About Possums and bringing this work into the world
The unsettled baby in the context of global health
"I wonder if I shall fall right through the earth! How funny it’ll seem to come out among the people that walk with their heads downwards!" Lewis Carroll, Alice in Wonderland, Chapter 5
Cue. Pronunciation: /kiu:/. Noun. 1 A signal for action.
For twenty years I was married to a public health physician whose academic expertise was in global health policy. There came a time when to my deep grief we divorced. But throughout the years of my marriage I regularly found myself in conversation with doctors from countries with less developed economies. They asked me what I did, and I was often embarrassed to confess over a traditional aromatic Cambodian or Ethiopian or Burkina Fasoan dish that I researched infant distress.
‘Crying babies?’ they queried, courteously. In these doctors’ countries, mothers and infants died at more than ten times the rate of my own. Often they’d dedicated their lives to improving the access of mothers and babies to quality medical care and technologies. But babies who cried a lot weren’t a health system problem.
‘Yes,’ I explained apologetically, ‘I come from a wealthy country where women and children are lucky to have one of the best health systems in the world. And our babies cry a lot.’
‘It’s actually very tough on parents,’ I would add. ‘It sets things off to a bad start.’ The doctors would look at each other, perplexed. They would nod politely.
‘In our country, babies don’t cry that much unless they are sick,’ someone would eventually explain, respectfully. ‘It’s not usually a problem.’
I shaped the Possums programs from evolutionary biology and neuroanthropology
To really make sense of the underworld new families might find themselves in, where babies scream for hours and parents are desperate, we have to be willing to consider for a moment the ancient biologies and the bloody, sprawling cultural histories of the female sex. And yet a painful anxiety surfaces in many health professionals and researchers if anyone puts ‘crying babies’ in the same sentence as ‘comparative anthropology.’
‘Twenty-first century mothers can’t be expected to adopt a Stone Age people’s lifestyle and live like hunters and gatherers!’ one psychologist exclaimed at a conference, jumping to conclusions when I mentioned the new field of neuroanthropology. She thought I was about to tell the story of natural and instinctive motherhood, lost.
‘Contemporary Western mothers don’t have anything approaching the kind of social support available in traditional societies!’ she continued. ‘A mother is on her own a lot of the time with her children, she can’t invest large amounts of time into just one infant’s needs (and that’s if she is even able to breastfeed). She has to have a reasonable night’s sleep to cope, especially if she is returning to work!’
I nodded in agreement. I’d still not had a chance to explain my position. The psychologist was convinced that my interest in applying the findings of neuroanthropology to infant crying can only lead to one thing: an exhortation that mothers bedshare, breastfeed every hour, and carry their babies all day long.
‘Asking mothers to sleep with their babies and feed twelve times in the night like !Kung bushmen is cruel,’ she went on. ‘It promotes unrealistic expectations. It makes mothers feel guilty, or as if they’ve failed.’ Then the psychologist concluded, emphatically: ‘We do not live in sub-Saharan Africa!’
I want to help make life easier for women and their children in the first year of life, not harder, whether they are teachers or shop assistants or Members of Parliament or neurosurgeons. That day I refrained from pointing out that millions of very modern mothers actually do live in sub-Saharan Africa, and that her perspective might be considered racist. I was also intrigued that she used the analogy of the !Kung people, half a world away, without considering the First Nations people – the oldest continuous living cultures on this planet – who share Australia with us. Outdated and dichotomised conceptions of the ‘primitive’ versus the ‘civilised’ still persist in infant care, perspectives that were widespread in the mid-1900s but which no longer make sense in today’s digitally connected, globalised, multi-cultural world.
I have learnt from my country's First Nations Peoples, and gratefully acknowledge this
When I worked in Indigenous health, many people who lived and worked in Aboriginal communities, including Aboriginal health workers, art centre staff, teachers, anthropologists, doctors, nurses, midwives, and not least, First Nations’ women themselves, told me matter-of-factly that First Peoples’ babies don’t cry much – at least not in more traditional contexts.
Traditional Aboriginal babies, like all babies, cried to signal a need or distress, and babies in traditional cultures initiate cries as often as in our own. But the amount of time they spend crying is dramatically reduced. What the people I worked with back then were saying was that in more traditional Australian societies, they didn’t hear babies screaming for long periods, or grizzling persistently, hour after hour, week after week, in the same way some little ones do in our Westernised culture. The anthropologist Professor Annette Hamilton wrote in her 1981 book Nature and Nurture: Aboriginal child-rearing in North-central Arnhem Land that the Anbarra people up on the coast of the Northern Territory called a baby from the first weeks until he could sit up unsupported the dalipa, ‘fat and happy one’.
When I read a sentence Raymond Evan’s book A History of Queensland reporting that a group of men from the ship The Fortitude, on which my great-great-great-grandfather voyaged to Australia, helped ‘clear the Blacks’ (the great-great-great-grandfather who said Grace and read the Bible before each meal, pacifist, abolitionist, tee-totaller) I froze. What do you do when you learn that your great-great-great-grandfather was among a bunch of Protestant emigrants in 1849 who went, ‘armed to the teeth,’ to drive the local people off their permanent campsite? A campsite where, from the beginning of time, women had brought their new babies in from the bush, rubbed them with goanna oil, smoked them, sung to them, suckled them, grown them fat and happy? Women had suckled and sung to their fat and happy babies by those campfires forever, until my forebears came. What are my responsibilities now?
I believe one responsibility is to acknowledge that I have things to learn from our country’s first inhabitants, the oldest living race upon the face of the earth, about how to care for a baby so that he or she becomes a sociable, well-loved, kind and reasonably happy human being.
I dined once with a grey-haired anthropologist, well known for a lifetime of work in Australian First Nations’ communities. When I mentioned that I was researching crying babies, she replied with the same matter-of-fact sentiment, though I hadn’t asked. She said: ‘In remote Aboriginal settlements, babies don’t cry.’
‘Not when I was doing so much field work in the 1970s and 1980s, anyway,’ she added. ‘They were always in someone’s arms, the breast was always in their mouth.’ I wasn’t convinced this entirely explained it, but I listened.
‘I have to say, though,’ she remarked, ‘when I’ve been back in the last decade, I’ve heard babies crying.’ She paused, and we ate in silence for a while. ‘Much more formula is used now,’ she added, ‘and other social problems are worse.’
I have learnt from other cultural contexts too, and gratefully acknowledge this
‘Do babies cry a lot in Vietnam?’ I inquired casually over a traditional Hue pork soup with bamboo shoots and noodles prepared for us by visiting Vietnamese friends. The doctor looked at his wife, also a health professional, and his mother who’d travelled with them to help. There was some discussion in Vietnamese.
‘No,’ he announced finally, in English, matter-of-factly. ‘My mother-in-law turned a chopstick when my son cried.’ His wife’s mother was a medical specialist.
‘It worked,’ he added.
They demonstrated with gestures. The chopstick was turned to point at the baby, then turned away.
‘Not scientific,’ he conceded, and they laughed. There is a time for science, and there is a time for the old ways.
The doctor had to go out and find the leaves of a particular plant when the baby was one month old. It used to be everywhere but it was harder to find now. The old men showed him how to weave the leaves together to make a wreath for the baby’s head. That little black-eyed boy with the brush of soft black hair, honey skin, cupid mouth, sitting on his grandmother’s lap at our table, still slept with a knife and a chopstick under the pillow, his father explained fondly, to protect him from crying and to keep him safe.
Later, I spoke with another young Vietnamese doctor, who agreed that yes, everyone slept together with the baby and the babies didn’t cry much.
‘But,’ she added, uncertainly, ‘maybe it’s unhygienic, maybe it is better to be like you.’
There are plenty of studies showing that babies in other cultures cry substantially less than babies in the West. But before we are tempted, with the psychologist, to dismiss these lifestyles as too remote from our own to be relevant, let me describe a study that Professor Ian St James-Roberts and his team published in 2006, to my mind one of the most important trials ever undertaken in the field of infant crying.[1]
A randomised controlled trial doesn’t make sense in a comparative study across cultures. So Professor St James-Roberts, always meticulous in his methodologies, did the next best thing: he took three large groups who practiced different parenting styles, followed them from birth to twelve weeks, and demonstrated that there is substantial variation in amounts of crying depending on infant care practices, even within the West.
Copenhagan parents are more likely to breastfeed, more likely to sleep the baby in the same room or bring the baby into bed for part of the night, and babies have on average about ten hours physical contact with the adult in a twenty-four hour period (whether asleep or awake). In London, parents tend to offer behavioural or routinised interventions for feeds and sleep, are less likely to breastfeed, and have about six hours physical contact with the carer.
At five weeks of age, London babies cry twice as much.
Biography of a baby's cry p 22-26 2013; adapted 25 February 2023
Reference
St James-Roberts I, Alvarez M, Csipke E, Abramsky T, Goodwin J, Sorgenfrei E. Infant crying and sleeping in London, Copenhagen and when parents adopt a "proximal" form of care. Pediatrics. 2006;117:e1146-e1155.