New AAP Policy recognizes value of nurturing family relationships

The American Academy of Pediatrics (AAP) has issued a new policy, Preventing childhood toxic stress: Partnering with families and communities to promote relational health.

We applaud this bold recognition of the value of nurturing parenting, given AAP’s influence on its global network of pediatricians:

Source: AAP

Safe, stable, and nurturing relationships can act as a powerful, protective buffer against the biological harms of toxic stress on children. These relationships are also key to building resilience—being able to bounce back from adverse childhood experiences.

When children feel connected and supported in the early years, according to the newly updated AAP report, they are more likely to become healthy, competent and educated citizens later in life.

The policy statement, “Preventing Childhood Toxic Stress: Partnering With Families and Communities to Promote Relational Health,” was published in the August 2021 issue of the journal, Pediatrics. The statement focuses on just how important relationships and positive childhood experiences are in preventing and healing toxic stress.

This policy moves away from a problem-based model that focuses on a child’s past adverse experiences and instead presents a positive, strengths-based approach that fosters solutions at the family, community and societal levels.

Related: Youth empowerment as peace education

A Slow-Moving Public Health Crisis

The AAP calls for pediatricians, parents, and policymakers to recognize toxic stress as a slow-moving public health threat that can be tempered by a preventive approach aimed at developing and strengthening healthy relationships.

“The concept of drawing on positive relationships as a shield against the toxic stress caused by adverse experiences has never been more relevant,” said Andrew Garner, MD, PhD, FAAP, a co-author of the policy statement generated by the Committee on Psychosocial Aspects of Child and Family Health, the Section on Developmental and Behavioral Pediatrics, and the Council on Early Childhood.

Related: ACEs too high with Jane Stevens

Forming Close, Healthy, and Nurturing Bonds

“Over the past few years, we’ve experienced a socially-isolating pandemic and reckoned with centuries of structural racism,” Dr. Garner said. “We must take steps to help kids form close, healthy and nurturing bonds, whether it is within the family, schools or community.”

The AAP recommends that pediatricians prioritize the trusted, respectful relationships that they share with patients and their families. They may refer families with strained relationships to evidence-based therapies, or work within their communities to make those therapies available if they are not offered.

New research also reveals that changes in the brains of parents who experienced trauma in their own childhoods may make it difficult for them to bond and nurture their children. These families can benefit from help from the community and others, especially after the pandemic.

Related: For better or worse, parenting changes your child’s DNA

“Families can help children adapt to harmful experiences and adversity by modeling their own skills at resilience,” said Michael Yogman, MD, FAAP, a co-author of the policy statement.

“This may mean demonstrating how to ask for help from family, friends, neighbors or others or demonstrating how to handle their own strong emotions,” he added. “Caregivers do not need to be perfect to help children feel safe, connected and supported.”

The AAP recommends that pediatricians watch for, screen, and address potential barriers to safe, stable, and nurturing relationships. Barriers include social determinants of health, such as inadequate housing, education inequities and food insecurity; the parents’ own adverse childhood experiences; intimate partner or neighborhood violence; parental depression; and/or substance use.

The pediatrician cannot do this work alone, however. The AAP calls for policy makers and community leaders to learn how relational health is influenced at all levels and support programs and funding that strengthen families.

This may include expanding family medical leave opportunities, increasing child tax credits, securing safe and affordable housing, supporting employment assistance and job training, promoting universal access to high-quality child care centers and schools, advancing preventive early childhood mental health services, promoting social emotional learning in schools, and expanding opportunities for playful learning in safe neighborhoods.

Related: A need for paid parental leave

The AAP also offers recommendations for families, caregivers, teachers, coaches, and others:

  • Learn about positive parenting techniques and developmentally appropriate forms of play, such as shared reading, as these foster the warm relationships that enhance literacy, executive function, and other core 21st-century life skills.
  • Learn how to handle their own strong emotions, so they can model this skill and be emotionally available when their children are distressed (“put your own oxygen mask on before helping others”).
  • Consider therapy to address unresolved trauma in the caregivers’ own history. Children are watching as caregivers strive to become slightly better versions of themselves each day, and the development of a “growth mindset” is a powerful predictor of future success.
  • Help children understand that there is nothing wrong with having strong emotions: the challenge is helping them to channel that energy into a constructive outlet like a passion, hobby, or activity that brings them joy while at the same time building generalizable skills.

Related: Manage your emotions: How to cool down before you blow up

Policymakers are encouraged to consider how adverse childhood experiences and toxic stress lead to long-term health problems from depression to diabetes and heart disease that are bankrupting the healthcare system.

“Our nation’s children are suffering both a mental health crisis and an educational challenge amid the pandemic,” Dr. Yogman said. “We must seize this opportunity and make sure that all children have someone they can turn to, that they can trust within a consistent, positive and nurturing relationship. This benefits our children, our society and our future.”

New study: Teens with secure family relationships bring more empathy to peer conversations

Source: News release by the Society for Research in Child Development

Teens’ ability to empathize – to understand others’ perspectives and emotions, and to care for their wellbeing – is an important contributor to their relationships, including with friends.

Prior research shows that teens who have more secure family relationships report higher levels of empathy for others, but little research examines whether teens with more secure family relationships actually show greater empathy when observed in real-life interactions with peers, or whether their empathic capacities show different patterns of growth over time.

A new study – by researchers at the University of Virginia – tested whether teens’ secure, supportive family relationships at age 14 related to their ability to provide their friends with empathic support across adolescence and into early adulthood.

Findings indicate that secure attachment – reflecting on close relationships in an emotionally balanced, coherent, and valuing way – predicts teens’ ability to provide empathic support to their close friends.

“What’s especially interesting is that close friends also sought out more support from securely attached teens,” said Jessica Stern, postdoctoral fellow at the University of Virginia.

Related: The room of a teenage boy, a look at attachment parenting with teens

While having secure family relationships at age 14 predicted greater empathy with peers across adolescence, those teens who did not have secure family relationships in early adolescence showed a pattern of catching up, increasing their empathy toward close friends as they developed.

This study is among the first to examine associations of attachment with the development of empathic support using longitudinal methods and observations of empathic support for friends across mid-adolescence.

The findings were published in the journal Child Development. This research was supported by the National Institute of Child Health and Human Development and the National Institute of Mental Health.

The study featured a sample of 184 adolescents (86 males, 98 females) recruited from a public middle school (7th and 8th grades) in suburban and urban populations from the southeastern United States. Adolescents in the study were 58% Caucasian, 29% African American, 8% mixed race or ethnic, and 5% other identity groups.

In the current study, teens at age 14 responded to an interview about their attachment relationships, unlike most prior studies which used self-report measures of attachment style and empathy. Teens who described their attachment relationships as supportive, who valued those relationships and reflected on them with coherence and emotional balance, were rated as more secure.

Related: How to heal attachment with your teen

At ages 16, 17 and 18, teens and their nominated closest friend participated in a video-recorded, 6-minute task in which teens helped friends deal with a problem they were facing. Friends’ bids for support, as well as teens’ ability to provide empathic support, were coded from videos of this task.

The findings suggest a strong association between a teen’s having a secure attachment – or perspective on attachment relationships as supportive – and the development of the capacity to provide empathic support to close friends across a 4-year period of adolescence.

Results also suggest that friends’ support-seeking develops alongside teens’ ability to deliver empathy, with support-seeking helping empathy to develop and empathy fostering support-seeking from friends as well.

“Investing in the quality of teens’ family relationships early in adolescence may be important for building empathy and positive interactions with peers,” Stern said. “Parenting programs, family therapy when needed, and school-based interventions that help young teens feel safe and supported in their relationships with adults – not only parents but teachers, mentors, and extended kin – may equip teens to ‘pay it forward’ in their empathy and care for others.”

WBW 2021: Protect breastfeeding by protecting nurturing

As we reflect on this year’s theme for World Breastfeeding Week, August 1-7 – “Protect Breastfeeding: A shared responsibility” – it is imperative that we understand that protecting breastfeeding requires us to normalize nurturing.

Nurturing parenting is invariably linked to breastfeeding. While not all mothers are able to breastfeed, we recognize that breastfeeding – and breastfeeding behaviors while giving a bottle – is one of nature’s best teachers of new parents in how to sensitively and consistently respond to their baby as well as learn to develop the reciprocity of a healthy relationship between parent and child.

Related: Nature’s case for breastfeeding

Largely due to cultural pressures, even when mothers are able to get breastfeeding off to a strong start, there is a sharp decline overall in breastfeeding rates in the weeks and months after childbirth. The World Alliance for Breastfeeding Action (WABA), of which we are a member, has found that premature weaning tends to happen when mothers are without access to knowledgeable support while encountering problems with breastfeeding.

Breastfeeding problems are common, making widespread access to breastfeeding support paramount. International Board Certified Lactation Counselors, La Leche League leaders, and other trained advocates are key players in not only breastfeeding education but also nurturing parenting. The early days, weeks, and months of breastfeeding serve as a crucial time when mothers and fathers learn how to parent…to relate to their baby with nurturing behaviors, or not.

Related: Who will Baby attach to?

These early parenting lessons, which set the stage for years of a secure or insecure mother-infant relationship, are often absorbed in a time of relative isolation.

Traditionally, support to new parents was provided by the family…particularly the new mother’s mother and grandmother. However, as society has changed, mother support must come from a wider circle. This is where community support enters.

A new mother and father may have access to lactation consultants, depending on their geographic location. Some trained health care providers are able to provide ongoing support between medical appointments for acute breastfeeding problems; many are limited by their funding. La Leche League International fills the gap by training mothers with personal breastfeeding experience to volunteer in their communities by offering mother-to-mother support that complements professional care.

Likewise, we provide training to become a Certified Attached at the Heart Parenting Educator to provide holistic support to mothers and fathers in your community as they learn how to incorporate nurturing into the parenting of their children.

Related: Find a parent educator

As certified parenting educators, we offer basic support and community resource referrals to help parents make the best decisions for their families while educating them on the research-backed ways of bringing nurturing into their parenting. We help mothers view breastfeeding within the context of the whole mother-infant relationship and family dynamic, and how the give-and-take interaction that builds the foundation of secure attachment can be applied beyond breastfeeding.

Breastfeeding naturally promotes nurturing parenting. Overcoming the challenges that may come with breastfeeding sets the stage for building resilience through nurturing parenting for years to come.

How being stressed-out hurts the brain, and what parenting has to do with it: Video

There’s a lot of talk about family and personal stress during this worldwide COVID-19 pandemic, but stress is hardly a recent development. Neither are the roots of resiliency that some people tend to have.

Scientist-turned-journalist Madhumita Murgia created a TED-Ed short film back in 2015 to illustrate what exactly happens to the brain on stress and how to mitigate this multi-lifetime effect.

“How Chronic Stress Affects Your Brain” is available for public viewing at no cost. Some highlights:

  • Stress isn’t always a bad thing, unless you’re feeling regularly stressed-out
  • This chronic stress changes how our body’s systems work, including our brains…even shrinking certain brain regions while enlarging the brain’s fear center

Related: What happens to the brain when we ‘lose it’

  • These effects lead to it being harder to learn and remember things and control anxiety, and has been linked to eventual depression and Alzheimer’s dementia
  • Stress is inevitable in our modern lifestyles, but there are certain coping skills linked to greater resiliency including exercise and mindfulness

Related: Mindful parenting with Inga Bohnekamp

  • What’s parenting have to do with this? Turns out, parenting style changes how our genes are expressed…nurturing parenting sets up children for a lifetime of resiliency, negligent parenting sets up children for a lifetime of more susceptibility to stress’s effects

Related: ACEs too high with Jane Stevens

  • And these changes to our children’s genes are heritable, meaning that not only can we change the trajectory of our family tree by shifting to a nurturing parenting style but also that our children’s children and grandchildren benefit from this choice

Related: For better or worse, parenting changes your child’s DNA

Curious as to what nurturing parenting looks like? Check out API’s approach.

The payoff of nurturing parenting

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