Many parents have concerns related to their baby's night-time sleep. Sleep deprivation is a serious problem for many parents of infants, and turning to sleep trainers who promise quick solutions, may seem like the best, and sometimes only, option.
In this article, I clarify what sleep training is, I give a brief explanation of the biology behind infant sleep and I offer some alternative ways to improve sleep in early parenthood.
What is sleep training?
Sleep training is based on Behaviourist Theory, which originated in the early 1900's. The methods aim to eliminate undesired behaviours in the baby by changing how the parent responds to the baby's signals.
Sleep trainers often perpetuate common misunderstandings about infant and child sleep, like the idea that babies need to be taught how to distinguish night from day, and trained to establish healthy sleeping habits.
Some sleep trainers may encourage parents to either leave their baby alone in a room and not check on him until the morning, or check on him in increasingly spaced out intervals. Other sleep trainers might promote the method of being in the same room as the baby, but not giving the baby the response he is desiring (in most cases, being comforted).
Ignoring the baby's crying responses is commonly called the Cry It Out-method or CIO. Based on current evidence we know that leaving a distressed child alone without parental comfort, or not responding to the child's signals in an responsive way, harms attachment and is unsupportive of neurodevelopment.
While there are some influential studies to support sleep training practices, like the Price study, these articles are flawed in the methodology or interpretation of results, often because there is a conflict of interest (1).
What is ‘normal’ sleep for a baby?
Babies’ natural sleep cycles are much shorter than adults’ and they spend a longer time in REM-sleep (light sleep where the brain is more active). This means that babies, by design, wake easily. This helps to protect them from SIDS (sudden infant death syndrome) and supports their brain development.Â
When babies are born, they do not have what we call a circadian rhythm, or a day-night rhythm, and their sleep-wake rhythm is instead governed by hunger, thirst, or psychological needs such as the need for safety and comfort. It is normal and expected for babies to wake and feed during the night throughout the entire first year and beyond.
At around three months, babies may show signs of a day-night rhythm, supported by their own melatonin production and other bodily functions that have a 24-hour cycle, such as changes in blood pressure, cortisol production and pulse.Â
Parents often notice that their baby's sleep goes through many changes over the first year. Through phases of rapid brain development, babies tend to need more emotional support during sleep transitions. For example, babies undergo many changes at around 4 months of age, which may affect sleep. Any changes in sleep patterns that happen around this time are often inappropriately labelled as a "sleep regression". Sleep regression is an unscientific and misleading term, as babies' sleep never regresses, it only develops.
Why sleep training is problematic
The goal of sleep training is to make the baby fall asleep without support, and sleep through the night much sooner than what is normal from a biological perspective. Unrealistic expectations of babies' sleep are re-produced by sleep trainers who rely on out-dated approaches, that we now know do not support attachment and development.
Even though the baby is the one getting sleep trained, it is as much a training for the parents who have to learn to ignore their hardwired neurobiological instincts to respond to their baby’s calls and cries. This is a high price to pay, especially as there is little evidence that suggests that sleep training leads to any lasting positive benefits for families.
In fact, mothers and babies are supposed to be physiologically synchronized. The mother-baby unit shares emotions, meaning that when the baby's cortisol levels rise, so does the mother's. Sleep training disturbs this mechanism by training the baby to suppress his behavioral responses, which are meant to let the mother know when her baby is in distress (2). Parents' sensitivity to their baby's needs, including his emotional needs, are foundational to a secure attachment.
Are there any gentle sleep training options for families who are struggling with sleep deprivation?
Sleep training is not the only option for sleep deprived parents. Alternative methods may offer more individualized approaches which lead to more sustainable results.
A holistic sleep coach takes the whole picture into account, including sleeping and waking patterns, nutrition and exercise, environmental factors, developmental changes, family situation and circumstances (1). Based on their assessment, they help parents reach their goals using developmentally appropriate strategies that protect infant mental health.
Instead of modifying the baby's behaviour, approaches based on Attachment Theory may also work to empower parents with coping-strategies, like adjusting expectations to what is biologically normal, and removing parents' guilt around their baby's sleeping patterns (3).
Bed-sharing as a way to parent at night
Parenting is a 24 hour responsibility, and many parents of infants struggle to get enough sleep in the night. When consulting health care professionals about sleep solutions, bed-sharing is rarely presented as a safe option. However, there is evidence that supports the still controversial, yet common, practice of bed-sharing with your baby.
Bed-sharing allows breastfeeding mothers to feed their babies on demand through the night, which protects long-term breastfeeding. Breastfeeding, in turn, has positive effects on the baby's long term health and development.
Learn more about how to safely bed-share with your baby here.
Resources and referrals:
(1) Hookway, Lyndsey (2019) Holistic Sleep Coaching: Gentle Alternatives to Sleep Training for Health and Childcare Professionals. USA: Praeclarus Press.
(2) Middlemiss, W. Et.al. (2012) Asynchrony of mother–infant hypothalamic–pituitary–adrenal axis activity following extinction of infant crying responses induced during the transition to sleep. Early Human Development, 88 (4). From: Asynchrony of mother–infant hypothalamic–pituitary–adrenal axis activity following extinction of infant crying responses induced during the transition to sleep - ScienceDirect
(3) Brown, Mark (2022/03/22) Crib sheet: experts issue advice for new parents to cope with sleepless nights. The Guardian. From: Crib sheet: experts issue advice for new parents to cope with sleepless nights | Children | The Guardian