What is a Secure Attachment? And Why Doesn’t “Attachment Parenting” Get You There?
April 3, 2017
A few months ago, a young friend of mine had a baby. She began a home birth with a midwife, but after several hours of labor, the baby turned to the side and became stuck. The midwife understood that the labor wouldn’t proceed, so she hustled the laboring Amelie into the car and drove the half-mile to the emergency room while Amelie’s husband followed. The birth ended safely, and beautiful, tiny Sylvie emerged with a full head of black hair. The little family of three went home.
When the baby was six weeks old, Amelie developed a severe breast infection. She struggled to continue breastfeeding and pumping, but it was extremely painful, and she was taking antibiotics. Finally she gave in to feeding her baby formula, but she felt distraught and guilty. “Make sure you find some other way to bond with your baby,” her pediatrician said, adding to her distress.
“Piglet sidled up to Pooh from behind. “Pooh!” he whispered.
”Nothing,” said Piglet, taking Pooh’s paw. “I just wanted to be sure of you.”
— A. A. Milne
Fortunately, sleep came easily to Sylvie; she slumbered comfortably in a little crib next to Amelie’s side of the bed. Still, at four months, Amelie worried that the bond with her baby wasn’t forming properly and she wanted to remedy the problem by pulling the baby into bed. Baby Sylvie wasn’t having it. When she was next to her mother, she fussed; when Amelie placed her back in the crib, she settled. Again, Amelie worried about their relationship.
“Amelie” is an amalgam of actual friends and clients I have seen in the last month, but all of the experiences are real. And as a developmental psychologist, I feel distressed by this suffering. Because while each of the practices—home birth, breastfeeding, and co-sleeping—has its benefits, none of them is related to a baby’s secure attachment with her caregiver, nor are they predictive of a baby’s mental health and development.
“Attachment is a relationship in the service of a baby’s emotion regulation and exploration. It is the deep, abiding confidence a baby has in the availability and responsiveness of the caregiver.”
— Alan Sroufe “Attachment is not a set of tricks,” says Alan Sroufe, a developmental psychologist at the Institute for Child Development at the University of Minnesota. He should know. He and his colleagues have studied the attachment relationship for over 40 years.
Why the confusion about a secure attachment?
Over the last 80 years, developmental scientists have come to understand that some micro-dynamics that take place between a baby and an adult in a caring relationship have a lifelong effect, in very specific ways, on the person that baby will become.
“Attachment,” Sroufe explains, “is a relationship in the service of a baby’s emotion regulation and exploration. It is the deep, abiding confidence a baby has in the availability and responsiveness of the caregiver.”
A secure attachment has at least three functions:
- Provides a sense of safety and security
- Regulates emotions, by soothing distress, creating joy, and supporting calm
- Offers a secure base from which to explore
In spite of the long scientific history of attachment, psychologists have done a rather poor job of communicating what a secure attachment is and how to create one. In the meantime, the word “attachment” has been co-opted by a well-meaning pediatrician and his wife, William and Martha Sears, along with some of their children and an entire parenting movement. The “attachment parenting” philosophy promotes a lifestyle and a specific set of practices that are not proven to be related to a secure attachment. As a result, the movement has sown confusion (and guilt and stress) around the meaning of the word “attachment.”
The attachment parenting philosophy inspired by the Searses and promoted by an organization called Attachment Parenting Internationalis centered on eight principle concepts, especially breastfeeding, co-sleeping, constant contact like baby-wearing, and emotional responsiveness. The approach is a well-intentioned reaction to earlier, harsher parenting advice, and the tone of the guidance tends to be baby-centered, supportive, and loving. Some of the practices are beneficial for reasons other than attachment. But the advice is often taken literally and to the extreme, as in the case of my “Amelie,” whose labor required hospital intervention and who suffered unduly in the belief that breastfeeding and co-sleeping are necessary for a secure attachment.
Attachment parenting has also been roundly critiqued for promoting a conservative Christian, patriarchal family structure that keeps women at home and tied tightly to their baby’s desires. Additionally, the philosophy seems to have morphed in the public consciousness into a lifestyle that also includes organic food, cloth diapers, rejection of vaccinations, and homeschooling. The Searses have sold millions of books, and they profit from endorsements of products that serve their advice.
“These [attachment parenting principles] are all fine things,” observes Sroufe “but they’re not the essential things. There is no evidence that they are predictive of a secure attachment.”
Sroufe unpacks feeding as an example: A mother could breastfeed, but do it in a mechanical and insensitive way, potentially contributing to an insecure attachment. On the other hand, she could bottle-feed in a sensitive manner, taking cues from the baby and using the interaction as an opportunity to look, talk, and play gently, according to the baby’s communication—all behaviors that are likely to create secure attachment. In other words, it is the quality of the interaction that matters. Now, one might choose breastfeeding for its digestibility or nutrition (though the long-term benefits are still debated), but to imply, as Amelie’s pediatrician did, that bottle-feeding could damage her bond with her baby is simply uninformed.
There is also confusion about what “constant contact” means. Early on, the Searses were influenced by the continuum concept, a “natural” approach to parenting inspired by indigenous practices of wearing or carrying babies much of the time. This, too, might have been taken up in reaction to the advice of the day, which was to treat children in a more businesslike manner. There is no arguing that skin-to-skin contact, close physical contact, holding, and carrying are all good for babies in the first few months of life, as their physiological systems settle and organize. Research also shows that the practice can reduce crying in the first few months. But again, what matters for attachment is the caregiver’s orientation and attunement: Is the caregiver stressed or calm, checked out or engaged, and are they reading a baby’s signals? Some parents misinterpret the prescription for closeness as a demand for constant physical closeness (which in the extreme can stress any parent), even though the Searses do advise parents to strive for a balanced life.
“There’s a difference between a ‘tight’ connection and a secure attachment,” Sroufe explains. “A tight attachment—together all the time—might actually be an anxious attachment.”
And what of emotional responsivity? This, too, has a kernel of truth, yet can be taken too far. It is safe to say that all developmental scientists encourage emotional responsiveness on the part of caregivers: The back-and-forth, or serve-and-return, is crucial to brain development, cognitive and emotional development, the stress regulation system, and just authentic human connection. But in my observation, well-meaning parents can become overly-responsive—or permissive—in the belief that they need to meet every request of the child. While that is appropriate for babies in the first half to one-year year of life (you can’t spoil a baby), toddlers and older children benefit from age-appropriate limits in combination with warmth and love. On the other hand, some parents feel stressed that they cannot give their child enough in the midst of their other responsibilities. Those parents can take some comfort in the finding that even within a secure attachment, parents are only attuned to the baby about 30% of the time. What is important, researchers say, is that the baby develops a generalized trust that their caregiver will respond and meet their needs, or that when mismatches occur, the caregiver will repair them (and babies, themselves, will go a long way toward soliciting that repair). As long as the caregiver returns to the interaction much of the time and rights the baby’s boat, this flow of attunements, mismatches, and repairs offers the optimal amount of connection and stress for a baby to develop both confidence and coping, in balance.
What is the scientific view of attachment?
The scientific notion of attachment has its roots in the work of an English psychiatrist named John Bowlby who, in the 1930s, began working with children with emotional problems. Most professionals of the day held the Freudian belief that children were mainly motivated by internal drives like hunger, aggression, and sexuality, and not by their environment. However, Bowlby noticed that most of the troubled children in his care were “affectionless” and had experienced disrupted or even absent caregiving. Though his supervisor forbade him from even talking to a mother of a child (!), he insisted that family experiences were important, and in 1944 he wrote his first account of his observations based on 44 boys in his care. (Around the same time in America, psychologist Harry Harlow was coming to the same conclusion in his fascinating and heart-rending studies of baby monkeys, where he observed that babies sought comfort, and not just food, from their mothers.)
Bowlby went on to study and treat other children who were separated from their parents: those who were hospitalized or homeless. He came to believe that the primary caregiver (he focused mainly on mothers) served as a kind of “psychic organizer” to the child, and that a child needs this influence, especially at certain times, in order to develop successfully. To grow up mentally healthy, then, “the infant and young child should experience a warm, intimate, and continuous relationship with this mother (or permanent mother substitute) in which both find satisfaction and enjoyment.”
But the attachment figure doesn’t have to be the mother or even a parent. According to Bowlby, babies form a “small hierarchy of attachments.” This makes sense from an evolutionary view: The number has to be small since attachment organizes emotions and behavior in the baby, and to have too many attachments would be confusing; yet having multiples provides the safety of backups. And it’s a hierarchy because when the baby is in need of safety, he or she doesn’t have time to analyze the pros or cons of a particular person and must automatically turn to the person already determined to be a reliable comfort. Research shows that children who have a secure attachment with at least one adult experience benefits. Babies can form attachments with older siblings, fathers, grandparents, other relatives, a special adult outside the family, and even babysitters and daycare providers. However, there will still be a hierarchy, and under normal circumstances, a parent is usually at the top.
In the 1950s, Mary Ainsworth joined Bowlby in England, and a decade later back in the U.S. began to diagnose different kinds of relationship patterns between children and their mothers in the second year of life. She did this by watching how babies reacted in a sequence of situations: when the baby and mother were together, when they were separated, when the baby was with a stranger, and when baby was reunited with the caregiver after the separation. Ainsworth and colleagues identified the first three of the following patterns, and Mary Main and colleagues identified the fourth:
- When babies have a secure attachment, they play and explore freely from the “secure base” of their mother’s presence. When the mother leaves, the baby can become distressed, especially when a stranger is around. When the mother returns, the baby expresses her joy, sometimes from a distance and sometimes reaching to be picked up and held (babies vary, depending on their personality and temperament, even within a secure attachment). Then the baby settles quickly and returns to playing.
The mothers who fall into this pattern are responsive, warm, loving, and emotionally available, and as a result their babies grow to be confident in their mothers’ ability to handle feelings. The babies feel free to express their positive and negative feelings openly and don’t develop defenses against the unpleasant ones.
- Babies in insecure-avoidant attachments seem indifferent to the mother, act unstressed when she leaves, and exhibit the same behaviors with a stranger. When the mother returns after a separation, the baby might avoid her, or might “fail to cling” when picked up.
The mothers in insecure-avoidant attachments often seem angry in general and angry, specifically, at their babies. They can be intolerant, sometimes punishing, of distress, and often attribute wrong motivations to the baby, e.g., “He’s just crying to spite me.” One study showed that the insecurely-attached babies are just as physiologically upset (increased heart rates, etc.) as securely attached babies when parents leave but have learned to suppress their emotions in order to stay close to the parent without risking rejection. In other words, the babies “deactivate” their normal attachment system and stop looking to their mothers for help.
As toddlers, insecure-avoidant children don’t pay much attention to their mothers or their own feelings, and their explorations of the physical world are rigid and self-reliant. By preschool, these children tend to be more hostile, aggressive, and have more negative interactions overall. Avoidance and emotional distance become a way of dealing with the world, and instead of problem-solving, they are more likely to sulk or withdraw.
- Babies with an insecure-ambivalent/resistant attachment are clingy with their mother and don’t explore or play in her presence. They are distressed when the mother leaves, and when she returns, they vacillate between clinging and angry resistance. For example, they may struggle, hit, or push back when the mother picks them up.
These babies are not easily comforted. They seem to want the close relationship, but the mother’s inconsistency and insensitivity undermine the baby’s confidence in her responses. This pattern also undermines the child’s autonomy, because the baby stays focused on the mother’s behavior and changing moods to the exclusion of nearly everything else. In insecure-ambivalent babies, separation anxiety tends to last long after secure babies have mastered it. Longitudinal studies show that these children often become inhibited, withdrawn, and unassertive, and they have poor interpersonal skills.
- The last pattern of insecure attachment—which is the most disturbing and destructive—is disorganized attachment, and it wasdescribed by Ainsworth’s doctoral student, Mary Main. This pattern can occur in families where there is abuse or maltreatment; the mother, who is supposed to be a source of support, is also the person who frightens the child. Such mothers may be directly maltreating the child, or they might have their own histories of unresolved trauma. Main and her colleague write, “[T]he infant is presented with an irresolvable paradox wherein the haven of safety is at once the source of alarm.”
This pattern can also result when the mother has a mental illness, substance addiction, or multiple risk factors like poverty, substance abuse and a history of being mistreated. Babies of mothers like this can be flooded with anxiety; alternatively, they can be “checked out” or dissociated, showing a flat, expressionless affect or odd, frozen postures, even when held by the mother. Later these children tend to become controlling and aggressive, and dissociation remains a preferred defense mechanism.
“The emotional quality of our earliest attachment experience is perhaps the single most important influence on human development.”
— Alan Sroufe and Dan Siegel
How important is attachment?
“Nothing is more important than the attachment relationship,” says Alan Sroufe, who, together with colleagues, performed a series of landmark studies to discover the long-term impact of a secure attachment. Over a 35-year period, the Minnesota Longitudinal Study of Risk and Adaption (MLSRA) revealed that the quality of the early attachment reverberated well into later childhood, adolescence, and adulthood, even when temperament and social class were accounted for.
One of the most important—and, to some ways of thinking, paradoxical—findings was that a secure attachment early in life led to greater independence later, whereas an insecure attachment led to a child being more dependent later in life. This conclusion runs counter to the conventional wisdom held by some people I’ve observed who are especially eager to make the baby as independent and self-sufficient as possible right from the start. But there is no pushing independence, Sroufe found. It blooms naturally out of a secure attachment.
In school, securely attached children were more well-liked and treated better, by both their peers and their teachers. In one study, teachers who had no knowledge of a child’s attachment history were shown to treat securely attached children with more warmth and respect, set more age-appropriate standards, and have higher expectations. In contrast, teachers were more controlling, had lower expectations, got angry more often, and showed less nurturing toward the children with difficult attachments—and who, sadly, had a greater need than the securely attached kids for kindness from adults.
The MSLRA studies showed that children with a secure attachment history were more likely to develop:
- A greater sense of self-agency
- Better emotional regulation
- Higher self-esteem
- Better coping under stress
- More positive engagement in the preschool peer group
- Closer friendships in middle childhood
- Better coordination of friendships and social groups in adolescence
- More trusting, non-hostile romantic relationships in adulthood
- Greater social competence
- More leadership qualities
- Happier and better relationships with parents and siblings
- Greater trust in life
A large body of additional research suggests that a child’s early attachment affects the quality of their adult relationships, and a recent longitudinal study of 81 men showed that those who grew up in warm, secure families were more likely to have secure attachments with romantic partners well into their 70s and 80s. A parent’s history of childhood attachment can also affect their ability to parent their own child, creating a cross-generational transmission of attachment styles.
But early childhood attachment with a parent is not destiny: It depends on what else comes along. For example, a secure preschool child can shift to having an insecure attachment later if there is a severe disruption in the caregiving system—a divorce or death of a parent, for example. But the effect is mediated by how stressed and available the primary attachment figure is. In other words, it’s not what happens, but how it happens that matters. Children who were previously secure, though, have a tendency to rebound more easily.
Sroufe writes in several articles that an insecure attachment is not fate, either; it can be repaired in a subsequent relationship. For example, good-quality childcare that offers emotional support and stress reduction can mitigate a rocky start at home. A later healthy romantic relationship can offset the effects of a difficult childhood. And good therapy can help, too, since some of the therapeutic process mimics the attachment process. Bowlby viewed development as a series of pathways, constrained by paths previously taken but where change is always possible.
Without conscious intervention, though, attachment styles do tend to get passed through the generations, and Bowlby observed that becoming a parent particularly activates a parent’s childhood attachment style. One study looked at attachment styles over three generations and found that the mother’s attachment style when she was pregnant predicted her baby’s attachment style at one year of age for about 70% of cases.
What about parents who might not have gotten a good start in life and want to change their attachment style? There’s good news. Research on adult attachment shows that it is not the actual childhood experiences with attachment that matter but rather how well the adult understands what happened to them, whether they’ve learned some new ways of relating, and how well they’ve integrated their experience into the present. In other words, do they have a coherent and realistic story (including both good and bad) of where they’ve been and where they are now?
Support matters, too. In one of Sroufe’s studies, half the mothers were teenagers, which is usually a stressful situation. Sroufe found that the teenagers with good social support were able to form secure attachments with their babies, but if they didn’t have support, they were unlikely to form a secure attachment.
How to parent for a secure attachment and how to know if it’s working.
“The baby needs to know that they’re massively important,” says Sroufe. “A caregiver should be involved, attentive, sensitive, and responsive.”
“The baby will tell you what to do,” Sroufe explains. “They have a limited way of expressing their needs, so they’re not that difficult to read: If they’re fussing, they need something. If their arms are out, they want to be picked up. And if you misread them, they will keep on signaling until you get it right.” He gives the example of bottle-feeding a baby: “The baby might want a break, and she looks around. What does the baby want? To look around! If the parent misreads and forces the bottle back, the baby will insist, maybe snap her head away, or pull away harder.”
“How can I know if my baby is securely attached?” a client asked me about her six-month old. Clearly observable attachment doesn’t emerge until around nine months, but here are some clues that a secure attachment is underway:
- The baby’s physiology is just settling as the baby cycles quickly among feeding, sleeping, and alert wakefulness. Meeting the baby’s needs at different points in the cycle helps establish stability.
- At this point, the baby has no clear preference for one person over another.
- In her quiet, alert state, the baby is interested in the faces and voices around her.
- Attempts to soothe the baby are usually effective at calming her down. (Caveat: An inability to soothe might not be predictive of insecurity but rather point to one of a host of other possible issues.)
- The primary caregiver has positive interactions with the baby where the back-and-forth is pleasant.
- The baby has calm periods where she is interested in the world around her, and she explores and experiments to the extent she is physically able to—looking, grasping, reaching, babbling, beginning crawling, exploring objects with her mouth, hands, etc.
- Infants begin to discriminate between people and start to show preferences. They direct most of their emotions (smiles, cries) toward the caregiver but are still interested in strangers.
- They are very interested in the people they see often, especially siblings.
- The baby shows a clear preference for a primary caregiver.
- The baby shows wariness toward strangers, though the degree varies with temperament.
- The baby is easily upset when separated from her primary caregiver, though that, too, varies with temperament.
- The baby is easily soothed after a separation and can resume her exploration or play.
- The child shows a clear emotional bond with a primary person.
- The child stays in close proximity to that person but forms close relationships with other people who are around a lot, too, e.g., babysitter, siblings.
Beyond this age, the attachment relationship becomes more elaborated. With language and memory, the rhythms of attachment and separation become more negotiated, talked about, and planned, and there is more of a back-and-forth between parent and child. By toddlerhood and beyond, an authoritative parenting style deftly blends secure attachment with age-appropriate limits and supports. A sensitive parent allows the changing attachment to grow and stretch with a child’s growing skills, yet continues to be emotionally attuned to the child and to protect their safety.
One of the best resources for how to parent for a secure attachment in the first few years of life is the new book Raising A Secure Child by Kent Hoffman, Glen Cooper, and Bert Powell, all therapists who have worked with many different kinds of families for decades. Their work is based squarely on the science of attachment, and they call their approach the Circle of Security. The circle represents the seamless ebb and flow of how babies and young children need their caregivers, at times coming close for care and comfort, and at other times following their inspiration to explore the world around them. The caregivers’ role is to tune into where on the circle their child is at the moment and act accordingly. Parenting for a secure attachment, the authors say, is not a prescriptive set of behaviors but more a state of mind, a way of “being with” the baby, a sensitivity to what they are feeling. The authors also help parents see the ways that their own attachment history shows up in their parenting and help them to make the necessary adjustments.
The neurobiology of attachment
“Attachment theory is essentially a theory of regulation,” explains Allan Schore, a developmental neuroscientist in the Department of Psychiatry at the UCLA David Geffen School of Medicine. A clinician-scientist, he has elaborated modern attachment theory over the last three decades by explaining how the attachment relationship is important to the child’s developing brain and body.
Early brain development, Schore explains, is not driven just by genetics. The brain needs social experiences to take shape. “Mother Nature and Mother Nurture combine to shape Human Nature,” he writes.
Infants grow new synapses, or neural connections, at a rate of 40,000 new synapses a second, and the brain more than doubles in volume across the first year. Genetic factors drive this early overproduction of neurons, Schore explains, but the brain awaits direction from the social environment, or epigenetic processes, to determine which synapses or connections are to be pruned, which should be maintained, and which genes are turned on or off.
One of the first areas of the brain that begins to grow and differentiate is the right brain, the hemisphere that processes emotional and social information. The right brain begins to differentiate in the last trimester in utero, whereas the left-brain development picks up in the second year of life. Some of the regions that process emotion are already present in infants’ brains at birth—the amygdala, hypothalamus, insula, cingulate cortex, and orbitofrontal cortex. But the connections among these areas develop in specific patterns over the first years of life. That’s where input from the primary relationship becomes crucial—organizing the hierarchical circuitry that will eventually process, communicate, and regulate social and emotional information.
“What the primary caregiver is doing, in being with the baby,” explains Schore, “is allowing the child to feel and to identify in his own body these different emotional states. By having a caregiver simply ‘be with’ him while he feels emotions and has experiences, the baby learns how to be,” Schore says.
The part of the brain that the primary caregiver uses for intuition, feeling, and empathy to attune to the infant is also the caregiver’s right brain. So it is through “right-brain-to-right brain” reading of each other, that the parent and child synchronize their energy, emotions, and communication. And the behaviors that parents are inclined to do naturally—like eye contact and face-to-face interaction, speaking in “motherese” (higher-pitched and slower than normal speech), and holding—are just the ones shown to grow the right-brain regions in the baby that influence emotional life and especially emotion regulation.
The evidence for epigenetic effects on emotion regulation is quite solid: Early caregiving experiences can affect the expression of the genes that regulate a baby’s stress and they can shape how the endocrine system will mobilize to stress. Caregiving behaviors like responsiveness affect the development of the baby’s vagal tone (the calming system) and the hypothalamic-pituitary axis (the system that activates the body to respond to perceived danger). High quality caregiving, then, modulates how the brain and body respond to and manage stress.
Schore points out that the ventromedial prefrontal cortex, a brain region in the right hemisphere, both has the most complex emotion and stress-regulating systems of any part in the brain and is also the center of Bowlby’s attachment control system. Neurobiological research confirms that this region is “specifically influenced by the social environment.” 
Stress management is not the only important part of emotion regulation. In the past, Schore explains, there was an overemphasis in the field of emotion regulation on singularly lowering the baby’s distress. But now, he says, we understand that supporting positive emotional states is equally important to creating [what he quotes a colleague as calling] a “background state of well-being.” In other words, enjoy your baby. It’s protective.
A baby’s emotion regulation begins with the caregiver, and the Goldilocks principle applies: If the caregiver’s emotions are too high, the stimulation could be intrusive to the baby, Schore explains. Too low, and the baby’s “background state” settles at a low or possibly depressive emotional baseline. Just right, from the baby’s point of view is best.
And babies are surprisingly perceptive at registering their feeling environment. Hoffman, Cooper and Powell write:
The youngest babies can sense ease versus impatience, delight versus resentment or irritation, comfort versus restlessness, genuine versus pretending, or other positive versus negative responses in a parent when these reactions aren’t evident to a casual observer. Little babies may pick up on the smallest sigh, the subtlest shift in tone of voice, a certain glance, or some type of body language and know the parent is genuinely comfortable or definitely not pleased.
Schore explains that in a secure attachment, the baby learns to self-regulate in two ways: One he calls “autoregulation” which is self-soothing, or using his own mind and body to manage feelings. The second is “interactive regulation” which is going to other people to help up- or down-regulate feelings. This twin thread of self-reliance and reliance on others, then, begins in the earliest months, becomes very important in the first two years of life, and continues in more subtle ways throughout the life span.
This all might sound daunting for a new parent, who could still be tempted to overdo the focus on the infant and how the connection is going—potentially leading to the same kinds of stress and guilt that the attachment parenting movement creates.
But fortunately, the caregiver doesn’t have to be 100% attuned to the baby and ongoing repairs are an important part of the process:
“The idea that a mother should never stress a baby is problematic,” Schore says. “Insecure attachments aren’t created just by a caregiver’s inattention or missteps. It also comes from a failure to repair ruptures. What is essential is the repair. Maybe the caregiver is coming in too fast and needs to back off, or maybe the caregiver has not responded, and needs to show the baby that she’s there. Either way, repair is possible, and it works. Stress is a part of life, and what we’re trying to do here is to set up a system by which the baby can learn how to cope with stress.” Optimal stress, he explains, is important for stimulating the stress-regulating system.
Still, both Sroufe and Schore acknowledge the emotional labor of parenting. And they are vehement that parents need to be supported in order to have the space and freedom to care for babies.
“It takes time for parents to learn to read their baby’s signals,” Sroufe said.
Schore calls America’s failure to provide paid family leave—and we’re the only country in the world that doesn’t—the “shame of America.”
“We are putting the next generation at risk,” he explains, pointing to rising rates of insecure attachments and plummeting mental healthamong American youth. Parents should have at least six months of paid leave and job protection for the primary caregiver, and at least two months of the same for the secondary one, according to Schore, and Sroufe goes further, advocating for one full year of paid leave and job protection. And a recent study showed that it takes mothers a year to recover from pregnancy and delivery.
Intellectual and cognitive development have been privileged in our society, but it is our emotion regulation that organizes us, our existence, and how we experience life, Schore says. A study from the London School of Economics draws the conclusion that “The most important childhood predictor of adult life-satisfaction is the child’s emotional health…. The least powerful predictor is the child’s intellectual development.”
So where does this leave my friend Amelie? The hard part will be navigating the distracting advice and creating the workarounds she needs for the lack of cultural support. But she enjoys her baby immensely, and I’m confident that she’ll form a secure attachment with Sylvie, as she trusts her own “right-brain” flow of empathy, feeling, and being, and tunes in to Sylvie’s own unique ways of communicating.
And Sylvie will do her part to draw her parents close. Because regardless of babies’ individual personalities—and whether they cry a lot or sleep very little, whether they’re breastfed or bottle-fed—they draw you in with their wide-open gaze, their milky scent, and their tiny fingers that curl around your big ones. Before you know it, they light you up with their full-body smile that’s specially for you, and they draw you near with their plump little arms clasped around your neck.
And the sweet elixir of the attachment relationship is underway.
 While many medications are considered safe to take while breastfeeding, complete side effects may not be fully understood. For example, recent research suggests antibiotics may change the test baby’s microbiome (the implications of which are unclear), and some antibiotics are thought to discolor developing teeth.
 This section refers to primary caregivers as mothers since this research focused just on mothers.
 This section was adapted from the chapter on Attachment, in D. Davies’ Child Development: A Practitioner’s Guide, Guilford, 2011.
 Sroufe, A. & Siegel, D. “The verdict is in: The case for attachment theory.”
 From Schore, A. (2017). Modern attachment theory, in APA’s Handbook of Trauma Psychology, p. 6.
 Schore, A. (2017). “Modern attachment theory.” In APA Handbook of Trauma Psychology: Vol 1 (publication pending).
 http://onlinelibrary.wiley.com/doi/10.1111/ecoj.12170/full p. F720, in Layard,R., Clark, A.E., Cornaglia, F., Powdthavee, N. & Vernoit, J. (2014) What predicts a successful life? A life-course model of well-being. The Economic Journal, 124, p. F720-F738.