Sleeping Like a Baby?

By Jennifer Slatton
Austin TX USA
From: NEW BEGINNINGS, Vol. 20 No. 1, January-February 2003, p. 4

When did you go to sleep last night? 8 pm? 10 pm? Midnight? When do you think your great grandparents typically fell asleep? Thanks to electric lighting and a schedule of nighttime activities, many adults are running on a sleep deficit. People manage, until parenthood hits. Caring for a baby or toddler who doesn't sleep well at night easily can push you over the edge. It might help a little to remember that you are in the trenches with millions of parents. "How does your baby sleep?" is a common question that new parents are asked. And, the reality is that "sleeping like a baby" means frequent night waking in the newborn period—and sometimes beyond.

So many of us have heard other mothers claim that their newborns sleeps 10-to-12-hour stretches at night. If it is true, it's a rare newborn who does that. It is much more likely for babies to wake many times during the night to breastfeed; babies have tiny tummies and human milk is easily and quickly digested.

It is also important to understand that the medical definition of "sleeping through the night" is not what many new parents think. It is defined simply by the ability to sleep for a five-hour stretch, even if that stretch begins at 7 pm and ends at midnight. And while every baby is different, there does seem to be something special about the three-month mark, at which time your baby will likely show signs of the ability to sleep for longer stretches.

If you ask friends and relatives—or look on the bookshelf of a local bookstore—for answers about infant sleep, you'll frequently be told that it's acceptable to let babies cry, sometimes for long periods of time, in order to train them to sleep through the night.

But, when babies are left to cry, their bodies produce the stress hormone cortisol, which in turn makes them less able to relax and fall asleep.

Within the LLLI Catalogue and Group Bibliography, there are a number of books on the subject of parenting and sleep that offer insight into the biology of infant and childhood sleep with tips on how parents can work with that biology to get more sleep for themselves without resorting to "crying it out" strategies.

Wouldn't it be nice if your baby could somehow, in her own great wisdom, lead you to the books that would help you and her the most? And if that were possible, what would she pick out?

Fortunately, there are a number of books out right now on helping baby and children sleep that take the needs of the child into account. They each have a unique style so different parents will be able to find one to meet their needs. Here's an overview of some of them.

Sweet Dreams

Sweet Dreams, by Dr. Paul Fleiss, gives comforting suggestions for establishing relaxing and sleep-inducing daytime and nighttime rituals for your child, emphasizing the common-sense (but often forgotten) benefits of outdoor exercise, good nutrition, and limited exposure to electronic media.

In Sweet Dreams, Dr. Fleiss provides the simplest, and maybe even most helpful answer to the question of how much sleep your baby should be getting, recommending that he, (and, in fact, the whole family) get as much as possible!

Dr. Fleiss explains the different sleep patterns throughout life and approaches sleep as a lifestyle issue, not separate from nutrition, exercise, and other behavior choices. He also emphasizes that "many of the so-called 'sleep problems' that parents report in their children are actually the result of unreasonable expectations, usually based on unrealistic myths about how children are supposed to be."

Co-sleeping has its own chapter in Sweet Dreams. In addition to explaining the benefits of sleeping with baby, he includes a history lesson on some of the reasons it fell out of favor in Western society. There's also an important section on safe co-sleeping.

He emphasizes the research of Dr. James McKenna, an anthropologist at the University of Notre Dame in South Bend, Indiana, USA, who has shown that babies who sleep with adults have lower risk of sudden infant death syndrome, or SIDS. Fleiss adds, "Even just sharing a bedroom with your child, without necessarily sleeping in the same bed, is protective against SIDS."

Fleiss concludes his book with an easy-to-read summary of his tips, although they're more a philosophical mind set to adopt than a quick-fix solution for sleep troubles.

Good Nights: The Happy Parent's Guide to the Family Bed (And a Peaceful Night's Sleep)

Good Nights, by Jay Gordon and Maria Goodavage, has an easy-to-read, humorous style that still includes lots of important information about infant sleep. Like Fleiss, the authors describe Dr. McKenna's work at his Mother-Baby Behavioral Sleep Institute.

Gordon, who is an unwavering advocate for the family bed, says that he has never lost an infant in his medical practice (he has a pediatric practice in Santa Monica, California, USA). Instead of horror stories of babies who died in their parents' bed, he relates stories of babies who stopped breathing and were saved because adults noticed a problem while they were with their babies.

Gordon writes, "I never recommend separate rooms for newborns and parents. Never." But, like other authors and La Leche League, Gordon recognizes that not everyone should sleep with their baby. He has a full chapter on safe co-sleeping that outlines some real reasons why sleeping with baby isn't always a good thing—and he acknowledges that it's simply just not always right for an individual family.

Full of anecdotes from co-sleeping families (and grown children who once shared the family bed), Gordon gives hope that sleep patterns do eventually settle down and children end up sleeping without their parents. Gordon, who was the first male and first physician to become an International Board Certified Lactation Consultant (IBCLC), speaks frankly.

Goodavage and Gordon provide a great section on dealing with criticism about your parenting style, particularly if you co-sleep. They advocate dropping names of all the famous people (frequently the parents of his patients) who co-sleep. The authors also addresses the issue of sexual relations and the family bed in a way that is helpful and light-hearted and includes a list of the "Top Ten Places Family Bed Parents Make Love." A list of answers for people who ask about that subject is also included.

Good Nights is a fun book to read with a strong point of view and the science to back it up.

Nighttime Parenting

(Available from the LLLI Online Store.)

This classic book by William Sears has recently been revised to reflect current information that recommends babies be put on their backs to sleep. Nighttime Parenting was one of the first alternatives to books advocating that babies "cry it out." Dr. Sears explains that human babies are designed to wake often at night.

Sears explains that young children spend more time than adults in REM sleep (the lighter phase of sleep wherein dreaming occurs), and are thus more likely to awaken during the night. Not only that, but babies, unlike adults, tend to start their sleep in the REM cycle, helping to explain why yours might pop up unexpectedly the minute you put him down to nap. Dr. Sears gives tips for recognizing when your baby has slipped past REM sleep into the deeper non-REM cycle, thus allowing you to put him down much more easily, without fear of waking him. Sears also addresses how to deal with the particular nighttime needs of the "high need" or fussy baby.

For Dr. Sears, handling your infants' nighttime needs is part of a larger philosophy of parenting. He relates the nighttime experiences of other parents, often with a wide range of practices, in order to give concrete ideas on getting some rest while allowing your child to still feel right with the world.

The No-Cry Sleep Solution

The The No-Cry Sleep Solution is of particular use for parents who have an older baby or child who is having trouble sleeping. The author, Elizabeth Pantley, approaches the idea of improving sleep one small step at a time, perfect for parents who want to be gentle and gradual in their attempts to help their baby sleep better and longer.

Pantley's book takes an active approach to sleep. She advocates watching your child's pattern and altering it gradually to allow longer periods of uninterrupted sleep for the parent.

An important part of Pantley's strategy is her insistence that both parent's and child's needs are respected. She explains that she had discovered that there are two schools of thought with regard to babies and sleep. "In a nutshell," she writes, "the two methods can be summed up as 'cry it out' or 'live with it.' I wanted neither. I knew there had to be a kinder way, a road somewhere between nighttime neglect and daytime exhaustion that would be nurturing for my baby and for me."

With that in mind, she has some tips for helping babies to sleep. Pantley's book is full of charts and worksheets for you to fill out. Using Pantley's book can make you feel as though you're doing something to get more sleep. At the same time, you might be uncomfortable with all that regimentation. She relates how some parents actually feel worse when starting her program because before keeping a chart they weren't aware of how often they were waking up.

If you are concerned that your baby might not be getting enough sleep, Elizabeth Pantley's The No-Cry Sleep Solution contains a detailed chart showing how much sleep is needed from birth through age five. She also gives helpful information on how daytime naps relate to nighttime sleep (preventing your baby from napping won't help her sleep longer at night, for example).

And if your baby is no longer a newborn and still waking frequently at night? Just as there are a few babies who easily sleep through the night at an early age, there are also some who get to late infancy, toddlerhood or beyond, continuing to wake at shorter intervals than five hours. Elizabeth Pantley is reassuring to the parents of these children, providing real-life examples from other parents who have been there, and offering hope that using her techniques will help lengthen your child's nighttime hours of sleep.

If you would like a detailed plan of action to follow in order to help your baby or child sleep better and longer, The No-Cry Sleep Solution contains techniques that are gentle, respectful of both you and your child's needs, and easy to follow. Pantley is also conscious of the fact that parents have different styles and not all her tips will feel comfortable to all parents.

In Conclusion

Even with the information in the newest sleep research books, tired parents need as much hands-on support as possible when babies wake often at night. It takes patience and trial-and-error to find exactly what will work for your child, and you will benefit from having someone to listen to your frustrations, someone such as your LLL Leader. Staying as well-rested and level-headed as possible helps prevent the parental exhaustion and frustration that can lead to vulnerability to bad advice. Determining exactly what you want for your child's sleep—whether it is two night wakings a night instead of 10 or an elusive five-hour stretch of sleep—will also help you decide what strategies to employ.

Co-sleeping Safety

In 1999, a report from the US Consumer Product Safety Commission said that children under two years of age should never be allowed to sleep in bed with adults. And while other experts have questioned both the methodology and conclusion that led to the recommendation, certain guidelines should be followed when parents make the choice to sleep with their children.

Make sure that your mattress is firm and fits tightly in the frame.
Babies should not have their heads covered by blankets.
No one who sleeps with the child should drink alcohol.
Always place your baby on his back to sleep.
Neither of the parents should smoke, take drugs, be exceptionally obese, or be on medication.
Consider having a young baby next to the mother only, because mothers seem to be especially aware of their babies in bed.
Keep an adult between an older child and a baby.
Use a crib or commercially available "sidecar" next to the bed.
Make sure there is no space between the bed and the wall where a baby could become trapped.
Keep the bed low to the ground, maybe even on the floor, to minimize any falls.

Sources: Good Nights by Jay Gordon, MD and Maria Goodavage and Sweet Dreams by Paul Fleiss, MD

What the Doctors Say About "Crying it Out"

Letting the baby cry undermines a mother's confidence and intuition...not responding to a baby's cries goes against most mothers' intuitive responses. If a mother consistently goes against what she feels, she begins to desensitize herself to the signal value of her baby's cries. The less intuitively a mother responds, the less confidence she has in the appropriateness of her responses. The less confidence she has, the less likely that her responses are appropriate, and the less she enjoys mothering. A mother who restrains herself from responding to her baby gradually and unknowingly becomes insensitive. This is the vicious cycle of detachment which I urge new mothers not to let themselves get into. Once you allow outside advice to overtake your own intuitive mothering you and your child are at risk of drifting apart.

William Sears, Nighttime Parenting

A crying baby's needs are so simple, and they are so simply supplied. A baby cries to communicate to you his need for the touch, warmth, comfort, security, and love that only you can provide. Why would anyone deny such a simple, human request? Is a cuddle and a tender word such a hard thing that we cannot give it to a child in need? I personally believe that no normal, emotionally stable parents would put their baby through this sort of "conditioning" unless they were grievously misled. Regarding a child as if he were nothing more than an animal to be trained is a grave mistake. We really have little idea what kind of long-term damage we are doing to our babies when we treat them this way. When a baby fails to call out for his parents when he is in distress at night, it cannot be because he has "learned" a useful behavior. It is more likely that he has just given up on his parents.

Paul Fleiss, Sweet Dreams

Putting your baby through cry-it-out sleep training isn't the worst thing you can do to him, but it's far from the best. We know of no studies on short-term effects or even possible subtle, long-term effects of crying it out in humans. But studies of parent-infant separation involving "crying" in nonhuman primates show that the hormonal stress response of babies in these situations can be "equivalent to or greater than that induced by physical trauma."
In addition, similar studies have found that stressful separation situations can have an adverse effect on immune function. While most children are very resilient and probably won't experience long-term problems from crying it out, we can't be certain of its effects on more sensitive children.

Jay Gordon, Good Nights

Last updated 11/17/06 by jlm.

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