In this episode, I welcome Dr. Brie Reid. She has a PhD in Developmental Psychology and studies stress and malnutrition in early childhood development.

We have a fascinating discussion about early childhood stress and cortisol research in children.

00;00;06;09 – 00;00;35;19

Dr. Mona

Hey, everyone. Welcome to the PedsDocTalk podcast. I’m your host, Doctor Mona, where each week I hope to educate and inspire you in your journey through parenthood with information on your most common concerns as a parent and interviews with fellow parents and experts in the field. My hope is you leave each week feeling more educated, confident, and empowered in decisions you make for your child.

 

00;00;35;21 – 00;00;55;03

Dr. Mona

Hello. Thank you for joining us for this week’s episode. I’m excited to have Brie Reid, who is a developmental psychologist at the University of Minnesota’s Institute of Child Development. And we are going to be talking about cortisol, her research and just about early childhood development and stress. Thank you for being here, Brie.

 

00;00;55;06 – 00;00;57;21

Dr. Brie Reid

I am so excited to be here. Thank you.

 

00;00;57;23 – 00;01;06;06

Dr. Mona

So tell me a little bit more about yourself and obviously your training and why you chose to pursue a PhD in what you’re doing right now.

 

00;01;06;09 – 00;01;29;23

Dr. Brie Reid

Yeah. So that is a great question. And it’s kind of been a long and winding road to get here. But, I study stress and malnutrition. How they interact early in development and how the experiences of what we would call toxic stress and very severe malnutrition predict mental and physical health through the lifespan. So that’s kind of at the broad level.

 

00;01;30;11 – 00;01;56;11

Dr. Brie Reid

I’m depending on when this podcast gets recorded, I will either have my PhD or be weeks away from getting my PhD. As I am at a in a doctoral program right now and months from to funding. And I’m also a new mom, so I’m experiencing, you know, stress and nutrition and development, you know, all through, all through my own experiences.

 

00;01;56;11 – 00;02;26;09

Dr. Brie Reid

So my daughter Sloane is six months today. And I really got into this field, through my interests and my previous experience. So initially I went to school for design and architecture, and I focus on designing health care spaces and spaces specifically designed to support the health and well-being of people in general. But I focus on environments for children, places like classrooms, health care, museums, things like that.

 

00;02;27;15 – 00;03;05;20

Dr. Brie Reid

And then through that experience, I got grabbed into an international nutrition, intervention, research program at Cornell University, where they were trying to figure out, okay, how do we make the environment supportive to promote healthy development for children in sub-Saharan Africa, so specifically in rural Zambia and Zimbabwe? And, through my work, over a few years there, I just felt like the nutrition, intervention world really was not capturing the stress and the physiology of stress in their interventions.

 

00;03;06;07 – 00;03;37;20

Dr. Brie Reid

And I wanted more of that expertise, because if you’re a substance farmer in, you know, sub-Saharan Africa, in rural Zambia, you water insecurity is an issue. You’re a mom who’s working 14 hours a day in the field, stresses happening to you and your family. And so I pursued a PhD at the University of Minnesota, which allowed me to both combine my interest in nutrition physiology and in stress physiology in development.

 

00;03;37;20 – 00;04;14;29

Dr. Brie Reid

Because there’s Meaghan. Gunnar is the leading expert on child development and stress physiology. Really in the world. And so I’m studying with her and Michael George’s, who’s an MD and, nutrition expert who is just, the babies, the babies documentary on Netflix, if you watch that. Yeah. So, that’s kind of where I am. And, my research looks at a few different populations from children who are adopted internationally from orphanage care, seeing how the early experience of stress and malnutrition impacts their now adolescence.

 

00;04;15;11 – 00;04;36;14

Dr. Brie Reid

So we’re looking at how that early experience affects their health and development as well as their stress response. But I’ve also worked in populations in, Chile and Santiago. And I’m working with a data set in Singapore and kind of the prenatal stress and nutrition there. So all over.

 

00;04;36;16 – 00;04;37;09

Dr. Mona

Awesome.

 

00;04;37;14 – 00;04;38;11

Dr. Brie Reid

Yeah.

 

00;04;38;14 – 00;04;58;18

Dr. Mona

Yeah. So I mean, I’m so glad we connected through Instagram because for me, early childhood development is so important. And then when you add in early childhood stressors, whether it be for the child or obviously the parents or caretakers, it has a huge effect and impact on their development. So I’m so excited that we’re gonna be able to talk about that, that early childhood.

 

00;04;58;18 – 00;05;21;22

Dr. Mona

And, obviously the stressors that can come into play that can affect the development. So you you’re a lot of your research looks at cortisol, which obviously for anyone who’s listening, cortisol, stress hormone that is good in some amount, but obviously in toxic amounts or large amounts, it can be detrimental to the developmental system. So tell me more about this concept of cortisol and how it impacts development.

 

00;05;21;24 – 00;05;43;04

Dr. Brie Reid

Yeah. So I’m so glad you asked because I think this is a huge misconception. Just everywhere for parents and non-parents alike about cortisol and stress. So I love what you said about good and little amounts, maybe not so much in toxic amounts, because, it is a hormone created by our body that really helps us in day to day life.

 

00;05;43;04 – 00;06;03;13

Dr. Brie Reid

It rises when we wake up in the morning to help us wake up and go look for food, and then before we go to sleep, it falls to help us kind of fall. And it follows a daily rhythm. And it also helps us respond to threat. So, no human in the history of ever has ever experienced no stress or no threat in their life.

 

00;06;03;13 – 00;06;27;22

Dr. Brie Reid

So it’s wonderful that, you know, we’ll say the unscientific term of Mother Nature provided us with, a system to help respond to that, and to kind of mobilize our body’s resources to respond to threats. We often think of it in terms of a fight or flight response. And, so cortisol is there’s two parts of that response.

 

00;06;27;22 – 00;06;56;10

Dr. Brie Reid

The first response is what we know as adrenaline, right? Our heart’s racing, our hands are shaking. And then cortisol is a product of, the hypothalamic pituitary adrenal cortical system, which we won’t get into in detail, but it’s just the stress, what we consider the stress response system, that produces cortisol, that helps us kind of maintain our response to a little more of a chronic threat, that we experience over a longer period of time.

 

00;06;56;10 – 00;07;15;27

Dr. Brie Reid

So we’re adrenaline is a few minutes. Cortisol is kind of more of like the 20 minutes to a couple of hours sort of response. And the really cool thing about it is that it helps change our brains. It kind of helps signal our brains to help us respond to a similar threat the next time we experience it.

 

00;07;15;29 – 00;07;39;22

Dr. Brie Reid

So that’s why we’re very excited about it in development, because it has wide ranging effects on the body, and it kind of helps our body program it program itself to respond to threat later. And so we use both. This is how cortisol rises in response to a threat and how cortisol is patterned over the course of the day.

 

00;07;39;24 – 00;08;09;03

Dr. Brie Reid

To help us understand how the body of a child or an adult is responding to the world around them, and how these patterns relate to physical and mental health problems. So again, it’s kind of like the Goldilocks situation. You don’t want too little cortisol, you don’t want too much. You kind of want like the just right amount. And that just right amount can depend on, the person and our own genetic background and also our own experiences.

 

00;08;09;03 – 00;08;36;00

Dr. Brie Reid

So we all have different threshold about what is too much or, you know, not enough. So I do want to emphasize that when we talk, when I talk about stress and when scientists talk about stress, we’re not talking about like, oh, that external thing was stressful to the person. We’re really talking about the physiological response of the body to and a threat.

 

00;08;36;00 – 00;09;00;17

Dr. Brie Reid

Right. And so, it’s really rooted in physiology. And so that’s what I’m going to probably keep coming back to. But I think the big misconception is that all stress is bad. And I think, you know, as a parent and you can probably say the same thing, we don’t want our children to experience stress. We want them, you know, to kind of glide through the world.

 

00;09;00;17 – 00;09;26;18

Dr. Brie Reid

In some ways, I think there’s a very natural inclination to try to protect our children from what we consider stressful experiences. But what’s really important is that stress is normative and very important, and it’s part experiencing stress throughout development and adapting to that is really a part of what makes us resilient and what makes us able to, be fully functioning adults in the world.

 

00;09;26;18 – 00;09;45;11

Dr. Brie Reid

Later, when we inevitably have a breakup or lose a job or, you know, experience a global pandemic, which will probably happen again in human history. And so, all of that’s really important. And I don’t know if you want me to go into kind of developmental what we see or what.

 

00;09;45;13 – 00;10;07;23

Dr. Mona

Yeah. So, you know, this is this is great because you, you know, you’re talking about that Goldilocks. And that is truly to me, parenting 101. Yeah. Finding that happy medium, for a child because, you know, my my parenting style that I educate my families on and then also how we are parenting Ryan is a balance of allowing some degree of fussing.

 

00;10;08;07 – 00;10;24;02

Dr. Mona

You don’t see the word crying. We do allow him to cry, before we jump at him, right? We we allow a small degree of it. And so, and then as we get to know him, we do permit more, more crying, you know, and because we know him, we know that he can do it. We know his needs.

 

00;10;24;02 – 00;10;53;21

Dr. Mona

Now, we figured him out very well. So my you know, my biggest clarification for the listener is, just a lot of my followers is based on your research. How early have you how early is there data or research on kids meaning? Are we seeing research studies on infants in regards to cortisol? Is it more, you know, older toddlers or is it like school age in terms of an effect from, you know, obviously, that, you know, a detriment to their development if they have too much stress.

 

00;10;53;23 – 00;11;16;10

Dr. Brie Reid

Yeah. So the studies actually start prenatally because as we know, the prenatal experience is really important. And we kind of consider there to be sensitive. I’m putting air quotes around which the air listeners can’t see. But a sensitive period and development to kind of program our stress response. And so there’s two periods that we think are really important.

 

00;11;16;10 – 00;11;40;15

Dr. Brie Reid

And the first one is really this prenatal and early infancy period. And then the second period, which is very exciting. And the research that I’m involved in is this pivotal period where our bodies seem to, you know, look at the environment around it, kind of see, is this a safe environment? Is there enough food? Can I exist in this environment or are there a lot of threats?

 

00;11;40;15 – 00;12;03;25

Dr. Brie Reid

Is there not enough food? And our body then is like, okay, let’s set our physiology up to respond to this kind of environment. So prenatally, you know, we start to see a stress response or a kind of a stress response system being active at around 20 weeks gestation. We don’t really see it any earlier than that.

 

00;12;03;25 – 00;12;28;07

Dr. Brie Reid

But mom and baby, they kind of have a stress response that rises and falls together prenatally. And this is actually really good because cortisol helps organs mature, as you can probably tell all the listeners. And, you know, it also helps labor begin. It’s kind of like a timer to help labor begin. So we consider, you know, a good amount of cortisol is what we want because we want lungs to mature, right.

 

00;12;28;07 – 00;12;53;19

Dr. Brie Reid

We want mature organs. And then there are studies that have found detrimental effects when there is too much stress, for the mother. So one of the these studies are really in like natural disaster studies. So for example, the Dutch hunger winter is a very famous one around World War two, when there was just a huge famine because food supply lines were cut off to the Dutch people.

 

00;12;53;19 – 00;13;25;27

Dr. Brie Reid

And so you could study when women were experiencing this kind of stress, what long term effects that their children have. And there are other studies like that. And then postnatal lead, there’s a lot of research beginning from birth all the way, you know, all the way into adulthood. So, what’s very exciting is that, our stress response system begins is immature in infancy, but continues to develop.

 

00;13;25;27 – 00;13;50;07

Dr. Brie Reid

And, you talked about crying, which is so interesting. So I think a very stressful experience for parents is seeing their children cry in well-child visits. And, so Meg and Gunnar actually did a series of landmark studies about well-child visits and different kinds of typical stress that an infant would go through. And, or at around three months.

 

00;13;50;07 – 00;14;12;17

Dr. Brie Reid

Infants do get upset when they get shots, of course. I mean, it doesn’t feel good. That makes sense. But as they have an attachment to their caregiver, we actually don’t see that their stress response, they don’t release more cortisol, in response to this stressor. They’re they’re crying and they will cry as they get older, which makes sense.

 

00;14;12;17 – 00;14;36;28

Dr. Brie Reid

But it doesn’t. The behavior doesn’t always match the the rise in cortisol. And that’s actually really adaptive because humans obviously will experience threats. And as our, as those little brains are, you know, setting the architecture and the foundation up for future growth, it’s kind of nice that there’s this caregiver that this built in kind of stress buffer.

 

00;14;36;28 – 00;15;03;15

Dr. Brie Reid

We call them a social buffer so that if you know, a stressful experience happens, this caregiver dampens kind of short circuits the stress response for children. And so, it kind of acts as a protective mechanism for the developing brain and for the stress response system. So when I’ve heard that the 12 month shocks are really very difficult, there’s probably a lot of crying.

 

00;15;03;15 – 00;15;27;14

Dr. Brie Reid

I’ve heard this from my siblings and their children. But it’s really difficult to get a cortisol response from a 12 month old at this time there. I mean, it’s really very heavily regulated by their attachment figure in the room at that time. So rest assured, if your child is crying, getting their shots, you know, they’re they don’t feel great about it because no one likes to get poked.

 

00;15;28;14 – 00;15;51;26

Dr. Brie Reid

But their cortisol, it’s not like a toxic level of cortisol. It’s really not even raising at all. And so this, buffering happens throughout childhood, which is very exciting. So nine year old who experiences stress with the we’ve done experiments where the parents in the room while the child experiences a stress. They don’t exhibit a rise in cortisol.

 

00;15;51;26 – 00;16;33;20

Dr. Brie Reid

If the parent is out of the room then the body’s like, okay, I need to react to the stress. So I’m going to mount a stress response. And then usually it comes back down, which is great. And then then puberty. You know, it doesn’t seem like the parent really buffers against that stress response. And I think some parents might hear that, especially if they are parents of teens think, oh, no, like, this is terrible, but it’s actually really great because you don’t want to be that child’s stress buffer forever because they need to go out and find a partner or, you know, you know, be on their own and be a fully functioning

 

00;16;33;20 – 00;16;59;25

Dr. Brie Reid

independent adult and have their own social connections that are independent of you as a parent. And what’s exciting about this pubertal period is that we find that we have children, have, a stress response that is disrupted very early in life from very severe levels of toxic stress. And then there. So in the case of international adoption, these children are in orphanage care.

 

00;17;01;02 – 00;17;24;24

Dr. Brie Reid

Just it’s just not a species expected. It’s not what the human species is, you know, designed to grow up in from a very early age. Right. We really need caregivers that are routine and normal and not caring for, you know, 20 infants in mass. So their stress response seems to be different than the normative stress response early in life.

 

00;17;24;24 – 00;17;57;13

Dr. Brie Reid

But when they’re adopted in infancy into highly responsive, highly supportive homes, and they experience this like safe and nurturing caregiving environment throughout childhood, we then start to see as they go through pubertal transitions, that their stress response begins to recalibrate and look more normal. More like the other teens that are our control group that have been in their responsive birth families for their entire lives, which is really exciting.

 

00;17;57;29 – 00;18;25;21

Dr. Brie Reid

Because it, you know, it emphasizes that nothing is fixed, no child is damaged forever. There seems to be times of life, where these, physiological systems can, you know, assess the environment again and say, okay, now that we’re entering adulthood, is this environment still harsh and scary, or is this supportive and safe? And can my systems start to react differently?

 

00;18;26;29 – 00;19;01;10

Dr. Brie Reid

And so that’s the second responsive period or sensitive period? I think the thing that I really want people to know is that it’s not necessarily a bad thing. If a child’s stress response is, you know, responding to a harsh environment, that’s really what the body is designed to do. There’s nothing in our body that I know of that’s designed to really like, screw us over somehow, physiologically, our body’s designed to survive and adapt to very different circumstances.

 

00;19;01;10 – 00;19;26;28

Dr. Brie Reid

And that’s kind of the beauty of the system, is that it can read the environment, adapt to that and survive. And of course, there might be long term consequences for that because there’s no free lunch necessarily. If you make adaptations one way, you might, you know, have to make adaptations or experience difficulties in another way. But, that’s always we always want to talk about stress and resilience in the same sentence.

 

00;19;27;27 – 00;19;31;04

Dr. Brie Reid

And yeah. Does that kind of answer your question?

 

00;19;31;04 – 00;19;53;11

Dr. Mona

Yeah, absolutely. And you know, it’s yeah, that resilience because it is for me I and we’re going to get into this later. We’re going to talk about attachment parenting versus security. Yeah. You know those are they’re actually very different. And I and we’re going to talk about that because I want especially in modern parenting attachment parenting has taken off, which I think everyone’s entitled to their own parenting.

 

00;19;53;11 – 00;20;13;29

Dr. Mona

But my concern with attachment parenting is that it’s it’s being, advertised as secure attachment. When you can be a secure you can you can practice secure attachment parenting and not be an attachment parent or meaning I, I we’re going to talk about this, but I did a cried out method of sleep training with my son. And we’ll talk about a little bit about that.

 

00;20;13;29 – 00;20;42;12

Dr. Mona

But I still see, even though I allowed my son to cry for crying out, I still see him securely attached. You know, I still see all those signs which, you know, I didn’t baby wear him. I didn’t breastfeed him for various reasons. But it’s you can still establish that secure attachment with the child without having that constant a physical attachment, you know, and I think that’s what I think a lot of modern parents, parents are concerned because they want their child to feel loved.

 

00;20;42;14 – 00;21;08;00

Dr. Mona

They want their child to feel nurtured, which you can do, and allow some level of separation and resiliency, which is that, I mean, I just from a pediatric world, I see it all. I mean, I see it all day with families being able to accomplish that, and we’re also being able to accomplish it too. So what is like I know it’s hard to quantify the level of stress that is healthy for a, and an infant or kid, but what would be an example of toxic stress?

 

00;21;08;00 – 00;21;17;18

Dr. Mona

Let’s just define that. Like what’s a situation? I know you mentioned like an orphanage, but what’s another example of something that’s considered toxic enough to cause an issue with development?

 

00;21;17;20 – 00;21;39;06

Dr. Brie Reid

Yeah. So again, it goes back to the physiology. So I’ll start with the positive amount of stress. This is kind of a brief increase in heart rate mild elevations and stress hormones. And this is normal and it’s essential for healthy development. And some examples would be you know the first day with a new caregiver or receiving your immune right.

 

00;21;39;06 – 00;22;04;03

Dr. Brie Reid

You have a slight increase potentially. But it’s it’s normal. Right. And I would say that, you know, fussing a little bit, babies cry. That’s their communication. That’s really the only way that they can communicate a lot of their moods. And so it’s normal for a baby to first to feel frustrated. My daughter is so mad that she can’t crawl right now and is very frustrated all the time.

 

00;22;04;05 – 00;22;29;26

Dr. Brie Reid

And that’s just a normal positive stress in her life that’s really going to drive her to try to crawl because she wants to move. And then there’s something that we consider a tolerable amount of stress. And this is from if your listeners are interested, the Harvard Center for the Developing Child really put together, a great set of resources for parents and policymakers to understand what is stress and toxic stress.

 

00;22;31;01 – 00;22;54;17

Dr. Brie Reid

And tolerable stress is kind of like the yellow light in the stoplight. And it’s serious. It’s a temporary stress, and there is a response to it, but there’s a supportive relationship in the child’s life that buffers them from long term effects of this. And so some examples of this is the loss of a loved one, you know, a natural disaster, a really scary injury.

 

00;22;54;17 – 00;23;19;08

Dr. Brie Reid

Those kinds of things are stressful. And they do amount for the vast majority of people as a stress response for the vast majority of children. But what makes it tolerable is that there is, an attachment figure, a caregiver in their life that can care for them and help their body and brain learn, okay, I’m still safe.

 

00;23;19;10 – 00;23;55;23

Dr. Brie Reid

Scary things can happen. I’m still safe and kind of help that stress response regulate and down regulate after experiencing a stress like that. So it’s kind of a time limited stress and it’s buffered by an adult. Toxic stress is a prolonged activation of a stress response and really an absence of these protective adult child caregiving relationships. So this can occur when a child experiences strong, very frequent or prolonged adversity without enough adult support.

 

00;23;55;23 – 00;24;22;12

Dr. Brie Reid

So this could be physical or emotional abuse. This could be chronic neglect. This could be caregiver, you know, extreme substance abuse or mental illness by a caregiver. Exposure to violence. You know, just like intense and accumulated burdens of economic hardship on the family without there being a caregiver who can really provide that buffer of the stressful experience.

 

00;24;22;23 – 00;25;06;08

Dr. Brie Reid

And that’s the kind of stress that we see, that can really disrupt things too, that are involved in developing brain architecture and other organ systems. And that can increase the risk for stress related disease and cognitive impairment into adulthood. And so toxic stress, if it happens on a continuous basis, on a chronic basis, that’s really when there’s kind of this wear and tear on the body, just like there would be wear and tear on your car if you never, you know, you never got it fixed, you never replace your tires, and you just drove it back and forth across the country like 700 times, right?

 

00;25;06;08 – 00;25;32;04

Dr. Brie Reid

Like that car is going to get beat up. And the same thing happens to our body and our physiological systems. And so that’s when we really see these later health and mental problems. And however, supportive, caring relationships from an adult can still buffer a child from these experiences. So always, always talking about resilience. But does that answer your question.

 

00;25;32;04 – 00;25;32;15

Dr. Brie Reid

Well.

 

00;25;32;21 – 00;25;51;20

Dr. Mona

So yeah, absolutely. And you had mentioned, I think briefly earlier that just say a child was exposed like, I’m going to I’m going to use an age group just for an example. Just say a child from birth to six years old was in a abusive home, whether it’s verbally or physically, and then at six years old, gets adopted by a family who is loving and nurturing.

 

00;25;51;20 – 00;26;05;23

Dr. Mona

You said earlier that there is an ability for the mind and body to kind of recalibrate itself, and the environment can help. Or is it is it kind of too late at that point to have any sort of resiliency or, you know, emotional kind of, reset, I guess.

 

00;26;05;25 – 00;26;28;19

Dr. Brie Reid

So I would never say that it’s too late for one. I think obviously prevention is key. We don’t want children experiencing these kinds of environments because of the structural issues in our society, just like full stop, right? We’d rather prevent it from the beginning. But I don’t think that there’s ever a too late time for any child or even any adult.

 

00;26;28;19 – 00;26;55;12

Dr. Brie Reid

I think there’s a lot of really critical interventions through therapy. And, you know, for example, a change in family situation or even, there’s a great work coming out of Delaware and Oregon and actually these two universities that do interventions with parents to help increase their caregiving capacity and their support of caregiving, and it actually really helps their attachment with their children.

 

00;26;55;12 – 00;27;27;07

Dr. Brie Reid

So, the studies that we do, the children were adopted before two years of age. We do think that there is a sensitive period in infancy. So that seems to be important, but it’s hard to say when exactly that sensitive period ends for each child. And this is the work that we do, with that kind of sensitive period in infancy, again, is just a very extreme form of neglect in the ter in institutional care, and orphanage care.

 

00;27;27;07 – 00;27;48;21

Dr. Brie Reid

So the wonder again, we saw that these children after years and their supportive adoptive families, we we didn’t see that stress response recalibrate through childhood. So we did follow them through childhood. And we still saw differences. And it wasn’t until the transition through puberty that we started to see the stress response recalibrate. So that’s that. He just came out.

 

00;27;48;21 – 00;28;14;15

Dr. Brie Reid

We just just found this out. Just found evidence of this second sensitive period in adolescence for the cortisol response. And so really, we don’t know, you know, what’s the cut point? Because those studies haven’t been done. It’s very difficult to find children who have, you know, been moved from one type of parenting to another type of parenting.

 

00;28;15;15 – 00;28;43;23

Dr. Brie Reid

Or unless you’re doing intervention studies. So and it’s very difficult to do cortisol research well, in general. And we can go into that later when we talk about cry it out and kind of yeah, the research LED is used to, to vilify it. We’ll put it that way. But yeah, I would say that it’s never too late for any child, and every child and every adult can benefit from stable, supportive relationship and intervention at any time.

 

00;28;43;26 – 00;29;10;20

Dr. Mona

And that is a good segue because we’re going to talk about I want to, you know, so try it out. So look, there are many methods of sleep training. And I, in my training and in residency, I actually didn’t get a lot of sleep training and residency was my first job that actually, you know, my mentor there taught me a lot about sleep training, and that’s when I kind of created my own practice on how I looked at sleep and, you know, infant sleep, toddler sleep, in terms of the research.

 

00;29;10;20 – 00;29;29;19

Dr. Mona

So, would you say, I mean, in general is if a family does decide to use a cried out method and maybe they don’t want to and I’m 100% okay with that. That is obvious. Is that considered an early life stress that would be impacting their development? Because I know there’s a lot of, negativity around cried out methods, but what would the research kind of show?

 

00;29;29;19 – 00;29;32;03

Dr. Mona

Is there just not enough research like you said?

 

00;29;32;05 – 00;29;55;25

Dr. Brie Reid

So a few things for from my personal opinion, no, I would not consider that a toxic stressor. I don’t know that I would even consider it a tolerable stressor. Right. I wouldn’t considered on the level of losing a loved one or losing a limb. That needs buffering from a supportive caregiver. I would consider that probably a positive stress response.

 

00;29;55;25 – 00;30;19;27

Dr. Brie Reid

There’s probably a stress response because an infant at that time is learning how to self-regulate and learning the skill of putting themselves to sleep. And so in the interest of full disclosure, we just finished sleep training my daughter and, you know, she we started that at around five months when it was clear that she was developmentally ready.

 

00;30;19;27 – 00;30;46;02

Dr. Brie Reid

And, it was, you know, picking her up and intervening in her sleep is actually making her more upset. She wanted the opportunity to try to figure it out on her own, and she wasn’t ready before, you know, she was probably ready. She probably could have been ready at around, like, maybe a little before that. But, you know, five months seemed to work for her and there might be individual differences there.

 

00;30;46;02 – 00;31;10;08

Dr. Brie Reid

So I don’t consider it a toxic stress. I’ve done it with my child. It is difficult as a parent to hear your child cry. I’m not going to lie and say that it wasn’t, you know, we were kind of sitting in the basement waiting and was like, wow, it’s very difficult to hear your child cry. And this is a normal physiological response because I’m a functioning human who just birthed child.

 

00;31;10;10 – 00;31;46;24

Dr. Brie Reid

And of course, of course, we are adapted to respond to a child, and we’re also adapted to let the child, when developmentally appropriate, you know, build their skill set and different things like self-regulation and putting themselves to sleep. And that’s a huge skill. Putting themselves to sleep is a huge skill development, especially in that first year. So from the research, as you could probably tell our listeners, there have been no studies that have found negative long term effects from sleep training methods.

 

00;31;46;26 – 00;32;07;25

Dr. Brie Reid

And I think every parent needs to find their own level of comfort. You know, it’s usually a parent distress that really predicts what sleep training method they do. You know, for us, we didn’t want to just, like, close the door and walk away for 12 hours. That didn’t feel right to us, but I don’t it didn’t feel wrong to us because we thought, oh, this will damage our child.

 

00;32;07;25 – 00;32;43;08

Dr. Brie Reid

It was just distressing for us to do that. And so we kind of did a graduated extinction approach. And for a cortisol perspective, I think from what I see in parenting boards and the internet, which I try to avoid in general when looking for parenting advice and interpretations of the scientific literature, I see people reference two kinds of studies to support the claim that cry it out is damaging children and the level of toxic stress to their brain.

 

00;32;43;10 – 00;33;19;16

Dr. Brie Reid

So the first uses one study on cortisol that was done in a very small population of children. And I would say that the methods used in that study were inappropriate and the conclusions drawn were misleading. As the study is written in its current form, and the second part is inappropriately using studies of the previously institutionalized children who spent their infancy in orphanages and around the world, and using that as a way as like, an analogy for this is cry it out.

 

00;33;19;16 – 00;33;42;11

Dr. Brie Reid

And so I’ll start with the first study that is reference. This is the only study that I know of that really looks at a cry it out in cortisol together. There really don’t seem to be that many studies, probably because long term studies have found no negative impacts of of cry it out or of sleep training methods for children’s development.

 

00;33;43;06 – 00;34;06;06

Dr. Brie Reid

And so it would be very difficult to secure funding from the government to say, let’s look at cortisol when there are no negative side effects, because we don’t need to see the mechanism there when there aren’t negative outcomes. So, the first study is by Middlemiss and other colleagues and I believe she’s, oh, maybe at UT Austin or something.

 

00;34;06;06 – 00;34;38;16

Dr. Brie Reid

I’m not sure. But the study was done in 25 mother infant pairs. There was no control group, so there was no group of children who weren’t undergoing sleep training. And and this the way that the study did their cortisol research is just not how we conduct high quality cortisol research. For one, you need to have a baseline measure of what is normal in a normal day, what is the level of cortisol.

 

00;34;38;16 – 00;34;57;25

Dr. Brie Reid

Because again, there are individual differences. What might be high for me might not be high for you. And what be what might be normal for me might be low or high for you. And so we always need to know, okay, what where is that individual’s baseline? This study didn’t have that for either the mothers or the children.

 

00;34;57;27 – 00;35;26;23

Dr. Brie Reid

They just said children exhibited high cortisol but didn’t really give us the what that was and didn’t really characterize it as a response, you know, from their normal levels. And that’s challenging. For one, there’s timing issues. There was no information about whether or not mothers breastfed their infants right before cortisol was collected, because cortisol passes through breast milk is a normal part of what our systems do.

 

00;35;26;23 – 00;35;51;07

Dr. Brie Reid

Not that that’s bad. But that could influence the cortisol levels in saliva. And then, you know, the statistical analyzes performed were incorrect based on the methods. There’s a huge amount of missing data. So they started with 25 infant pairs. And then by the end of the study, they only they made their conclusions based on ten infants, which is not a lot of infants to go off of.

 

00;35;51;07 – 00;36;17;20

Dr. Brie Reid

If you really want a larger sample of infants to understand, okay, what’s normal for a population? Because, you know, you could ask ten parents and you get answers all over the board, right? What? Yeah, what worked for them, what’s stressful, etc.. And so because of all of these methodological questions that come up from this one study, it just makes interpretation of her findings and conclusions really impossible.

 

00;36;17;28 – 00;36;40;08

Dr. Brie Reid

And so I would not use this study as a way to say it’s either good or bad. Because really, when I read the study, I say, we don’t know and there’s not enough information. And I would point to the other studies on sleep training. So the other set of science that people reference is the studies of children growing up in institutional care or orphanage care as infants.

 

00;36;40;08 – 00;37;13;05

Dr. Brie Reid

And this context is not the same as your infant going to sleep in their crib with you as a caregiver. Day after day, night after night. The levels of psychosocial and cognitive deprivation in these institutional contexts are very severe, and there is, you know, the caregivers in these situations are obviously paid not well. They are trying their best, but it’s really an impossible task of caring for, you know, 12 to 20 infants at a time.

 

00;37;13;05 – 00;37;37;02

Dr. Brie Reid

You know, you really have to systematize the process. And it’s kind of, it’s just it’s not the kind of responsive caregiving that we would anticipate. And so these children often just don’t get the kind of stimulation either from their physical environment or from their social environment that we know that children need in order to develop and thrive.

 

00;37;37;02 – 00;38;04;00

Dr. Brie Reid

And so as a response, yes, or cortisol increases initially and then it becomes downregulated because their body says, oh, there’s too much stress in this environment to handle and too much cortisol is toxic. And so I’m going to down regulate it way below normal. Because I can’t afford to keep mounting this stress response. And that’s, those outcomes from those children.

 

00;38;04;00 – 00;38;47;22

Dr. Brie Reid

Then we see, you know, behavior issues kind of, externalizing or aggression issues or kind of like ADHD symptoms, really indications that they’re not really able to regulate their emotions and that, again, when you have a supportive caregiver, it’s just a very different context from institutional care. And I cannot emphasize that enough that the levels of toxic stress that these children experiences in the institution are without that caregiver support, without that buffer, and just like totally different from the normal human infant, the adult relationship that we would expect.

 

00;38;47;22 – 00;39;12;10

Dr. Brie Reid

So that’s why I don’t from the literature, I don’t think that from my opinion, cry it out. Methods of sleep training or sleep training in general is a negative thing. I actually think that it can be very positive depending on the family context. It can reduce rates of maternal and paternal depression and really help caregivers be their fully responsive selves for the infant.

 

00;39;12;13 – 00;39;38;16

Dr. Brie Reid

Very difficult to, you know, operate on sleep deprivation for multiple years or months at a time. And so getting a child the opportunity to learn how to put themselves to sleep and cycle through those more adult patterns of sleep can be really adaptive for them, because more sleep is great for children, linked to a lot of positive outcomes and really good for adults.

 

00;39;38;19 – 00;39;55;22

Dr. Mona

I, I love you said you said two main points that I just love. One is thank you for thank you for differentiating your personal and professional opinion. I love that because, you know, I wanted to I do the same thing. I talk about the data. I’ve talked about those two studies that you’ve mentioned. So I love hearing it.

 

00;39;55;23 – 00;40;15;28

Dr. Mona

You explain it so eloquently. So thank you for those two research studies. And you know, the the personal aspect, you said that you did a, you know, extension method for our son because we understood his nature. We understood how we are comfortability. We did the I love you kissed the night. We didn’t go in till the morning.

 

00;40;16;01 – 00;40;35;20

Dr. Mona

Yeah, it worked for us. It worked for us because we knew his nature. We. I don’t think it’s going to work. If your child is a fussy, fussy, fussy baby. Because that’s just going to be really hard for you. Now, the reason I’m happy we’re talking about this is that it really comes down to the parental comfort, because I know that the kids are going to turn out fine.

 

00;40;35;20 – 00;40;54;27

Dr. Mona

How do I know this? Because I see them in my office grow up to be amazing children. I wish there would be more research studies about sleep training, but unfortunately there’s just not that many research studies. And the reason I’m happy we’re talking about this is that the families who do do it, there is a level of guilt because they get told on social media, or how could you let your baby cry?

 

00;40;54;27 – 00;41;09;20

Dr. Mona

And I’m like, you know, if you can block out that noise, do what you, the parent wants as what they feel comfortable, right? If they don’t like it for them because it gives them, you know, worry they don’t like the way it makes them feel, then don’t do it. But don’t look at it as that. It’s damaging your child.

 

00;41;09;23 – 00;41;25;10

Dr. Mona

I give the example. So I have obviously a big social media following and I this is actually the first time that someone’s listening to this, that they’re knowing what I did with Ryan. Like, I never I haven’t talked about our sleep training mechanisms, mainly because I was waiting a little bit to see how it goes. But he is he’s doing well with it, right?

 

00;41;25;10 – 00;41;44;02

Dr. Mona

And he is still so securely attached to me and my husband. And it’s because of that. Right? I think there’s a misconception on on sleep training. And you talked about the, you know, the orphanage that we are literally callous when we do it. Right. You we’re dumping the child in the crib and running out. There is a protocol.

 

00;41;44;02 – 00;42;02;26

Dr. Mona

I mean, I literally sit with when we were doing it, there was I sat with him. I, you know, I cuddled with him. Obviously we fed him before I read to him. I saying to him, it’s literally like a 30 minute routine. I yeah, I put him down. I gave him a kiss on his forehead. I tell him I love him and there’s that, that bond.

 

00;42;02;28 – 00;42;23;06

Dr. Mona

And it’s that second thing that you mentioned that you’re giving your child an opportunity. It’s not a I’m a callous parent. And by it’s I’m giving you this opportunity to do something that I know you can do, which is self-soothe yourself. And when you look at it that way, it actually can provide a parent who is debating, should I, do, you know, sleep training or should I not?

 

00;42;23;13 – 00;42;40;13

Dr. Mona

It can give them kind of that understanding that, you know what, my kid, it’s a positive thing. It’s a I’m giving them a skill. And if they don’t want to do it, that’s fine. But I’m glad you brought it up, because I find that especially, like in the last 3 or 4 years, I feel like it’s gotten worse with this anti cry.

 

00;42;40;13 – 00;42;59;21

Dr. Mona

Anti-Slip training and sleep is so important, like you said. I mean, the I mean my husband before we had our son when I was pregnant, we both love to sleep. Okay, I don’t think I mean we both got seven eight hours of sleep a night before a child. And my husband asked me, he’s like, Mona, you’re the pediatrician.

 

00;42;59;27 – 00;43;16;09

Dr. Mona

When are we going to be able to sleep? And I’m like, let’s. And I said it. I’m like, I know that. Cry it out. And other sleep, training methods are safe. And I was like, we have to see our child. We have to see what’s going to happen and what we’re comfortable with. Because I could say, you know, eight months pregnant that I want to do cry it out.

 

00;43;16;09 – 00;43;33;00

Dr. Mona

But when I have him in front of me, I may not want to. And then he came, and I saw his nature, and I saw how he was sleeping already. And I was like, you know what? We made the decision and we talked about it and we’re like, let’s try it. And in another episode, I’m going to talk about how it actually went down.

 

00;43;33;00 – 00;43;39;24

Dr. Mona

But I am I’m very, very impressed by, you know, it was hard because like you said, I, I cried, I said.

 

00;43;39;24 – 00;43;40;09

Dr. Brie Reid

Oh yeah, and I.

 

00;43;40;09 – 00;43;58;02

Dr. Mona

Cried and I’m like, but I knew that I wasn’t harming him. I cried because I just felt bad hearing the cry. But I knew that he was going to be fine and he’s obviously fine. All my followers can see that this kid loves his mom loves us, and that’s kind of, you know, I want to the last thing I want to talk about is that secure attachment, right.

 

00;43;58;04 – 00;44;28;06

Dr. Mona

So I mentioned earlier, like attachment parenting is a parenting style, but I kind of get concerned that attachment parenting has basically, taken secure attachment and said that this is the way that you create secure attachment and my my worry is that attachment parenting can really create unrealistic expectations. So, you know, you so I mean, just basically breastfeeding baby wearing, you know, sleep training like basically that the baby’s kind of close to you and the infant toddler is close to at all times.

 

00;44;28;08 – 00;44;38;26

Dr. Mona

I think that’s great if a family wants to do that. But there are ways to create secure attachment without that. What are your thoughts about, you know, attachment parenting versus secure attachment?

 

00;44;38;28 – 00;45;09;20

Dr. Brie Reid

Yeah. So I will say first that secure attachment cannot be boiled down to a list of tactics that you can check the box off that you do or you don’t do. So it’s a specific physical, psychological concept, secure attachment that’s based on around 60 years of research. And it’s really, in the scientific sense, a relationship in the service of a baby’s emotional regulation and their exploration.

 

00;45;09;20 – 00;45;34;08

Dr. Brie Reid

So, we’ll talk about what a secure attachment is. It’s a sense of safety and security for the infant and child. It’s a regulating emotion by, you know, soothing distress, you know, having periods of joy in play and supporting a calm and predictable environment. And it also offers a secure what we consider a secure base, which child can explore.

 

00;45;34;08 – 00;46;02;13

Dr. Brie Reid

Right. So if you’re securely attached, then your child is like, okay, like everything’s cool. Now I can just like play here. I don’t need you right now. You’re there and that’s fine. I would say that the big misconception I see in parenting and, the book on attachment parenting, I read the original because someone, gave it to me, trying to be helpful, not knowing that I was already a PhD in doubt about that.

 

00;46;02;24 – 00;46;34;11

Dr. Brie Reid

And so I was just curious to read it because we do, are the Institute of Child Development actually did one of the longest studies of attachment and their, the outcomes from secure attachment, in this country. So, insecure attachment in contrast, is really it’s not from a caregiver, not baby wearing. It doesn’t come from a be a caregiver, not breastfeeding or not picking up the baby or not doing co-sleeping or any of those things.

 

00;46;34;11 – 00;46;39;18

Dr. Brie Reid

Any of those things can be a part of your parenting practices if you want them to be. They’re not bad things. It’s just.

 

00;46;39;18 – 00;46;40;05

Dr. Mona

Exactly.

 

00;46;40;06 – 00;47;05;19

Dr. Brie Reid

There’s no such thing as I’m going to check all we want. I think the the fear that a lot of parents have is that you worry that you’re going to mess up your children, right. That makes sense. You know, we want to do our best. And what I constantly remind parents is that good enough parenting is encompasses like a wide range of normative parenting behaviors.

 

00;47;05;19 – 00;47;31;13

Dr. Brie Reid

And by and large, children end up totally fine and develop great, right? And so it’s not it’s kind of like parenting is not about perfect parenting. It’s about, just a series of if there is a misstep, you just look to reconnect with that child. It’s not you can never make a mistake or you have to do these things.

 

00;47;31;13 – 00;48;02;23

Dr. Brie Reid

And so I think the I think what I see is an issue with how rigid the, the expectations on parents are around attachment parenting and how you must follow this formula of parenting in order to create a secure attachment. Is just not founded by the research. There’s not any scientific studies that find that attachment parenting as a paradigm predicts better outcomes.

 

00;48;02;26 – 00;48;35;21

Dr. Brie Reid

What’s challenging is that, attachment parenting is different than the concepts in scientific literature on secure attachment. So, there can be something that is, you know, you want secure, you don’t want like a tight attachment. So sometimes insecure attachment can arise from the caregiver not being responsive to a child. And that can mean either not paying attention to the child and like ignoring them or not paying attention to the child and kind of like getting in their face over and over again.

 

00;48;35;23 – 00;49;00;06

Dr. Brie Reid

When the child is signaling, maybe they’re turning away, they’re over stimulated. They need they need less of that. Or, you know, you can be like less responsive and less sensitive to a child. If the child wants to play or the child needs their diaper change and you just breastfeed them, right? I mean, you can that’s not responsive to the child’s needs if they’re already full right, of they don’t need any food.

 

00;49;00;06 – 00;49;36;02

Dr. Brie Reid

And that’s you’re like default. So not that people attachment parents are doing that necessarily. But I just want to step back from the idea that those specific levers create secure attachment. The book unfortunately also makes very broad claims about the benefits of attachment parenting that say, you know, if you do this, then your child will have the biggest IQ or like the best IQ and will be the brightest and smartest and most healthy, and we really just don’t have that kind of control over our child’s development.

 

00;49;36;02 – 00;50;03;13

Dr. Brie Reid

Obviously, we want to create a supportive environment. It’s kind of like gardening, right? You want an area, you want the soil to be supportive, but you want to let them grow in that space. And like let kind of different factors influence a child, not just, like tightly control every aspect of that garden, because that doesn’t result in healthy plants and it doesn’t result in healthy children.

 

00;50;04;06 – 00;50;21;06

Dr. Brie Reid

But you can’t control all of the outcomes. Now, often it’s just impossible. So, yes, I would say I mean, I can go into more of it, but do you have any questions based on that?

 

00;50;21;08 – 00;50;39;07

Dr. Mona

That’s exactly. Well, that’s kind of what I was, you know, obviously kind of my concern and it’s and again, you you hit you, you said it perfectly that if that parent decides that they want to do that aspects of any parenting style, I think it’s great. But it’s when you say that this is the end all, be all, you have to do it this way.

 

00;50;39;07 – 00;50;58;27

Dr. Mona

To get a kid that successful is when why I get concerned, and I find that attachment parenting philosophy, that’s the only parenting philosophy that says that. That concerns me. Like I do authoritative parenting style, which obviously, for anyone listening who doesn’t know it, it’s the loving, loving, loving love that you give a kid. But it’s also boundaries, right?

 

00;50;58;27 – 00;51;19;18

Dr. Mona

It’s the it’s it’s that mix that we’re finding that talking about that Goldilocks right there situation where there is you’re looking at their needs and saying you don’t want like and it’s happened to me too with Ryan already that we’ve been spending the day all day. And he does not having me meaning I’ve been holding him, I’ve been playing with him, and he just needs a moment for me to just not be in his space.

 

00;51;19;18 – 00;51;41;22

Dr. Mona

So I, you know, I put him on, do some floor, play, in a safe space, I walk away, I let him just be on his own. Safe and safe space. But you’re right that it’s reading the child and understanding that look, I can still be a good parent and a good enough parent. And I love how you say it is and provide the needs for my child by reading them, and that we’re not going to mess our kids up.

 

00;51;41;22 – 00;51;56;24

Dr. Mona

I think you’re so right that that’s why I think our generation is so worried about parenting is that we’re like, wow, well, you know, so so-and-so said that I have to do it this way to for my child to love them. And if I let my kid cry because they don’t want a popsicle, I’m a bad parent.

 

00;51;56;26 – 00;52;15;27

Dr. Mona

It is, it is you having to set boundaries with decisions that you make for your kid and also understanding that at the end of the day, whatever we do with our kids, we’re the same way. They’re going to be responsible for some, they’re going to be responsible for their own growth as well. Right. Meaning which we parent our kids and we’re going to do the best we can.

 

00;52;15;27 – 00;52;30;19

Dr. Mona

We love them. We nurture them. We’re there for them. We say, you know, if you need me, I’m here. But at the end of the day, they when they grow up, they’re not going to be perfect people, people because they’re human. So they’re going to have to look at, you know what? My awesome parents when I was younger did X, Y and Z.

 

00;52;30;19 – 00;52;53;25

Dr. Mona

And maybe I want to do this differently. And that’s I think the misconception is that they think that there’s a there’s a formula, like you said, a checklist and there’s not. It’s and I see with myself, I love my parents, but there’s some things that I wish weren’t done. And now as an adult I’m working on that. And that’s what I think modern parents need to understand that you are not going to raise a perfect, perfect, quote unquote kid because that’s not humans.

 

00;52;53;28 – 00;53;14;05

Dr. Mona

You if you get caught up in the checklist, well, I have to, you know, do this, that and oh my gosh, I couldn’t breastfeed. And if I give my kid a drop of formula, I’m a bad parent. Absolutely not. That’s what I don’t want people to feel when they’re listening to this. Because for someone who wanted to breastfeed my child, I couldn’t because of what happened with my my birth.

 

00;53;14;12 – 00;53;20;02

Dr. Mona

And, you know, I, I was actually fine with the decision. And when I saw him grow and I saw him, you know, he’s obviously.

 

00;53;20;03 – 00;53;20;11

Dr. Brie Reid

A.

 

00;53;20;11 – 00;53;38;11

Dr. Mona

Lot and I see and I look at him and I’m like, this kid could care less. How come said he doesn’t still loves me and cuddles me and looks for me for comfort. Right. And it’s that that secure base that you mentioned. It’s that I, my mom and my dad are my secure home and now I feel free to explore.

 

00;53;38;11 – 00;53;54;13

Dr. Mona

And it’s such a beautiful thing when you can see your kid do that even from a young age. The last question I had, I mean, I know obviously there’s different things in the infancy period, maybe because we both have I have a four month old and you have what are there certain signs? Let’s look maybe between the four and nine month period.

 

00;53;54;13 – 00;53;59;01

Dr. Mona

Let’s just use that, of of signs of secure attachment at that age.

 

00;53;59;24 – 00;54;35;20

Dr. Brie Reid

So yes and no, scientifically, it’s very difficult to determine secure attachment before around nine months of age. That seems to be the earliest when we can reliably test and say, like this is a secure or an insecure attachment. But, before that, you know, there kind of signs that a secure attachment is developing. So if the primary caregiver has positive interactions with the baby where there’s a back and forth and it’s pleasant, and I just I want to add like a little star here because research has found, you know, the little missteps and Miss Attunement happen.

 

00;54;35;20 – 00;54;56;13

Dr. Brie Reid

Right. We’re reading a totally new human. They’re totally new to the world. And of course, there’s going to be kind of a back and forth and there’s going to be, you know, maybe missteps where, oh, maybe I got into your face a little bit insecure attachment relationships. That happens around 70% of the time. And so this isn’t even like, like 90% of the time.

 

00;54;56;13 – 00;55;17;25

Dr. Brie Reid

My interactions back and forth with my child are pleasant and positive. No, I mean, that would be great, but that’s just not what we’re seeing. And that doesn’t seem to be the reality. So I don’t want people to put pressure on themselves that every interaction is positive and perfect because that’s stressful for adults. Just, it’s it’s unrealistic.

 

00;55;17;25 – 00;55;50;10

Dr. Brie Reid

And it’s okay that as you learn about a new person and as they learn about you, there’s kind of some mismatch there. Another sign between 4 to 8 months is that they have calm periods. The baby is interested in the world around them, and they, you know, they explore and kind of experiment as they’re able to or that can be reaching, babbling, kind of exploring objects, you know, just brief regular milestones, as I’m sure you see in so many babies all the time in your work.

 

00;55;51;02 – 00;56;16;11

Dr. Brie Reid

And then around 4 to 8 months, infants begin to discriminate between people and start to show kind of preferences for people that they’re familiar with. So they tend to direct most of their emotions, like their smiles and cries toward their caregivers, but they’re still interested in strangers. And then at around nine months, the child really starts to show a clear preference for a primary caregiver.

 

00;56;16;29 – 00;56;37;01

Dr. Brie Reid

And they start to show a little bit more of that wariness toward strangers. But again, this can really vary based on a baby’s temperament, because any parent can tell you that their babies, you know, if you have multiple children, babies just are born into the world with like different software and hardware, right? Yeah, they have different temperaments.

 

00;56;37;01 – 00;57;02;15

Dr. Brie Reid

And this can impact how they interact with you and kind of interact with the world. So, usually at nine months, a baby is easily upset when separated from their primary caregiver. But this also varies with temperament. And it’s not a sign that anything is wrong or right. And the baby is easily soothed after a separation and can resume their exploration or or play when the caregiver comes back.

 

00;57;02;15 – 00;57;34;15

Dr. Brie Reid

And so, those are kind of the signs early on. And then between nine months and three years, secure attachments look like a clear emotional bond with a primary person. And this can be a parent. This can be a grandparent. It can be an adoptive or foster parent. And the child stays in close proximity with that person, but also forms close relationships with other people who are around a lot, like the babysitter or the nanny.

 

00;57;34;15 – 00;58;08;03

Dr. Brie Reid

Siblings, grandparents. And then beyond three years, the attachment relationship just becomes more complicated as, as the child grows up and develops and is able to have more nuanced relationships with the people around them. So, yeah, there’s great there’s early signs, but, you know, so for people who are worried because I think a lot of people have questions, I hear so often people say, my child was born preterm.

 

00;58;08;03 – 00;58;29;19

Dr. Brie Reid

I wasn’t able to be with them all the time in those like first three weeks of birth, are they damaged forever or I wasn’t able to breastfeed? Or my child is adopted and there have been studies, there have been studies on babies born preterm who really weren’t able to be with their primary caregiver for like a number of weeks.

 

00;58;29;19 – 00;58;53;09

Dr. Brie Reid

And then, they have the same rates of secure attachments, a one year old that, you know, full term babies do. So there’s not different rates of secure attachment there. It’s not like, an all or nothing thing. Again, there’s no differences between you can be a responsive caregiver while bottle feeding and an unresponsive caregiver while breastfeeding.

 

00;58;53;09 – 00;59;16;05

Dr. Brie Reid

You know, if you’re on your phone all the time breastfeeding and there’s no shame, like, I’ve been on my phone while breastfeeding before, and, you know, she’s slowness and damage. But if it’s just you’re not responsive while you’re feeding, regardless of how the food is getting from, you know, the one thing to the baby’s mouth, it you know, you can be responsive in both situations.

 

00;59;16;23 – 00;59;42;13

Dr. Brie Reid

Or in the case of adoption, for international adoptees coming from these intense orphanages situations, we actually find that after around nine months with their primary caregiver, 90% of them exhibited a secure attachment, which is really amazing and really wonderful. So for anyone who’s hearing us and saying, oh God, like, is my child securely attached? Like, what does this mean?

 

00;59;42;13 – 01;00;05;12

Dr. Brie Reid

Am I doing things wrong? You know, just work on self-regulation as an adult. Work on reading your child’s cues and responding to them as best you can. And you know it’s not messed up. Regardless of how you formed your family or what your family practices are, secure attachment is attainable for everyone. So that would be my big message.

 

01;00;05;12 – 01;00;39;00

Dr. Brie Reid

Regardless of what what you do and if you choose to do skin on skin, that’s great. Like I love doing skin on skin in my maternity leave with my daughter in those early morning hours, you know, to let my husband sleep. And, you know, I, I breastfeed. And we had to supplement the formula early on before my milk came in and I will be the first to tell you, as someone with a PhD in child development and nutrition who has worked on breastfeeding interventions, that breastfeeding is very difficult and I for me and I have the most privilege of anyone.

 

01;00;39;06 – 01;01;07;23

Dr. Brie Reid

You know, I have a nanny who can bring her in so I can breastfeed during the day, right? Like I can work from home most of the time. This is not attainable for what, like 98% of the population would have had a baby. And it’s still challenging. So I would hate for anyone to beat up on themselves for, you know, not doing something that they think they should be doing to check off a list that someone else told them.

 

01;01;07;23 – 01;01;24;16

Dr. Brie Reid

It’s a checklist for perfect parenting because there’s no such thing. All we can do is do our best until we know better. And then when we know better, do better. I think that’s Maya Angelou, who’s like my, my personal hero, but it’s, Yeah.

 

01;01;24;16 – 01;01;43;09

Dr. Mona

So what a yeah, I love that was a great way to to end this call. It is that is that is it and I, I can’t, I can’t thank you enough because, obviously especially you also because you’re a young you’re a new mom in a way, like six month old. And it’s just nice to hear your obviously perspective as a mom and obviously as a professional as well.

 

01;01;43;09 – 01;02;11;28

Dr. Mona

So thank you so much, because all this is, I think, going to be really helpful for people just to kind of take that breath and remember that, focus on their kid, focus on what also makes them feeling good. Right. Like you said earlier, a lot of maternal depression and maternal depression comes from the stress of not doing what they may want to do, meaning they’re so afraid to sleep train, or they’re so afraid to introduce formula things that they were told that if they do, they’re a bad parent, when in reality it’s not like that.

 

01;02;11;28 – 01;02;18;04

Dr. Mona

And I am. I was I was so big on this before I had Ryan. And then now because I actually ended up.

 

01;02;18;09 – 01;02;19;25

Dr. Brie Reid

Doing this thing.

 

01;02;19;27 – 01;02;40;09

Dr. Mona

It just happened. And I’m like, it’s so it’s so interesting that that’s how my the life kind of happened that way, that all the things that I, you know, I was pro breastfeeding, I obviously was pro formula too. But in a way I almost feel like this was my story just so I can help people understand that. Well, from this perspective, it is 100% from a personal perspective, not even a professional perspective.

 

01;02;40;11 – 01;02;46;07

Dr. Mona

Okay? And our kids are going to love us. So Brie, thank you so much for being here today.

 

01;02;46;09 – 01;03;01;08

Dr. Brie Reid

Thank you. It’s been such a delight to talk to you. I just love your approach on everything. So it’s been great to kind of share the science and give it away. And thank you so much for doing all that you do. Giving away the science and the pediatric policy opinions.

 

01;03;01;08 – 01;03;15;01

Dr. Mona

Yes, yes. Thank you. And I’ll we’ll see if we can attach any like links or any research studies that you know, that are out in terms of, you know, like the secure attachment or whatever it is, we’ll test whatever we can on my show notes. But guys, thank you so much for listening. Brie. Thank you for joining us.

 

01;03;15;06 – 01;03;16;13

Dr. Brie Reid

Thank you.

 

01;03;16;16 – 01;03;36;03

Dr. Mona

Thank you for tuning in for this week’s episode. I hope you guys enjoyed it. As always, please leave a review. Share it with a friend. Comment on my social media and if you’re not already, follow me at PedsDocTalk on Instagram. Love doing this for all of you. Have a great rest of your week. Take care. Talk to you soon.