Here is my response to Elizabeth Baldwin's requests for help with  with Lamb's article. It might be of interest to some of you. 
 
Attachment literature does not specifically focus on nursing as a behavior that enhances the development of secure attachment systems, even though nursing is noted by some researchers as an important relationship. Attachment theory focuses on the development of the quality of attachment. This means that all children are believed to form attachments to their significant others but that the "quality of attachment" need not always be the healthiest in terms of present behavior and future interactions with others. The optimal quality of attachment is called a "secure" quality of attachment. Secure attachment systems are formed under the influence of various factors. 

An important ingredient to the development of secure attachment is maternal sensitivity to infant cues. There are aspects of nursing that seem to promote sensitive mothering styles. However, this is not usually acknowledged in a significant manner in the attachment literature. 

On the other hand, I conducted a study that examined the interaction between nursing mothers and babies. This study postulated that factors unique to nursing contribute to the development of healthy attachment.((( Epstein K. 1993. The interaction between breastfeeding mothers and their babies during the breastfeeding session. Early Child Development and Care.87:93-104.))) This study suggests that the interactions during nursing seemed to facilitate the appearance of mutually satisfying interactions and the development of sensitive mothering styles, a necessary component of secure attachment systems. I noted that the facilitative factors of nursing are important for all couples and are particularly significant for dyads at risk for attachment difficulties.  

Lamb stated that nursing "..is by no
means an essential context." He also states that there is no evidence that breast-fed babies form closer or more secure relationships to their parents than do bottle-fed babies." 

I would not focus on the essentiality of nursing, rather I would look at the facilitative factors in inherent to nursing. Furthermore,  I would not engage in the comparison of the quality of attachment of nursing and non nursing children. I do not think that this is relevant in the context of custody decision making. It has been my experience that psychological assessments for the purpose of determining custody, attempt to decipher the needs of individual children.Therefore, the question is what specific role do factors integral to nursing play in the evolvement of healthy emotional behavior for the child at hand.  

In order to assess how nursing enriches emotional health for each family, one must first realize the nursing is not a form of feeding but that it is a relational behavior with features specific to each nursing couple. In the same study noted above, it was demonstrated that each nursing couple has their own unique manner of interacting that is emulated in between nursing sessions. It was indicated that these nursing specific interactions occur frequently throughout the day and night in younger as well as older nursing children.  Furthermore, I am presently investigating interactions in breastfeeding families and it seems that the special relationship between the nursing dyad is recognized by all family members. Hence, Lamb's suggestion that fathers feed their infants expressed milk in lieu of nursing sessions does not seem to reflect the relational reality of nursing.  You can't put a relationship in a bottle.     

Disregard for and disruption of patterns unique to each couple's nursing relationship might likely impair the establishment of healthy emotional scripts. Children who experience family separations are already at risk for emotional disruptions and thus, it seems unjust to further complicate an unfortunate situation. On the contrary I believe that the aim of the resolution of custody issues is to implement steps that ensure that children's best interests are met. Is it not in the best interests of a child to ensure that activities that boost their individualized emotional well being are maintained in a consistent and respectful manner? Suggesting that a child spend a night or other large periods of time away from their nursing partner, disregards the child's perspective, is disruptive and further compounds the difficulty that children sense when their families break up. 

I thought that I would add that Lamb has published some very insightful research on fathering. I believe that his work indicates that the maternal and paternal paths towards the internalization of the parenting role are distinct. These differences continue as the parenting roles evolve. I understand that this author indicates that children benefit from being exposed to each parent's unique manner of interacting. 

Bearing this in mind, one might suggest that parental  differences should also be recognized and celebrated in divorced families. As such, interactions between children and their nursing mothers should also reflect the unique physical aspects of mothering through nursing. Children benefit through exposure to this aspect of mothering just as they do by experiencing unique interactions with their fathers.   

Satisfying interactions with both parents are contingent on parental capacity to display sensitivity to children's cues. Sensitive parenting reflects evolving parental tasks that are modified in tune with children's ever changing developmental tasks. As such, parents should also demonstrate a capacity to be sensitive to children's needs expressed in the nursing relationship.  I would seriously question the sensitivity (in terms of being able to adequately answer a child's cues, meet the child's needs) of a father who wishes to deny his nursing child a normal developmental sequence. It seems that fathers who hold their children's best interests at heart will admit that the emotional difficulties that children suffer due to divorce and separation,should not be complicated by  disregarding developmental patterns integral to nursing relationships. 


Keren Epstein-Gilboa MEd BScN RN FACCE LCCE IBCLC
PhD (Candidate, Human Development/Family relations)
psychotherapist  

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