Parenting in the United States of America

I. Foundational Concepts and Contextualizing Diversity

The landscape of infant and toddler rearing in the United States is characterized by profound cultural diversity, ecological adaptation, and stark socioeconomic disparities. Understanding how American ethnic populations raise their young requires moving beyond a single, normative framework, acknowledging that parenting is an adaptive behavior intrinsically linked to cultural values and structural environments. This analysis adopts an intersectional perspective, examining practices through the lens of ethnotheories—the implicit cultural beliefs about child development—and the pervasive influence of the Social Determinants of Health (SDOH).

I.A. Defining Ethnotheories and Developmental Goals

Effective parenting universally relies on sensitive and responsive care, yet the specific behaviors that manifest sensitivity exhibit significant differences across cultural contexts. This concept is often referred to as "universality without uniformity".¹ These differences reflect divergent world views that prioritize distinct developmental outcomes for the child.

The Western Model: Independence and Autonomy

The dominant developmental paradigm in Western cultures, particularly within middle-class non-Hispanic White communities, emphasizes individualism and autonomy.² In this framework, sensitive parenting is typically defined by following the infant's lead, responding directly to cues about what the infant needs in a highly individualized manner.¹ The overarching goals are to socialize the child toward independence, self-regulation, and the exercise of personal choice, a psychological construct built firmly on principles of liberty and freedom in the US literature.² Consequently, parenting experts in Western contexts frequently caution against parental overinvolvement and stress the necessity of early self-soothing and autonomy.²

The Collectivist Model: Interdependence and Relatedness

Conversely, many non-Western and minority cultures within the US adhere to an interdependent or collectivist model. These societies, often rooted in strong psychological and material dependencies between family members, view the individual as inherently interrelated with the group.⁴ In these contexts, sensitive care is often parent-directed, focusing on guiding the infant’s activities to help them internalize the wants and needs of other people.¹ Developmental goals prioritize relational harmony, conformity, and obedience to maintain group stability, sometimes viewing early child autonomy as a potential threat to the family unit.⁴

If public health recommendations and developmental advice are based predominantly on the Western, infant-led model of sensitive care, interventions aimed at minority families who prioritize interdependent socialization may be misconstrued or rejected. For instance, a parenting behavior viewed as highly responsive and appropriate—like physically directing a child’s attention to an older relative—might be labeled as intrusive or over-involved by a Western observer, yet it is culturally appropriate for teaching the child necessary social integration.

I.B. Structural Determinants of Health (SDOH) as Primary Context

Parenting practices exist within an ecological framework, and the decision-making of caregivers cannot be isolated from the structural environments they navigate. A comprehensive analysis of US ethnic parenting must adopt an intersectional approach, recognizing that variables like race, socioeconomic status (SES), quality of residential environments, and chronic exposure to discrimination fundamentally shape both care choices and child health outcomes.⁵

Structural determinants, including economic stability, access to quality healthcare, and neighborhood factors, exert a major influence on health disparities, including infant mortality.⁵ Chronic experiences of racial discrimination and treatment within low-quality healthcare systems are strongly correlated with high infant mortality rates (IMR).⁵ Therefore, observed differences in parenting strategies—such as elevated rates of discipline or specific limit-setting behaviors noted in some minority groups ⁸—are best understood not as inherent cultural flaws, but often as adaptive strategies or coping mechanisms developed in response to unstable environments and systemic threats. A strong emphasis on conformity, for example, may be an adaptive parental response aimed at ensuring the child’s safety and survival in a world characterized by systemic racial bias and surveillance.⁶

II. Disparities in Infant Health and Survival: A Structural Crisis

Before analyzing specific rearing practices, it is essential to establish the differential structural risks confronting various ethnic groups in the US, particularly regarding maternal and infant health outcomes. These disparities reflect systemic failures that often predetermine infant well-being before a child’s postnatal care begins.

II.A. Quantifying Racial and Ethnic Disparities in Birth Outcomes

The overall decline in the US infant mortality rate (IMR) masks profound and enduring disparities based on race and ethnicity.⁵ The cumulative effects of systemic racism and socioeconomic instability, often described by researchers using the weathering hypothesis, result in biological and developmental disadvantages for minority infants from birth.

Preterm Births and Low Birthweight

The non-Hispanic Black population experiences the most alarming disproportion in adverse birth outcomes. In 2022, the Black preterm birth rate was 14.6%, and the low birthweight rate was 14.8%. These figures are approximately double the rates observed for White infants (9.4% preterm and 7.1% low birthweight).⁹ While Asian infants experience rates comparable to White infants (9.2% and 9.4%, respectively), other groups show moderate increases, such as Hispanic infants (10.1% and 7.9%) and American Indian/Alaska Native (AIAN) infants (12.6% and 8.8%).⁹

Access to Prenatal Care

A major indicator of systemic access failure is the rate of late or no prenatal care. Non-Hispanic White and Asian populations have the lowest rates (4.7% and 4.5%, respectively).⁹ Conversely, Native Hawaiian or Other Pacific Islander (NHPI) mothers face the greatest barrier, with a staggering 22.4% reporting late or no prenatal care. AIAN (12.6%) and Black (10.0%) mothers also experience significant hurdles.⁹ For NHPI communities, this extreme lack of early healthcare access implies that structural or geographic isolation, combined with economic barriers, creates a health crisis. In these contexts, interventions must focus primarily on improving access, trust, and proximity rather than individual parental health literacy.

Infant Mortality Rates

The IMR gap serves as the most critical measure of structural inequity. As of 2018, the non-Hispanic Black population experienced an IMR of 10.8 per 1,000 live births. This rate is substantially higher than the IMRs for Native Hawaiian or Other Pacific Islander populations (9.4), American Indians (8.2), non-Hispanic White infants (4.6), and Asian infants (3.6).⁵ These persistent differences confirm that for Black infants, health risk is significantly predetermined by environmental and systemic factors regardless of the quality of postnatal care practices.

Table II.1

US Infant Health Disparities by Race and Ethnicity

II.B. The Maternal Health Context and Systems-Level Failures

The inequities extend to severe maternal morbidity. AIAN, Black, NHPI, Asian, and Hispanic women all demonstrate higher rates of admission to the intensive care unit during delivery compared to White women.⁹ This serves as a powerful marker of systemic inequities within the delivery system itself. When maternal health is compromised by systemic bias and lack of quality care, the foundation for healthy infant rearing is inherently weakened.

In recognition of these structural failures, states have initiated programs specifically targeting health equity. For example, California’s Black Infant Health Program focuses on empowerment group support and client-centered life planning to improve the health and social conditions for Black women and their families. Similarly, Utah's Embrace Project Study for NHPI women delivers culturally responsive health services emphasizing mental health and self-care rooted in ancestral NHPI cultural traditions.⁹ These initiatives validate the conclusion that improving infant outcomes requires addressing structural disadvantages and cultural appropriateness, rather than simply instructing parents on best practices based on a single cultural norm.

III. The Ecology of Infant Care: Feeding, Sleep, and Physicality

Ethnic differences are strongly evident in the daily routines of infant care, including feeding practices, sleeping arrangements, and physical interaction styles. These differences often reflect specific cultural valuations regarding health, developmental milestones, and relational proximity.

III.A. Variations in Infant Nutrition and Feeding Practices

Breastfeeding duration and the timing of introducing solids vary substantially across US ethnic groups. Hispanic mothers report the highest rate of any breastfeeding initiation (69%), compared with White mothers (46%) and Black mothers (33%).¹⁰ Furthermore, Hispanic infants are breastfed for significantly longer durations than White infants, whereas Black infants are breastfed for substantially shorter periods.¹¹

The duration of breastfeeding is heavily influenced by intersectional factors, such as educational attainment. Research indicates that Black participants with low educational attainment exclusively breastfed for 1 month less than White participants with high educational attainment.¹² This suggests that access to resources, supportive employment policies, and healthcare education linked to higher educational attainment may be crucial buffers that disproportionately benefit White families, while economic necessity and lack of support undermine duration for minority mothers.

High-Risk Practices and the Obesity Paradox

Specific feeding behaviors thought to increase obesity risk later in life are more prevalent among Black and Hispanic parents.¹⁰ Bottle propping, which has been independently associated with increased obesity risk, was reported significantly more often by Black parents (adjusted odds ratio (aOR) of 3.05) and Hispanic parents (aOR of 2.47) compared to non-Hispanic White parents.¹⁰ Additionally, Black non-Hispanic families (24%) and White non-Hispanic families (16%) reported introducing solid food (primarily cereal in the bottle) far more commonly than Hispanic families (4%).¹⁰

A compelling observation is the paradox regarding maternal concern: despite engaging in these high-risk practices, Hispanic/Latina and Black mothers report greater concern about their infant overeating or becoming overweight compared to non-Hispanic White mothers.¹³ This apparent contradiction suggests that high-risk practices may not stem from indifference, but rather from cultural concepts of healthy weight (where a robust infant signifies good care or prosperity) or from practical constraints related to time poverty and necessity (e.g., maximizing caloric density or bottle propping for time efficiency in low-income homes) that override modern Western pediatric advice.¹⁰

III.B. Sleep Ecology and Cultural Values

The Western emphasis on individualism and independence is strongly reflected in mainstream US pediatric sleep guidelines, which heavily discourage co-sleeping (bedsharing) due to concerns over Sudden Infant Death Syndrome (SIDS) and suffocation.¹⁴ Consequently, the US exhibits low rates of co-sleeping overall (13% at 6 months).¹⁴

However, this practice is highly divergent across cultural lines. Asian infants, for example, have substantially higher rates of co-sleeping, sometimes reaching 86.47%.¹⁴ This reflects powerful cultural commitments to interdependence, where relational closeness and family cohesion are prioritized over early individual self-soothing.¹⁵ For instance, studies of contemporary Japanese culture show 72% of mothers report sleeping within arms reach of their infant, reinforcing the interdependence model of child-rearing.¹⁵ Similarly, in Egyptian cultures, sleep is viewed as a social behavior integral to maintaining familial relationships.¹⁵

The high rate of co-sleeping in interdependent cultures highlights the difficulty in standardizing safety recommendations nationally. While SIDS protocols are vital, cultural imperatives often dictate that physical proximity and the maintenance of familial closeness during sleep are necessary for socialization and security, overriding individualistic risk-avoidance strategies.

III.C. Physical Interaction and Indigenous Practices

Physical proximity and touch are significant, non-verbal ways through which cultural values are transmitted. When comparing mother-infant dyads in the US, research indicates no overall difference in the total frequency of mother-infant touch between Hispanic and Anglo groups. However, Hispanic mothers utilized more close touch and close/affectionate touch, whereas Anglo mothers used more distal touch.¹⁶ This difference is tied to cultural variations in the evaluation and prioritization of close physical contact. The higher use of close physical direction in interdependent cultures may serve as a crucial mechanism for quickly socializing the infant into the physical and spatial proximity necessary for multi-family living and group harmony.

In American Indian/Alaska Native (AIAN) communities, traditional practices like the use of cradleboards persist. While serving the practical function of securely carrying and restraining the child, cradleboards are also viewed as profound symbols of kinship and Native identity.¹⁷ Research on swaddling techniques, which cradleboards facilitate, suggests they can reduce motor activity, decrease startling, and increase sleep.¹⁸ These practices exemplify how care routines simultaneously fulfill utilitarian needs while transmitting deep cultural identity and relational values.

IV. Socialization Goals and Parental Control

Parenting goals translate into specific practices designed to instill desired social and emotional competencies, reflecting whether independence or relatedness is the primary developmental objective. Variations in discipline, expectations for family roles, and communication styles are starkly evident across US ethnic groups.

IV.A. Discipline, Conformity, and Expectations

In line with collectivist ideologies, Black and Latino parents tend to place a higher emphasis on conformity and rules than White parents. Studies indicate that rules/limit-setting were reported as higher for Black parents compared to White parents.⁸ Critically, Latino mothers and fathers, followed closely by Black parents, had the highest expectations regarding children's family obligations, while White parents had the lowest.⁸ Black and Latino children perceive their parents as having higher expectations regarding family obligations compared to White children.⁸

This prioritization of conformity and obedience must be analyzed through a contextual lens. In environments where minority children face external threats, racial bias, and systemic barriers, the parental emphasis on strict rules and adherence to structure can be understood as an adaptive, protective strategy. The goal is to socialize the child to safely navigate hostile external institutions (e.g., schools, legal systems) where following rules is crucial for physical and social survival, making limit-setting a mechanism of safety rather than simple control.

Conversely, non-Hispanic White parents tend to exhibit different patterns related to authority. A greater share of White parents report tending to "give in too quickly" (39%) compared to sticking to their guns (29%). In contrast, Black, Hispanic, and Asian parents are more evenly divided between these two approaches.¹⁹ This supports the finding that the White cultural context places greater weight on the child's individual choice, which can sometimes result in less consistent application of discipline, a tendency that aligns with the socialization goal of maximizing autonomy.²

IV.B. Emotional Expression and Parental Responsiveness

Emotional communication also varies. Hispanic parents (36%) are more likely than White (24%), Black (25%), or Asian (21%) parents to state that they praise their children "too much" rather than criticizing them too much.¹⁹ This may reflect a cultural commitment to strong familial warmth and esteem building, supporting the interdependent goal of secure attachment within the family unit.

In terms of interaction quality, research confirms that parent-child interactions are fundamentally bidirectional across all socioeconomic status (SES) backgrounds. The child’s behavior influences the parent’s response, and vice versa, underscoring the concept of mutuality.²⁰ While specific parenting practices often vary by ethnicity, recent studies comparing explicit socialization communications across racial/ethnic groups have found similar practices in the deployment of Explicit Racial/Cultural Socialization (E-RCS) among families, challenging earlier assumptions of fundamental differences.²⁰

IV.C. Cultural Socialization and Identity Development

For minority children in the US, communicating about race and ethnicity is a necessity for positive developmental outcomes. When parents avoid conversations about race and ethnicity, children are more susceptible to developing a negative self-concept, are more likely to incorrectly judge other groups, and may not know how to respond to racially-charged experiences.²¹

Conversely, when parents openly address race and ethnicity—an act of E-RCS—it fosters critical protective outcomes. Children develop higher self-esteem, a stronger appreciation for their own race, ethnicity, and identity, and are better equipped to recognize and respond appropriately to racially-charged situations.²¹ This dialogue thus serves as a crucial parental mechanism for translating environmental threats into opportunities for identity formation and resilience.

Furthermore, studies suggest that socialization goals are highly complex, particularly within Asian American families. Research on Chinese mothers indicates they strongly endorse both collectivistic goals (training) and individualistic goals, differing from European American mothers who predominantly focus on individualism.⁷ This suggests that Asian American parenting, often influenced by immigrant experiences, strategically integrates both cultural systems: maintaining collectivism for family security while leveraging individualistic achievement goals to ensure success within the competitive US structure.

V. The Kinship Imperative: Extended Family and Community Support

The structure of the household and the support available from extended kin and community members are pivotal ecological factors, particularly for families facing resource constraints or systemic instability.

V.A. The Protective Role of Extended Households

Extended household structures—where grandparents, other kin, or nonkin coreside—are far more prevalent among African American and Latino families than among White households.²² For these groups, the extended family often functions as a crucial safety net, providing care, resources, and emotional stability in challenging socioeconomic environments.

The adaptive function of kinship is especially evident in developmental outcomes. For African American children, living with a grandparent was associated with the highest predicted cognitive scores.²² This suggests that the three-generation household provides significant developmental advantages that can buffer or counteract the socioeconomic disadvantages often associated with extended living situations. Similarly, for Latino children, nuclear, vertically extended, and laterally extended households showed similar positive associations with cognitive and behavior scores, indicating that various forms of extended kin support are functionally beneficial or neutral.²²

V.B. Mechanisms of Kinship Support

The benefits derived from extended households extend beyond mere economics, although income pooling strategies are sometimes employed, particularly in African American and Latino families.²² The primary strength lies in the provision of greater social support.²²

Among African American families, kinship networks embody "family-based collectivism".⁶ Extended family members traditionally play a key role in the cultural socialization of children, often resulting in co-parenting arrangements with fluid gender roles regarding child-rearing responsibilities.⁶

Significantly, research attempting to explain the positive link between grandparent coresidence and high cognitive scores for African American children found that controlling for social support or potential income gains did not account for the protective effect; rather, the positive association slightly strengthened.²² This strongly indicates that kinship serves as a resilient, culturally integrated ecological buffer, providing consistent care, historical knowledge, and emotional stability that counteracts external systemic pressures, making it an irreplaceable developmental asset.

Nationally, organizations exist to formalize assistance for relatives and non-relatives who become caregivers to children when parents are unable to provide a safe environment.²³ These kinship navigation programs focus on connecting families to necessary services, expanding support systems, and reducing stress to promote family stability, confirming the critical role of kinship in child welfare and placement stability.²³

V.C. Community Support and Parental Judgment

Community support for parenting also varies by ethnicity. Non-Hispanic Black and Hispanic mothers of young children report less overall social support for parenting than White mothers.²⁵ However, the key difference may not be the total number of people available for support, but the sources and perceived quality of that support.²⁵

Paradoxically, White parents report facing the greatest levels of interpersonal scrutiny regarding their parenting choices. Four-in-ten White parents (40%) say they feel judged by other parents in their community for how they parent their children at least sometimes, a rate significantly higher than Asian (31%), Hispanic (28%), and Black (24%) parents.¹⁹ This disparity suggests that while minority parents contend with profound structural challenges, White parents often experience intense, internalized pressure to conform to the dominant culture’s often competitive and resource-intensive parenting norms. The high rate of perceived judgment underscores the demanding and potentially stressful nature of adhering to this prevailing cultural script.

VI. Integrating Culture into Practice and Policy Recommendations

The analysis of ethnic child-rearing practices in the US confirms that effective support and policy must acknowledge and integrate cultural differences, recognizing that practices developed outside the dominant model are often strengths and necessary adaptations, not deficits.

VI.A. Principles of Culturally Responsive Care for Infants

For professionals working with young children—including medical providers, educators, and social workers—adopting a culturally responsive approach is essential to promote positive relationships and minimize developmental challenges.²⁶ This is particularly urgent given the documented higher rates of suspensions and expulsions faced by African American boys in preschool settings compared to other children.²⁷

Culturally responsive practice requires practitioners to engage in critical self-reflection to uncover implicit personal biases and assumptions, ensuring that their perceptions do not negatively impact their ability to connect with and teach children and families from diverse backgrounds.²⁷

Five core culturally responsive strategies are recommended for promoting positive outcomes ²⁷:

1.     Learn about children and families: Practitioners must partner with families, inviting participation and arranging informal discussions or home visits to understand family routines, religious holidays, home language, and cultural values.²⁷ This process validates the family’s context and helps mitigate potential teacher bias by confirming that diversity exists even within a single racial or ethnic group.

2.     Develop and teach expectations: Classroom or program expectations should be positively stated, developmentally appropriate, and explicitly linked to the shared values and cultures of the children, teachers, and families. This ensures guidelines are contextually relevant and promotes buy-in from all participants.²⁷

3.     Take the child’s perspective: This strategy requires providers to analyze behavior through the lens of the child’s cultural and familial background, challenging one-size-fits-all assumptions about appropriate conduct.²⁷

4.     Teach and model empathy: Modeling warm, responsive actions and utilizing culturally relevant materials are crucial.²⁷ Choosing high-quality storybooks whose characters reflect the ethnic makeup of the classroom is vital to ensure children of color "see themselves" represented. Incorporating culturally specific forms of expression, such as combining music, creative movement, and dance—a form of expression emphasized in Afrocentric teaching tenets—can facilitate emotional development and empathy.²⁷

5.     Use group times to discuss conflict: Rather than relying on exclusionary practices like "time out," using group time to discuss conflict promotes inclusion and allows the classroom community to engage in problem-solving in a non-shaming environment.²⁷

VI.B. Policy Recommendations for Mitigating Disparities

The enduring and severe health disparities underscore that individual-level parenting interventions alone are insufficient to achieve equity. Policy must shift focus to address structural determinants ⁵:

●       Targeting SDOH: Policy must prioritize interventions that address neighborhood quality, guarantee economic stability (e.g., paid parental leave, living wages), and ensure equitable access to high-quality healthcare and educational resources, thereby mitigating the systemic stress that contributes to poor birth outcomes.

●       Supporting Kinship Networks: Government agencies and nonprofits must formally acknowledge the adaptive and protective role of extended kin, working across systemic boundaries to improve supports and services for families where grandparents or other relatives are raising children.²⁴

VI.C. Future Directions in Cross-Cultural Developmental Research

Future research must move beyond simply comparing minority parenting practices to the normative White, middle-class standard. The focus should shift toward validating the strengths and adaptive utility of parenting goals (such as conformity, relational direction, and family obligation) that have developed within historically marginalized or resource-constrained environments. Additionally, research should continue to expand the study of bidirectional parent-child interactions in diverse cultural settings, examining how infants from various backgrounds respond to standardized stimuli to deepen the understanding of early emotional and social development across cultural milieus.²⁹

VII. Appendix: Annotated Educational Video Resources

The following video resources, stemming from academic centers and expert organizations, provide visual and auditory context for the cultural and systemic factors discussed in this report.

VIII. Conclusions

The analysis confirms that infant rearing in the United States is deeply stratified by race and ethnicity, reflecting underlying divergences in developmental goals (individualism vs. interdependence) and the dramatic impact of structural inequities. Practices observed across ethnic groups are not random choices but sophisticated, often adaptive responses to specific cultural imperatives and environmental constraints.

The most critical takeaway is the enduring link between systemic factors—namely racism, economic instability, and lack of healthcare access—and adverse birth outcomes, which disproportionately burden Black, AIAN, and NHPI populations. The elevated rates of preterm birth, low birthweight, and infant mortality among non-Hispanic Black infants demonstrate that improving health outcomes requires policy directed at the structural determinants of health, not just behavioral modification.

Furthermore, cultural practices observed in minority groups, such as the high emphasis on conformity and family obligation among Black and Latino parents, and the reliance on co-sleeping and close physical contact in Asian and Hispanic dyads, are crucial protective strategies consistent with interdependent socialization models. The success of extended household structures in bolstering cognitive scores for African American and Latino children validates kinship as a powerful, culturally derived ecological buffer against external systemic pressures.

To foster health equity and culturally informed development across the United States, professional practice must adopt cultural humility, and public policy must prioritize the dismantling of structural barriers while formally supporting the resilient, adaptive family structures—particularly kinship networks—that have historically sustained marginalized communities.

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