– by Tiffany Gough
If you haven’t read Part I & Part II of this series, please take a minute to go back and check them out! Here, I have outlined some very effective (and pretty simple) tools for supporting healthy sleep in infants, which when used early on generally support the kind of sleep learning in which a child is free to express emotions but is not made to follow a “plan” or “system” that may not meet their needs. This respectful sleep learning can generally be used from birth on without affecting establishment of milk supply and absolutely without causing any psychological harm. This is the information I searched for, but couldn’t find, when my son was an infant; a consolidated summary of healthy sleep.
Wants vs. Needs: Babies NEED to sleep. Babies WANT to fall asleep sucking on a bottle or breast. If we use that crutch when it’s easy and let it become a habit, they will soon be conditioned to NEED the bottle or breast to fall asleep. If we do not distinguish between needs and wants, responding to each one with the same urgency, the wants will become pseudo-needs. We always meet real needs (hunger, thirst, cleanliness, security, safety, sleep, etc.) promptly, but wants should be delayed, if possible, when they interfere with meeting primary needs.
“Some parents are afraid that setting limits or disagreeing with a child will be perceived as unloving. Yet sometimes setting a limit is in the best interest of the child, and is therefore an act of love. Even though the child may be protesting, you know that what you are doing is for the child’s sake. The most obvious example is the baby’s car seat. Even when she objects to being strapped into it, you continue with the task because you know that it keeps her safe” (Magda Gerber). We know that restorative sleep is a crucial need for our children, so it is our responsibility to ensure that we prioritize our response to that need above our children’s desire to play or socialize. Discerning needs also means setting effective limits.
Begin as you mean to go on: At first, I didn’t think it was a big deal to nurse my baby to sleep. After all, who can resist cuddling a sleeping infant? What I didn’t know at the time is that I wouldn’t be willing to HAVE to keep doing that for years. It isn’t a big deal until it is. For a year, I was the only one who could put my baby to bed or get him back to sleep. It was exhausting and draining to carry that burden and it had to change. If you’re not sure you can keep it up, give your baby and yourself a fair chance by helping them learn to fall asleep on their own so that you won’t have to break the habit later.
Sleep training is not synonymous with “CIO”: If you haven’t already read it, Part I of this series is the explanation for this one.
Basic Sleep Science: When babies fall asleep, they cycle through deep sleep into partial arousal about every 40-50 minutes. Partial arousal means they will move into very light sleep and/or partial wakefulness before cycling back into deep sleep (goodnightsleepsite.com). If their environment has changed since they fell asleep, they will wake fully, looking to recreate the exact environment they have come to depend on to fall asleep.
Sleep Associations: We all have sleep associations; for me it is a cool, dark room, my own familiar pillows, and a heavy blanket. These are things I can control easily in my dazed state of partial arousal. For babies, healthy sleep associations may be a predictable bedtime routine, a dark room or a nightlight, and their fingers or fist to suck on.
Other common sleep associations are: a pacifier, nursing, bouncing, rocking, shushing, singing, stroking mom’s arm, driving in a car, or having their back rubbed. What these other associations have in common is that an adult’s presence is required to control them. If your child depends on you to get to sleep, he or she will depend on you to get BACK to sleep at almost every partial arousal (4-8 times per night)!
Night Feedings: Sleep training does not necessarily mean night weaning. When you have removed feeding as a sleep association, you will find that baby will wake more fully when hungry in order to take a full feeding. Without needing nursing or a bottle to fall asleep, she will likely get more sleep overall without sacrificing milk intake. Complete night weaning (or not) is a personal decision that you should make along with your child’s doctor.
Sleep Cues: It is best to put your baby to bed when he shows signs of drowsiness because an overtired baby will have a much harder time falling asleep. Early signs of drowsiness to look for are: quiet and calm demeanor, drooping eyelids, yawning, slower sucking, decreased activity and lack of interest in surroundings. These other signs indicate you’ve missed the drowsy signs and are heading toward an overtired child: rubbing eyes, fussing, cranky and irritable, or crying.
Put your baby down drowsy, but awake: This means do whatever you normally do for her bedtime routine, including nursing or giving a bottle, but when she starts to get nice and sleepy, break her latch and set her down in her sleeping place. If she gets upset when you set her down, don’t give up! Help her relax again with nursing or snuggles or whatever she needs and try again. It takes practice to develop healthy habits, but you and she can do it! This one may not work every time from the start, but it will likely work most, if not all of the time by at least 6 weeks.
You can’t make your child sleep… but you can help them learn healthy sleeping habits, provide a calm, dark, relaxing environment conducive to sleep, and let them do the rest. Read one mom’s experience with respectful sleep learning here.
And here’s the big one…
Not all crying is bad and crying alone is not inherently damaging: Many people tend to believe this issue is black and white—that any crying at all triggers a stress response and is likely to cause long-term psychological or emotional harm. This is simply not the case. It takes a whole host of factors (typically those associated with severe neglect) to cause a child to be damaged by unattended crying. Assuming your child’s physical needs have been met, if he knows how to communicate with you and you’re honest with him about where you will be if you leave and that you will come back if he needs you, he won’t have a brain damaging stress response to being left alone, even if sometimes he is really mad about having to stop playing for sleep.
The biggest thing I wish I had really understood was how to differentiate between my son’s struggling cries and his suffering cries. I will never let my baby suffer alone if I can help it! Struggle is different though; struggle is how we learn new things and discover our strengths. Sometimes we need help, and sometimes we just need to work through something on our own. I was so afraid of the dangers of crying that I never understood how to listen for the difference.
Let go of your fear and really listen to your child, trust his competence, and wait, giving him time to show you what he can do. If it still feels wrong, go to him! Help him relax and calm back down so he can try again, or if he’s too overtired, you may just have to wait until the next sleep time and try again then. You may find that your baby is just fussing a little as he’s trying to get to sleep, or you may find what your baby really needs is to know he is loved and supported and safe to express his feelings. So give him a chance to tell you what he needs, because it may not be what you expect.
How did your fears about sleep training affect your child’s sleep story? What have you learned about sleep that you wish you knew when your child was an infant?
I highly recommend reading these other related posts:
Sleep Facts from the Goodnight Sleep Site
Janet Lansbury: Helping Babies Sleep with Empathy and Compassion (guest post by Eileen Henry)
Janet Lansbury: Baby’s No-Cry Sleep Is Exhausting (More Wisdom from Eileen Henry)
Newborn Sleep Tips from Dr Marc Weissbluth
Science of Mom: 6 Tips for Sweet Newborn Sleep
Helping Your Baby Get the Sleep She Needs | Magda Gerber
Here’s a basic summary of the RIE Approach as it relates to infant sleep, written by a RIE mama: https://respectfulparent.com//how-we-learned-abou-sleep-the-rie-way/
And one by an AP mama: http://www.alternative-mama.com/creating-a-respectful-sleep-solution/
Great post Tiffany! Very detailed, well researched and balanced.
I wish I had known all this when my dd was a baby. I was so scared that I would be telling her that I was not trustworthy that I walked her to sleep for 6 months. At the end, it would take 90 minutes or more. And then I finally decided to research a little more on options. I wish that I had not been so misled and scared of the term CIO…so scared that I refused to even look into any sleep training because obviously if I left her to cry she would get brain damage and never trust me again.
Thank you!
Thank you, Jessica. Me too!
Not breastfeeding to sleep can absolutely disrupt the establishment of milk supply. If you are following this method of sleep training and having difficulty with breastfeeding, it may be that your baby needs to be breastfed when falling asleep. It is very normal for babies to fall asleep at the breast and their ‘want’ to nurse while falling asleep may in fact be a ‘need.’ All nursing mother/baby pairs are different and not all nursing pairs have the ‘luxury’ of being able to do this method of sleep training, particularly in the early weeks and months.
I don’t believe that is correct, Jenny. Do you have any evidence to support this claim? Based on my experience and understanding of breastfeeding, a full feeding is considered to be complete when the baby’s suckling slows from suck-swallow-suck-swallow to suck-suck-swallow or suck-suck-suck-swallow. At that point, unlatching from the breast and putting the baby down drowsy, but awake will NOT negatively impact milk supply.
It is myths like the one you shared that cause so many misconceptions about healthy sleep!
You’re not taking into account those babies who are unable to transfer milk optimally and need to hang out close to the breast. They’re also less likely to be able to access a full feed so even though their pattern changes in line with expectations that may simply be due to an inability to trigger the next full let down. Hidden tongue ties are one of the biggies that cause this issue and advocating this method may lead to a cessation of breastfeeding earlier than either mother or baby is prepared for.
We got off to a rough start breastfeeding, compounded by a NICU stay, tongue and lip ties, a high palate, and some hormonal issues on my end. His weight gain started out slow. We had to supplement a lot at the beginning because baby wasn’t getting enough milk, and it took until he was 5 or 6 months old before he realized that if he kept sucking, he’d get another let down – so he never did. When he was awake, he’d pull off, frustrated and still hungry. The only times he was actually able to stimulate that additional letdown he needed was when he was falling asleep on the breast, sucking sleepily for long enough that he’d get more milk. We were able to have a successful breastfeeding relationship by the skin of our teeth, and he hasn’t needed formula since he was 6 weeks old, but I absolutely don’t think I could say the same if I hadn’t let him fall asleep at the breast whenever necessary.
Now, at 1, we’re working on his sleep habits, which aren’t ideal (that’s why I’m here). I understand that our early (and continuing) nursing habits played a role in that, but I was willing to sacrifice some sleep to make sure I could feed my baby. I would only take the breastfeeding advice in this article if you’re *very* confident in your milk supply and breastfeeding relationship and baby is gaining well.
Here is research that sleep interventions before 6 months of life are ineffective and can lead to early cessation of breastfeeding. Here are 2 of them.
http://www.ncbi.nlm.nih.gov/pubmed/24042081
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3922698/
I have two boys, both were fed to sleep until they chose to stop on their own. One was a terrible sleeper and one was a wonderful sleeper from day one. It has to do with their personalities as I did NOTHING differently (if anything I was stricter with my poor sleeper as we tried various forms of sleep training, none of which worked). My poor sleeper is an anxious and worried child, my wonderful sleeper is easy going and relaxed. When my poor sleeper moves between sleep cycles he wakes up afraid, my good sleeper wakes up happy and so goes back to sleep again. My poor sleeper is now 5 and still wakes from nightmares although he is now capable of putting himself back to sleep. My good sleeper is 2 and only wakes if he is extremely ill.
All my sleep training friends need to “retrain” their children after every illness, trip, etc. it hardly seems like a permanent solution to me.
I can’t speak to sleep training, but I’ve done everything I wrote about above with my second and he’s a great sleeper! My first became a great sleeper after we worked on it and we’ve never had to re-train. Both kids fall asleep on their own every time, though both occasionally need a little extra connection or support on the way there and I consider that normal.
I also wouldn’t consider parent-dependent sleep associations to be permanent solutions either, since they requires a level of intervention most parents aren’t willing to give for the length of time that is typically needed. It all comes down to trusting and respecting yourself and your child and meeting everyone’s needs, including the need for sufficient quality and quantity of sleep.
GREAT POST!!!We saw that our daughter had a 45 minute fuss, and if we left her alone she really would go back to sleep, and sleep for hours. Now I know why!! Thank you.