Why Sleep Matters to Babies and Parents

This is my second post in a series on sleep. My first post explained why the controversy around CIO concerns me and told the story of how sleep training helped our family. The purpose of this series is to take an honest look at the research on the risks and benefits of sleep training in babies.

In this post, I review the research on sleep deprivation in babies and their parents, because I think this topic often gets lost in the debates about how our babies should sleep. This post is not about sleep training and contains no shocking confessions, but this topic needs to be a part of the conversation.

Sleep deprivation is a part of parenthood. It doesn’t matter what sleep “secrets” you may have discovered. It doesn’t matter if your baby was sleeping through the night at 8 weeks. Regardless of our children’s sleep habits or our parenting philosophies, we parents know sleep deprivation all too well.

We now have a great sleep routine with BabyC, and she usually sleeps through for 12 hours at night. Still, we go through tough patches when she wakes during the night for one reason or another – because she is teething or sick or going through a growth spurt. I do my best to parent during the night just as I do during the day: being responsive and sensitive to her needs. And that means that some days, the morning comes way too soon and starts in a bleary-eyed fog with a headache that screams for coffee – two cups, ASAP!

All of this is completely normal.

Yes, sleep deprivation is a normal part of parenting. But when babies and parents suffer from chronic sleep deprivation, we need to be seriously concerned. Babies need sleep to support healthy development. Parents need sleep to maintain sanity. Sleep is a universal human need.

Why do babies need sleep?

As parents, we have all witnessed first-hand the effects of a missed nap, a delayed bedtime, or travel-induced jet lag in our kids. I know that I consider BabyC’s sleep one of my primary responsibilities, because when she is tired, I see that she has shorter attention and is less able to engage with the world in a positive way. My observations are supported by the scientific literature as well. Here’s why sleep is important to babies:

Learning. Sleep has been shown to be important for maturation of infants’ brains and consolidation of their memories [1]. Several studies have shown that babies with more efficient nighttime sleep (greater percentage of time spent asleep during the night) had higher cognitive scores [2].

Here’s one striking example of sleep affecting learning: Dr. Rebecca Gómez and colleagues at the University of Arizona played a 15-minute recording of a fake language to 15-month-old infants. Four hours later, the infants were tested for their memory of the new language. Those that napped after hearing the recording had better abstract memories of the language, which gave them more flexibility in learning, compared to those that didn’t nap after hearing the language [3]. Twenty-four hours later, the nappers still remembered the grammatical structure of the language, while the napless babies had no memory of the language at all [4].

Mood. Babies that sleep more at night have been found to have an “easier” temperament, being more approachable, less distractible, and more adaptable [5]. In a study of well-rested vs. fatigued infants (i.e. missed nap), the fatigued infants were more easily frustrated and more distressed by a brief separation from their mothers [6]. In multiple studies of interventions that improved infants’ sleep, parents noted that their babies were more secure, predictable, less irritable, and less fussy [7].

Growth. Several studies have shown that babies that get less sleep gain more fat as infants [8] and are at higher risk of being overweight at 3 years of age [9].

Of course, there is plenty of normal variation in the amount of sleep that a given child needs. Some children have high sleep needs and others don’t, and parents are the best judge of whether or not their kids are getting enough sleep. I know my daughter is getting enough sleep if she falls asleep easily and wakes up happy.

Why do parents need sleep?

When infants don’t sleep, their mothers don’t either. And mothers of infants with sleep problems are at higher risk of postpartum depression. Approximately 10-15% of U.S. mothers report being depressed during the first year of their baby’s life (and how many more go undiagnosed?). The association between infant sleep problems and maternal depression has been shown in study after study [10-12]. Studies that have specifically tested sleep interventions have found that when baby’s sleep improved, so did mom’s symptoms of depression [13, 14]. [Dads: Sorry to leave you out here. I know you are probably short on sleep, too, but the research in this field has focused on moms.]

Postpartum depression is hard on moms, but it is also hard on babies. A mother suffering from depression may not be able to be emotionally available, sensitive, and responsive to her baby, day in and day out. A meta-analysis (analysis of many studies combined) showed that infants of depressed mothers had less secure attachment [15]. Mothers suffering from depression are more likely to report behavioral problems with their children, particularly issues with eating, sleeping, temper tantrums, and separation difficulties [16]. Infants with depressed mothers grow up to have higher levels of the stress hormone cortisol in preschool [17] and higher risk for depression in adolescence [18].

By the way, remember Darcia Narvaez, the author of the Psychology Today article, Dangers of “Crying It Out”, that warns that CIO causes neurons to die? This same author tells her readers that for her, “shampooing with cool water seems to prevent depression.” I don’t think Dr. Narvaez understands the seriousness of depression.

Sleep deprivation puts a mother at risk for postpartum depression and can affect her parenting. Of course, missing sleep affects our lives in countless other ways. It increases the odds of getting into a car accident [19] and impacts work performance, marriages, health… I could go on and on.

Sleep is important for parents and their babies. If a mother-infant dyad is suffering from sleep deprivation, the consequences are serious. I say this not to promote sleep training or any other type of sleep practice in particular. I just think we need to recognize it is not always enough to tell a sleep-deprived parent to suck it up for another month or year or two. Sleep-deprived parents need solutions.

But wait! Maybe we just need to adjust our attitudes and expectations about infant sleep. Perhaps it is just our modern Western culture that is the problem. I often see this claim, and there is something to it. It is completely normal for a newborn to wake every couple of hours during the night, and it is vital for parents to know this and be responsive to their baby’s needs. But what if my 9-month-old wakes and needs my attention every two hours, night after night? Is it only in Western cultures that this is perceived as a problem?

To answer these questions, Dr. Jodi Mindell of The Children’s Hospital of Philadelphia and colleagues from around the world asked parents of over 29,000 infants and toddlers (0-3 years) from 17 countries to complete a questionnaire about their children’s sleep [20]. This survey revealed striking cross-cultural differences, particularly between predominantly Caucasian and Asian countries.

In the Caucasian families, most babies fell asleep independently and in their own beds. In the Asian families, babies usually fell asleep with a parent present, and co-sleeping was the norm. Asian babies had later bedtimes, more night wakings, and about 40 minutes less sleep per day compared to babies from the predominantly Caucasian countries. These sleep practices are the norm in Asian cultures, and Asian parents probably don’t have to worry about their pediatricians or the well-meaning lady next door telling them that they have a problem.

So how did the Asian parents feel about their children’s sleep? Interestingly, 52% of parents in the predominantly Asian countries self-reported that their children had a sleep problem. In predominantly Caucasian countries, 26% of parents reported a sleep problem [21].

I’m including these cross-cultural data not to say there is anything wrong with Asian sleep customs or with co-sleeping. What these data tell us is that, regardless of cultural expectations, parents around the world struggle with sleep. Sleep is a universal human need.

My husband and I fell into a common trap in how we got BabyC to sleep. Our bedtime struggles and frequent night wakings meant that neither BabyC nor I were getting enough sleep, and it affected both of our moods. I did not suffer from postpartum depression, but I do remember how sleep deprivation affected my attitude about my job as a mother. On the mornings when I awoke after only a few hours of fragmented sleep, I can remember feeling a certain kind of despair. Even though I loved being with BabyC and everyone told me that I should savor this beautiful time with her, there was a voice in my head that said, “I don’t know if I can do all of this – all this patient feeding, changing, caregiving, and soothing – all over again today.” I did not like that feeling and knew that I needed to make a change to improve things for all of us.

When parents look for advice about their children’s sleep, recognizing that what they are doing isn’t working, I think we need to take that call for help seriously. Instead, I see a lot of responses like this, particularly from those that insist that we should never let babies cry:

“This too shall pass. One day you will miss these sweet nights with your baby.”

“Just sleep when the baby sleeps. Leave the dishes, and take a nap.”

“Ask for help. Find someone to hold the baby while you take a break.”

Don’t get me wrong – all of this is good advice, especially during the first few months of parenthood, but it only goes so far to help a family struggling with chronic sleep deprivation. Yes, it is good to keep perspective when things get tough. Yes, naps can save the day. And yes, we need to be better at asking for help when we need it, and we as a culture need to do more to support new parents. But in my experience, nobody – no matter how close a friend or relative – is willing to stay up all night with your baby, unless they are paid to do so. Even if they were, my baby wanted nobody but mama (maybe Daddy) in the middle of the night.

The struggle for sleep is a legitimate concern, and this is the context in which sleep training methods were developed. Parents don’t turn to sleep training because they are lazy, insensitive, or because they think babies should be seen and not heard. They turn to sleep training because they and their babies need more sleep, and they recognize that sleep deprivation can take a serious toll on their family’s health. To those that are tempted to judge, please remember this.

I loved reading all the comments on my previous post. To those currently struggling with sleep, my heart goes out to you, because I have been there and know how tough it is. To those that have found a solution – whether it is co-sleeping, sleep training, or something in between – I say BRAVO.

{Next up in my sleep series, I’ll discuss the research on efficacy and benefits of sleep training, and the following post will be about the risks.}

How does sleep deprivation affect you? How does it affect your child? What do you do to ensure that your family gets enough sleep?

Check out other posts from my infant sleep series:

REFERENCES
  1.  Tarullo, A.R., P.D. Balsam, and W.P. Fifer. Sleep and Infant Learning. Infant Child Dev. 20(1): p. 35-46. 2011.
  2.  Scher, A. Infant sleep at 10 months of age as a window to cognitive development. Early Hum Dev. 81(3): p. 289-92. 2005.
  3.  Gomez, R.L., R.R. Bootzin, and L. Nadel. Naps promote abstraction in language-learning infants. Psychol Sci. 17(8): p. 670-4. 2006.
  4.  Hupbach, A., R.L. Gomez, R.R. Bootzin, and L. Nadel. Nap-dependent learning in infants. Dev Sci. 12(6): p. 1007-12. 2009.
  5.  Spruyt, K., R.J. Aitken, K. So, M. Charlton, T.M. Adamson, and R.S. Horne. Relationship between sleep/wake patterns, temperament and overall development in term infants over the first year of life. Early Hum Dev. 84(5): p. 289-96. 2008.
  6.  Ross, C.N. and K.H. Karraker. Effects of fatigue on infant emotional reactivity and regulation. Infant Mental Health Journal. 20(4): p. 410-428. 1999.
  7.  Mindell, J.A., B. Kuhn, D.S. Lewin, L.J. Meltzer, and A. Sadeh. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep. 29(10): p. 1263-76. 2006.
  8.  Tikotzky, L., D.E.M. G, J. Har-Toov, S. Dollberg, Y. Bar-Haim, and A. Sadeh. Sleep and physical growth in infants during the first 6 months. J Sleep Res. 19(1 Pt 1): p. 103-10. 2010.
  9.  Taveras, E.M., S.L. Rifas-Shiman, E. Oken, E.P. Gunderson, and M.W. Gillman. Short sleep duration in infancy and risk of childhood overweight. Arch Pediatr Adolesc Med. 162(4): p. 305-11. 2008.
  10.  Wake, M., E. Morton-Allen, Z. Poulakis, H. Hiscock, S. Gallagher, and F. Oberklaid. Prevalence, stability, and outcomes of cry-fuss and sleep problems in the first 2 years of life: prospective community-based study. Pediatrics. 117(3): p. 836-42. 2006.
  11.  Martin, J., H. Hiscock, P. Hardy, B. Davey, and M. Wake. Adverse associations of infant and child sleep problems and parent health: an Australian population study. Pediatrics. 119(5): p. 947-55. 2007.
  12.  Bayer, J.K., H. Hiscock, A. Hampton, and M. Wake. Sleep problems in young infants and maternal mental and physical health. J Paediatr Child Health. 43(1-2): p. 66-73. 2007.
  13.  Hiscock, H., J. Bayer, L. Gold, A. Hampton, O.C. Ukoumunne, and M. Wake. Improving infant sleep and maternal mental health: a cluster randomised trial. Arch Dis Child. 92(11): p. 952-8. 2007.
  14.  Hiscock, H. and M. Wake. Randomised controlled trial of behavioural infant sleep intervention to improve infant sleep and maternal mood. BMJ. 324(7345): p. 1062-5. 2002.
  15.  Martins, C. and E.A. Gaffan. Effects of early maternal depression on patterns of infant-mother attachment: a meta-analytic investigation. J Child Psychol Psychiatry. 41(6): p. 737-46. 2000.
  16.  Murray, L. and P. Cooper. Effects of postnatal depression on infant development. Arch Dis Child. 77(2): p. 99-101. 1997.
  17.  Essex, M.J., M.H. Klein, E. Cho, and N.H. Kalin. Maternal stress beginning in infancy may sensitize children to later stress exposure: effects on cortisol and behavior. Biol Psychiatry. 52(8): p. 776-84. 2002.
  18.  Murray, L., A. Arteche, P. Fearon, S. Halligan, I. Goodyer, and P. Cooper. Maternal postnatal depression and the development of depression in offspring up to 16 years of age. J Am Acad Child Adolesc Psychiatry. 50(5): p. 460-70. 2011.
  19.  Connor, J., R. Norton, S. Ameratunga, E. Robinson, I. Civil, R. Dunn, J. Bailey, and R. Jackson. Driver sleepiness and risk of serious injury to car occupants: population based case control study. BMJ. 324(7346): p. 1125. 2002.
  20.  Mindell, J.A., A. Sadeh, B. Wiegand, T.H. How, and D.Y. Goh. Cross-cultural differences in infant and toddler sleep. Sleep Med. 11(3): p. 274-80. 2010.
  21.  Sadeh, A., J. Mindell, and L. Rivera. “My child has a sleep problem”: a cross-cultural comparison of parental definitions. Sleep Med. 12(5): p. 478-82. 2011.

 

47 thoughts on “Why Sleep Matters to Babies and Parents

  1. Sleep is super important to our family! I have always been an early-riser so early mornings don’t bother me, in fact often times I am up before Baby Mil. However my husband is NOT an early-riser so once Mil is up the two of us usually leave the bedroom to allow Daddy to sleep another hour or so. Mil is nearly a year old and wakes once in the night, or twice if teething or not feeling well. If I stay up too late or Mil wakes too often during the night I am usually in a bad mood come the am. My husband always recognizes it immediately and will take Mil into the other room while I rest/sleep a bit longer. Our household sleep schedule is decided by Baby Mil but my husband and I have learned that with routine and compromise we can all get a good night sleep :)

    • You have a good husband:) Mine has a serious need to sleep in since he often works evenings and nights, so the mornings are ALL mine. I know I do better if I can get up before BabyC, have a cup of coffee, and collect myself, but these days I almost always go to bed too late, am up one in the middle of the night (teething, I think), and I hit the ground when I hear her start babbling in the morning. I freely admit that I am most to blame if I am short on sleep at this point!

  2. Sleep is pretty much the only thing that matters more than food to babies, and I think people forget this. The baby will be happier if he/she sleeps better, too.

    We sleep-trained our daughter at nine months. Her previously-good sleep went to hell at six months, and she was waking every two hours again. And not hungry, judging by her “two minutes and then pass out” behavior. She’s slept through the night with rare exceptions (teeth, illness, travel) ever since.

    Our son (now five months old) could NOT sleep on his back. We thought he was colicky – he just screamed all afternoon and evening, until he passed out at 9 or so (if we were lucky), and then he woke every 90 minutes. All night. He woke from naps at the 20-minute mark. One night, in desperation, I did the Evil Mom thing and flipped him to his tummy. He slept for six hours straight. And since that day, he sleeps on his tummy and is the happiest baby I’ve ever met. No one needs to tell me that the temperaments of babies who sleep well are better than those that don’t.

    • I know, I’m not sure any parent of a baby needs to be reminded of how much sleep deprivation sucks for everyone. People who are farther out from the first year or two or who have never had kids (but like to hand out advice) sometimes forget. And I agree – after love (which goes without saying:) and food, babies need sleep. And quite frankly, they are harder to love if they aren’t getting enough sleep.

  3. Very insightful and definitely something parents should at least explore – sleep deprivation is not fun for anyone and makes for a miserable person!

  4. It’s wonderful to read such a lot of common sense! In my job as a community midwife and child health nurse I deal daily with sleep and settling problems and mother’s struggling to cope, often in the face of a lot of conflicting advice and pressure to be perfect mothers.
    Often, what looks like postnatal depression is actually plain old sleep deprivation. Get the family sleeping well and those mountains start to look more like molehills. I try never to be prescriptive when offering professional advice – each family has to go with what feels right for them – but I do strongly believe that sleep training is not damaging. In fact I’m always amazed to see the difference in BOTH mother and infant when the family starts getting enough sleep. Bravo Alice!

    • Thanks for your comment, Sally. It is nice to know that someone on the ground, working with families every day, can attest to the importance of sleep. Your point about the link between sleep deprivation and depression is interesting. One study that I read during my research (Martin et al. 2007) looked at 5000 Australian families, infant sleep problems, and parenting mental and physical health. In mothers without a history of depression, having an infant sleep problem (bedtime struggle, frequent night wakings) increased their odds of depression by 4.6x. In mothers that already had a history of depression, an infant sleep problem did not seem to make it worse. So it does seem like there is a large subset of mothers whose depression is really driven by sleep deprivation, not that it is any less of a problem – but it is easier to fix!

  5. My only request is that I have permission to print this off so that mums can read it while sitting in my clinic waiting room (with acknowledgement of source included of course).

  6. I personnaly need a lot of sleep and have always put sleep way up on the priority list. I do the same for my baby although she is not a good sleeper. She’s 10 months old and still wakes up every 2 hours. I put a lot of effort in my everyday life to make sure that she gets all her sleep. It’s so easy to see when she is tired or overtired! The one thing I find difficult to deal with other people’s reactions ans behavior. I find a lot of times people (especially those without kids) don’t respect my baby’s need for sleep and don’t seem to understand the importance I give it. For instance, people don’t seem to understand that I try to organise my days around my baby’s naps or won’t want to stay overnight because my baby’s not sleeping well. For some reason they are often surprised that I would give this much importance to my baby’s sleep as to sacrifice social activities for it.

  7. Seeing as I have a not-quite 3 week old (and his 2 older siblings), all this resonates very clearly with me! In fact, I’m probably a bit too sleep deprived to add anything of value, other than I totally agree with everything you have said. In terms of managing everyone’s sleep, I just try as much as possible to keep regular routines for the older kids, or have early bedtimes when daytime naps are not possible. Early bedtimes for parents are also important (especially when you know you’ll be waken several times in the night), as you never quite know when the day will begin.

    • Oh my goodness, you are in the throes of it all! I definitely remember how important it was for me to go to bed early back during those first few months. That is still hard for me, but it makes all the difference! I can imagine it only gets harder with more kids. Hang in there, and go to bed!

  8. “They turn to sleep training because they and their babies need more sleep, and they recognize that sleep deprivation can take a serious toll on their family’s health.”

    This doesn’t explain the women who sleep train from day 1; the likes of which we saw in your previous post.

    • I’d say that depends on what’s meant by “sleep training from Day 1″. With my second, I did a number of things from “Day 1″ that I didn’t do with my first, just due to experience. For example, we never co-slept. We did with our first, and it took a toll on our own sleep – neither of us got restful sleep that way. So we trained our son to sleep in his own basinet from…well, actually Day 2. The first night, while we were still in the hospital, he slept on me with a boob in his mouth.

      I’d say there’s a case to be made for experience telling a mom what she didn’t like about how her first baby learned to sleep and making those changes from the first day of life.

        • I definitely wouldn’t recommend to anyone that they leave their newborn to cry, but I think Rachael is onto something in terms of shaping healthy sleep habits from Day 1. I have been thinking a lot about what we could have done differently with BabyC from the start. I think I was so focused on stopping the crying that I didn’t always listen to what she was trying to tell me by crying or think about the habits that I was developing in her. I thought it was my job to stop her from crying as quickly as possible, and bouncing did that (as long as she wasn’t hungry, in which case feeding did that). In hindsight, I wish I had taken a second to think about what she really needed and adjust my response appropriately. If she was tired, I wish that I had focused more on quiet methods of soothing and given her a chance to try falling asleep without those big movements. I *hope* I can do a better job of this the next time around, but I recognize it is easier said than done, especially with a fussier baby.

          Anyway, I got off topic. Back to your original comment – I never suggested that anyone let their baby cry from day 1. As I said, sleep deprivation and waking up every hour or so is just part of the job description during the newborn stage. My point is that sleep deprivation has serious consequences, and if sleep training helps a family with an older infant get more sleep, then I don’t think a guilt trip about sleep training is helpful.

  9. Interesting… flicking through some of these studies now (I should be in the shower getting ready for work) and some of the bits you didn’t quote strike me.

    Reference 10, you quote to support your argument about sleep and the effects on maternal depression. However, this also says:

    “The prevalence of cry-fuss problems decreased from 19.1% at 2 months to 12.8% at 4 months, with 5.6% of mothers reporting cry-fuss problems at both ages. Prevalence rates of sleep problems were 21.2%, 16.2%, 10.0%, and 12.1% at 8, 12, 18, and 24 months, respectively; 6.4% had a problem at ≥3 of these ages.”

    Which — and I must admit that I am no expert at reading these things so you must correct me if I’m wrong — reads to me like the sleep problems were decreasing as infants age? To me that is argument for holding off on the ‘cry it out’ techniques, however inconvenient the wakings are.

    In the conclusion of that same study, it states “Most cry-fuss and sleep problems in the first 2 years of life are transient.”

    Reference 14 has some interesting responses: http://www.bmj.com/content/324/7345/1062?tab=responses which are too long for me to quote here but provide some possible additional reading (for me, if nobody else, haha)

    Really must jump in the shower now, but will probably come back to this…

    • The focus of this post was why sleep deprivation sucks and how it can be bad for both parents and babies. There are tons of things from all those studies that I didn’t discuss. As is my general pattern, I usually do all this research, write about 10,000 words and then cut it down to no more than 2,000 so that someone will have the stamina to read it:)

      The findings of the Wake et al. study do show us that sleep problems decrease as the child matures, and I don’t think that would surprise anyone. Does that mean that we should live with our child’s sleep problem (however you define that – it was defined in this study by the parents themselves) for another couple of years, particularly if it is affecting the health of the family? I think each family has to answer that for themselves. We also don’t know from the Wake study what parents may have done or not done to help their children sleep. I’m sure that some of the parents used sleep training methods, and that may account for some of the reduction in sleep problems with age. There is definitely a maturity component as well, although multiple studies have also shown that children that have “sleep problems” as babies are more likely to have them in preschool, etc. As parents, we shape our children’s sleep habits in one way or another. From an early age, we teach them that “this is the way we sleep.” I taught my daughter that we sleep by bouncing, and that ultimately ended up affecting both her quantity and quality of sleep. Those early habits are sometimes in opposition with how we want our children to sleep later, and sleep training gives parents a chance to change course and tell their children that we are going to sleep a different way.

      In theory, I completely understand your feeling that babies should know that we will always respond to their cries (I hope I have that right). In practice, I think many families, mine included, find that they need to make a change in the way they sleep, and most babies are going to protest that change. My experience was that my baby seemed to forgive me for the lapse in responsiveness, become a wonderful sleeper, and seeing how it helped my family, I have been able to forgive myself for it. That said, if I had known of a way to make that change without crying (or co-sleeping), I would have tried it, believe me.

      • re: above – I know you weren’t recommending people leave a newborn to cry from day 1, I just take issue with the assumption that parents move to controlled crying X months down the line after months of sleep deprivation, for the good of the family. A few comments here and comments on a post elsewhere about CIO that I recently read show that’s not always true.

        re: study quotes – I wasn’t criticising your post for not including the bits I picked out, just emphasising some bits that I found interesting. I had to cut my comment short because I was late for work :O

        I have so many thoughts on the topic but don’t want to spam you to death so I’ll leave it there.

        Oh, also I have some (anti-CIO) links in my old delicious account if they are of any use to you whilst composing the next post… http://delicious.com/jemjabella/controlled-crying

  10. With my youngest child, I went 13 months with 4 hours being the longest stretch of uninterrupted sleep. We attempted sleep training for one night at 9 months of age, and he just wasn’t having it. It was after weaning him at 13 months when we tried it again that sleep training actually worked. The sleep deprivation was debilitating. My husband wanted to help, but couldn’t because our son only wanted me… all day, every day, 24/7.

    My son is turning 2 next week, and since 13 months of age has been sleeping 12 hours per night, usually waking once. My husband takes care of the night wakings now :)

    When you’re in the middle of it, there is no light at the end of the tunnel. You think “if only I knew how much longer this is going to last”… but night after night, month after month.. you’re still without sleep that your body and your baby NEEDS and you feel like it’s never going to come.

    I always thought the “take a nap when the baby does” was funny… What Nap? My son’s naps were never more than 20-30 minutes and I needed that time to run to pee and take a shower! lol

    • Thanks for your comment, Tamara. I have been reading that 9 months can be a tough time to sleep train, because many babies have an increase in separation anxiety at that time. I wish I could say there was more research on infant age and appropriateness of sleep training, but there isn’t (although I’m still looking). And I agree with you on the naps! I was able to nap during the first few weeks of my baby’s life, but once the real fussiness started, then her naps were way too short for me to do much more than go to the bathroom or grab a bite to eat! I’m also just not that good at napping. It takes me a while to wind down to sleep during the day, and I often wake up feeling like a zombie (especially when I am woken by a baby rather than being able to complete a sleep cycle).

  11. Thank you for this post. I could not agree more. I have a 12 week old and he is my first, I never imagined how important sleep would become, to both of us. I have been trying to follow babywise, but am not sure it is “working” the way i’d hope. When you say sleep training, are you referring to any type of training to help the baby sleep? What method did you use with your baby that you found to be effective? Thanks for the time you spent writing this. So great!

    • I wrote about what we did with BabyC – around 12-14 weeks – in my last post, so you can read more there. We basically did a version of the Ferber method – where we put her down drowsy but awake, even though that meant she cried for a while before she went to sleep. We came in to check on her and briefly comfort her at increasing intervals – 3 min, 5 min, 7 min, etc. I am not an expert on this by any means and would not necessarily recommend what we did to anyone else, and many people feel that you shouldn’t let a baby cry alone this young. We were stuck, and BabyC couldn’t go to sleep at bedtime or again throughout the night without a LOT of bouncing. And I can say that sleep training vastly improved sleep for all of us and made BabyC a happier baby. Sleep training can mean many things, but in general, it means trying to help your baby learn to fall asleep on his own, without your soothing (or bouncing!), because this will help him fall back asleep when he wakes normally during the night (assuming that he doesn’t need to be fed, diaper changed, etc). What method you use to get there depends a lot on your baby and your parenting philosophy, so you have to figure out what you are comfortable with. And many parents prefer to soothe their baby to sleep until much older, and that’s their choice – but they are, in general, more likely to be up a lot more at night!

      I have to say that from the little I know about Babywise, I’m not a huge fan. My understanding is that it provides some pretty specific guidelines about timing of feedings and naps, and I prefer working on developing healthy routines rather than trying to stick to a schedule. I think the most helpful thing is to foster a back-and-forth communication with your baby about when he is hungry and sleepy, and establishing a routine helps to keep things predictable for both of you. Trying to stick to a set schedule can make it harder to tune into what your baby is telling you. Again, I haven’t read the Babywise books, so my knowledge of it is second-hand and I may have it wrong. I read a lot of books in those first few months and found something useful in all of them, even if I didn’t buy into the overall philosophy. Just don’t forget that you know your baby better than anyone – none of the experts know your baby like you!

      • I actually used part of Babywise…I can say that a great deal of the book I threw out completely, but Chapter 6, which lays out the basic schedule idea, was a lifesaver in terms of giving me an outline for our day. My son (and many of the babies I nannied for whose parents also used Babywise, which is where I was first introduced to the method) all seemed to benefit greatly from having feedings, naps, and wake time set up in an understandable routine. It did seem to help them regulate their patterns (and also helps in not associating food with sleep, which was good in not always needing a nipple or a bottle to get drowsy). It does actually tell you to listen to your baby’s cues and adjust your schedule as needed depending on where they are (a point that I think is often overlooked by people who get too militant in sticking to the schedule). And it also helped me as a sleep deprived new parent who was just learning how to listen to her baby’s cues to be able to look at our dry erase board when he was crying and know that ‘nope, I just fed him 30 minutes ago, but it has been two hours since he slept (which I’ve lost track of, since I’m so sleep deprived!), so it’s probably a tired cry rather than a hungry one’–it was at least a place to start in decoding his crying ;-). Again, I think a lot of the book should be tossed, but I always recommend Chapter 6 to parents for help in just setting up a basic routine–because the routine certainly seemed to be something that my baby found comfort in and thrived on. As with the modified Ferber method, it was about taking the general idea and modifying it to work with my own parenting style.

        • Hi Kate, Thanks for sharing your experience with Babywise. I was hoping that someone would chime in who knew more about it. Part of my perception about the rigidity of the schedules came from some comments I read on Babywise forums when I was trying to figure out how to help my baby nap for more than 45 min at a time (this was around 4-5 months). Everyone there seemed stuck on the idea that naps should be a certain non-negotiable length, and if your baby woke up earlier, you should leave her in her crib until the clock said it was wake-up time. I wasn’t into that! However, like you, I found it VERY useful as a new mom to develop healthy routines of sleep, feed, activity, sleep, etc, all within a 2-3 hour cycle. Thinking about our days that way saved me, and I think babies do well when they have rhythms to their day as well, so long as we stay tuned into their cues to guide the pace of the routine.

    • Yay! Interestingly, my posts on sleep have coincided with my baby routinely waking in the middle of the night (after months of sleeping straight through) and also transitioning from two naps to one. We’re teething and easing through some changes here right now (what’s new?).

  12. Thanks for your post and blog! I love it! As a mum and scientist myself, I really appreciate all your efforts and research that go on your posts. I am reading this post today at work and the only thing I want to do, is go back to bed. I always needed a lot of sleep and so since my daughter is born, I had to make sure I have enough sleep, as I know I can’t function when I am tired. So I took naps every time I could. Now that I am working 3 days a week, my husband and I take turn sleeping in on the weekend. My daughter is 16 months old and has been sleeping through the night (apart when sick or teething, which is happening now!) since she was 9 months old. At around 7 months old, after an overseas trip, where all the routine and hard work done previously was gone, we had to retrain her to go to sleep. We followed professional advices, and we would let her cry for 30 sec, then be in the room with her for 2 mins, and so on until she fall asleep (and it took 3-4 nights for her to fall asleep without crying). It is a hard thing to do, but it is worth the effort and it worked for us. Sleep is very important for us, so we make sure the three of us get enough of it (going to bed early, taking turn minding her or sleeping in, napping), but some days it just doesn’t happen and getting through the day is hard work. And I am already concerned about how I am going to nap once we have a second child. I think this is when the sleep deprivation will hit me for good!

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  14. I’m really taken aback by your assertion: “I don’t think Dr. Narvaez understands the seriousness of depression.” when you are referring to a *personal* essay on her own depression. That’s a little insensitive, no?
    Also, you misrepresented what she said. Here is the full quote:

    “My remedies.
    It sounds crazy, but for me shampooing with cool water seems to prevent depression. So do B-complex vitamins, getting enough sleep, and huggling with my husband.”

    Interesting that she says that getting enough sleep are important to her to ward off depression, yet you did not mention that which leads me to believe that this is really just a thinly veiled attempt to discredit her (extensive) research by misrepresenting what she said.

    • Well, I think Narvaez is out of touch with the realities of parenting a baby and depression. This was evident to me in her previous post, in which she said. “What does extensive baby crying signal? It shows the lack of experience, knowledge and/or support of the baby’s caregivers.” I can’t imagine hearing that from someone after months of trying to soothe my fussy baby, day in and day out. And I can’t imagine what someone suffering from depression would feel if she was told to take a cold shower and feel better. And, unfortunately (because so many people have read her words and trusted them), I’m not convinced that Narvaez has really done serious research before making her recommendations. The research she has cited is on rats with extended maternal separations and children that have been severely abused or neglected. I actually think that a case can be made for avoiding CIO (but there is very little science to back it up – I’ll write more about it), but I think Narvaez has done a poor job of it. I’m glad she agrees that getting enough sleep is important for preventing depression, but she doesn’t offer solutions to mothers whose babies aren’t sleeping and who are at risk for postpartum depression.

  15. As a behavioral geneticist and neuroscientist, I’d like to back Alice up re: Darcia Narvaez. Dr. Narvaez’s arguments about CIO amount to: babies crying is indicative of stress (probably), stress causes cortisol release (yes), cortisol kills neurons (it can; it doesn’t always and depends on context and levels), therefore CIO is causing your baby brain damage. Um, no. That link is inappropriate at best and irresponsible at worst. To make that assertion valid, she’d need to show me studies where they can show elevated cortisol levels in the brains of babies who are undergoing CIO, AND show me that those levels are sufficient, in the context of a normal baby’s developing brain, to kill neurons. I’d even take a normal mammal’s brain, of any type. She’s got neither of those connections properly made, and yet writes articles telling people that letting their babies cry will cause them brain damage. Unacceptable.

    (Oh, and also? Neuronal death is a normal part of brain development, so you’d also have to show me that any neuronal death after CIO was actually harmful in a measurable way.)

    And while she, personally, may find that a cool shampoo alleviates depression…she’s a psychologist. What she says about depression will carry weight with people. Thus her saying such a thing, even if it is personal, is open for criticism. Because people who have studied (or experienced) real depression, postpartum or otherwise, know that cool water on your head doesn’t really help a lot. What she’s talking about in that case isn’t depression; it’s the baby blues, which I think almost all mothers get. And she completely neglects to note that, even if her cortisol = brain damage theory is true, women who are depressed due to sleep deprivation may well wind up with babies with elevated cortisol levels. So it comes down to “pick your poison” in that case.

    It’s cruel to tell a woman who has decided to let her baby cry as part of teaching him/her to sleep that she’s doing harm, with no real data to back that assertion up…it’s especially cruel in light of the fact that most people who sleep train are doing so because they absolutely have to get more sleep, for their own mental health.

    • Thank you so much for breaking down Narvaez’s study, and all its deficiencies! After having 2 children, I know more than ever that parenting is not one-size-fits-all. My kids have VERY different sleep needs, and as such, I’ve had to make adjustments and find what works. And I think that’s really key: find what works. If a mother can co-sleep with her baby and they can both get a good night’s sleep, then hooray for them! Another mother may find that some form of sleep-training is what’s going to save her and her family’s sanity, and that needs to be respected as well. What’s most important is the evidence that sleep-training doesn’t necessarily have negative long-term effects. I’m looking forward to Alice’s next post… :)

  16. Pingback: Week in Review for Parenting in the Loop « ParentingInTheLoop's Blog

  17. Thank you so much Alice for your hard work in writing this! I feel guilty for being able to read it for free :). We are in the midst of sleep deprivation with our second baby 2 1/2 months and trying to decide how we are going to “sleep train” her and when. Our first was never sleep trained well and the whole family definitely felt the affects. It does really take a scientist to interpret many of these studies and I feel confident in your analysis. Look forward to reading along!

    • Thanks, Erica! It really is a tricky topic, but I’m doing my best to sort through the data. To be honest, the science is useful, but I think the way we each handle sleep is dependent on our parenting philosophies, cultural ideals, and how much sleep we can survive on!

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  23. My personal experience is I obtain way more sleep and feel my babe has very healthy sleep habits because we co-sleep. We have never had the experience or stress of letting our LO fuss it out in an attempt to have him sleep elsewhere. I know so many parents who have very stressful experiences around sleep because the cultural norm is to have babies sleep separate from their parents when physiologically that is the exact opposite of what a baby instinctively requires. For breastfeed babies it is def more common for night nursing to happen and my little guy def still nurses throughout the night. Neither of us are fully awake during these times as he is right next to me and it is a seemless easy experience for us both. I cant imagine how much less sleep we woukd both get if he had to fully wake up to cry to let me know he needed to eat because he was in another room…..not to mention having myself to get up feed him and then calm him down to sleep again. I would easily be waaayyyy more tired and sleep deprived if this has to happen every night for months. He is a busy guy during the day and his night nursing is not only physiologically normal, but also where he still obtains a good portion of his caloric intake along with all the other health benefits associated with breastfeeding. He takes two great naps a day and has done so with ease for many months……this routine, which I def agree is important to his overall health, has never required us to let him fuss it out. Sleep is, I agree essential for everyone involved. Babies or even young toddlers who are classified as having sleep problems if they are still awake at night I believe is part of the problem. Wakefullness at night, whether due to the need to nurse, pain from teething or because a child is experiencing a normal sleep regression for babies and young toddlers is completely normal and should physiologically expected. I appreciated the research sited for this article, but I believe important research was left out……the work by Dr James Mckenna offers what I believe to be a much more realistic look, backed up by solid research, on what sleep looks like for babies and young children. In addition, he offers some wonderful suggestions for night time parenting.

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  26. Co-sleeping works for many of my friends and their babies/toddlers. But co-sleeping does not get all babies (or Moms) the sleep they need. I think it’s important to remember that every baby is different and every family is different. One friend was not able to co-sleep with her baby (though she had planned to and very much wanted to), because she was anxious about rolling onto her baby. I tried co-sleeping, but my son just stayed awake much of the night. He was a very easily stimulated baby and being near Mom or Dad absolutely DID NOT help him sleep. Mckenna has done extensive research on co-sleeping, but surprisingly, he never mentions families for whom co-sleeping did not/does not work. I can’t imagine in all his years of research he did not come across even ONE family like this. I don’t do research in this area and I know myself know several families who HAD to have their babies sleep separately from them.

  27. I’m six weeks in to this whole parenting thing, and I’m really missing the days when I could get more than two hours of sleep at a time. Even if my daughter sleeps for longer than a couple hours at night, I still wake up every two hours because my body’s gotten used to feeding her that often. We’ve ended up co-sleeping because she won’t stay asleep while in the crib and I badly need rest, and my husband has to sleep because he works with potentially dangerous chemicals and really doesn’t want to accidentally kill someone at work. She doesn’t sleep long enough during the day to let me have a nap–that “sleep when the baby sleeps” thing is rubbish, at least with my child. She’s been slow to gain weight because my milk supply’s been lower than it’s supposed to be, so we’re working on building that up and getting her to gain more weight before we transition her over to the crib. So far she seems to be sleeping better now that she’s getting more milk, so I think once she’s back to gaining weight at a normal rate, we’ll have an easier time getting her to rest. At least I hope so. I’m not looking forward to those few days when we’ll be convincing her that sleeping in the crib is a good idea, but I think we can survive them.

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