By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D

Q. I would like to hear your thoughts on how to raise a child to have a strong sense of self-esteem.

A. The word “self-esteem” has been so overused that its meaning has been lost and sometimes confused with “selfishness.” But these are entirely different. Thank you for your question and this opportunity to clear up the confusion.

Self-esteem does not refer to an inflated view of one’s self. Instead, it is the capacity to hold onto a basically hopeful view of one’s self while facing and integrating experiences that challenge this view.

The development of healthy self-esteem in a child allows her to confront her mistakes without taking apart her positive feelings about herself, so that she can mobilize these positive feelings (confidence, faith in her potential, etc.) to find the courage to learn from and overcome her mistakes. The result is not a skewed view of one’s self, but a realistic one in which both strengths and weaknesses can be acknowledged and accepted.

How to help a young child develop healthy self-esteem? Here, too, there’s been a great deal of misunderstanding.

Overpraising a child (“Yay!” for every least little utterance or gesture) can interfere with a child’s learning to motivate herself, to praise herself when she deserves it, and to face her failures so that she can work to overcome them. I have seen 5-year-olds in Kenya care competently for younger siblings without anybody cheering them on, yet radiating a quiet confidence in their own abilities.

In some upper-middle-class communities in this country, I have seen some children who seem to lack the inner motivation to challenge themselves, and who have become dependent on external sources of praise – over which they have a different kind of control.

Abundant opportunities for small successes and an environment rich with developmentally calibrated challenges are important, but total protection from small failures deprives a child of the experience of facing mistakes, feeling the feelings that go with this, getting these feelings under control, and then developing the resolve to try again.

Perhaps most important of all for the development of healthy self-esteem in a child is a parent’s unconditional acceptance – entirely independent of performance – of a child not for what she does, but for who she is. Feeling loved no matter what does not fill us with illusions about how wonderful we are, but helps us to tolerate our imperfections. When we can do this, we are more likely to learn to live with the imperfections of others. This is why self-esteem is such an important first step in learning to get along with others.

Q. I am writing to appreciate you for being such a fine pediatrician who cares as much about the parents as you do about our children … I felt you were like a friendly grandfatherly type of doctor sitting by my side as I faced each developmental phase. I’ve always felt my daughter is my teacher, and with your guidance, I learned to listen and observe her better so I could support her to develop her potential.

A. It is good to hear that I was able to get across to you what I truly believe, that parents need support at least as much as they need advice, and that their best teachers are not the “experts” but their children, if only parents can really watch and listen, as you have been able to.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Before Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is now the director of the Brazelton Touchpoints Center. Learn more about the Center at

Reprinted with permission from the authors.