Thursday, March 4, 2010

Why We Don't Like "Sleep Training" for Babies: Part I

Several of the questions recently asked by readers included requests for more information on how to get babies to sleep longer. That's no surprise, since sleep deprivation is one of parenting's biggest challenges. We've had a few questions specifically about "sleep training" systems that often include claims that their use will result in getting babies to sleep through the night permanently. We'd like to use this post to explain why we think that the use of "sleep training" (especially without understanding more about infant sleep) may be more likely to lead to frustration rather than a full night's sleep.

Younger Babies Need to Wake

As hard as it is to wake so often with newborns and young babies, the little ones must wake up frequently to feed, stay warm, and be healthy. Newborns dream far more than adults, so they stay in a lighter state of sleep for more of the night than their parents. Dreaming plays a part in the development of their brains and the light state of sleep makes sure that babies wake if they need to. Trying to "train" a newborn to sleep longer will not work and may even be harmful.

For the first 6 to 8 weeks, babies fall asleep dreaming and may continue dreaming for 15 or 30 minutes before they fall into deeper sleep. Parents can see their babies dreaming. Their eyes will move and their faces and bodies will twitch. Waiting until babies fall into a deeper sleep before putting them down can help them stay asleep. As babies get older, they will dream less and have longer stretches of deeper sleep but early on, they are going to wake frequently. That's why new parents need so much help at home.

Waking in Older Babies

By the time babies are 4 months old, they fall asleep into a deeper state of sleep and stay asleep longer. Bedtime routines that end in these older babies being slightly awake when put down for the night can help babies and parents get more rest. By the time babies are about 6 months old, most parents believe their babies should be sleeping through the night but many find that this doesn't happen consistently. Around this time, some babies start teething, catching colds, and traveling to see relatives. As the months go by, babies start to fear separation from their parents and develop motor drives that make them want to practice new skills in the middle of the night. Unfortunately, all of these things can result in waking.

Good Parenting and Sleeping Through the Night

We've noticed that parents whose babies sleep through the night sometimes are seen as the "good parents" who don't spoil their children versus parents who are still getting up as "indulgent" or "giving in" to their unreasonable babies. While parents do have a lot of influence on how much or how little their babies sleep, the truth is that babies wake up for lots of reasons, many of which are not under their parents' control. Some babies are very sensitive to changes in stimulation or the discomforts of teething. Others are driven to practice crawling and standing or are fearful of sounds in the dark. Efforts to get these babies to sleep through the night might work, but only for a short time. Now, I'm not trying to tell you that your baby will never sleep through the night! Babies do sleep! The problem is in the belief that you can force a baby to sleep the way you do.

Sleep "Training" versus Understanding Infant Sleep

Some of the sleep training methods require that babies be put in their cribs and left to cry for ever lengthening periods of time. This is very stressful for parents and babies. While these systems might work for a few nights, many parents find that they have to do the "training" over and over again. Bedtime becomes a battle for weeks on end until one day, the baby starts sleeping longer and parents congratulate themselves that the training finally worked. But the baby is also several weeks older and most older babies will sleep for long stretches if their parents don't interfere. From our perspective, understanding how infants sleep and why they wake can go a long way in helping parents cope with their babies' nighttime behavior.

Next time: We'll review some specific tips to help your baby sleep longer at night.

19 comments:

  1. Thank you for this post. I am one of those "bad parents" whose children did not sleep thru the night at an early age, and though we have a consistent night time routine and they are put into bed drowsy but awake, they do not "self soothe" or put themselves back to sleep when they wake up in the middle of the night. Hope that is part on one of your next segments. Thanks!!!

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  2. How do you put a baby down when slightly awake without them waking back up and crying? After 4 kids, I still haven't figured it out.

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  3. We've been debating implementing a sleep training regime and were happy to read your position in the issue. We look forward to the remainder of the series.

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  4. Just like Renata I can't figure this out either. Babies put to bed slightly awake simply end up fully awake seconds later...

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  5. My first baby would wake up the instant she was put down awake or asleep...for a year! This one occasionally goes back to sleep when putting her down wakes her up and often sleeps roght through the transition--thanks for pointing out that babies are different and it isn't always about parenting style!

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  6. Oh sleep! This is timely in that I've been debating when/how to deal with sleep with my second daughter, now almost 5 months old. Hoping to not repeat the year long challenge with my first daughter. I agree that babies are different and some just aren't ready for the all night sleep early on. But how to temper this with the parent need to sleep is a tough one for me. Looking forward to the next installment.

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  7. I have no idea when my babies started seeping through the night because we co-sleep and I can nurse without waking up. No sleepless nights for me!

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  8. Oh, I hate it when I write a quick comment only to see later how arrogant it may sound. That wasn't my intention at all. I really appreciate the information on this blog and was just looking for a clarification.

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  9. Hello Renata, I didn't think your comment sounded arrogant at all. There are a lot of babies who aren't willing to cooperate with being put down slightly awake. Among the children of the women in our office, about half the babies did okay with that and half did not. This recommendation seems to be clinical-based rather than research-based. We continue to look into it.

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  10. Hello Dr. Jane & others - I posted in Part II as well - the mom in the trenches! This sleepy but awake approach is quite challenging, and confusing.

    I am a psychologist who has specialized in child development issues. Perhaps that is why I feel so frustrated that, even when armed with a lot of knowledge, I have difficulty applying it to the real situation. Last Thursday, she slept 8 hrs in her crib with no attendance from mom and dad. Obviously, she was able to soothe herself back to sleep several times. The last few nights, however, she is waking very frequently. We have never actively "taught" her to self soothe. In fact, we have pretty much rocked her to sleep since day one. So, the evidence suggests that she has the skills to self-soothe, but is unable to use them consistently. Perhaps this explains all of the frustration people have with this approach.

    I am unsure what to make of the warning that I read everywhere: If you don't use the sleepy-but-still-awake approach, you'll be rocking your child to sleep for years. Is this really true, or is it simply a behaviorist conjecture? To Dr. Jane and the women in her office, what did the half whose children rejected this approach do?

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  11. Hi "Mom in the trenches" - We're planning a series of posts to address many of the issues you and others have shared with us. We can tell you that your baby is in a "transition period" at 3 months as she shifts into a different sleep pattern. As an expert, you understand that babies must work toward consistency in nearly every developmental advancement, with backsliding along the way. We agree with you that you do not want to keep your baby in a swing for long periods of time (from your other comment). We'll share more research and our own experiences very soon. In the meantime, try not to be discouraged by your baby's erratic sleep patterns. If you take out your old texts, you'll see that it is standard for babies to do this, off and on throughout the first year. Growth spurts, teething, mild illnesses etc, can throw good progress off course. We encourage you to ask for some help this weekend and get some rest!

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  12. I have a similar experience to Anonymous from March 11th. My baby girl is 11 months old now and we did the cry-out method when she was 7 1/2 months old, it worked well, it took about 3 night, but then we had to go away for 10 days, then she got sick etc. etc. We did it again a couple months later and again it seemed to be working but then she started falling asleep as soon as I put her down (before I could get out the door, at least I think she was sleeping. Then I realized that she must know I'm still in the room when she falls asleep cause she'd still wake up at night. Now I know, she'll fall asleep alone in her crib but she needs to know that I'm in the room. The thing is that occasionally she will sleep through the night, so she must be capable of self-soothing, right? I know she's been teething latley and some nights are better then others, I am just desperate for some answers, has anyone else had similar experiences?

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  13. I don't know that anyone tries a sleep training method for "weeks". I believe in trying for a few days and if it doesn't work wait a week or two and try again.

    When my kids were little I never put them to sleep with a bottle, and after 3 or 4 months of age I rarely rocked them to sleep (I would rock them, just not until they were asleep). I always laid them down after a bath, meal, and some quiet night time cuddling. By that time they were sleepy, but awake. My son did use a pacifier for awhile, and I made sure he had that. They fell asleep themselves. My son would wake up at night, and want to be cuddled back to sleep. When he was 9 or 10 months old I did some modified sleep training. When he would cry I would go in there and let him know I was there but wouldn't pick him up. I'd pat his butt, sooth him, but without picking him up. Once he settled down I'd leave. He would cry and fuss. The first night was the worst and lasted all of 10 minutes. It only took three nights and he was sleeping through the night. Of course if he was sick I didn't expect him to self sooth, but after those three nights we never had a problem. I've suggested this method to may people and it usually works well.

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  14. Thank you for your blog its refreshing to read. As a first time mum of a 3.5month old Im at my wits end trying and reading sleep training. My baby boy sleeps well at night but cat naps during the day if he is placed in his cot and as a result he now sleeps in my arms for all his day time naps too avoid those overtired days.This is not a sustainable habit and causes a lot of frustration as its not something I ever wanted to create but it just happened cos I didnt have any other way

    I have one of those babies that doesnt sleep in a car or pram and puts up a fight no matter what time you put him to bed!(i know his tired signs and we have a consistant routine). He also wakes up when placed in his cot drowsy and the crying that follows definitely does not lead to a settled baby. The only thing that has work is to put him down at night drowsy and pat him to
    sleep.We can now after weeks put him down awake and pat him to sleep but none of this works during the day
    thus Ive been searching for answers everywhere and I
    refuse to do CIO Ive felt like such a failure when sleep
    training does not work largely due to the fact that I have
    an individual and real mothers dont always have the
    energy to deal with sleep training as you want to enjoy
    your baby too and not just faced endless hours of tears
    and fustration.

    Although your blog does not give answers its just great for mothers like myself as it gives a little peace of mind. Thank you!

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    1. Anonymous take heart, my daughter finally learned to sleep through and not battle at 9.5 months, now sleeps 13 hours straight 95% of the time, her twin brother has given up bedtime fights just now at 14 months but still wakes up a lot during the night, you are not alone....It doesn t depend on you but on their own nature and maturity of nervous system

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  15. My 14 month old son is able to take 1 to 2 hour long naps and goes to bed at bedtime awake not even drowsy, falls asleep 100% on his own. And yet he wakes up a lot during the night. He then needs to be walked to calm down and I usually wait until he is drowsy to put him back down. Usually this takes 10 minutes and he never looks truly fully awake. Even if he falls back asleep on his own then, he will wake up again 10 to 15 minutes later. This has been going on for months (admittedly he has been sick constantly for 4 months : 3 ear infections, 4 gastro enteritis, 2 sore throats, bronchitis and the like). I m not sure if he hurts or is unable to go to deep sleep? he usually sleeps 2 hour uninterrupted once or twice in his 12 hour night time sleep. HAs anyone had experience with this kind of pattern? Thanks for you help

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  16. Illness can really impact sleep. Please make sure you discuss your sleep concerns with your doctor.

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  17. There is no one right way to make baby sleep through the night because there is not one baby. However, I find it helps me to keep it all in perspective. The baby is gonna be a baby for a short period of time and then they will grow up and be "mature enough" to sleep through the night without all these "methods". As a baby from a family who co-slept and had ZERO routine or bedtime, we all slept great by the time I was old enough to remember sleeping, and I'm the oldest of three siblings. We never had a bedtime even after we had our own rooms and believe it or not, we all did well.

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    Replies
    1. Here, here. Everything with little ones is just for a season, all the tough stuff and all the wonderful stuff.

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