Around the world, all babies have the same needs – to sleep, to be fed and to be responded to when they cry. As children grow, all parents face decisions regarding discipline, norms of behavior and how best to prepare their children for successful adulthood in their culture. Yet in the United States, Eurocentric, middle-class, culturally based judgments regarding the “best” approaches to child raising are presented as “conventional” wisdom in the numerous mainstream parenting books and resources available. Ubiquitous parenting books and magazines debate the merits of one parenting style or another. Put your baby in a crib or co-sleep? Negotiate with your child or set strict boundaries?
These resources ignore many questions. Where do these norms of behavior come from? Who decided that my child should grow, eat, behave according to these percentiles and milestones and what were their cultural values and perspectives? For parents of color, the situation becomes more complex. Our cultures bring with them thousands of years of human development from around the globe, with varying yet valid approaches to raising children. Yet, are our cultural traditions and expertise included in the canon of parenting resources used by pediatricians and child-development specialists? Are our styles of parenting seen as “wrong” instead of just “different”? How can we expand the notions of what is “right” to include the wisdom and experience of people across many cultures?
Unfortunately, the lack of research and discussion of these issues leaves many parents of color questioning their approach. Worse, the lack of culturally competent research can leave parents of color discounting all Western conventional wisdom. The stakes can be high for children, as practices such as breastfeeding have real benefits but suffer from continued stigma, the intentional spread of baby formula by Western corporations and a work climate hostile to nursing mothers.
Ten years ago, to better understand these issues and to attempt to add cultural complexity to the child-development field, the field of ethnopediatrics was born. A group of pediatricians, child-development researchers, and anthropologists, notably Carol Worthman of Emory University, gathered in Atlanta and presented a series of papers on this new branch of research: the study of child-rearing practices across cultures.
Not surprisingly, what the group found is that most parents in the world do not follow the advice of popular U.S. parenting experts Dr. Spock, Penelope Leach or Dr. Sears.
Parents of color
For parents of color trying to lay the best foundation for their children, the lack of culturally relevant parenting resources can be frustrating. While there are a few books pertaining to one culture or another, such as Gloria Rodriguez’s “Raising Nuestros Ninos: Bringing Up Latino Children in a Bicultural World,” few examine the cultural biases of the dominant culture’s parenting establishment. Even fewer look at the ways in which parents of color can preserve their cultural traditions as well as add others to their cultural “toolbox” as well.
While it can be difficult to trace how child-rearing practices have been retained and transformed by American families of color, there are numerous differences between how children of color are raised versus white children. Much has been written in the African-American media, for example, about the different approaches taken by Euro-American and African-American parents regarding discipline. Many Asian Americans still value “Hsiao,” the Confucian ethic of familial love, which includes reverence of elders and ancestors. And while Euro-American Western culture emphasizes the nuclear family, many communities of color structure their families into kinship groups.
One avenue to broadening the definition of a “normal” child is through education. To this end, in November, a new college was founded in Seattle called The Praxis Institute for Early Childhood Education. The word “praxis” means practical application or exercise of a branch of learning, but to founder Debra Sullivan it has a more refined definition, taken from the work of Brazilian educationalist Paolo Freire: “Theory, action and reflection for critical social change.”
The college will prepare early-childhood educators to teach diverse children – children from low-income families, children of color and those who need training in English as a Second Language. “If teachers can increase their own cultural competency,” says Sullivan, “that will lead to more success for children, and eventually to social change and social justice.”
As an African-American mother, Sullivan has some personal observations about her parenting style and that of other black parents. Her observation is that black parents are generally firmer and more explicit than white parents, with clarity of both direction and expectation. “We have an advantage over white parents,” she says, “because we have a larger parental toolbox. We have no choice but to acculturate.” Black parents have learned white parenting methods by unavoidable osmosis, but few white parents know black parenting methods. “I know white parents better than they know me,” says Sullivan.
Sullivan says black parents do not feel that their parenting methods are wrong, but sometimes they feel disapproved of by white parents. This is usually because their style is misunderstood.
For example, Sullivan says, black parents sometimes do not demonstrate that they are in touch emotionally with their children in ways that white parents would expect. “We roughhouse, but we aren’t touch-feely,“ she says. “We read our children’s body language better.”
Another example is the game “playing the dozens,” in which people exchange insults, trying to outdo each other. “It is not rude,” explains Sullivan. “The point is how you use language. It’s verbal jousting.”
She adds that some black parents provide fewer “manipulatives” (what people in her profession call toys) to their children than do white parents. “Black children’s games tend to be more collaborative, less competitive. They play verbal games, hand games, and call and response games.” This is a living relic of their African ancestors.
Understanding cultural origins of modern behavior is further complicated by historical realities such as slavery.
Dr. Joy DeGruy-Leary, a professor of social work at Portland State University, has developed a theory called “Post Traumatic Slave Syndrome” (PTSS), which proposes that the trauma of slavery has been passed down through the generations and accounts for troubling practices that continue today. One of these behaviors is making denigrating statements about children.
Before emancipation, this was done to dissuade the slave master from molesting or selling children. It was such a profoundly ingrained survival mechanism that it persists to this day. But, says DeGruy-Leary, “It is not our whole story.” She believes that African Americans are capable of addressing uncomfortable issues. By shining a light on PTSS, she hopes to dispel it.
Frustration with the lack of culturally competent parenting resources for African Americans led Philadelphia’s Janice M. Robinson to create her own publication in 1995 called “Successful Black Parenting Magazine.” As a child-development specialist, Robinson found that mainstream articles and resources that she would give to parents of color did not resonate with their experience. To address this, she launched the now-defunct magazine to give African-American parents help from their own cultural perspective.
In addition to efforts to cultivate change in the private sector, Seattle’s city government is also trying to diversify its public services. The Human Services Department has several childcare task forces separately focused on the African-American, Asian/Pacific Islander, Latino and Native American communities. Children in these communities speak different languages, have different family values, eat different foods and have different traditions, including pedagogical ones.
Native Americans, for example, traditionally allowed their children to learn through their own observations, and instructed their children with nonverbal cues rather than giving verbal directions. It makes sense that children with varying backgrounds would have distinctive curricular needs. The task forces assess these needs in minute detail.
Rice and spice
Unexamined culturally based approaches to parenting can result in decades of misguided “authoritative” wisdom passed on by anxious parents and parenting experts. One such example is in feeding babies. In the U.S., the modern history of feeding babies has been fraught with stigma, Puritan mores regarding propriety as well the insidious influence of formula marketing that told American parents that breastfeeding was not only difficult and time-consuming but not as good as formula for babies’ growth and development. According to La Lache League, by 1956 U.S. breastfeeding rates were down to 20 percent. Today, the issue has come full circle, with breastfeeding advocates struggling to bring back breastfeeding and reverse the decline. Yet for many women of color, years of stigma around wet nursing and the “backwardness” of breastfeeding still linger, and women of color continue to have lower rates of breastfeeding.
Further, as babies grow older, pediatricians and child experts advise the addition of rice cereal to supplement a baby’s diet. However according to a recent story by the Associated Press, much of what is accepted wisdom about baby food is not based in science. Dr. David Bergman, a Stanford University pediatrics professor, says, “There’s a bunch of mythology out there about this. There’s not much evidence to support any particular way of doing things.” The story reported that there is no scientific basis for rice cereal and bland baby food as the first foods that should be introduced to a baby and that the conventional wisdom – repeated thousands of times by Western pediatricians and others – that spices are bad for babies is largely unfounded. The researchers found that across the world, parents feed their babies largely what they are eating and children suffer no ill affects. The researchers also found that children who are exposed to a range of food, including spicy foods, develop more advanced palates in later years and are then able to enjoy a wider range of food options. This flies in the faces of decades of conventional wisdom in the U.S.
Immigrants and parenting
What happens to the kaleidoscope of world parenting methods when they are first brought to the United States?
“In the U.S., that tends to mean non-Europeans” – Americans of color, refugees, and other immigrants – says Dr. Ellie Graham, a pediatrician at Harborview Medical Center who treats children from low-income families.
Over the years, the needs of refugee families have heightened Graham’s interest in cultural differences. “What distinguishes these families from others,” she says, “is their anxieties.”
She gives an example: malnutrition. About 50 percent of children who die worldwide die from malnutrition, not a disease per se. “Because of malnutrition, they can’t mount a defense against disease,” Graham explains.
Consequently, when they come to America, “some refugee parents want to see their children plump,” she says. They overcompensate, discounting the dangers of obesity.
Another anxiety of refugee parents is infant gastroenteritis, or diarrhea and vomiting. In the U.S., doctors often prescribe extra fluids like Pedialyte for re-hydration, but symptoms may not stop for a few days.
In Africa, gastroenteritis is a more urgent matter. An African baby with gastroenteritis would be placed on an I.V., because many African babies die from the condition. “Perhaps an African parent has witnessed that,” says Graham. “A few days is a long time to them.”
Something she stresses to medical interns and residents is that they must better understand where the patient is coming from. “Empathy fosters better communication,” she says.
Harborview makes a concerted effort to understand traditional healing methods from around the world. Overall, Harborview provides interpretation services in 83 languages. In addition, there are online services.
One responsibility of Ellen Howard, who heads the K.K. Sherwood Library at Harborview, is to oversee a Web site called EthnoMed (ethnomed.org). “We’re very pragmatic,” says Howard. “EthnoMed is not a research tool, it’s a clinical tool – we want to increase understanding and communication when we’re trying to treat someone,” including infants and children.
Information about a particular traditional healing practice is gathered and then reviewed, not just by medical practitioners, but also by people from the relevant culture. Then it is posted and continually updated, and corrected. “We receive lots of feedback about word use, spelling, and whether or not the entire gist of an idea makes sense,” Howard says.
EthnoMed focuses on groups that need it most. There are 10 culture-specific pages, from Amharic to Vietnamese, and 12 more under “other.”
Graham has found that inter-generational conflict in immigrant families has more to do with behavior than illness or other physical matters. A Filipina grandmother, for example, thinks her American grandchildren are rude because they look her in the eye. In the Philippines, young people never look their elders in the eye.
Mergitu Argo, an East African family advocate and project coordinator at the Refugee Women’s Alliance (ReWA), agrees with Graham. “Refugee families want to raise their kids the old way,” she says, “but kids want to be raised the American way.” Argo is a refugee herself, from Ethiopia (see sidebar page 13).
Originally founded for women, ReWA now also opens its doors to men. Among its many programs are parenting classes and support groups. In parenting classes they teach how to raise a bilingual child, incorporating what they see as good parenting methods from both old and new cultures.
Tsege Tsegay, also from Ethiopia, teaches a parenting class at ReWA. The current class consists of parents from Cambodia, Ethiopia, Somalia, and Vietnam. Tsegay teaches in English, but there are four interpreters in the room as well.
Discussions about infants and young children focus on nutrition, safety and immunizations. Tsegay advocates that refugee parents acquiesce to one significant Western parenting method: putting babies on a feeding and sleeping schedule. Many Western women do this because they work outside the home, and many refugee women must meet this demand as well.
Homeland cultures are kept alive by re-telling family stories, wearing traditional clothing, not converting to Western religions and eating traditional foods.
When discussions at ReWA turn to older kids, the topics are school and discipline. Parents learn how they can become more involved in their child’s education, and they learn that in the U.S., corporal punishment is frowned upon.
In Tsegay’s opinion, spanking works in the short run, but not in the long. Children obey immediately out of fear of punishment, but it is not good for their relationship with their parents. Here again, she advocates disciplining the Western way, by withdrawing privileges, for example.
Pluralistic parenting “is rich,” she says. “If parents know both cultures, they can better answer their children’s questions.”
Nonetheless, a gap is widening. “Kids change fast,” says Tsegay. “They Americanize faster than their parents.” In support groups, participants complain that their children have no respect for their cultural heritage or their parents. They see this in children of all ages, not just adolescents. Kindergarteners have threatened to call 9-1-1 when they don’t get their way. They have been told at school that in this country they can call 9-1-1 if they are abused, but their notion of abuse is broad. Not getting ice cream is not abuse.
Refugee parents fear this more than other parents, because it could jeopardize their immigration status.
In addition, many refugee parents greatly value an education, something that may not have been available to them in their homeland. These parents are dismayed when their children are truant. “I can see their disappointment,” says Tsegay. It is as if the children have too much of a good thing, “too much freedom,” she says.
Many refugee parents have fled horrific conditions, so they are bewildered when kids act out. It is far from what they dreamed or imagined. “They have struggled to come to the U.S.,” says Argo. “‘I give up,’ they say.”
To prevent this from happening, ReWA mediates between the generations. They not only identify what each side wants and help them negotiate, they follow up afterward. Fortunately, they have some success stories to tell.
Demographic changes
There are a host of reasons why Western concepts of parenting are considered conventional wisdom in the United States. The dominance of Euro-American traditions and values in the U.S. social and political landscape as well as the continuation of unexamined practices have led to the current climate.
But as the ethnic landscape of our country is changing, so must experts in the field of parenting change to accommodate the new wealth of traditions and cultures.
As our country becomes ever more diverse, so do practices of all kinds, including child-rearing. What most parents around the world have foremost in mind is what is best for their children.
And what is best may be to get away from the dominant mainstream message that’s out of balance for families from non-European cultural backgrounds. What may work best may be a judicious mix of the old and the new, of the tried and true tips and practices from all cultural backgrounds that can be used to bring up healthy, well-adjusted and happy children.
Ethnopediatrics:
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.”
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.
