Dr. Spock's Book Changed The Face Of U.S. Child Care

In thinking about how much Dr. Benjamin Spock changed America's child-rearing practices, you have to remember the lowly place children held before his landmark book came out in 1946.

Says Dr. Bob Hauck, a Seattle pediatrician: "People looked at children as little automatons, sort of mechanistically. They didn't respect the differences between different children; in fact, they didn't respect children too much."

The idea was children should be seen and not heard, he said, "and use any discipline necessary to keep them in their place."

Dr. Spock changed that.

The man who became known as "America's Baby Doctor" died Sunday at 94. His book "Dr. Spock's Baby and Child Care" (Pocket Books, $7.99) has sold almost 50 million copies in 42 languages and is believed to be the second best-selling book of all time, after the Bible.

His legacy, says Dr. Don Shifrin, an Eastside pediatrician, was akin to "a rock in the center of the pond" that spread ideas about parents paying attention to, and understanding, children, "and it took off from there, sometimes unbeknownst to him, and not always directly traced to him."

"Dr. Spock had a psychiatric background, and he looked at a child more as a developing being - you couldn't expect the same behavior of a 2- as a 10- or 20-year-old," says Dr. Kathy Mikesell, a Bellevue pediatrician who collaborated on the last two editions of Dr. Spock's book.

By explaining the notion of developmental stages, Dr. Spock rebutted the popular but misguided notion that infants were an "undeveloped clean slate and you could write what you want on them," says Shifrin. Dr. Spock also publicized the idea that children have different temperaments - some infants easygoing, others intense, for example - and could not be treated uniformly.

Parents, say local pediatricians, were ready for his message, in part because many already chafed at the preachings of a pediatric establishment that advocated rigid, harsh child-rearing methods.

It was believed it would spoil children to pick them up when they cried, or kiss them when they were hurt. Feeding and sleeping schedules were inflexible.

That a child would have psychological needs wasn't appreciated until Dr. Spock, says Shifrin, because it was believed that children weren't evolved enough to have psychological issues.

While Dr. Spock didn't invent these notions, he was the first to take the message to ordinary pediatricians, and ordinary parents.

The timing of the book's first appearance, just after World War II - when people were ready to settle down and raise what would become the baby-boom generation - was significant, and part of what contributed to its huge impact, notes Dr. Sarah Weinberg, a Woodinville pediatrician.

The biggest bum rap Dr. Spock got, say local pediatricians, is that he was "permissive" and soft on discipline. Rather, he advocated that parents expect respect and politeness from children just as they bestowed it on their children.

Adds Mikesell, "He became more and more convinced that corporal punishment was not in a child's best interest in general. But he was very much in favor of letting children know what was right and wrong, time and again."

As Dr. Spock became involved in liberal causes and anti-Vietnam War politics, his opponents twisted his message to say hippies and anti-war activists were Dr. Spock-raised spoiled children, says Weinberg.

Really, his messages were quite traditional in many ways, note pediatricians. He advocated that women stay home to raise their young children, and supported breast-feeding during a time when there was a strong marketing push touting formula-feeding as safer and scientifically superior. He recommended that parents work harder to avoid divorce because he believed kids inevitably suffer, though he got a divorce himself after 48 years of marriage. (Shifrin says Dr. Spock claimed he couldn't communicate with his wife, and thought he'd given it a good try.)

Pediatricians note that some of Dr. Spock's "traditional" ideas, once considered out of date, are being accepted again.

Just last November, Hauck notes, the American Academy of Pediatrics came out with a new statement that unequivocally recommended breast-feeding for the first 12 months of a child's life.

Though Dr. Spock ran afoul of the women's movement for saying mothers of young children should be home, Hauck says, "That's what we're hearing today; it's happening in Northern European countries where they have more liberal new-parent leaves and policies. Day care is not as good as a parent."

(Later, Dr. Spock softened somewhat, changed this to "a parent" should stay home, except in the breast-feeding period.)

But he also bent with the times, notes Shifrin. When it was clear that day care was here to stay, he became a strong political advocate for better subsidized day care, and urged parents to join him.

The latest, seventh edition of Dr. Spock's book is due May 2, his birthday. The previous two editions of "Baby and Child Care" were co-authored by retired pediatrician Michael Rothenberg, a University of Washington psychiatry and pediatrics professor emeritus, who rewrote them extensively.