The Truth About Daycare, ADHD, and Attachment Issues

Hey, everyone. Dr. Josh Axe here, and welcome to the Growth Lab Podcast, where each and every week we cover the science behind how to grow. Now, in this episode, I'll be reviewing a clip from an interview between Alex Clark and Dr. Erica Komisar, where they discuss the impact of daycare on childhood development. And so, take a watch of this first clip with me right now.

Well, we know that the longer you leave your child when they're under the age of 3, the greater the chance that they'll develop either, remember I said fight or flight, that they'll either develop aggressive behaviors, behavioral problems, and/or a flight response, which is ADHD. And we know that ADHD diagnoses are seriously up in very young children, and a lot of that has to do with the stress.

So think of ADHD as not a disorder. There's a movement to take the D off of it 'cause it's, It's not a disorder. It is a symptom of children under stress.

Wow.

So, you know, there are a rare few number of cases that are truly brain disorders, developmental disorders. The rest of it is cortisol in the brain causes the brain to go into that HPA axis, that stress response. So think of the fight or flight and think of ADHD as the flight part.

So we have very young children being diagnosed either with behavioral problems and early signs of hostility and aggression, Uh, and/or ADHD.

Now, I want to pause here and say this for, for this interview, is that this is something I've been saying for years, is that ADHD isn't a disorder. It could be— it's more of an emotional issue that can be happening with a kid being in a high-stress state and environment. So again, an ADHD diagnosis is kind of a throwaway diagnosis. It's not a disorder.

It could be more personality-related or having a need that maybe isn't totally being met here as the doctor's saying. So let's continue and watch here just a little bit more, and then I wanna give a breakdown.

And what's the correlation between kids who are diagnosed with ADD or ADHD and being put in daycare?

Oh, there was a study done that showed that children put in daycare, the more hours they spent in daycare per day, the greater the chance they developed either aggressive behavioral problems and/or attentional issues.

Is that only before the age of 3 or? Any age?

The study was done on children who were in, in sort of in that area of preschool, right before preschool, so it would have been daycare.

What is better for part-time moms, working 5 days a week, only a few hours a day, or a couple days a week, but those days have longer hours?

To work every day a little bit.

Okay.

So you want to be away from your child for shorter periods of time. Think of it this way, that your child can hold Hold it. Think about holding your breath underwater. You might be able to hold your breath underwater for 1 minute, maybe if you're really strong, 2 minutes. Um, that's what it's like for children when you go away. They're holding their breath until you come home.

And as she's saying here, what's happening is when kids are not next to their parents, especially from zero— some people believe it's zero to 3, some people believe it's zero to 5 years old— but without that human connection of the parent, because, you know, there's something physiologically that happens with moms and dads, and when kids are with them, there's an Oxytocin release.

There is a, there's a secure place. It's a safe place that keeps cortisol down, as she's saying, that keeps those stress hormones down. So it's really important that there's that parental connection. Now, before I dive into a little bit more here, I want to start off saying this. My goal is not to make anyone feel guilty about anything.

My goal as a physician is to help bring truth to help you and your family live the best life possible. By the way, I had a working mom. My mom worked as a schoolteacher. And I know that even one of my siblings was put in daycare. My, my youngest brother, uh, was, was put in daycare. And so this is something that our family did. I had amazing parents. My siblings turned out great.

And so I did wanna share, but what I wanna get into in this video is what is ideal in order to build connection with your kids and to bring up, raise kids that are as, uh, that have the best relationships with the parents as possible, that have the least amount of mental, mental health issues like ADHD.

Mm-hmm.

And other problems here as well. So, I want to dive in now and then we're going to come back to one more clip I don't want you to miss on this video. But here's the reality. The need for daycare started rising dramatically in the 1970s with a push to get women in the workplace. And in the 1980s, this happened with the baby boomer generation.

And in 2019, nearly 60% of children ages 5 and younger that were not enrolled in kindergarten were in at least one weekly non-parental care arrangement. So at least one day a week they were in daycare. Now, in 2014, around 4— about 40% of married women with a child under the age of 3 worked full-time. So again, 40% we're seeing here as a number.

While there are obviously many good things to be said about the professional progress of, of women and the significant contributions they've made in their fields, in the workplace, of course there's always going to be trade-offs, right? And that's the thing that I'd really encourage you with here is, is that you want to be able to sit back.

And a big part of what I try and teach here always is using wisdom. And one of the things that you need to do to be wise is understand their trade-offs and then just make the best decision possible. So it might be where your family, to put food on the table and have a house over your head, you have to work, right?

And especially this happens in single-parent families where there's really almost there, there, there doesn't feel like there's as much of a choice. Well, I want to get into the best solutions at the end in ranking order.

And then sometimes you just have to, but there's even solutions where if your child does need to be in daycare, well, how do you manage that and still, uh, still care in the best possible way for your child? So there are really 2 main problems, as the clinician's hitting on here, when it comes to daycare at a very young age.

Number one is Something called insecure attachment, which happens between the mother and child. And number 2 is attention deficit-related disorders in children. By the way, I was the child that was diagnosed with ADHD, so I really understand this.

I really have been in a situation in my own life where I got prescribed Ritalin, I got prescribed Adderall, and I had trouble in school really up until late in college when I finally was able to overcome this. Uh, this ADHD diagnosis and breakthrough limiting beliefs. That's a whole nother podcast episode that you could go back to and watch.

But I want to share now and getting into this problem just for a minute. And so here's the reality for the mother. One, this can be incredibly difficult for the mother.

Like, we have a preschooler right now, and my wife Chelsea, when she drops her off— I remember by the first time that Chelsea dropped off Arwen at daycare, I remember calling her right after And I could tell she was in the car and she was crying. And she had a really hard time because they've built such a beautiful and incredible bond.

And so for Chelsea to drop, uh, uh, Arwen off at— I'm sorry, at preschool— that alone was, was really, really so, so difficult. And, and one, that's normal, right? It should— it really should be an emotionally painful experience for, for mothers because when you have such a deep and personal and loving connection. That's going to be normal, but you want to do the hard thing.

And so, it's a good thing to do. But today, women are often pressured to prioritize work over caring for their children full-time. Now, I do want to say this is that we have our daughter in preschool. She goes, I want to say it's 4 hours, 3 days a week. Okay?

Now, if you homeschool, that's another great option where the mom can be connecting all day But we'll get into this here a little bit more in a minute with a few things. The next thing here is just with the mothers. I want to say, you know, this causes mothers to sometimes feel and have a sense of, you know, abandoning their children.

Now, some women maybe don't feel that, but I know that my wife Chelsea, even though she knows she's not, she still has this feeling sometimes of a little bit of guilt of, you know, having Arwen go to a place where she can learn. Now, obviously the preschool situation can be different than daycare, but I, I wanna continue to get into this here a little bit more as well.

Now, for the child, attachment forms primarily in that first year, but it's really the first 3 years are when kids are the most sensitive for that attachment. So between the ages of 1 and 3 years old, it was when you really get attachment to, to your children. So I wanna go through this study that was just released on daycare and the effects. Here's what it says.

By age 4 and a half, extensive hours in daycare predicted negative social outcomes in every area of a child, including social competence, externalizing platforms, and adult-child conflict, generally at a rate 3 times higher than other children.

And so what we're seeing here in this study is that kids who spend time in daycare, they have more social issues, they have problems, uh, they externalizing problems, and they have more problems with adult-child conflict. Because what happens is these, these, these kids don't have that secure anchor on a regular basis.

And so rather than learning how to deal with conflict and problem solving and how to socialize with a mature adult, they're learning from it from other kids. And so it's whoever they're spending more time around. So being able to learn it from a parent and that one-on-one attention Versus, you know, maybe a daycare is a 1 to 11 ratio, and maybe somebody's jumping in on occasion.

That's probably not as— they may not be as virtuous as you, but really getting more and more in time with kids where there's a lot of chaos and a lot of problems going on, your, you know, kids are oftentimes going to absorb that. Now, I'm going to give a statement here by Joe Biden that was done in 1981.

By the way, this might be— and I say this jokingly, but also not joking— It might be the only— one of the only things I've ever agreed with him on. The desire to avoid individual responsibility. He said, I believe this issue is a perfect example of the cancer of materialism that has stricken our society. We do not take care of our own families these days.

We want someone else to bear that responsibility. He says the daycare centers and nursing homes are blossoming across the American landscape are monuments to our growing unwillingness to accept personal responsibility for those to whom we owe the most— our children, our parents, and our grandparents.

If we continue to turn our backs on those we are closest to, how long can we hope to meet any of our obligations to the great nation history intended us to be? And so what he's saying here is, is, you know, when you go back throughout history, when you had societies that were more based on a tribe in a very close-knit community.

I remember talking to my grandfather and I asked him about why he decided to move to this little city in Ohio called New Bremen, Ohio. He said, well, most of our ancestors were German and we were, uh, you know, a certain denomination of evangelical Protestant. And he said there was a church in the center of community. We had a lot of our family members and friends and we all sort of shared things.

We lived together. It's more of this communal living. And there was no such thing as a daycare. You know, your grandparents watched your kids or your family friends, or there was more of this communal living in that way that we don't have today. And obviously there are a lot of benefits of that.

There are also maybe some negatives and, and greater— there are also some other benefits of, uh, being exposed to people from across the globe and more of this sort of globalization living. But again, there are some negatives. And some trade-offs. And so what I want to do now is go through in ranking order some of the ideal things you can do.

And I want to give some solutions on the best way to create connectivity for your kids and allowing them to thrive. Because again, the idea of this video here is that we not only— I'm not here to guilt anybody. Listen, there are some parents and you feel like you don't have a choice. Of what to do with daycare.

But I always want to be a bearer of truth in sharing even hard realities and give solutions as well. Now, before I get into these solutions, actually, I want to go back to the video here and play one more clip.

Children under the age of 3 do something called parallel play. They don't actually, until they're about 3 years old, even interact with one another. You're not putting them in daycare for their own good. You're putting them in daycare for your good. And that's the problem.

It's not for their good because what benefits a child under the age of 3, sure, you can go to classes like Mommy and Me classes or gym classes, but as long as you're within eyesight or physical touch of your child so they can, what Margaret Mahler, a very famous psychoanalyst, called emotional refueling, she called it rapprochement, the idea that you can explore the world with great courage and inspiration, if you will, If you have your primary attachment figure within reach or eyesight of you.

Ah, okay.

So you can toddle off and explore, but if you can come back and get a hug or look back and make sure your mom's there, then you can toddle off and explore again. And that builds resilience over time.

And I feel like we see that at playgrounds a lot. Yes. Like a kid falls over and they're totally fine. They don't even have a scrape, but they fake cry or whatever and run over to mom for a few seconds of reassurance. And then they're like, okay, my mom's here now. I'm going back.

That's it. That's it. That's called emotional refueling. If you're not there, they're not emotional refueling. They're having to hold their breath.

I love this term here, emotional refueling. And this is what kids need. It's not that you have to be with them every second of the day, but they're coming back and they're getting refueled emotionally on a regular basis. And I see this with our daughter Arwen when we're at the playground.

She'll run off, she'll play, but then she comes back and she needs a hug from mom or she needs her to do something with her or dad. You know, when I bring her, For, for— so for a very similar thing. And by the way, before I learned this research and started doing research, I thought, well, maybe there's a benefit on a day or two a week of doing daycare for that socialization.

But as the expert here is sharing with us, Dr. Erica, is that that's not the case. And it is better off, by the way, rather than one full day doing— if you had to, do a part day or, or a half day And then going back and being able to interact with your child because again, she says it's like coming up for air. It's getting this sort of emotional fuel on a regular basis.

So I want to dive into some of the solutions here and some of the best outcomes that you can hope for or best strategies. Number one ideal is parental care, right? So one of the parents, and by the way, this could also be not just the wife, this could be the husband. Staying home, you know, certain parts of the day, but being there with a parent all day from the ages of 1 to 3, that is the ideal.

Now, that might not be possible for every single person, but again, for that, that's the ideal. And I think it's always important that we aim for the ideal. We don't need to have a sense of guilt if we can't hit the ideal, but at least we know what it is and then we can do the next in line of what's best.

Now, the second best ideal is Having grandparents or other family members nearby that can be there with those children, again, that are 1 to 3 or 1 to 5 years old as she's sharing. And so again, grandparents, this is something that Chelsea and I have done. So we have Chelsea's parents that live very close.

My parents are willing to as well to be there for Arwen or our other daughter anytime that, that anytime that we can't be there for some reason. Third is a nanny or someone you really trust and who is willing to spend, here's the key, one-on-one time with your child. Okay?

So, if you have a nanny, somebody with virtue that's high character, that's great with kids, that's the next ideal scenario if you're a working mom and you need to— it's by necessity, you need to leave your kids with somebody for a period of time. So, again, number 1 is parents are there, number 2 grandparents or family, number 3, you got a great nanny that can really connect there with the child.

Number 4 is a double-duty caregiver with another family. So at least the child is part of another family environment. There's— maybe it's not one-on-one, but maybe it's one-on-four attention. So there is more attention there. That's the next best option. And remember, it's better if you are going to work that it's not all day for 3 days.

It would be better to do— half days and then be there with your kids most of the day. And then, and be— and if you are one of those people that are working and you have to, then you're able to then at least go for, let's say, that second half of the day and give your child a lot of one-on-one attention. And last here, last resort is daycare.

And here's what I would say is if you have to do daycare, do your research and try and find the best ones in your area with the smallest ratio. Of caregiver to child. Because part of what happens is, is your child is put in a chaotic environment.

And as she talked about, and as I studied this research, was what's happening is, is kids, when they're around a lot of other kids without a parent there to anchor them, their cortisol levels go up, their stress hormones go up, and they get their body in a fight-or-flight state. And so when the fight-or-flight state comes up, ADHD increases.

Issues like, like anger and getting out of bounds emotionally. Because when you, when, when you have 3-year-olds with a lot of other 3-year-olds, there's all of this chaos versus when they come back to their parent, there's order, there's peace, there's calm, there's love, all of those things to help balance out the chaos, which, which is normal.

There should be a little bit of chaos, but they have to have that balance. And if not, that chaos starts to breed fight or flight response. Emotional issues and conditions like ADHD. Now listen, if you're in a situation where you feel like daycare again is the only option, here are some ways you can help your child.

Number 1, again, spend as much quality time with them as you can outside of daycare. And number 2, play with them. You know, read to them before bedtime. Do everything you can to interact and build those strong bonds that you can The rest of the time that you're not with them. And I wanna make this note on if your child is diagnosed with something like ADHD, here's what I encourage you to do.

Follow a more natural approach. You know, consider supplements and dietary changes and trying to connect with them more one-on-one. And, uh, and, and, and even, even, even therapy, you know, being able to connect with those kids instead of medicating it. Because most of the time medicating it is you're just, you're not actually treating a medical condition. Condition.

As Dr. Komisar was talking about, it is that ADHD is not a disorder, it's not a disease. ADHD is based on 2 things: personality and the child getting in too much of that fight-or-flight response. And so medicating it isn't going to help. Instead, do things that are natural to help those kids. Now listen, I, I— final thing here.

This video was not to— I almost didn't record this video, but I wanted to because I always want to bring the truth and share with you what I'm learning and this breaking news that came out about daycare, this new study that was just released. I think it's so important that we know the truth so we can grow and help our kids grow and become the best they can be.

And just understanding the reality and knowing the trade-offs so you can operate with wisdom. And I'd love to hear from you. Leave a comment below and let me know if you've seen or personally experienced any of these effects on daycare. In childhood development. So let me know your thoughts here in the comment section below.

Hey, thanks so much for watching this video on the side effects and trade-offs of daycare.