Infant health depends on specific kinds of help.
- If babies don’t receive particular types of care, they suffer.
- Young children need a supportive holding environment.
- Mothers need extensive support to be a good enough caregiver.
D.W. Winnicott (1987) coined the term “good enough mother.” It refers to the ‘holding environment’ for the child that ensures that, during the first years of rapid neuropsychological growth, the child feels appreciated, confident, and trusting. Good enough caregivers know that babies need to feel secure, safe, wanted, connected all of the time. Thus, good enough care does not impose any pain or distress, which can be traumatic for a baby.
Overall, a good enough mother or caregiver does not deny the baby’s need fulfillment, understanding that babies have an inner compass of what is needed for optimal growth (Schore, 2019). They signal developmental needs by what interests them (e.g., crawling for neurodevelopment) and the good enough caregiver allows them to practice those interests.
What does good enough care look like? Here are a few characteristics identified from ethnography, psychotherapy, and neurobiological science.
Provide security and stability. Good enough caregivers keep a child feeling secure through human contact and positive presence. The young child is never purposefully left alone. (When the child is older, he or she will explore and leave the caregiver behind, but this is done at the child’s discretion and with the opportunity to return to the caregiver as a secure base; Bowlby, 1988). Thus, good enough caregivers support the development of secure attachment (Siegel, 1999; Stern, 1985; Winnicott, 1957). Winnicott also emphasized how good enough mothers do not introduce more than one change at a time so as not to associate them in the child’s mind (e.g., new food with new routine).
Foster self-regulation capacities. Good enough caregivers help children develop self-regulation capacities through countless times of calming baby down when baby starts to get uncomfortable (recognized by grimace, grunts, limb movement), helping neurobiological systems (e.g., stress response, vagus nerve) establish calm patterns. The child is never left to despair (Winnicott, 1957).
Babies need to learn to breathe with the lungs, which was not necessary in the womb. Physiological self-regulation, like breathing, is facilitated by extensive skin-to-skin contact (Bergman et al., 2004). Being carried and held facilitate this. In fact, crying can occur because not enough body-to-body contact has been experienced to help with learning to breathe.
Provide for biochemical/nutritional needs. Ideally, the child’s needs are satiated with breastfeeding on request. There are no delays. As a result of their small stomachs, young babies may request feeding every few minutes (Hewlett & Lamb, 2005). Why is this important? The child is growing thousands of brain connections every minute and building the immune system (which is mostly in the gut). This is called the “gut-breast axis” and is foundational for lifelong health (Rodriguez et al., 2021). Children need the biochemical growth stimulation that breast milk provides (Power & Schulkin, 2016) in contrast to growth-inhibiting cortisol that is released during distress (Murgatroyd & Spengler, 2011). Infant formula, an emergency food, does not have all the brain- and gut-building ingredients of breast milk.
Attend to establishing circadian rhythms. Caregivers organize circadian rhythms by following the rhythms of the earth and body. In the evening, good enough caregivers provide low-level natural lighting (not blue lighting) and in the morning, exposure to sunlight. Evening breast milk has agents that induce relaxation and sleep (e.g., tryptophan, which is also in turkey meat) whereas morning milk has energizing agents (Italianer et al., 2020).
Provide authentic communication. Good enough caregivers are authentically present, providing “limbic resonance” or intersubjective connection, which contributes to healthy psychosocial and neurobiological development, along with secure attachment (Lewis, Amini & Lannon, 2000; Stern, 1985; Sorenson, 1998).
Maintain optimal arousal. Good enough caregivers facilitate a cooperative personality, intelligence and health by maintaining optimal arousal in infancy (before age 3) (Schore, 2019). In contrast, an overactive stress response can be established (for life) when baby is frequently left in distress (Lupien et al., 2009). When the stress response is activated, it redirects blood flow away from higher order thinking, away from social openness, instead mobilizing the body for self-protective action (Sapolsky, 2004). If this becomes habitual, it makes it hard for the child to learn (Cozolino, 2013).
Encourage free movement. Good enough care encourages the child’s free movement. There is limited use of plastic carriers and strollers. Instead, the young child is allowed to crawl then walk as they go through multiple developmental stages of body-mind learning. Good enough caregivers avoid interfering with the movement of the child through the world. The child is assumed capable of taking care of self in normal natural environments (Liedloff, 1985). (Of course, this does not hold on a busy street where a child might run out into the street.) The child is allowed to be exuberant, honored for their dignity as a person (Cavoukian & Olfman, 2006). Overall, the motivation to learn from the world is encouraged and efforts at autonomy are not punished (Panksepp, 1998). The child is given as much freedom as the context allows (and contexts are selected for their safety and openness (Skenazy, 2010).
Encourage self-directed play. Good enough caregivers provide lots of time and opportunity for daily self-directed play and self-directed social play. Such play characterizes our ancestral childhoods and turns out to be the best way for a child to learn life skills, self-control, cooperation and creativity (Gray, 2013; Panksepp, 1984), especially with playmates of all ages (Hewlett & Lamb, 2005).
Integrate the child into meaningful community. Good enough communities not only provide support for mother or primary caregiver but immerse the child in experiences with multiple different others who provide stable, warmly responsive care (Hrdy, 2009). They embrace the child with meaningful stories about the child’s positive place in the family and community. They welcome the child into active community membership, understanding that the child is learning their way and developing their skills. The child practices mutual sharing with community members (Widlok, 2017).
Model appropriate behavior. The child expects community caregivers to model how to behave. They are ready to imitate and become a contributing member (Liedloff, 1977). Adults who have been well-supported are able to model self-control, generosity, and all the other virtues desired.
Encourage self-transcendence. Time for transcendent feelings are incorporated into daily life, such as spending time in forest, watching sunsets or grass grow. These can be helpful in redirecting an upset child (Doucleff, 2021).
Good enough mothering or caregiving is not a soloist affair. We know that mothers or primary caregivers do not provide ‘good enoughness’ alone. They are supported by communities that are present to provide them the same kinds of support they provide their children (Hrdy, 2009)—someone to help with meeting their basic needs (e.g., for rest, nutrition, safe and stable support, a sense of competence and self-control, ability to be generous), someone to lean on when stressed. The good enough community sets up the practices and policies that make good enough caregiving possible (e.g., parental leave after the birth of a child).
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