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There is no right way to help infants sleep through the night

Wendy Sue Swanson, MD
Physician
October 30, 2012
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We had one of each in our house: one baby that we let cry for periods of time to self-soothe and one where I simply couldn’t bear to hear the crying in quite the same way. You’d think it would have been just the same for both of our boys, but it wasn’t. Clearly I wasn’t the same parent each time around.

There are many things that go into the equation of how we get our babies to sleep thought the night. And those of us who struggled after our babies after 6 months of age are in good company. Research shows that about 45% of mothers say they struggle with their 6-12 month-old’s sleep.

Solving the sleep solution requires a diverse mix of instinct, patience with personal and baby temperament, timing, mood, advice we get, and good luck.

The reality is that there isn’t one perfect way to help support an infant who’s learning to sleep through the night. But there are few pearls I believe in:

  • Start letting your baby learn to fall asleep on their own (not at the breast or with a bottle or always being rocked) at 1 months of age when they are drowsy but content. At least a few times a day, let them fall off to sleep on their back, in a crib without you. This will help them learn the skills of self-soothing. This can serve your entire family…
  • Start a bedtime routine during early infancy. Do your best to keep the same bed time with the same routine each and every night.
  • Let your baby show you their resilience. Allow them to fuss and crank and re-position themselves at times to learn how to calm themselves and learn how to self-soothe. I sincerely believe infants surprise us with what they can do. This doesn’t mean you have to listen to your baby wail!

Beyond those pearls, I’ve yet to commit to recommending one strict sleep method for patients. I often try to offer up the options. I believe some babies and parents do very well letting their babies “cry-it-out” while others really suffer. The good news is that we’re all doing it right—in the long run, we all can care for our children with equal love and compassion. New data this month sets this straight.

Teaching parents to regulate their children’s sleep behavior is a form of limit setting that, combined with parental warmth, constitutes the optimal, authoritative, parenting style for child outcomes.

A study published recently followed up on infants and moms who had reported challenges with sleep at 7 months of age. The researchers initially (5 years prior) had randomized babies and their moms into groups — one group got no advice about sleep while the another group learned about two sleep training methods from nurses at 3 visits:

  1. Controlled comforting: parents let their baby “cry it out” for longer and longer stretches of time. They still return to the babies for comforting but give their babies a chance to learn to self-soothe for periods of time.
  2. Camping out: a technique where parents sit or lie with their babies and children until they fall asleep and gradually extract themselves from their children’s sleep space.

In the original study, parents who learned the two techniques found their babies slept better at 10 months of age compared with the parents who didn’t. The mothers who used sleep training had significantly less depression, as well. In the short term, these sleep interventions served both the baby and the mothers.

The researchers then followed up on the infants after they had reached their 6-year birthday. They evaluated the children’s sleep, their levels of stress hormones (cortisol) twice during the day, their mom’s anxiety and depression, and the bonding between children and their moms. What they found should make us all feel pretty good. Didn’t matter if you let your baby cry it out, if you camped out, or if you did none of the above, neither setting seemed to affect mom’s mood, the degree of bonding, or the levels of stress children experienced when they were entering the school years.

The best kind of news of all: maybe we’re all right.

Wendy Sue Swanson is a pediatrician who blogs at Seattle Mama Doc.

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