On the vexed topic of child care and working mothers

This is a sensitive topic, and I don’t pretend to be an expert on it. I write from the point of view of a mother, a GP and medical researcher. I am not a sociologist or paediatrician.

I also recognise the unique differences in every family – their circumstances and beliefs. The research I am about to present is also “soft” in that it cannot prove causation, merely associations.

However, it is based on thousands of observations over several countries, and often on longitudinal studies, where families are followed over a number of years, and “confounding factors” are adjusted for. I believe this research is a valid piece of the puzzle.

Sentiments I have heard often as a result of my post on working and stay-at-home mothers are

(1) Working mothers feel guilty leaving their children in the care of others, worrying about their emotional well-being
(2) Mothers who choose to stay at home instead of participate in the workforce strongly believe that it is best for children if mothers remain at home, at least until school age.

Even if you don’t feel strongly about either of these sentiments, as a mother you will probably wonder at some stage, even for a moment – what is “best” for children? Does placing children in institutionalised child care have negative consequences? Will these children be less adjusted emotionally, have more behavioural problems, and suffer academically? Is it really best for children to be at home with their mothers as almost exclusive carers?

The truth is, I think this really depends on your belief system. If you believe your children are best off at home with you and you whole-heartedly embrace this, your children will thrive. Similarly, the overwhelming evidence points towards the fact that being a working mother does not impact negatively on your child’s wellbeing, unless you are stressed, irritable, hostile to your children, have a poor relationship with your spouse, or are insensitive to your children’s needs. Researchers have always pointed out that home factors matter much more than what type of non-maternal child care children receive, the number of hours they spend in alternative care, or the quality of care.

Working mothers are vulnerable to guilt from leaving their children in the care of others. I certainly experienced this. So, in an effort to understand the impact of child care on children’s well-being, I did some simple searches of a database and read the salient and most recent articles. I chose to read reviews, which summarise the data from multiple studies, and large recent studies. I have read the full text copies of these papers to some detail, and report my understanding of the results. I did this for myself, and hope this will help other mothers in their journey to balance work and family in the way that suits their families the best. It is not meant to be an exhaustive review. I may have missed out some studies, and there is also personal bias, as I am a working mother myself.

Are there any negative consequences from attending child care, compared to children being raised at home by their mothers or other carers?

A seminal paper in 2007 reviewed forty years of data on children in child care, and concluded that children who began care early in life and were in care for 30 or more hours a week were at a slightly increased risk of developing stress-related behavioural problems. The risk was greater if parents displayed insensitivity or if the children had difficulty interacting with their peers.

It is possible that child care quality has increased in recent times. More recent large studies carried out in the UK and USA have failed to confirm the behavioural disadvantages, demonstrating either no difference in behavioural outcomes, or higher scores for orientation and engagement in the group attending child care. However, the USA study focussed on 4 year olds only, although the British study (which found the higher orientation and engagement scores) looked at the effects of early child care (while infants) on outcomes at 18 months.

Attending child care was associated with higher rates of illness from infectious disease (eg colds and flus, ear infections), and may be associated with an increase in body mass index.

Are there benefits from attending child care?

Research consistently demonstrates that children who attend child care perform higher on cognition and academic tests, even when socioeconomic status and maternal education is controlled for.

The 2007 review noted higher language scores and early school achievements in the child care group compared with the home raised group. This was greater if children were from disadvantaged backgrounds and centres offered high quality care.

The other studies confirmed this association. However, the difference between cognitive scores is not huge – it is reported as “modest”.

A large review looked at all the studies comparing the effects of maternal employment vs no maternal employment. There were no significant differences in children’s achievement overall, and possibly a trend towards a small positive association (i.e. maternal employment predicts higher achievement to a small degree) – after adjusting for confounding factors like maternal education, socioeconomic status etc. Higher achievement was noted for children whose mothers worked part time vs those with mothers in full time employment.

These effects have been demonstrated to be particularly important for girls. If mothers are employed, their daughters have higher achievement scores compared with girls whose mothers stay at home.

The results were confirmed in a recent large British study. There were no detrimental effects on behaviour noted in the group whose mothers returned to work. More difficulties were reported at 5 years of age if mothers did not return to work within the first year of the child’s life, and the more time the mother spent out of the labour market, the greater the difficulties.

Girls whose mothers worked fared better than girls whose mothers stayed home whereas no difference was seen in boys – except when the mother was the breadwinner and/or the sole parent.

One limitation is that this study did not control for race (although maternal education and family income were controlled for) and it is known that Pakistani and Bangladeshi women living in the UK are more likely to not be in the workforce.

What about maternal stress?

An Australian study found that parents who reported work-family conflict, or feeling stressed by the conflicting demands of work and family, were more likely to report behavioural difficulties in their children. This was especially if parents reported “irritable parenting”. However, if both parents reported high work-family facilitation, in that they felt their work was rewarding and a positive for the family, fewer behavioural difficulties were reported.

Of course it’s difficult to tease out which is the chicken and the egg (did the behavioural difficulties cause the work-family conflict?) but it wouldn’t hurt for parents to examine their own levels of stress and explore appropriate ways of managing work-family stress. Navigating through the unavoidable stresses of life in a successful way can be one of the most important skills we pass on to our children.

And lastly, working mothers are spending more time with their children than they think

Do you worry about not spending enough time with your children? Results from an interesting study suggests you’re spending more time than you think.

This study looked at time journals for mothers of 7 month old babies from a sample of over 1000 families in the USA, which were a diverse sample racially and socioeconomically. Employed and non-employed mothers spent their time differently with their infants. Overall, employed mothers spent 84% as much time as non-employed mothers directly caring for their child on a working day (1.7 hrs less). Proportionally, they spent more time in social interaction and less time in instrumental care (feeding, changing nappies etc). On weekdays (working days), employed mothers spent less time on leisure, household, organisation and travel time, and worked outside the home for an average of 8 hours.

On weekends, employed mothers appeared to compensate for the working week by spending more time interacting with their infants than non-employed mothers did (an extra 30 minutes per day).

Some thoughts in conclusion

Children and parents are not numbers. Research, especially from observational studies only, has to be interpreted in context, and can only show associations, not causation.

The decision for mothers to raise their children exclusively or use child care services full or part time is a very personal one, underpinned by individual beliefs and circumstances.

Obviously there are many benefits to a child having a mother at home exclusively. He has near constant access to a beloved carer, and the mother derives enormous satisfaction from personally raising her child. There are fewer illnesses and fewer variations in carers, and the child may display fewer behavioural problems.

Also, child care is a “one size fits all” solution. Some children may not cope with being in a large group, with less access to personalised care, especially if very young. My children happen to be sociable creatures, and both enjoy being at child care, but if they had had different temperaments, the situation may not have been quite so rosy.

However, it is my opinion that the belief that “children should be raised at home by their mothers” may not apply universally. Firstly, this fails to recognise mothers as individual women who may have needs beyond caring for families. A mother is a woman, not a clone or robot. It is not anathema for a mother to need or want to work outside of the home and to arrange for alternative care for her children. In many other cultures, it is unusual for mothers to be the exclusive carers for their children.

Secondly, there is little evidence from decades of observational research that maternal employment is harmful to children. In many cases maternal employment also allows significant advantages – allowing greater resources at home for children’s learning and wellbeing, and increase in self-esteem and financial independence for mothers. Earlier research suggesting behavioural difficulties raises concern, but has not been confirmed by more recent studies. And obviously, considering each child on an individual basis is of paramount importance. If there are signs that a child is not coping with child care, after the initial transition period, it is wrong to rely on observational research findings.

Some mothers may prefer to be at home with their children, but circumstances require them to be at work. This is a difficult situation, but at least these mothers can be reassured that, on the balance of things, their children will not be worse off by them being at work.

Quality of child care has been suggested as an important factor in these outcomes. This has been inconsistently demonstrated in observational studies. One study has defined high-quality child care as one where there are frequent, warm, positive interactions between the children and their carers. This is certainly the top priority for me. I need to know that my children would be comforted when upset and would develop a close and secure relationship with trusted carers. When I visited our current child care centre and saw all the babies being held by carers, lovingly too, I knew it was a good place for my children to be. And I was right. My children have developed very strong relationships with wonderful carers. They are loved, nurtured, and disciplined appropriately.  Additionally, the carers provide all kinds of activities that I do not at home. Finger painting, playing with pet turtles, incursions, music classes, and all manner of arts and crafts (even my infant was making collages at the tender age of 9 months!) Our centre makes it really feel as though this is the “village” that I need to raise my children – the extended family that I do not have here in Melbourne.

I believe that parents need to make the right decisions for their family, and many do choose to raise their children at home exclusively – without the use of outside child care. The main carer may be the mother, or, increasingly, the father. Should a mother feel pressured to seek employment because some studies suggest a small link between employment, child care and cognitive abilities? Of course not! She knows best how to raise, teach and nurture her children. These studies look at averages, and fail to take into account individual situations.

If mothers decide it is in the best interests for everyone (including herself) that she remain at home for some time, or all time, or works part time or full time, then that is the right decision. And if she is a working mother, and she feels deep inside her very core that this is the right fit for her family and that her children are happy, then she does not need to fear any “unseen” consequences. She should be able to go to work with a clear conscience and happy heart, and return with open arms to love and care for her children.

And most of all, no-one should judge a parent’s decision. This comes from the “lack” or scarcity mentality. If another mother chooses to stay at home and you choose to work, how does it impact on your life? It doesn’t. Why judge? And vice versa? Leave parents in charge of their own decisions.

You decide how you will lead your life and lead your children. Nobody has the right to judge you, especially in the light of the evidence. This leaves you with a deep responsibility. Choose the principles you wish to live by. Will you display strength, resilience, love, wisdom, gentleness, courage? Or will you be snarky, irritable, unhappy, hostile, resentful, and a slave to your emotions? What is the most important legacy to leave your children? You – not child care – will make the biggest impact on them regardless of what you do in your life.

It’s how you lead your life that matters.

Photo credit: By U.S. Navy photo by Photographer’s Mate 3rd Class Joseph M. Buliavac [Public domain], <a href=”http://commons.wikimedia.org/wiki/File%3AUS_Navy_050114-N-3659B-050_he_Morale_Welfare_and_Recreation_Child_Development_Center_on_board_Naval_Support_Activity_Mid-South_in_Millington%2C_Tenn.%2C_provides_daycare_services.jpg”>via Wikimedia Commons</a>