The Last Word on Sleep Training?

In a study published in the journal Pediatrics this week [1], an Australian research group found no evidence of harm in kids that were sleep-trained, 5 years after the fact. This is the longest follow-up study of sleep training to ever be published, and it’s a randomized controlled trial no less.

Not surprisingly, the media has jumped all over this study with headlines like this one from the Huffington Post: “Baby Sleep Training Methods Safe For Infants.” (The best part about that article is that, below it, there is a link to another HuffPo article from last December entitled, “Cry It Out: The Method That Kills Baby Brain Cells.” That’s a great demonstration of how much the media loves this story and why parents are probably sick of hearing judgment on it either way.)

Parents – particularly those of us who sleep-trained our kids and enjoyed the benefits – are breathing a sigh of relief. I’m happy if the coverage of this study allows parents to shed an unwarranted layer of stress and guilt. If you’ve been following my blog for a while, then you know how I feel about sleep training. After reviewing the literature on this topic, I have concluded that there is no evidence that sleep training harms kids. In contrast, there is a significant body of literature that sleep deprivation poses very real risks to families and that sleep training is often helpful in these situations. It may not work for all babies and parents, but when it does, it can make all the difference.

So where does this new study fit in with the previous research in the field?

Continue reading

6 Little Secrets of a Sleeping Baby

So, here we are, six posts and two months after my declaration that I would get to the bottom of this little issue of infant sleep. It shouldn’t have surprised me that it has taken me this long to begin to understand this topic. After all, it is a field with decades of research and thousands of published papers. If I was only interested in finding support for one side of the issue, I could have dug up a few papers in an hour or two and whipped something out, but I needed a more complete understanding – for myself, if for nobody else. My experience was quite beautifully summed up by a reader’s comment on my last post:

“…wide reviews of research (rather than simply focusing on the work of one or even a few researchers or studies) tend to show that dogmatism on many parenting issues is rarely justified.” ~Becky

I couldn’t have said it better myself. My conclusion: do what works for your family.

I want to wrap up this project by sharing some of the major lessons on infant sleep that I learned along the way, both from the science and in reflecting on my own experiences.

These first 3 are things we can do from the very start:

1.    Know that crying is normal. It is how we respond that matters.

When I was pregnant with BabyC, I knew that for the first few months of her life, she would wake often during the night, but I envisioned sweet nights with her – a dim light, a comfortable rocking chair, nursing her until she faded back to sleep. And in my imagination, these scenes of maternal bliss were always quiet. So I was not prepared for the nights during those early weeks when BabyC would wake at 2 AM and I would do everything I knew to do – nurse her, burp her, change her, hold her, rock her, try nursing again – and she would only cry. There were nights when she would wail, eyes squeezed shut, for hours, while I tried everything to soothe her. Looking back, I realize that in my mind, I believed that my success as a mother was tied to my ability to stop my baby’s cries, as quickly as possible. If she cried, I felt that I was failing. Continue reading

Helping Babies Cope With Stress and Learn to Sleep

We’ve all seen the warnings that sleep training causes so much stress to a baby that cortisol floods the brain, killing neurons and altering development.

Even without these alarming stories, most parents considering sleep training naturally worry about how stressful it is to a baby. None of us like to hear our babies cry. It makes us feel stressed, and the baby probably feels the same way. But how stressful is it? And is it damaging to a baby’s brain?

Despite decades of research on sleep training, most studies have focused on outcomes related to sleep and daytime behavior, but few have examined babies’ stress responses to this change. Those that warn that letting babies cry is damaging to their brains cite studies of babies that were subjected to chronic neglect or abuse or raised in orphanages and lacking strong attachment figures. These are examples of chronic, toxic stress. They are deeply saddening to me, but I’m not convinced that they tell me, or any other loving parent, much about the effects of sleep training my little girl.

This has left me digging through reams of research, trying to put sleep training in perspective among other sources of infant stress. A good place to start is the American Academy of Pediatrics’ (AAP) recently released report entitled The Lifelong Effects of Early Childhood Adversity and Toxic Stress [1] and an accompanying policy statement. The AAP report gives us a framework for looking at stress that I think is very useful. It defines 3 types of stress responses in children: Continue reading

Infant Sleep Research: Bedsharing, Self-Soothing, and Sleep Training

This is the fifth post in my sleep series. In my last post, I discussed how my view of infant sleep has evolved to be more inclusive of a wide range of solutions that can work in different families. In this post, I look at what the research tells us about infant sleep across the spectrum of nighttime parenting philosophies.

[Please note: It is beyond the scope of this article to discuss the bedsharing/crib/SIDS/suffocation debate, but suffice it to say that parents should pay careful attention to making baby’s sleep environment safe, whether the baby bedshares or sleeps in a crib.]

Bedsharing Infant Sleep

Let’s say that you choose to bedshare. You feel that the best place for your baby is right by your side, in your own bed. (I use the term “bedsharing,” because the more commonly used “cosleeping” can also mean sharing a room but sleeping on separate surfaces.) Many parents choose to bedshare because it just feels right, even if they had carefully prepared a crib before the baby’s arrival. BabyC slept in my bed for a couple of weeks early in her life, though it was not my plan and ultimately ended up not being the choice that Husband and I made. Still, in those weeks, I felt a real shift in my bond with BabyC. It certainly made breastfeeding during the night easier, and it was sweet to wake up and watch her sleeping next to me. I understand the choice to bedshare, and I think that for many families, it can have numerous benefits. These benefits are not well-defined by research, however. For example, I have yet to find study that investigates if bedsharing actually increases infant attachment. Continue reading

Sleep Solutions for Every Baby

This is my fourth post in my evolving series on infant sleep.

I have at least 100 journal articles on sleep saved on my computer, and I’ve been dutifully slogging through them, trying to systematically summarize the effects of different sleep training methods or otherwise. But… yawn. I myself didn’t get enough sleep last night. And besides, I keep coming back to all of your many comments – your stories about how sleep works in your house and why you like it that way. They remind me that the best parenting philosophy is the one that makes sense to you, the one that gives you a framework within which to guide your interactions with your child, and the one that makes you love your job as a parent. I’ve come to realize that we can’t talk about sleep without first acknowledging our diverse philosophies on the subject. I’d like to discuss that a bit more in this post, and my next post will be chock-full of the science on cosleeping and sleep training.

Photo Credit: Lori Cole

Sleep is so personal, and yet, it can so often feel like someone is telling us that we’re doing it wrong. This topic triggers such strong emotions, from guilt and shame to defensiveness and judgment. If you haven’t experienced this, take a look at the conversation on blog posts like this one and this one. It is actually kind of embarrassing that we are so darn hard on each other when we talk about infant sleep. Why is that? Continue reading

The Importance of Self-Soothing to Infant Sleep (and how to support it!)

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. Continue reading

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? Continue reading

The Cry-It-Out Controversy and My Family’s Sleep Story

I’m coming out. My name is Alice, and I sleep-trained my daughter. I let her cry while she learned to go to sleep on her own. Yes, I let her cry-it-out.

I have since learned that letting babies cry is very controversial. Spend a little time on parenting forums or blogs, and you will find that some feel cry-it-out (CIO) is akin to child abuse. Recently, there have been several online articles that claim there is scientific evidence that CIO can cause lasting damage to a child’s brain. The Psychology Today article by Darcia Narvaez (Dangers of “Crying It Out”) was widely shared and retold to huge audiences on Babble, Huffington Post, and Yahoo Shine.

I read these articles with concern. Many, many families use some form of CIO and find that it helps everyone in the family sleep better. As the theories about CIO and brain damage bounced around parenting communities, I wondered how many families were second-guessing the choices they had made. Were their kids really at risk for brain damage and long-term relationship problems?

Closer to my heart, had my decisions put BabyC at risk? My love for my daughter is beyond words. The focus of my every day is on doing the best thing for her, and to me that means being sensitive, respectful, responsive, and patient. Some days, I am overwhelmed by the weight of that responsibility, but that is motherhood, isn’t it? When someone tells me that I may have harmed my child, I take it very seriously.

Sleep is intensely personal, and writing about this topic is hard for me, but I feel that CIO is something that I have to write about. When a parenting practice becomes controversial and “hot-button,” as CIO has, we often shy away from talking about it. None of us like to feel judged, and I personally have no interest in judging others. While the loudest voices continue to shout rhetoric, many parents internalize the self-doubt and then feel paralyzed with fear that they are making the wrong choices for their kids. I want to write about this topic with open-hearted honesty and respect for all the different ways families find to get sleep.

This is the first in a series of at least three posts on sleep and stress in babies. Continue reading