This is the third post in my series on sleep. I have written about my family’s experience with sleep training and why sleep deprivation is a problem for both babies and their mothers. I admit that I’m feeling a little buried in sleep research. Part of me wants to be done with it, and part of me wants to do a second postdoc in infant sleep! I set out to write this post on sleep training methods and their benefits (risks to come), but I got side-tracked on the topic of self-soothing. Since self-soothing is the goal of sleep training, I figured it was worth taking some time to explore. So that’s this post, and my next post will delve into the research on specific sleep training methods.
When I was five months pregnant with BabyC, I babysat for Little J, a friend’s one-year-old. His mom left me written directions for Little J’s bedtime routine: a cup of milk, brush teeth, diaper change and pajamas, a few books, then lay him in his crib. Hand him his Pup-Pup, wind up a little music box, say goodnight, turn off the light, and shut the door. I was used to rocking babies or rubbing their backs until they were in a deep sleep, and then stealthily tiptoeing from the room. I was nervous about Little J’s bedtime routine, particularly since it was his first time with a baby-sitter besides his grandmother.
From start to finish, Little J’s bedtime routine took all of 10 minutes. He smiled at me when I handed him his Pup-Pup, and I said goodnight. From the living room, I watched him on the video baby monitor as he chatted with Pup-Pup for a few minutes. He rolled around the crib as if looking for a comfortable sleeping position and then fell asleep. I was in awe of this kid. Little J seemed so confident and at ease in his bed. He welcomed sleep, and he knew how to get there without my help.
When Little J’s mom got home that night, I told her that I had never seen a baby transition to sleep so independently and so easily. “You are so lucky!” I said.
She smiled. “No, not lucky. That took some work, but it sure was worth it.”
Little J was my first introduction to self-soothing. Although I knew little about it, I hoped that the baby kicking away in my belly might one day be able to sleep like that.
When babies associate something like feeding, rocking, or bouncing with their transition to sleep, they often expect those same conditions when they wake during the night. All of us wake during the night – babies and adults alike. We check our surroundings to make sure everything feels right, and if it doesn’t, we go on alert. When BabyC was bounced to sleep, she woke 45 minutes later and everything felt wrong – she wasn’t bouncing anymore! She called for help, and, being good, responsive parents, Husband or I came running to see if she wanted to nurse, to change her diaper, to shush her, and then finally, to bounce her again so she could go back to sleep – often only to wake again 45 minutes later to repeat the whole process. This was not a very restful night of sleep for any of us.
When a baby knows how to self-soothe and falls asleep independently, she wakes in the night, checks her surroundings, and finding nothing to be alarmed about, she goes back to sleep without needing our help. Babies that have this skill of self-soothing have been shown to get a full additional hour of sleep during their longest nighttime sleep period and an average of 45 additional minutes of total nighttime sleep. They wake during the night just as non-self-soothers do, but they are less likely to cry out for help and more likely to roll over and go back to sleep (Anders et al. 1992; Goodlin-Jones et al. 2001). We often hear BabyC wake around midnight, but she rarely sounds distressed or calls for us. We listen as she practices her current favorite word, “app-uu (apple), app-uu, app-uu,” for a while, gradually quieter, until she falls back to sleep on her own.
All sleep training methods have the goal of teaching babies to self-soothe, however gradual that process is. I wondered: Is it a good thing for a baby to know how to self-soothe? Is it “natural?” Won’t all children learn to self-soothe eventually? If sleep training makes babies cry, then are we pushing them to self-soothe before they are ready?
We know that it is our job to soothe our newborn babies. The transition from womb to world is traumatic and abrupt, and babies are neurologically immature. We hold and swaddle, bounce and rock, nurse and shush our babies through those first few months of life, often called the “fourth trimester.” Gradually, babies become less fussy and their cries less mysterious. And at some point, they learn to settle themselves, to self-soothe, but this happens more quickly in some babies than in others. Why?
Melissa Burnham and Thomas Anders and colleagues at the University of California, Davis, set out to answer this question in a longitudinal study of 80 babies’ sleep, measured at 1 month, 3 months, 6 months, 9 months, and 12 months (Burnham et al. 2002). At each time point, the babies were videoed for two consecutive nights so that the researchers could study their sleeping and waking patterns. All of these babies slept in cribs, some in their parents’ room and some in their own room.
As expected, the sleep videos showed that it is normal for babies to wake during the night, usually multiple times. However, some babies woke but were able to go back to sleep without a parent’s help – they were self-soothers. The researchers asked, “What factors seem to set up a baby for being a self-soother by 12 months?” They found that as the self-soothers got older, they spent progressively more time in their crib and less time being held and soothed during the night. In addition, when they were 3 months old, their parents generally waited a little longer to respond to their night wakings. In other words, the self-soothers’ parents didn’t come running at their first peep in the night, and when they did come, they were probably less likely to spend an hour soothing their babies.
A third important factor predicting self-soothing at 12 months was identified, but it wasn’t related to parenting: the 12-month-old self-soothers were more likely to have spent a greater percentage of time in quiet sleep (vs. active sleep) as newborns. Some babies really are born to be better sleepers!
About 60% of the babies in the Burnham study showed an increase in their ability to self-soothe as they grew older. Not surprising, right? As the babies matured and learned other skills of self-regulation, they became better at self-soothing. What surprised me was that the other 40% were actually less able to self-soothe and spent a greater percentage of their nights outside of their cribs as they grew older. These infants were generally placed in their cribs already asleep, slept in their parents’ rooms, and did not have a transition object or “lovie.” As they matured, they were losing the ability to self-soothe.
A follow-up study of the same children found that babies who were unable to self-soothe from 6- to 12-months of age were more likely to have trouble falling asleep at 2 years and to be waking up at least once per night at 4 years. They were also more likely to be in their parents’ bed for at least part of the night at 2 and 4 years of age (Gaylor et al. 2005).
It is important to note that these studies all identify correlations between infant self-soothing and parental responsiveness, but they don’t prove causation. For example, the non-self-soothers identified in these studies could have just been born to struggle more with sleep, and their parents recognized this and found that they had to help them to sleep, soothe them more, and keep them closer at night. There is almost certainly some truth to this, and the fact that the Burnham study identified “% of quiet sleep at birth” as a factor predicting self-soothing at 12 months supports this. However, several randomized controlled studies (reviewed by Mindell et al. 2006) have found that when parents are taught some basic principles about encouraging self-settling in infants (putting them down awake, waiting a few moments before responding to their cries), their infants sleep longer and wake less. That doesn’t mean that these strategies work for every baby, but it does show that parenting matters in helping babies form sleep habits. [This paragraph added 02/24/12 in response to Kathleen's excellent comment below.]
What these studies describe is a continuum of parental responsiveness and infant self-soothing. Some parents hear the baby cry at night and may lie in bed, listening for a few moments, thinking, “That doesn’t sound like a distress or hunger cry, maybe she’ll go back to sleep if I give her a little time.” (We’re really only talking a few minutes here – on average, the parents in the Burnham study waited 3 minutes before responding to their babies’ cries during the night.) This hesitation gives the baby an opportunity to try to self-soothe. Gradually, she may find ways to soothe herself and transition back to sleep without comfort from Mom or Dad. Other parents may be “hyper-responsive” – responding so quickly that their babies never get a chance to try self-soothing. If always attended to with “hyper-responsiveness,” a baby that sometimes self-soothed as a 1-month-old may actually lose this natural ability over time, since she never has the chance to practice it. Regardless of where we fall in this continuum of parental responsiveness, how we respond to our babies at night shapes their sleep habits and their need for nighttime comfort.
I recognize that there is a range of philosophies on the importance of infant self-soothing. Many parents feel that the priority should be on immediately responding to the baby’s cries with the idea that, first and foremost, the baby should always feel secure in her relationship with her caregiver. After all, we know that self-soothing will come with time. By middle childhood, it is rare to find a child that needs a parent’s help to go to sleep or with waking in the night. I don’t think there is anything wrong with choosing this path, but it usually means that mama remains the child’s primary resource for soothing, night and day, for the first several years of life.
Personally, my interpretation of the research on self-soothing and my experiences with my own child lead me to believe that self-soothing is an important skill that babies are quite capable of learning when given the chance. I try and give BabyC opportunities to self-soothe on a daily basis, by not immediately rushing to her side when she falls or picking her up when she whines. I try to help her understand where her discomfort is coming from and give her a chance to mend it herself, while also showing her that I am here if she needs help. I believe that this helps her to develop a strong sense of security in herself as well as in her relationship with me.
Of course, I still soothe BabyC all the time. This exchange of warm fuzzies between us is an important part of our relationship. Lately, BabyC has been transitioning from two naps to one, and she’s so tired at naptime now that she often falls asleep nursing. When we are traveling, I usually stay with her as she falls asleep, because I know how hard it can be to sleep in a strange place. I enjoy these quiet moments with her, and I don’t worry about them “undoing” her sleep habits. I know that she has the ability to self-soothe, and it will be there at bedtime and whenever she needs it to help her sleep.
Where does sleep training fit into all of this? After all, when families find they need to sleep train, they usually have to let their babies cry for longer than 3 minutes before they learn to self-soothe. It could certainly be argued that sleep training rushes the natural learning process towards self-soothing. Learning this new skill is often a struggle for babies, and when they struggle, they cry. Is it worth it?
The answer depends on the family. For my family, it was worth it, even though it took a few nights of tears at bedtime. Self-soothing was the foundation on which BabyC built her good sleep habits. It has given us months of happy bedtimes, peaceful transitions to sleep, and long, restorative nights.
The research on sleep training shows that when babies are given a chance to go to sleep on their own, even when that comes with some crying, they learn to self-soothe remarkably quickly. In my next post, I’ll discuss this research, including specific methods. Since the crying is the hardest part of sleep training for everyone, I am researching more gradual methods of teaching babies to self-soothe as well.
In the meantime, I’d love to hear your thoughts on self-soothing. Does your child self-soothe? Do you do anything to encourage self-soothing, or do you soothe your child immediately when he or she cries?
Check out other posts from my infant sleep series:
- The Cry-It-Out Controversy and My Family’s Sleep Story
- Why Sleep Matters to Babies and Parents
- Sleep Solutions for Every Baby
- Infant Sleep Research: Cosleeping, Self-Soothing, and Sleep Training
- Helping Babies Cope with Stress and Learn to Sleep
- 6 Little Secrets of a Sleeping Baby
Anders, T. F., L. F. Halpern and J. Hua (1992). “Sleeping through the night: a developmental perspective.” Pediatrics 90(4): 554-560.
Burnham, M. M., B. L. Goodlin-Jones, E. E. Gaylor and T. F. Anders (2002). “Nighttime sleep-wake patterns and self-soothing from birth to one year of age: a longitudinal intervention study.” J Child Psychol Psychiatry 43(6): 713-725.
Gaylor, E. E., M. M. Burnham, B. L. Goodlin-Jones and T. F. Anders (2005). “A longitudinal follow-up study of young children’s sleep patterns using a developmental classification system.” Behav Sleep Med 3(1): 44-61.
Goodlin-Jones, B. L., M. M. Burnham, E. E. Gaylor and T. F. Anders (2001). “Night waking, sleep-wake organization, and self-soothing in the first year of life.” J Dev Behav Pediatr 22(4): 226-233.
Mindell, J. A., B. Kuhn, D. S. Lewin, L. J. Meltzer and A. Sadeh (2006). “Behavioral treatment of bedtime problems and night wakings in infants and young children.” Sleep 29(10): 1263-1276.