Ethnopediatrics: Emerging field takes comparative look at parenting practices around the world

By Teru Osato Lundsten

Among the thousands of main­stream books published in the U.S. to help parents understand and raise children, we were able to find only one author who questioned the cultural bias of Western parenting resources and researched parent­ing practices around the world. Meredith Small, an anthropology professor at Cornell and author of the books “Our Babies, Ourselves” and “Kids: How Biology and Culture Shape the Way We Raise Our Children,” is the foremost expert on ethnopedi­atrics, the study of parenting across cultures.

Small says the orthodoxy of Western parenting resources needs to acknowledge the cultural, social and economic foundations of specific U.S. culture and experience. Mainstream U.S. culture’s affluence, individualism and nuclear families have a large part in how American parenting practices developed. In other parts of the world, lack of resources, collectivist traditions and extended family networks created their own set of mores and expecta­tions.

In “Our Babies, Ourselves,” Small traces the evolution of human babies, explaining why we are the most dependent infants on earth. Unlike a newborn deer, whose first and immediate task in life is to stand up, human babies are help­less.
Human fetuses have large heads, to accommodate large brains, and the human pelvis can expand only so far during labor, to enable biped­alism. Consequently, human beings are basically born neurologically unfinished, otherwise they wouldn’t make it through the birth canal. That’s why they need more help than any other species during their early development.

And that’s why human parents have so much to do, but there are many ways to do it.
Small compares parenting practices in three aboriginal and two industrial societies. She closely examines two extremes of human civilization, but not Third World countries.
She starts with the !Kung San of Botswana – or, as they are known in the West, the Bushmen of the Kalahari Desert. The San are some of the few remaining hunter/gath­erer groups on Earth. No one owns anything. Food is shared, so no one goes hungry. The San sleep together outside, close to the fire; there is no concept of privacy.
Babies stay with their mothers at all times, slung on their mothers’ hips with good and constant access to the breast, seeing the world from the same vantage point as their mothers. San babies never cry for long. As they grow, they are never alone, eventually transitioning to a child group by the time a younger sibling is born.

San babies and children develop superior motor skills, skills that are essential to the San lifestyle. It is a priority with San parents to make sure their children are physically adept.
The parental goals of the traditional San can be summed up as being social integration, mobility and sharing.

Recently, some San have adopted a more settled lifestyle, which entails ownership of goods. This has radically altered their values. Huts are built far apart and cattle are more important than neighbors, says Small. The notion of sharing has disintegrated, privacy has become a need and children spend less time with their parents.
Small looks closely at two other subsistence cultures, the forest-dwelling Ache of Paraguay and the Gusii of Kenya. They are different from the !Kung San in many ways, and from each other, but all three cultures have similar child-rearing practices. Notably, babies are con­stantly with their mothers for the first several years of their lives.

Small then examines two industrial societies, one that values the “other,” and another the “self.” The first is Japan. The Japanese became modern and economically successful not through individual achievement, but rather with a sense of collectivity. As a relatively homogenous society, they have been able to apply the values of much smaller societies on a national level.
For the Japanese, as in many Asian cultures, obedience is implicit, and therefore “normal” expecta­tions – as in Dr. Spock’s book – regarding corrective discipline are neither applicable nor useful. In her book “Kids,” Small contrasts the Japanese collective approach of early childhood education. “(In Japanese preschools) pressure to be good often comes from peers. In addition, teachers emphasize qualities such as empathy and pride in the group; they believe that intelligence can only be associated with self-control and good social behav­ior. There are no isolated timeouts, nor are there any kids who do not want to participate in group activities.” In these environments, Small says, children do not need to be taught to share, since that is their default inclination.

In the United States, the last society scrutinized by Small, the parental goal is the child’s eventual independence. Parental efforts to foster independence start from Day One.
Physical contact with infants is minimal compared to other societies. There are strollers, cribs and other paraphernalia in which babies are placed. Only half of American babies are breast-fed, and even then ­­ it’s only for about five months, on average. If done in public, breast-feeding must be discreet. Many babies are fed on a schedule, and as they grow they are often introduced to solid foods according to detailed charts. They often don’t have the same mealtimes or bedtime as the rest of the family.
Babies cry a lot, and parents do not always feel it is necessary to respond, at least not right away.

The American family is a conjugal unit and parental privacy is key. It is important that the baby sleep in a separate bed, usually in a separate room, as soon as possible.
Many Americans rarely see infants at all until they become parents, when they learn parenting skills from doctors and books. A favorite book for generations, Benjamin Spock’s “Dr. Spock’s and Baby Child Care,” first published in 1946, is now 992 pages and in its eighth edition.

American babies are regarded as “bundles of potential,” says Small, and a good parent is one who uncovers that potential. Many parents see themselves as teachers rather than protectors (whereas Gusii parents do not make a con­certed effort to teach their children anything). Americans stimulate their babies, starting with baby talk and hanging bright mobiles above the crib (whereas Gusii mothers do not interact verbally with their babies).
American parents are concerned with the developmental stages of childhood, and are expected to know the norms of those stages, most of which have been established by testing white, middle-class babies. This does not realistically reflect the experiences of the many ethnici­ties in the country. Small cites the example of Latino babies, who for a variety of reasons are born smaller than white babies. Latino parents would be spared unnecessary worry about their newborns if norms were more culturally sensitive.

In the U.S., says Small, “Having children is just like any job. … one which can ultimately be judged a success or a failure.” This suggests that in other cultures parenting is not considered work or something to be judged.
Small then addresses the issues of sleeping, crying, and feeding, which she calls “the triumvirate of infancy.”

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Small says the orthodoxy of Western parenting resources needs to acknowledge the cultural, social and economic foundations of specific U.S. culture and experience. Mainstream U.S. culture’s affluence, individualism and nuclear families have a large part in how American parent­ing practices developed. In other parts of the world, lack of resources, collectivist traditions and extended family networks created their own set of mores and expectations.
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For most of human history, babies and children have slept with either their mothers or both parents. In many parts of the world they still do so today. According to Small, the U.S. is the only society in which babies routinely sleep alone. In fact, she says that American babies spend 67.5 percent of their time alone.
Co-sleeping is biologically advantageous because the breathing of babies and their mothers is remark­ably in sync when they are sleeping together, with the neurologically incomplete baby “learning” to breathe regularly from the mother, as if she were a metronome.
It is interesting to note that a bestseller in the U.S., “The No-Cry Solution” by Elizabeth Pantley, claims to help parents teach their babies to fall asleep without breast- or bottle-feeding or using a pacifier.

Small points out that the incidence of Sudden Infant Death Syndrome (SIDS) in the United States is the highest in the world. Whether or not there is a correla­tion between solitary sleeping and SIDS is a matter of controversy, but she discusses it openly.
A baby’s crying is the only way it can communicate its needs. It is a call for engagement, a signal for some sort of change, and “the infant expects a response from their environment,” pediatrician T. Berry Brazelton says.

All babies cry, but non-Western babies cry much less than Western babies, according to Small. The difference is how quickly their mothers respond. Non-Western mothers respond within seconds, but Western mothers don’t respond as quickly.

Small says that American mothers “deliberately do not respond to 46 percent of crying episodes during the baby’s first three months of life.” Consistent with the American cultural imperative of fostering inde­pendence, this may be an attempt to teach children early on to work out their problems on their own.

Colic is another controversial topic. Colic is commonly regarded as an infant’s pathological reaction to some mysterious internal distress – mysterious because there is rarely anything physically wrong with the baby. In fact, pediatrician Ronald Barr says that “colic is something infants do, not something they have.” Non-Western parents rarely complain of having a colicky baby.

Small concludes that Western babies cry for extended periods “because the accepted and culturally composed caretaking style is often at odds with infant biology. … Babies are still stuck with their Pleistocene (Ice Age) biology despite our modern age.”
This is the crux of her entire book: the conflict between culture and infant biology. She infers that in preparing children for adulthood, when they will experience different pressures depending on their culture, this conflict is more obvious in some cultures than others.

Breast-feeding is another issue that highlights this conflict. The bio­logical advantages to breast-feeding are many: Both nutrients and pro­tectants are transferred from moth­er to infant until the child develops its own immune system.
During the industrial revolution, in 1867, the first baby formula was developed by a German chemist, enabling Western women to work away from home and their babies. Baby formula became big business in the West, and eventually in Third World countries as well.

But both history and cross-cultural studies show that when more babies are fed with formula, depriv­ing them of important nutrients and protectants, more babies die. According to Small, UNICEF esti­mates that 1.5 million babies die each year worldwide because they are not breast-fed, and the U.S. National Institute of Environmental Health and Safety estimates that four out of every 1,000 babies in the United States die each year for the same reason.
In recent years, underdeveloped countries have begun to combat the invasion of Western feeding practices. In Papua New Guinea, for example, a prescription is now required to buy a baby bottle.

No one parenting approach is “right” or “wrong,” even if parents might think so. Western parents aren’t the only ones who need to be reminded of this, says Small. Efé pygmies in Zaire, for example, pass a nursing infant from one lactat­ing woman to another, a practice which would appall a !Kung San mother.

Books For Further Research
Elyse Zorn Karlin and Daisy Spier,
"The Complete African American Baby Checklist." New York: Avon Books, 1999.

Gloria G. Rodriguez PH.D.,
"Raising Nuestros Ninos: Bringing Up Latino Children in a Bicultural World." New York: Simon & Schuster, 1999.

Meredith F. Small,
"Kids: How Biology and Culture Shape the Way We Raise Our Children." New York: Doubleday, 2001.

Meredith F. Small,
"Our Babies Ourselves: How Biology and Culture Shape the Way We Parent." New York: Doubleday, 1999.

(Reprinted with permission from January 2006 issue of the ColorsNW magazine: www.colorsnw.com)

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