“When will my baby sleep through the night?” is a common question pediatricians are asked on a frequent basis. Right after birth, most babies pick up right where they left off from their days in the womb: they sleep during the day and are active at night. As newborns, that pattern persists — they get their days and nights mixed up — and seem to want eat and fuss and cry the most in the evening, just as things get dark, just as exhausted new parents are ready to call it a day. During daylight hours, when our circadian rhythms keep us up, young babies sleep.
Having gotten through the last few weeks (months?) of pregnancy, most new mothers are already sleep deprived when the baby arrives. What’s a few more months, you might say, until the baby’s own circadian rhythm becomes established? Besides, won’t she need to be fed through the night? (Yes, probably for the first few weeks.) Can she go all night without peeing or soiling her diaper? (Probably not for the first few weeks.) Will I hurt her if I just let her cry herself back to sleep?
Apparently not. A new study published this month in Pediatrics says that sleep training is safe and effective, and won’t cause undue stress, such as emotional, behavioral, or parental attachment problems, with young babies. Linda Carroll explains the methods of this small, Australian study, where the stress hormone cortisol was monitored in the infants:
Australian researchers found babies allowed to CIO — “cry it out” or cry themselves to sleep, a method called “graduated extinction” by researchers, did not produce any more signs of stress in the infants than a “gentler” method, according to the study published Tuesday in the journal Pediatrics.
“Both treatments helped the babies fall asleep quicker,” said the study’s lead author, Michael Gradisar, an associate professor and clinical psychologist at Flinders University in Adelaide, Australia. “However graduated extinction was better in reducing the number of times the infants woke during the night, as well as the amount of time they spent awake during the night.”
Both infants and parents slept better with the “cry it out” method:
The advantage of CIO, Gradisar said, is that parents and babies are less likely to fall into what researchers call “a coercive behavior trap,” meaning that babies are more rewarded by their parents’ responses to their cries than they are by falling back to sleep.
“This is especially true if the parent responds quickly after the child cried,” he said. “The result being the child is more likely to cry more often thus disrupting the sleep of both themselves and their parents.”
Pediatrician Perri Klaus acknowledges the parental need for good sleep:
There’s some good evidence that the various methods of “sleep training,” none of which should involve letting a small infant cry for hours in a dark room, work for many children and many families. There’s no evidence that they do lasting damage to the child or the parent-child bond and, in fact, some reassuring evidence that they don’t.
There also doesn’t seem to be evidence that you do harm by deciding to forgo “sleep training” and waiting for the child to outgrow the night waking — as long as that doesn’t damage your marriage or your mental health.
As a pediatrician, I think about the baby, but I also try to take into account how the parents are doing. I sometimes wonder how the people who are most strongly opposed to any form of sleep training would feel about having their children’s teachers, or doctors or bus drivers, coming to work sleep deprived after really disrupted nights. Sleep matters, as we have learned to acknowledge in medical training. Babies matter, and so do parents.
Writer Laura June shares her own personal experience of successfully training her children to be great sleepers:
I sleep-trained my daughter when she was 8 weeks old, partly because I am a selfish monster who has a career, and partly because my pediatrician, Tribeca Pediatrics, is a famous proponent of so-called “early” sleep training. In their thinking, the earlier you do it, the faster the job will be completed. I can tell you that in the case of me and my daughter, that was true: It took a few nights, and she started to sleep through the night fully at 9 weeks old.
She is over 2 now, and rarely wakes up after going to sleep, generally sleeping for 11 or 12 hours. On the one hand, we’re lucky. On the other, I still let her whine or cry herself to sleep on days when she is overtired and simply decides she’s not onboard with the program. We all sleep pretty well, and she is very happy and almost never cranky from sleepiness. All of this seems totally reasonable for my family.
June steps right in the Mommy Wars:
Being politically opposed to sleep training ignores the reality that almost all of us operate in, one in which many women work. It’s hard to function in a workplace when you’re bone-tired. It’s just as hard — to Dr. Klass’s point — to drive your kid around, or make important family decisions, in an exhausted haze. And it’s scary to imagine someone else who’s sleep-deprived offering medical care or shepherding your child across a busy street. Every adult is different, and some of us are fine choosing little sleep, but that decision is ours to make, and ours alone.
Tensions run high in the sleep-training movement because the unspoken subtext is that if you sleep-train your kid, you’re a bad mother. If you need more than two hours of unbroken sleep, you’re a bad mother. If you have a job or a career that requires you to have some semblance of a schedule, and brain cells remaining to devote to it, you’re a bad mother. If you’re looking out for your own mental health, you’re a bad mother.
Parenting is hard, and parents shouldn’t judge one another: None of us has it easy. But we should also start asking who benefits from some of our newer parenting strategies, and who the authors of those strategies are.
So let your baby cry it out. Or don’t. It’s your choice. It’s never too early and it’s never too late. Your baby will sleep through the night when you are ready to let her.
More PediaBlog on infant sleeping issues here.