Sleep training is something some parents embrace while others want nothing to do with it. What is the right way to do it? For those parents struggling to get their little to become a good sleeper, it worth taking a look at this post over at Today's Parent about training babies to sleep well.
What, exactly, is sleep training?
“Sleep training means creating a good sleep environment, establishing a healthy bedtime routine and separating feeding from sleep,” says paediatrician Ian Paul, author of a Penn State study of infant sleep patterns that was published by Pediatrics in June 2016. “It’s building good sleep associations and teaching a baby to self-soothe.”
Epidemiologist Michelle Garrison, a sleep researcher at Seattle Children’s Research Institute, has encountered the same confusion. “It’s frustrating to me that there’s a dichotomy of either cry-it-out or nothing at all. The reality is there are so many middle ground options.” Garrison, a new mom herself, explains that learning to sleep is a set of developmental skills that require practice, just like walking. “Some kids are just slower to reach those milestones—and it’s the same thing with sleep.”
I think here lies some of the problem. People associate the idea of sleep training with only meaning letting your kids cry until they fall asleep. There are different ways to do this but the goal remains to promote helthy sleep habits for your child, which in turn allows you to gain a little normalcy in your own sleep.
Another Pediatrics study, this one out of Flinders University in Adelaide, Australia, received lots of media attention this past summer. The study looked at different sleep training methods with 43 babies, ages six to 16 months, divided into three groups: fading or camping out; gradual extinction (a.k.a. crying with checks); and a control group (whose parents simply kept doing their normal bedtime routine). The researchers found that fading—when the parent stays in the room as their baby falls asleep and the sneaks out—and gradual extinction—letting your baby cry for increasingly longer periods before returning to check on her—are both effective and neither causes long-term harm. (Total extinction wasn’t part of the study.)
After three months, the babies from the fading and the crying-with-checks group dozed off faster than the control group babies, who hadn’t been sleep trained. The crying with-checks infants slept longest overall and were less likely to wake during the night. The researchers also found that levels of cortisol, a stress hormone, were actually lower in the sleep-trained infants than in the non-sleep-trained ones, reassuring many parents who have fretted about attachment issues and whether or not it’s “unnatural” to leave your child to cry. (Thank you, science!)
That's important to note. Good sleep is so healthy for us. It's not surprising that the children who were trained to sleep better had lower levels of cortisol.
Paul says CIO is misunderstood and often demonized. “Cry-it-out implies that even if a child vomits from crying, we should ignore him, and I think that’s extreme. We’re not that militant. It’s not ‘shut the door and that’s it.’ Letting a baby cry could be part of sleep training, but it’s not the only component.”
Again, we can look at the total goal and make small steps. Some parents might strongly prefer a more gradual approach. You have the freedom to do what you feel good about, as long as it moves towards your goal.
In his Penn State study, the babies who hadn’t been sleep trained had poor sleep associations—meaning, their parents relied on common crutches like rocking or feeding to sleep. He found that the sleep-trained babies who had been taught how to self-soothe and could fall asleep in their cribs on their own (using a variety of sleep-training methods) began sleeping through the night at a younger age, woke less and slept, on average, 80 minutes longer. Furthermore, the babies who were routinely rocked to sleep while nursing or drinking from a bottle were more likely to be overweight by age one. That’s a pretty resounding victory for the pro-sleep training camp.
That's all pretty significant findings. I might add that the parents are getting more rest too, which is very critical.
Sleep do’s and don’ts
By four months, it’s not normal for an infant to wake up multiple times a night, says paediatrician Ian Paul. Here are his tips for better baby sleep.
* Don’t rock or feed your baby to sleep. Instead, put her into the crib drowsy, but still awake.
* Don’t feed as your first response to fussiness.
* Respond to night wakings with other “care-taking behaviours:” Go in, let your baby know she’s not abandoned, pat her on the back and use a calm, reassuring voice.
* If your baby is older than two months, try not to pick her up while soothing, because if you do, it’s hard not to move on to feeding, especially if you’re a nursing mom.
* Be consistent.
These are simple steps to follow and allow for flexibility in exactly how you respond.
Consider a super early bedtime
If your baby or toddler is waking up in the night, try this gentle, no-tears tactic first: an earlier bedtime. Sleep consultant Alanna McGinn of Good Night Sleep Site explains that if your baby has entered the overtired zone, bedtime becomes a battle and the stress hormone cortisol contributes to more restless sleep and frequent wake-ups. “Shifting bedtime earlier, even just by 15 to 30 minutes, can allow your child to accept sleep much easier at bedtime and then sleep through the night,” she says.
McGinn suggests a bedtime of 5:30 to 6:30 p.m., but it depends on your child’s age and the quality of his or her daytime sleep. (“The 5:30 p.m. bedtime is for the younger babies who aren’t napping great yet,” she says.) She recommends even two-year-olds go to bed no later than 7 p.m.“This might necessitate having separate meal times for the baby instead of family dinners, but remember that it’s not forever and focus on quality time together in the morning instead.”
She knows it’s easier said than done. “Parents pushing back against my early-bedtime advice is probably the biggest fight I get from clients, and I completely understand,” says McGinn. “As a sleep educator and a working mom of three, I have also had to make adjustments to our schedule, like meal planning and keeping routines consistent, in order to facilitate earlier bedtimes. But once parents see how well their child does with an earlier bedtime, they get it.”
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