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Parenting in Chile

Bridging Kimün and Clinical Care: A Medical Anthropological Analysis of Infant Rearing Practices Among Chile's Indigenous Peoples

Huu Ho

I. Introduction: The Cultural Tapestry of Chilean Infancy


The study of infant and early childhood development among Chile’s indigenous communities requires a comprehensive approach that synthesizes traditional ethnographic observations with modern public health data and a critical recognition of historical trauma. Chile is home to several distinct indigenous groups, the largest being the Mapuche, predominantly residing in the Central and Southern regions (notably La Araucanía), known historically for their agricultural-livestock economies.1 In the far north, high in the Andes, are the Aymara, whose traditions are shared with neighboring Bolivia and Peru.2 Finally, the remote Pacific territory of Rapa Nui (Easter Island) is home to a unique Polynesian culture with distinct maritime and ancestral practices.3 This ethno-geographic diversity translates into varied approaches to pregnancy, birth, and the crucial early stages of life.

The foundational concept of the child within these indigenous ontologies is one of deep communal belonging. For the Mapuche, the child (pichikeche) is not viewed solely as an individual but as an essential part of the extended family and community structure. Learning and development are inherently tied to maintaining balance with other people and beings in the territory, underscoring a communal vision of education that necessitates the participation of multiple adults.4


A. Socio-Historical Framework: Institutional Mistrust and Historical Trauma


Any contemporary analysis of indigenous child-rearing practices must be situated against the backdrop of systemic violence and institutional breaches of trust perpetrated by the Chilean state. During the military rule of General Augusto Pinochet, specifically between the 1970s and 1990s, Chile facilitated the illegal kidnapping and trafficking of thousands of babies for international adoption.5 Estimates from civil and nonprofit organizations place the actual number of children stolen from their parents during this era closer to 50,000.6

The military dictatorship explicitly targeted poor, young, and often Indigenous women, believing that trafficking their children would reduce the country’s poverty rate and simultaneously generate revenue from adoption fees paid by unwitting families in North America and Europe.6 This horrific system relied on a network of corrupt actors, including hospital staff, judges, social workers, priests, and nuns, who created fraudulent documents to convince birth mothers their children had died or that they had willingly given them up.6

The catastrophic breach of trust resulting from this widespread practice means that vulnerable families, particularly those who are Indigenous, have justifiable and deep-seated apprehension toward state-run health and welfare institutions. When public health initiatives—such as the National Child Health Programme—are implemented by the same institutional frameworks (hospitals, social workers) that historically participated in child trafficking, efforts to achieve health equity are severely complicated.6 This historical violence acts as a fundamental determinant of current public health engagement challenges, as Indigenous mothers are naturally hesitant to fully submit their children to mandatory state protocols when the state’s historical actions indicate institutionalized oppression and racism.


II. Perinatal Care and the Spiritual Integration of Birth


The approach to pregnancy and birth across Chile's diverse indigenous cultures demonstrates a profound integration of the spiritual, communal, and physical. Traditional practices often prioritize ancestral connection and the mother’s agency, aspects that the modern biomedical system frequently overlooks.


A. Traditional Rapa Nui Birthing Rites


For the ancient Rapa Nui people of Easter Island, pregnancy and childbirth were considered sacred events, marked by specific rituals to venerate the forthcoming child.3 Traditional birth involved the mother kneeling while the husband crouched down to support her, giving her massages to aid breathing and delivery. Upon the baby’s emergence, the husband traditionally cut the umbilical cord using his teeth and tied it respectfully, believing the cord held the Mana (power) transmitted from the child's ancestors.3

A medicine man or priest was central to the process, observing the rituals and analyzing the mother’s dreams from the night before the birth to offer guidance on the newborn’s life. The connection to the land and sea was immediately established through the ceremonial disposal of the afterbirth: the umbilical cord and placenta were carefully buried or thrown into the waves, accompanied by the words, "Go, return to Hiva," symbolizing a spiritual return to the ancestral homeland.3 The commitment to cultural preservation in child-rearing continues today, exemplified by native musicians dedicating themselves to running free music schools for islander children, teaching traditional songs to ensure the cultural heritage endures.10


B. Mapuche Birth Context and the Intercultural Health Model


As Mapuche families face increased urbanization and state mandates for institutional birth, there has been a necessary transition from traditional home births to hospital settings. This transition presents a critical point of tension between traditional healing knowledge (kimün) and standardized clinical care.

In response to this conflict, certain institutions have developed progressive protocols. The Osorno hospital in Chile, for example, pioneered an intercultural delivery room designed to validate and integrate traditional Mapuche practices into the biomedical environment.11 These integrated practices are crucial for restoring a spiritual component to healthcare that is often lost in sterile, isolated hospital settings.

Specific Mapuche practices incorporated into the customizable labor plans include: allowing the mother to wear traditional clothing, such as the munulongko headscarf, believed to offer protection; ceremonial purification of the space by a cultural liaison; the mother dancing around the room; and the husband playing the kultrun (a ritual drum).11 Furthermore, mothers may opt to reduce or decline pain medication in favor of massages and oil rubdowns provided by the cultural liaison. Hospital protocols allow for doctors to approve traditional herbal treatments (lawenko) from trusted traditional healers, formally establishing a collaboration where doctors manage the physical aspect while ensuring compatibility with the family’s spiritual beliefs.11

Perhaps the most significant ritual concerning the newborn involves the placenta. Mapuche people view the placenta as holding a twin spirit to the child. The hospital allows women to take their placenta for ceremonial burial in their ancestral lands (lof). This practice, often accompanied by planting a tree on top, is believed to create a profound, lifelong connection between the child and the natural elements of their family’s territory, binding the newborn to their ancestral roots.11


C. Neonatal Health Metrics: Disparity at Birth


Analysis of early neonatal outcomes offers important clarification regarding the role of ancestry versus environment in infant health. A study analyzing over 1.1 million birth records in Chile (2000–2004) showed that, by international standards, Chile’s anthropometric indexes (birth weight and length) are quite favorable.12

Crucially, the data reveals only a trivial degree of ethnic disparity in these metrics. Mapuche newborns averaged only 14 grams more in birth weight compared to non-indigenous newborns, with proportions of low birth weight remaining stable in the indigenous population.12

The observation that clinical outcomes are statistically equalized at the moment of birth leads to a crucial policy conclusion: the existing state prenatal care system and institutional birth access, despite historical and cultural tensions, appear largely effective at mitigating initial biological disparities. This means that if significant health and developmental gaps emerge later in childhood (e.g., stunting or obesity), those issues must stem not from genetic differences or lack of access to high-quality perinatal care, but from external post-natal factors, primarily socioeconomic and environmental determinants of health that intensify after the protected prenatal period.


III. Daily Infant Care, Attachment, and Early Nourishment


Daily care routines among Chile’s indigenous communities emphasize constant physical proximity, responsiveness, and prolonged natural nourishment, reflecting cultural values of attachment and community integration.


A. Carrying Practices and Proximal Parenting


In the Andean regions of Northern Chile, Aymara and other indigenous groups utilize the quepina, which is a type of woven sling or carrying cloth, often known more widely by the Aymara term aguayo.2 Woven from llama or alpaca wool and decorated with colored stripes, the quepina allows women to carry young children on their backs, enabling them to simultaneously perform domestic or market tasks.2

This practice of continuous, close-contact carrying is highly significant anthropologically, reflecting how cultures view time, space, and attachment.13 Proximal parenting styles foster strong emotional security and integration into the daily life of the community from the earliest age. For visual illustration of this technique, videos demonstrating the securing and functionality of traditional Andean slings can provide essential context, emphasizing the secure positioning necessary for mobility and the maintenance of clear airways for the newborn.14


B. Breastfeeding Duration and Nutrition


Chile generally maintains favorable statistics regarding breastfeeding, a practice supported by both traditional culture and public health campaigns. In studies focusing on populations with high Indigenous representation, 63% of infants were fully breastfed at six months, and 24% maintained full breastfeeding at twelve months.16 This pattern of prolonged and exclusive breastfeeding is vital, as it adequately supports infant growth and health during the first months of life.16

Factors influencing sustained breastfeeding include maternal characteristics (higher maternal weight) and high suckling frequency (seven or more times a day) during the first six months, factors that are susceptible to positive intervention by health services.16 Furthermore, traditional child diet in harsh environments, such as the Atacama Desert in Northern Chile, has historically shown adaptive resilience, with infant and child diets being dictated by the mother's broad-spectrum intake, effectively mitigating environmental stresses.17


C. Sleep Ecology and Co-Sleeping (An Area for Policy Consideration)


Specific academic data on traditional indigenous Chilean infant sleep patterns is limited; however, drawing parallels to global indigenous psychologies and practices (such as those observed among the Māori in New Zealand) reveals a general prioritization of responsive, proximal care.18 These traditional approaches commonly include co-sleeping, bed-sharing, and responding immediately to infant cues (e.g., breastfeeding or being held to sleep).18

This high-responsivity approach to sleep often places parents in conflict with modern public health campaigns aimed at Sudden Infant Death Syndrome (SIDS) reduction, which frequently advocate for separate sleeping arrangements based on Euro-American norms. For Indigenous communities whose parenting models globally prioritize group cohesion and constant physical contact, mandating individualized sleep patterns risks undermining cultural norms and parental comfort. Health policy must seek to address safety concerns regarding SIDS with culturally sensitive guidance, acknowledging that these proximal sleep practices are profoundly tied to traditional family structure and emotional development.18


IV. Socialization and the Extended Family Structure


The development of the indigenous Chilean child is intrinsically linked to a communal socialization model, which contrasts sharply with the nuclear family structure often assumed by state welfare programs.


A. Multi-Parenting and the Authority of Elders (Kimün)


Mapuche parenting is characterized by shared responsibilities within the extended family, a robust system known as multi-parenting.1 This structure has been amplified by socio-economic changes, particularly labor migration, which has resulted in an increasing number of single mothers. Consequently, these mothers frequently live with their parents, solidifying the grandmother's role as an immensely important socializing agent in both rural and urban Mapuche settings.20

Central to this structure is the authority of elders. Respect for the elderly is paramount because they are the repositories of kimün—accumulated knowledge, experience, and wisdom acquired throughout their lives.4 This knowledge is a highly valued cultural asset transmitted to guide new generations, ensuring balance and continuity within the community.4


B. Learning Through Collaboration and Participation


Mapuche children are socialized through a model of learning by observation and participation. A key role for the pichikeche is to accompany adults and provide assistance. Through this daily collaboration, children learn from the wisdom of multiple adults, which in turn helps maintain equilibrium within the community, transcending purely individual development.4

Interaction with adults is often described as horizontal and collaborative, recognizing children as legitimate contributors to the family and community unit.1 Traditional Mapuche pedagogy relies heavily on oral and attitudinal communication. An example is pentukum, the protocol Mapuche greeting, which serves as a methodology for developing crucial social skills, including memory, speech, prudence, empathy, solidarity, and respect from an early age.22


C. Naming, Identity, and Spiritual Connection


The process of naming an indigenous child, particularly among the Mapuche, is not a simple administrative act but a profound spiritual undertaking that defines their identity within Creation. Receiving a spirit name connects the child to their ancestors, providing guidance, personal protection against sickness, and ensuring a strong beginning to life.23

The naming ceremony traditionally involves an Elder, who is deemed to have the ability and honor to confer the spirit name. The Elder often receives a message or dream concerning the name and communicates its meaning directly to the baby in the native language, believing the child’s spirit hears and understands.23 The spirit name is considered fifty percent of the child’s healing and balance, anchoring them to their origins, purpose, and destination.23


V. Challenges in the Modern Context: Acculturation, Poverty, and Health Disparities


While traditional indigenous child-rearing practices offer strong foundations for communal identity and attachment, these methods are increasingly challenged by urbanization, poverty, and state policies that favor assimilation.


A. Poverty as the Primary Determinant of Later Disparity


A detailed examination of child development outcomes reveals that poverty, rather than Indigenous ancestry or genetics, is the overriding factor accounting for health and developmental disparities that manifest later in childhood.25

Research on Chilean schoolchildren aged 6 to 9 years demonstrated that growth retardation (stunting) was strongly related to poverty exposure across all ethnic groups. Within similar poverty levels, there were no significant differences in stature between Mapuche and non-Mapuche children.25 This led researchers to conclude that poverty, not ancestry, explains the short stature observed in some Mapuche children.25

Similarly, socioeconomic status (SES) plays a major role in explaining differences in cognitive and psychosocial development among toddlers.20 Environmental variables, such as the number of books in the home and the quality of responsive parent-child interactions, which are often correlated with SES, directly impact cognitive development.26 Therefore, structural inequality and the environment of poverty are the primary pathologies that generate these disparities, emphasizing the need for targeted social and nutritional interventions. Furthermore, the modern health crisis of childhood obesity disproportionately affects children who are socioeconomically vulnerable, belong to an indigenous people, or live in rural areas, largely driven by the high consumption of ultra-processed foods.27

This analytical framework confirms that since birth metrics are largely equalized by state care, the subsequent emergence of health problems like stunting and obesity is symptomatic of structural socio-economic failure to protect children post-natally, not cultural deficiency or genetic predisposition.


B. The Urbanization Effect and Cultural Erosion


The encroachment of urban Chilean culture into indigenous life, driven by rapid social change, has placed significant acculturation pressure on communities.28 Indigenous populations in urban areas often struggle to sustain their language (Mapudungun), identity, and culture, complicating efforts to educate future generations in traditional ways.28

Urbanization also perpetuates stereotypes that reduce indigeneity to rural dwelling, suggesting traditional ways of life are anachronistic in a globalized world.22 As family routines adapt to external pressures, such as formal school schedules and adult work outside the home, the traditional learning-by-participation model can weaken, decreasing the child’s collaboration in domestic activities.29 This necessitates the development of a bicultural or dual cultural identity, where Mapuche children navigate between their native culture and mainstream Chilean society.22


C. State Health Programs as Acculturation Devices


The National Child Health Programme (PNSI) is a critical public policy aimed at fighting infant morbidity and mortality. However, the implementation of this program reveals a fundamental ethical conflict between public health objectives and cultural respect.

Studies show that state-employed nursing professionals often transmit standard, homogenizing values and expectations.9 Indigenous and migrant mothers (especially those of African descent) utilizing the program report being judged by caregivers for failing to "correctly" follow instructions or for exercising traditional or transnational maternity practices.9

In essence, while the PNSI is an effective assistance policy, its requirement for adherence to uniform national guidelines often functions as an "acculturation device".9 The system’s unstated mandate is often to elicit behaviors and attitudes similar to those of the dominant Chilean mother, generating few instances of learning or appreciation for the native cultures of the infants. This dynamic confirms that institutional health practices frequently articulate ethno-racial and class prejudices, undermining cultural integrity in the pursuit of standardized health metrics. This assimilationist pressure stands in direct opposition to the spirit of collaboration found in progressive intercultural hospital models, such as the one in Osorno.11


VI. Multimedia Integration and Visual Ethnography


To fully convey the complex dynamics of indigenous infant rearing, video ethnography is invaluable, providing immediate, lived context for practices and historical tensions.


A. Recommended Video Topics for In-Depth Understanding


Visual documentation is uniquely positioned to bridge the gap between abstract policy analysis and lived cultural experience:

  1. Traditional Rites and Modern Care: Documentary footage of intercultural delivery rooms, such as the Osorno Hospital model, is essential.11 Video can contrast the controlled clinical setting with the emotional intensity of Mapuche ritual elements—the sound of the kultrun, the ceremonial purification, and the integration of traditional dress (munulongko).

  2. Infant Mobility and Attachment: Video segments showcasing the use of the Andean quepina or aguayo are crucial.2 These videos should demonstrate the practical aspects of traditional babywearing, highlighting the secure attachment, constant physical proximity, and how the carrier enables the mother or caregiver to participate fully in economic and social life while keeping the infant integrated into the daily flow.13

  3. The Learning Environment: Visual documentation of Mapuche children accompanying elders, illustrating the pichikeche role, offers a clear view of the collaborative learning model.4 Capturing moments of pentukum or traditional storytelling can visually convey the oral and attitudinal basis of traditional indigenous pedagogies.22


B. Video as Historical Context and Reconciliation


Any comprehensive report should include visual media that addresses the historical trauma of state-sanctioned child trafficking. Integrating footage from investigative documentaries (e.g., those following the work of organizations like Nos Buscamos) powerfully illustrates the sheer scale and human cost of the "Stolen Children" crisis.5 This historical context is not merely archival; it is a prerequisite for understanding the deep institutional mistrust that impedes modern health interventions and community engagement efforts today.


VII. Data Synthesis and Conclusions


The analysis presented highlights the sophisticated and adaptive nature of indigenous infant-rearing practices in Chile, while simultaneously exposing the structural forces that undermine cultural integrity and infant well-being. The data mandates a policy shift that moves beyond assimilationist healthcare to one focused on addressing structural inequality.

Table 1: Comparative Overview of Indigenous Chilean Infant Practices


Indigenous Group

Geographic Region

Key Traditional Birth Practice

Infant Spiritual/Land Connection

Kinship/Socialization Structure

Source Examples

Mapuche

Central/South (La Araucanía)

Intercultural hospital model; husband playing kultrun; use of lawenko (herbal) 11

Ceremonial burial of placenta linking child to lof (territory) 11

Extended family, strong role of grandmothers (multi-parenting); learning via kimün from elders 1

1

Rapa Nui (Pascuense)

Easter Island (Pacific)

Husband physically assists birth; traditional midwife role 3

Burial/disposal of placenta into waves; umbilical cord holds Mana (ancestral power) 3

Strong focus on cultural education and preservation 10

3

Aymara (Andean)

Northern Chile

Midwife care; ritual care of placenta (Andean tradition) 30

Traditional beliefs connected to high-altitude ecology (Atacama diet adaptation) 17

Extended family/community structures

2

Table 2: Developmental Outcomes: Disaggregating Ethnicity and Socioeconomic Status


Metric/Outcome

Indigenous vs. Non-Indigenous Comparison

Primary Determining Factor

Broader Implication

Source Examples

Birth Weight/Length

Trivial difference; values stable and favorable (14g avg. higher for Indigenous) 12

Effective state prenatal care coverage and access to institutional birth.

Ethnicity is not a factor in initial physical outcome; disparities develop post-natally.

12

Growth Retardation (Stunting)

Significant disparity observed later in childhood (6-9 years) 25

Poverty/Socioeconomic Vulnerability (Not Ancestry) 20

Later growth failure is a symptom of structural inequality and poverty exposure, reinforcing the need for targeted social interventions.

25

Obesity Rates (Preschoolers)

Higher prevalence in socioeconomically vulnerable and Indigenous rural children 27

High consumption of ultra-processed foods, poverty, and rural residence 27

Modern lifestyle shifts, coupled with poverty, introduce new, severe health risks not traditionally faced.

27

Cognitive Development

Differences observed in toddlers 20

Socioeconomic status (mediated by resources like books and responsive parenting) 20

Intervention strategies must focus on supporting parental resources and early childhood stimulation in vulnerable families.

20


Conclusions


  1. Reversal of Causal Focus: The overwhelming evidence from anthropometric and developmental studies indicates that initial health equity achieved at birth degrades into disparity later in childhood, driven not by ethnic ancestry or inherent cultural factors, but by socioeconomic vulnerability.20 This compels public health policy to cease conflating ethnicity with pathology and instead target the structural poverty and lack of resources that undermine child development.

  2. The Necessity of Intercultural Validation: Traditional practices—from the Mapuche placenta burial establishing a spiritual link to the land 11 to the Aymara use of the quepina reflecting core attachment values 13—are essential for maintaining cultural continuity and identity. The successful integration models, such as the Osorno hospital's intercultural delivery room, demonstrate that clinical safety and cultural validation are not mutually exclusive, provided institutional staff adopt protocols developed collaboratively with traditional healers.11

  3. Mitigating Institutional Trauma: The historical reality of state-sanctioned child trafficking under the Pinochet regime has created an institutional context of deep mistrust.6 Efforts to improve indigenous child health, such as the National Child Health Programme, must explicitly recognize and address this trauma. Policy implementation that ignores cultural context and pressures mothers to adopt the "behaviors and attitudes" of the dominant society functions as an acculturation device 9, further eroding trust and exacerbating the historic conflict between Indigenous communities and the state.

  4. Prioritizing Cultural Competency: Future policy formulation must focus on promoting the inherent strengths of indigenous child-rearing—such as the multi-parenting structure, the centrality of elders' kimün, and learning through participation—while providing economic and educational resources necessary to mitigate the damaging effects of poverty and urbanization. Interventions should support resources known to positively impact development (e.g., books and responsive interaction) within the family’s existing structure, rather than attempting to enforce assimilation into a foreign model of care.26

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