Hektoen International

A Journal of Medical Humanities

Fixed schedules and no kissing: Child rearing according to Drs. Holt and Watson

Howard Fischer
Uppsala, Sweden

Child crying alone on forest path
Photo by Arwan Sutanto on Unsplash

“Trust yourself. You know more than you think you do.”
– Benjamin Spock, MD

Child rearing “experts” first appeared at the end of the nineteenth century. L. Emmett Holt, MD (1855–1924), graduated from the College of Physicians and Surgeons in 1880. He decided to devote himself to pediatrics, which was not yet a recognized specialty. During his career he wrote three books and published 170 articles, researching and writing about the value of disease prevention and milk pasteurization and describing proven treatments for birth asphyxia. Holt was a recognized pediatric expert. He was a founding member of the American Pediatric Society, helped establish the first American pediatric journal, Archives of Pediatrics, and became the professor of pediatrics at his alma mater, the College of Physicians and Surgeons.1

Holt’s manual for mothers, The Care and Feeding of Children, A Catechism for the Use of Mothers and Children’s Nurses, appeared in 1894 and went through seventy-five editions.2,3 To today’s reader, this book is an example of the notions of “the strict regime” and “no coddling.”4 Holt did not accept the idea that “if a baby cried he was fed, if he was fretful he was rocked…Instead of following the baby’s demands, the rules laid down by the specialist” are what mothers must follow. The child must be fed the same food—a precisely compounded “formula”—in the same amounts, at the same time each day. He must also be put to sleep at the same times each day.5,6 A better guide than “mother’s instinct or mother’s love” was the kitchen clock.

A child should not be rocked when put to sleep. Babies younger than six months should not be played with—it will make them nervous, irritable, and give them indigestion. Infants should not be kissed, as this spreads disease. If a parent has to kiss a baby, it should be on the forehead, “but even less of this is better.” Thumb sucking and nail biting may be cured by putting mittens on the child, or fastening his hands to his sides, or by splinting his elbows so that they do not bend.7 “The continued presence of the young child in the home may lead to an unwholesome emotional attachment between mother and child.”8 Later generations called this emotional attachment “bonding,” and thought it essential for normal emotional development. Holt saw nursery schools as a way of preventing this attachment.

John Watson, PhD (1878–1958), grew up in a poor family. His father left the family when John was thirteen years old, and John was brought up by a strict, religious mother.9 His “behaviorist” view of children was that there was no “nature versus nurture” controversy. The infant was a blank canvas, and “nurture” (environment) could produce any sort of person. His Psychological Care of the Infant and Child (1928) sold 100,000 copies within months of publication. He stressed that a child has no need of affection,10 and children should be “treat[ed] as if they were young adults…Dress them, bathe them, with care and circumspection…Never hug and kiss them. Never let them sit in your lap…If you must, kiss them once on the forehead when they say goodnight. Shake hands with them in the morning.”11 These rules, he thought, would prevent the “harm a mother could do to a child’s psyche.”12

The mother of Dr. Benjamin Spock, the psychiatrically trained pediatrician, used Holt’s text in raising her son.13 As an adult, he relegated the ideas of Holt and Watson to an outdated antiquity. Recent writers have called the ideas of Holt and Watson “Victorian sado-masochism.”14


  1. Peter Dunn. “Dr. Emmett Holt (1855–1924) and the foundation of North American pediatrics,” Archives of Disease in Childhood – Fetal and Neonatal Edition, 2000;83(3).
  2. L. Emmett Holt. The Care and Feeding of Children. A Catechism for the Use of Mothers and Children’s Nurses. New York: D. Appleton and Company, 1907.
  3. Holt, Care and Feeding.
  4. Howard Markel. “What you ought to know about ‘what you ought to know about your baby’,” Menckeniana, 1989;111.
  5. Elizabeth Bernstein. “Misogyny and motherhood,” 3 Quarks Daily, December 2, 2019. https://3quarksdaily.com/3quarksdaily/2019/12/misogyny-and-motherhood.html.
  6. Holt, Care and Feeding.
  7. Holt, Care and Feeding.
  8. Bernstein, “Misogyny.”
  9. “John B. Watson.” Wikipedia.
  10. Bernstein, “Misogyny.”
  11. “On Dr. John Watson – psychology’s bad boy and founder of behaviorism- and the impact of controversial child rearing beliefs,” Motherhood in Point of Fact, September 18, 2015. http://motherhoodinpointoffact.com/dev/dr-john-watson/.
  12. Bernstein, “Misogyny.”
  13. Markel, “What.”
  14. “The man who said it was all right to love,” The Irish Times, March 21, 1998.

HOWARD FISCHER, M.D., was a professor of pediatrics at Wayne State University School of Medicine, Detroit, Michigan.

Winter 2023



2 responses

  1. They also allowed cigarette sales in hospital patients’ rooms and would laugh at hand washing. Don’t be outraged. we do equally ridiculous things today as servants of corporate medicine.

  2. Fascinating. One wonders if these views were influenced by the 18th- and 19th-century German manuals on child rearing, which were exceeding cruel.

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