Archive for January, 2010

This is a bit of an aside post, as it’s not to do with parenting. I am pleased to report that Prof. Patrick McGorry has been awarded the title of ‘Australian of the Year’. He is a psychiatrist who has done heaps of work in youth mental health. He has also worked with refugees and has made a public comment today about the fact that keeping asylum seekers in detention is a recipe for mental health problems. I worked for a while for an agency who treated torture and trauma survivors (refugees) and  I was horrified at what these people had been through pre-migration, and just as horrified at what had happened to them when they arrived here, so I am pleased that he has made such a comment at a time when the newspapers will jump on it.

Psychiatrists rarely are in the media, as mentally ill people are still unfortunately stigmatised and judged in our community. We hear about doctors who treat burns, cure cancer and cut out brain tumours, but not psychiatrists. I hope that Prof. McGorry’s award helps to publicise mental health issues, particularly in young people.

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Returning to work, for a new mother, is a big and difficult decision. Once a parent has decided to do this, the next step is looking for childcare.

Child care is talked about as if it is one entity, but of course there are many options and huge variations in the quality of it. Options range from hiring a nanny to come into your house, giving a consistent one on one figure in the familiar surroundings of your home, to home day care, and centre based day care. And of course, the outcomes for children will depend not only on the type and quality of day care, but also on the age at which they go into care and the length of time they spend there. A child who has full-time day care from eight weeks is a different situation to one who attends three half days a week from age three. And the variable that is often not considered is the quality of the relationship with their parents.

In the 1980s, there were a couple of studies which said that having more than 20 hours a week of childcare in the first year of life was associated with a more insecure attachment relationship between mother and child, but these results were controversial. Other studies found no such difference, and a study was designed to answer this question: The NICDH (National Institute of Child Health and Human Development) Study of Early ChildCare and Youth Development. This followed up 1364 children randomly chosen from birth from across the USA, and is still going as the children become older. They found that child care factors themselves (hours, age at entry, quality, frequency of changes in child care) did not predict poor attachment. Children were more likely to be insecurely attached when they had ‘dual risk’  i.e. problems in the relationship with their mother/parent as well as child care factors. Also, good quality child care could ‘compensate’ for a poor mother-infant relationship more than in low-quality care.

(Howes & Spieker: (2008). Attachment Relationships in the context of Multiple Caregivers. In Cassidy and Shaver, (eds.),  Handbook of Attachment, 2nd ed (pp 324-325). New York:  The Guilford Press.)

The study is large and there are many more factors to take into account, but it seems to confirm that child care itself – particularly if it is high quality – is not a risk factor for poor attachment relationships, and probably what is more important is the quality of the mother-child relationship.

As with most things in parenting, each family makes the choices that are right for them. A mother who feels isolated when she isn’t working, or a family under financial stress, is potentially much more of a problem than a child being in some form of child care.

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