When Winnie-the-Pooh gets stuck in Rabbit’s doorway after eating too much for elevenses, he is anxious and gloomy at the thought of having to forgo food for a whole week to get out. He asks Christopher Robin to read him “a Sustaining Book, such as would help and comfort a Wedged Bear in Great Tightness”.
A.A. Milne’s first children’s novel, Winnie-the-Pooh, does not exactly explain what a “Sustaining Book” is. But E.H. Shepard’s illustration provides some clue. Christopher Robin is shown reading an alphabet book with the word JAM for J visible on the page.
Jam is not Pooh’s favourite food, of course, but the word is more than apt. Pooh is in a jam, but being read to sustains him in his difficult situation by bringing him comfort. The book acts as “an aid in the crisis”, as former teacher Ethel Newell noted in a study of bibliotherapy for children in 1957.
Dating back to the early 19th century, bibliotherapy is a therapeutic approach that fosters reading books and other forms of literature to support mental wellbeing and healing.
This year marks the centenary of the first Winnie-the-Pooh book. Milne based the timeless tales on the nursery toys and games of his son, Christopher Robin – the boy who lives in the fictional world of the Hundred Acre Wood. His adventures with his bear, Winnie-the-Pooh, and friends (Piglet, Eeyore, Kanga and Roo, Rabbit and Owl), are equally gentle, clever and funny – and above all, comforting.
The book was an overnight success when it was first published (as was its sequel, The House at Pooh Corner, in 1928), and continues to cheer readers world over.
Literary caregiving
When Winnie-the-Pooh was published, books had been used in hospital libraries to alleviate the suffering of ill and wounded soldiers from the first world war. This idea of books as a source of comfort was not new, but there had been an increasing need in this period for what authors Sara Halsam and Edmund G.C. King term “literary caregiving”.
It was at this time that American journalist Samuel McChord Crothers coined the term bibliotherapy, and reading for wellbeing began to be recognised in the medical sphere.
Milne had himself fought in the war and experienced the suffering and trauma firsthand. Winnie-the-Pooh has long been considered a response to war, particularly in terms of the book’s nostalgia and depiction of psychological damage. But as an example of bibliotherapy – and how this too is tied to the war – Winnie-the-Pooh has received scant critical attention.
It is, of course, not just soldiers – nor bears in rabbit burrows – who need good books. Children stuck in hospital need them too. Undergoing medical treatment, especially for serious illness, can be one of the greatest challenges a child can face, as highlighted by the Read for Good initiative.
This hospital reading programme has run in 31 hospitals across the UK over the past 15 years, and has found that books and storytelling can “have a significant impact on children’s health, wellbeing and education” – at a time when children are facing illness or injury, missing out on schooling, and feeling isolated.
CBW / Alamy
While Winnie-the-Pooh is not currently among the books in the Read for Good hospitals programme in the UK, the benefits of this children’s novel in hospitals have long been evident in initiatives in the US.
In 1999, the University of Florida launched a reading programme for the waiting room at the University’s Pediatric Continuity Care Clinic. One report describes a four-year-old girl who, nervously awaiting treatment, was calmed when Winnie-the-Pooh was read to her. And, just like Pooh being taught his ABCs, the child also learned new vocabulary from the story.
This programme is part of the Reach Out and Read campaign, endorsed by the American Academy of Pediatrics, which serves 4.8 million children across the US each year. Continued research efforts evaluate and maximise the impact of this initiative, and have found that there are positive results for children, families and clinicians.
More recently, in 2024 there was study of the parent-led Little Bookworms bedside reading programme in a neonatal intensive care unit (NICU) in Nashville.
Winnie-the-Pooh was selected as a book from childhood recommended by study participants to read with their infants, to “reduce anxiety and improve attachment for parents and caregivers who have infants in the NICU”. Supporting the wellbeing and engagement of carers in this way can help reduce some of the risks NICU infants face, including interruptions to language development which can affect subsequent literacy development.
E.H. Shephard / Wikipedia
Books to grow up with
More broadly, the potential of rereading a childhood book cannot be underestimated. Books read in childhood do not disappear, but “continue to unfold and inform the way in which we interpret the world” in our minds, as children’s literature expert Kimberley Reynolds of Newcastle University has established.
Paula Byrne, founder of the ReLit Foundation – which promotes reading as a way to combat stress and anxiety through “the slow reading of great literature” – has described the rereading of Winnie-the-Pooh in adulthood as therapeutic. Byrne believes the book has the capacity to grow with the reader from childhood to adulthood, offering new insights that can be appreciated in later life.
It is this ability of a book to grow with the reader that is of most help to children in distress, Newell suggested, providing “real armour” to children over a sustained period, and not just “a shot of penicillin for a particular infection”.
Over the past 100 years, Winnie-the-Pooh has grown from a book containing an example of bibliotherapy to a book for bibliotherapy in hospitals. As we celebrate the centenary of its publication, these ties to books as therapy for children and adults are well worth remembering.
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