By the twenty-first century, most infants in the United States experienced some form of child care in their first year of life. This represented an enormous shift in how children in the United States were raised, a shift that led to concerns about whether infant child care disrupts mother-child attachment. Some have argued that infants experience daily separations as maternal rejection, which should lead to avoidance, while others have suggested that separations prevent mothers from having sufficient opportunities to develop sensitive caregiving styles. The results of the National Institute of Child Health and Human Development Study of Early Child Care, a study of more than 1,000 infants and their mothers, clearly demonstrated that neither security nor avoidance in the Strange Situation was associated with type of care, amount of care, or quality of care. Instead, security was associated with characteristics of mothering, such as sensitivity. Infants who experienced dual risks, for example poor quality child care and insensitive mothering, were at increased risk for developing insecure attachments. Thus, the effects of child care on attachment depend primarily on the nature of ongoing interactions between mothers and children.
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