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Communication, not conditioning, best promotes infants’ water safety

On ITV Good Morning 10th May 2016, Keri Morrison, a mother whose lost her 2 years and 10 months old son in a tragic drowning accident, spoke as an advocate for the US based Infant Swimming Resource's Self-Rescue® program (IRS).  Paul Thompson, from Water Babies, was in the studio to contrast their respective approaches to water safety for infants. Scientific research was invoked but no convincing argument was put forward against the very powerful fear-based call for action ‘to save babies’ lives’.
 What has worried me most about this interview and the related clips posted on YouTube about the drown-proofing of infants through flip and float is the endorsement of the extreme mixed messages that babies receive in this training.

On the one hand, the training involves visible physiological and mental stress. To develop a new specific combined motor and cognitive function with the aim of back floating for survival upon the eventuality of falling in water, babies undergo intense repetitive stressful stimulation. The six months old baby on the clip uses protest cues: crying, spluttering, arm and leg movements. These cues are deliberately suppressed in exchange for imposing a pattern of midline alignment for coordinated limb movements that can support her head afloat. The trade off, the other hand of the process, is an emphatic sensory reward as the trainer offers visual and auditory signals in expressions of praise. The rising intonations of the praise lavished on the baby after each floating attempt went straight to her limbic system, creating a positive affective association with the practice. Babies crave for and love this reinforced communication: they are wired to thrive on it.

What to make of this ambivalence? It definitely seems pernicious for those of us who believe that ignoring babies’ signals of distress is not right, both ethically and for their brain development, even if this is in their best long term interests. I say ‘believe’ because there are powerful arguments at stake here and it is not easy to disentangle the threads of best practice on the basis of patterns of brain activity , . In the flip and float, the limbic system, located in the inner brain, is involved with its collection of small structures dealing with emotional reactions, stress responses and reward-seeking behaviours. It also includes the hippocampus is involved in memory formation and spatial learning, and the hypothalamus, that acts as control center for stress, regulating the release of cortisol and other hormones while the amygdala evaluates threats and triggers the body’s stress response.

Early years drowning is a serious matter. It is imperative to save babies and children’s lives. The stats used to support drown-proofing programs send a wave of fear that reach the core of our triune brain: mega threat to our offspring, ACTION needed for survival! If there is a way of preventing tragedy, let’s go for it! Book now!
But then the neo-cortex kicks in with its more evolved skeptical appraisal. Wait a minute!
 Does this method actually save lives beyond anecdotal show cases? If so, which age group benefits most? (we know from statistics in the USA that the majority of toddler drowning occurs in shallow water rather than in deep water, often baths or paddling pools where infants could stand up if they did not panic). The three to six year olds who most commonly fall in swimming pools are well able to learn to swim. This leaves a window of vulnerability, 20 months to 36 months, when back floating could be most valuable for survival.

Are there different age-based techniques for flip and float? What happens when the ‘righting reflex’ that prompts a baby to sit up and therefore to reject back floating between 5 and 10 months, is forcefully suppressed? In the first year, which is the year of major brain growth through the ‘pruning and blooming’ of synapses to create the neuron networks used in later life, babies are most sensitive to repetitive stimulation. Developmental psychologists explain how this creates ‘habituation’ –the baby ignores the signal of a bell ringing during sleep if it is repeated at regular intervals- and ‘resilience’: the neurons start firing less after some time but there is a change in the setting of nervous system arousal, commonly shown through levels of cortisol in the body. Neurobiologist Bruce Perry refers to the ‘defeat response’, when regulatory modulators are compromised in threat response patterns. The monkey that gets electric shocks and is offered a banana after each shock gets desensitized, or withdraws in the corner and refuses bananas. Are drown-proofing conditioning methods more suitable to induce resilience in younger babies? Do they produce ‘toxic stress’ for sensitive toddlers?

When is the best time for inculcating water safety in infants? How many children trained in drown-proofing fail to become ‘resilient’ and develop extreme sensitivity, perhaps losing the enjoyment of water? While this is not in the interest of drown-proofing ‘programs’ to alert parents to this possibility, statistically, it must be actualized in at least a minority of children trained. Russian parents with traumatized toddlers trained in the Tjarkovsky method, that is founded on desensitization of babies through repeated dives, have turned to Birthlight to restore their children’s rejection of being in water through gentle communicative moves. It is not clear whether this rejection was induced by forceful conditioning or by the temporary loss of connection between baby and primary carer. When a baby is pushed under, as when a baby is left to sleep alone, sensory contact is lost. The special feature about back floating conditioning is that loving signals are maintained and communicated to the baby throughout.

In both the ‘flip and float’ method and the Tjarkovsky method, enforcement is at the service of a higher cause: saving lives in the former, and developing superior brains in the latter. This is seductive and moreover the outcome is presented as a valuable competence that babies have gained.

As human parents, we use loving conditioning a lot in our interaction with babies so that we can get on with our lives in families and society. Even before the publication of Sue Gerhardt’s book ‘Love Matters’ in 2004, the importance of caring interaction in infants’ self-regulation of affect and the fact that learning is best done in a loving environment were well known. Her book provided neuro-scientific arguments against practices such as ‘controlled crying’ and finally nailed the remnants of Victorian child-raising in their coffin. 
Now is there such a thing as a loving rod? Hurting a kid with loving signals? Without the pretense of ‘cognitive enhancement’ or the mandate of saving lives, as in drown-proofing, this is exactly what child abuse is about.

Back floating enforcement with loving praise takes us in one of many gaps between neuroscience and parenting common sense. We need some amount of resilience to function as social human beings but using the rod, loving rod or its psychological equivalents is bound to cause trauma and detrimental mental and physiological effects in life, at least to those sensitive members of society. Evolution is taking us towards higher brain function without the need for resilience: recent research on oxytocin, on the polyvagal system and the connection between vagus nerve, heart and immunity shows that the ‘relaxation response’ induces modes of brain functioning preferable in all ways to the adrenalin/cortisol driven stress loops of the fight/flight response.

If enforced back floating for survival, through the mixed messages it conveys to babies between stress and rewarding praise, results in compromising at least some of the drown proofed babies’ capacity for trust, empathy and compassion, is it worth it given the lack of hard evidence for its outcomes? What is the real trade off for suppressing babies’ signals of distress communicated so visibly during training? If, as neuroscience shows in increasing detail and complexity, early experiences are translated into precise physiological patterns of response in the brain that then set the neurological rules for how we deal with our feelings and those of other people, is this the best we can do?

Violence, even coated in loving words and with the highest motive, always has a price tag. Authors such as Joseph Chilton-Pearce have eloquently written about the need for eradicating parenting violence since pregnancy. There is always another way. Listening and responding to cues in a real dialogue that gives babies the autonomy they deserve at every stage of their development enriches the connection between cognition and affect that is inscribed in our human physiology and increasingly unraveled in neuro-physiology research.

In the two years when I lived with Amazonian forest people and in all my subsequent trips I have only come across one case of toddler drowning, a little boy who followed older children into boggy water he could not be pulled out of. Why are so many infants drowning in affluent societies in spite of all the protection devices, admonitions and regulations?
Amazonian parents, together with African rainforest pigmy parents are reputed to be the gentlest parents in the world. I watched in wonder how they patiently trained their infants to stop on the edges of the raised platforms of houses standing on stilts in water. There never seemed to be any drama: babies were pulled back, played with a little, left to crawl to the edge again until something seemed to click and the babies stopped and sat there. This sometimes instilled an urge in me to go and grab them for safety until I learnt to trust this style of parenting. Had I interfered on basis of my fear, I could have disrupted a wonderful body-based dialogue made of thousands of minute body signals that these far more sensitive parents learn from childhood within their culture. In water, close physical connection between infants’ bodies and the bodies of close adults or siblings in swimming or wading provided the foundation for independent swimming.

It is true that parents cannot watch their children 24/7 and all parents have experienced instances of toddlers getting into scrapes within very short windows of inattention. But there is a lot that can be done before resorting to drown-proofing: calmly and patiently instilling the need to wait for an adult to give permission for entering the water (Amazonian parenting style); teaching toddlers to regain their footing in baths and paddling pools as soon as they learn to stand up, which can be a real fun game; creating the fun conditioning of taking off to mum or dad and going back to bar or pool deck, reinforcing communication, trust and a clear sense of achievement in the infant; jumping in and returning to poolside, since after all most toddlers fall very close to water edge, are probably some of the most valuable water safety skills that can be taught from six months onwards. All these practices are characterized by an absence of coercion, whether crude or disguised under rewarding praise. The infant is the agent, has to initiate and carry out the actions. This can be infuriating when a toddler is not in the mood to participate, but it’s also good to explore and negotiate boundaries and time needs to be made for that, saving tantrums or refusals later on.

Parenting programs that on paper save time, trouble and in the case of drown-proofing, is presented as life-saving, fits well in a society in which resilience is used and valued even at the cost of medicating infants who respond with extreme sensitization. At Birthlight, we have taken on the task of gently leading parents to enjoy the infinite pleasures of watching and responding to their infants in a true communication that sets a reliable long term basis for trust and open dialogue and promotes what Chilton Pearce has called ‘creative competence’. This is all important between the third trimester of pregnancy and the second year, when brain plasticity is greatest, with lasting consequences of the neuron networks set at this time. Water uniquely supports a focused interaction between parents and infants with the mutual adjustments that result from learning and brain regulation based on affect. Water encourages playful sensory-motor exploration that is inevitably curtailed, at least to some extent, by using back floating as a default position. Water safety is best based on communication, not on conditioning. We would not have it any other way. We give heartfelt thanks to Amazonian forest parents who currently face the pollution of their waters and the destruction of their environment for showing us in practice what gentle parenting can be.

In the absence of studies to assess the physiological stress levels of infants undergoing drown-proofing or the impact of drown-proofing on the developing child, perhaps the policy statement on controlled crying issued by the Australian Association of Infant Mental Health could be issued as a warning to parents: ‘(controlled crying) is not consistent with what infants need for their optimal emotional and psychological health, and may have unintended negative consequences’.

Françoise Barbira Freedman
Birthlight Founder & Director

My baby swimming journey

Birthlight’s pioneering techniques are at the forefront of international approaches to baby swimming. Françoise received the prestigious Virginia Hunt Award in 2009 for her contributions to early swimming and together with other birthlight tutors she continues to innovate to in promoting a life long enjoyment of swimming from an early start.

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Center on the Developing Child: Harvard University

Baby’s Brain: The Urban Child Institute.
  Webb, S.J., Monk C.S., Nelson C.A. (2001) “Mechanisms of postnatal neurobiological development: implications for human development” Developmental Neurobiology 2001:19(2):147-171.
Perry, Bruce (2013) Seven Slide Series of video webcasts. Video 2: Sensitization and Tolerance.

Gerhardt, Sue. (2004) Why love matters: how affection shapes a baby’s brain. East Sussex” Brunner-Routledge.

Shore, Allan. (1994) Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. New Jersey: Erlbaum.

Tracey, Kevin (2012): Andersson, U; Tracey, KJ (2012). "Reflex principles of immunological homeostasis". Annual Review of Immunology 30: 313–35.

Chilton Pearce, Joseph (2002) The crack in the cosmic egg: new constructs of mind and reality. 

Chilton Pearce, Joseph (2012) The Heart-Mind Matrix: How the Heart Can Teach the Mind New Ways to Think. Inner Traditions.