Understanding of parenting behaviors can help pediatricians address parenting challenges

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Boston Medical Center pediatricians Laura Johnson, MD, MPH, Jenny Radesky, MD, and Barry Zuckerman, MD, the Joel and Barbara Alpert Professor of Pediatrics at Boston University School of Medicine, have published a paper in the current issue of the journal Pediatrics that addresses how understanding the origins and goals of parenting behaviors can help pediatricians strengthen relationships with families, demonstrate cultural sensitivity, and more effectively offer guidance on the challenges of childrearing.

According to the paper, parenting goals and behavior are strongly influenced by cultural norms and expectations of adult behaviors that are valued by a particular society. They contrast "Western" cultures emphasizing individual autonomy achievement, independence, self-reliance, and self-assertiveness with many Asian, African, and Latino cultures that value interdependence: collective achievement, harmonious collaboration, and sharing. "Many parenting priorities, such as feeding practices, sleeping arrangements, and school and social success, fall somewhere along the spectrum from autonomy to interdependence and are likely affected by the parents' cultural beliefs related to their own upbringing," said Zuckerman. "This can result in some parenting behaviors conflicting with the beliefs of the pediatrician, as well as with policy statements from experts and professional societies based on culturally-bound empirical data, we aim to review a few examples of parenting differences that pediatricians might encounter," he added.

The authors explain that every family is both a unique microcosm and a product of a larger cultural context. The three examples they highlight may be viewed through a cultural lens that promotes autonomy or interdependence. Importantly, these values are not dichotomous but rather exist along a spectrum co-existing sometimes changing over time.

In conclusion the authors state that by eliciting and understanding how cultural norms shape parenting behavior, including the role of extended family, and how they relate to a child's growing autonomy and/or interdependence, pediatricians can help parents gain better insight into what they want for their child and how they address parenting challenges. This approach may encourage parents to more openly discuss their struggles with their child's pediatrician and more readily consider their guidance and advice.

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