO1

73. Variations of Safe/Unsafe Sleep Practices Infra-red Video Studies: Crib-Solitary and Bedsharing ( HD 39456-01 ) Examples: 1.Solitary-crib baby placed prone, face down; 2. Neck-wrap, head covering, pillow, solitary, crib baby; 3.Bottle-feed bedshare between pillow, teen mom ,lack of maternal response; 4.Breast feeding mothers, high level of responsivity to infant;

74. Does “Normal” Human Infant Sleep Biology Really Matter? Is It Still Relevant For An “Advanced” Society ?

76. Distribution of Number of Feeds Received by Infants Per Group Per Night RB-SN RB-BN RS-SN RS-BN

78. And why do you suppose, 45-60% of American infants…. Have “sleep problems to solve”?

79. Mother and Infant Bedsharing Orientation on BN (in min) From: Richard et al., Sleep 19 (9) 1996 ( F ace E ach O ther)

85. Number of Maternal Arousals With Temporal Overlap *note sensitivity of routine bedsharing mother waking to infant arousal (no habituation!)

87. Why Do Babies Co-sleep? because they are supposed to…!

91. Study Design 4-site prospective longitudinal study of a population-based, representative sample of 400 adolescents and their children and an ethnically matched sample of 400 adult mothers and their children (160 low- education and 160 high-education) TOTAL SAMPLE 400 TEENS 320 ADULTS 100 teens 80 adults 100 teens 80 adults 100 teens 80 adults 100 teens 80 adults Kansas City Washington, DC Birmingham South Bend

92. University of Kansas Kansas City, KS University of Notre Dame South Bend, IN University of Alabama at Birmingham Birmingham, AL Georgetown University Washington, D.C. USA (The Four Research Sites)

94. Measured Variables Informant Method Contact Consistency (in Parenting) Encouragement Celebrations Protect Stimulate Regularity (in Routines) Unhappiness Affectionate Rigidity Child Abuse Potential Responsiveness Protective/Risky Positional Relatedness Response Latency Punitive/Rejections Impulse Control Verbal Encouragement Confidence Verbal Accessibility Responsivity Sleep Lab Behaviors Maternal- Child Characteristic Scale Cellular Phone Data Mother Other Mother-Child Play

95. Human milk composition, carrying behavior, supine infant sleep and co-sleeping: An integrated adaptive system

97. All-night sleep-wake histograms for five (A-E) cosleeping pairs. Mosko, McKenna et al (1993). Journal of Behavioral Medicine 16 (6). Mom Baby Wake Sleep Mom Mom Baby Mom Baby Mom Baby Baby Wake Sleep

101. Evidence -Based Science: Infants sleeping alone in a room by themselves are at least twice as likely to die from SIDS than are infants sleeping in the company (same room) as a committed adult caregiver… Sources: Great Britain (Blair et al 1999), New Zealand (Mitchell and Scragg 1995), and European Collaborative Study (Carpenter et.al.in press, Lancet )