Over the last month I received five questions, all from women who were or had been cohabiting (living together without being married), asking me about custody, visitation or absentee fathers.

The Institute for Research on Poverty in its โ€œFamily Change: Itโ€™s Complicatedโ€ report highlighted four big changes in the family between 1960 and 2010.

First of all, the nuclear family (mom, dad, kids) that was the norm has given way to several different kinds of families.

Some, like many gay marriages, are committed and stable. Some are not: Five years after the birth of children, half the women who were cohabiting were no longer living with the childโ€™s father.

Second, the percentage of births to unmarried parents has increased, leading to more relationship instability and single-parent families.

Third, how parents earn a living has changed. More women are in the workforce. And their wages have increased for those with a high school diploma, although women still earn less than men for comparable work. Median earnings for men have decreased, so more women must return to the workforce after childbirth, often before they want to.

Fourth, โ€œIncome inequality rose far more among households with children than among other households.โ€ This has led to a two-tiered family system divided by education and income level.

When I was raising my kids in the โ€™60s, I was the only woman on our very long block who worked outside the home. Today, a whopping 71 percent of women with children under 18 are in the workforce in a nation that cannot yet brag about family leave policies, especially in those jobs that do not pay much.

The key to a good childhood is stability. Children do best with parents who love each other, a happy household and what I call โ€œpredictable routinesโ€ peppered with delightful surprises.

The opposite of stability can be chaos. As children develop, their parentsโ€™ presence is the rock beneath their feet.

From a longitudinal study of 17,000 children, we now know that adverse childhood events such as physical, emotional or sexual abuse, neglect, parental addiction or mental illness, parental divorce or separation, a parent in jail, and even witnessing a mother being abused, can all cause downstream changes to body and brain.

The human species has evolved a pretty neat way to escape from dangers. Danger activates our hard-wired fight-or-flight response system. When activated by physical danger, it rapidly readies us to run or fight to escape the charging lion or dodge the speeding car. This kind of stress to our body to save life or limb is referred to as normal stress.

โ€œToxic stressโ€ is what can affect children exposed to adverse childhood events. This stress arises not from immediate danger like the lion in the bush. It arises from thinking about or remembering or worrying about these toxic experiences. Itโ€™s actually easier to run from a lion than to stop a negative thought.

How can parents and the community help children with adverse childhood events? First of all, try to prevent them. Of course, some marriages or relationships fail and divorce or separation is necessary. But do not willingly or casually put your child in chaos.

A parent whose child is affected by the big bad Ds (death, divorce, disability, detention, desertion) should get help for both self and child. Individual and group therapy can help.

A word to remember is neuroplasticity. We can learn to make new connections in our brain that minimize toxic stress. Google neuroplasticity and explore community resources.

Grandparents and other relatives can really fill important gaps in a childโ€™s life. Ideally, every child grows up in a stable home, not weakened by the effects of poverty, and with parents and grandparents to provide unconditional love. Even, or maybe especially, loving and caring step-grandparents can be invaluable.


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Dr. Heins is a pediatrician, parent, grandparent, great-step grandparent and the founder and CEO of ParentKidsRight.com. She welcomes your questions about parenting throughout the life cycle, from birth to great-grandparenthood! Email info@ParentKidsRight.com