One of my most important jobs is giving families permission to sleep train their children because parents often feel very guilty and selfish about this. The fact is, sleep training your child is not selfish, and sleep training doesn’t hurt your child.
Why sleep training isn’t selfish
Several years ago, I got a taste of what the parents of many of patients have experienced on a nightly basis for months or years– a perfect storm of bad sleep
Let me preface this by saying that I’m pretty lucky in the sleep department in my home. I have two little boys, C and T, who are 8 yo and 5 yo respectively who are great sleepers. Sure, we’ve had to fine tune things occasionally (for example, when T got up at 4:30 AM for a month). I don’t think I can take much credit, as I think that this is just the way that they are. We had a much easier time than many of our friends getting a good night of sleep. My experiences has led me to believe that every kid is good in some area and struggles in others. (My older son is a great sleeper, but we struggle with his diet, for example). Parents usually bring their child into Sleep Clinic for sleep problems around certain milestones. The imminent birth of another child, or after about two years, which is as much as most people can stand. There is inevitably a lot of guilt, and at least one prior failed attempt at sleep training.
So back to our night. It was going smoothly until around 3 AM when C came into our room announcing that he had wet the bed. (Fortunately a very unusual event). We cleaned him up, changed the sheets, and put him back to bed. About 30 minutes later, the little one started to cry. I went into his room, replaced his binky, and then back to sleep for all of us. Then I hear C shout, “Dad!” I go into his room and he is perched on his pillow. He had gotten out of bed, rearranged his blankets, and turned on his nightlight. He was concerned about monsters in the room. I laid down with him for a few minutes, went back to bed, then T was up again for about 30 minutes. By now it was around 5:30 AM. My wife got him up, and he had soaked through his diaper. Apparently I had given him a diaper wedgie the night before. My credentials as the resident sleep expert in our home, already tenuous, were further in jeopardy.
The next day, I was a slug at work. The application of caffeine helped me limp through my day. My wife fared about the same. I mention this because we felt lousy after one bad night. I see parents in clinic who have had nights like this for years. The consequences of chronic sleep deprivation is significant for children — and parents.
Bad sleep is bad for parents
During my experience with ONE bad night of sleep, I didn’t feel like I was the best parent I could be. The fact is, ensuring that YOU get a good night sleep is critical for your child. Why is this? The potential consequences to parents of chronic sleep deprivation include:
- Depression and low mood: Alice Callahan wrote a great series of posts at Science of Mom about sleep in infants (and her book is amazing (affiliate link)). Poor sleep in infancy is associated with maternal depression. Alice points out, “Postpartum depression is hard on moms, but it is also hard on babies. A mother suffering from depression may not be able to be emotionally available, sensitive, and responsive to her baby, day in and day out.” Read more about infant sleep and maternal depression here.
- Difficulty being attuned to your children. As Kathleen Berchelmann writes, “Sleep deprivation steals your patience towards your children. Without patience, apathy and anger easily replace love and gentleness. “
- Poor driving: A researcher named Daniel P. Chapman has studied the effects of children on parental sleep. Children seem to be a risk factor for insufficient sleep in adults (not that you need research to prove that). I worry about the effects of chronic sleep deprivation on the parents I see in clinic in terms of car accidents and their own health. Parents need to be well rested to be vigilant behind the wheel so they can keep their children safe. Drowsy driving is like driving drunk. You owe it to your kids to come home safe, and to be safe when you drive them around town.
Bad sleep is bad for kids as well.
Twenty to 30% of infants and children will have difficulty with falling asleep and/or night-wakings. Without treatment, these issues may persist in 60% of those children. However, there is a cost to continued sleep disruption in terms of mood, learning, attention, behavior, and even weight.
Sleep training helps parents and kids sleep better
Behavioral sleep training is very effective in treating sleep problems in children (The American Academy of Sleep Medicine published a Practice parameter on sleep training which reviews much of this evidence.) There are many methods of effective and safe sleep training. Here’s a link to my post providing a comprehensive overview of sleep training techniques.
Someone told me that sleep training will hurt my child.
It’s unclear when people started making accusations about sleep training being dangerous, but I suspect that it goes back to the publication of The Baby Book by Dr. William Sears and Martha Sears in 1993. This kickstarted a movement called “attachment parenting”. They espoused “the family bed”, wearing your child everywhere, even at work, and nursing on demand and indefinitely. Cosleeping was a cornerstone of this1.
The Sears’ books and world view has been very influential. At this point a whole generation of families has subscribed to the attachment parenting philosophy. One of the most significant consequences of this has been the politicization of sleep in children. In his book, Dr. Sears makes the claim that allowing your child to cry can cause brain damage. (You can also read about his views on this on his website). However, this has been extrapolated from research looking at children who were the victims of severe abuse or neglect, not children who cried on occasion for 30 minutes of less. Many of the researchers referenced actually refuted Sears’ interpretation of their work. For a detailed account of this, I recommend this article from Time which talks about how the risks of crying were greatly overstated.
The term “attachment parenting” was coined by two psychologists working in the mid 20th century named Mary Ainsworth and John Bowlby. When they started their work, the conventional wisdom was that showing too much attention or sympathy a child would make them weak. Through a large body of work, Ainsworth and Bowlby showed that emotionally available parents produced confident and successful children. Their work has been hugely influential. However, these two founders of “attachment theory” were curiously mum when it came to topics such as nursing, sleep patterns, or wearing children. They emphasized that there was little advantage for one parenting technique over another:
Questions like whether to breastfeed or bottle-feed, or at what age to introduce solid foods, though still important, no longer carry the same urgency. Attachment theory suggests that babies thrive emotionally because of the overall quality of the care they’ve experienced, not because of specific techniques. A bottle-fed baby whose mother is sensitively attuned will do better than a breastfed baby whose mother is mechanical and distant [emphasis mine]. (Quoted in The Atlantic, “What Everyone’s Missing in the Attachment Parenting Debate” 5/31/12).
My concern is that exhausted parents can’t be as attuned to their children. Healthy, well rested parents are better parents. Do I have a problem with people who make their own choice to practice attachment parenting? No. Do I have a problem with people who tell others that sleep training will brain damage their child? Absolutely.
I also worry that cosleeping actually leads to worse sleep in parents, and, long term, in children. Scan through the comment threads on this website to find many examples of this.
What’s the evidence that sleep training is safe?
I am not aware of any research which demonstrates harm. The best study to date looked at five year old children who had and had not sleep trained. There was no difference in their behavior, no evidence of psychological problems in the sleep training group, and, importantly, no change in their secretion of cortisol, a stress hormone. This is important as much of the discussion about the danger of sleep training centers on experimental data showing increases in cortisol associated with crying. Long term persistent elevation in cortisol can be dangerous to development, but this is not going to occur with intermittent crying in otherwise healthy children who are well cared for. For more on this study, you can read this article here.
I will say that some pediatricians have been espousing sleep training as young as two months of age; I don’t think this is a good idea as a) all of the studies of sleep training safety have looked at older kids b) two month olds are quite immature from a neurological standpoint.
The take home
The fact is, if your child is sleeping poorly, you owe it to yourself and her to help her sleep better at night. There are many safe and well studied ways for your to do so. Don’t feel bad about making changes that will benefit your whole family long term even if they are associated with a little bit of distress for a few days.
I’d love it if people would share their experiences with sleep deprivation. How did it affect your life? How did you cope? Any advice you would offer to other parents?
1. To be clear, the terms bedsharing and cosleeping are frequently used interchangeably. Bedsharing means having your child sleeping in your bed. Cosleeping may include bedsharing, room sharing, or having your child sleep immediately adjacent to your bed in a sort of crib called a cosleeper. For the purposes of clarity, I use cosleeping to mean bedsharing in this book as this is the way that it is most commonly used. ↩
Craig, thanks for linking to my post! I’m looking forward to your upcoming posts. You are so right what some parents need more than anything is permission to sleep train. I hear from parents who avoid it at ALL costs, and they seem to disregard the cost of sleep deprivation as a serious one. I think there is some degree of adaptation – or at least a conception of adaptation – to sleep deprivation, but we suffer in lots of little ways (and at the risk of big ways), day in and day out. We have a good sleeper in our house (though that did require sleep training, but it was a smooth transition for us), but when we have the occassional rough night, I just hate life in the morning. The contrast in my attitude about the tasks I have to tackle during the day, including motherhood, is incredible. I think we can’t underestimate the value of a good night’s sleep!
Alice, your work has been really excellent. Your series on pediatric sleep alone is a great primer for parents and medical staff alike. I tend to see parents who have either been very reluctant to sleep train or have tried and failed. They are frequently amazed when we can work together to fix things in a few weeks and it makes a huge difference for both parent and child.
Craig – Wonderful point. I suffered through the sleep deprivation phase with my first child, but with the second, I had had enough. Although I had been warned NOT to take the baby to bed, it seemed like the only way to get sleep, and by baby #2, I didn’t believe half the advice I was given anyway. She slept on my chest or tucked under my arm for the first few months, as I recall, and it was very peaceful. Later, when we put her in her own “big girl bed,” she used to wake up in the early hours (she called in the “half morning”), walk into our room, and climb into our bed. I barely woke up. We all got sleep! I think proper sleep training is also a great idea (we did it with our first) if you can do it, but this is another option for families that can’t or don’t want to do it, but still need to get some sleep!
I love the story about the “half morning”, a time many parents see a lot of! You are right to point out that different arrangements work for different families, and even for different kids in the same families. I don’t think that there is a problem if the child is sleeping, the parents are sleeping, and everyone is happy.
I do want to make one point. I’m thrilled that the arrangement in infancy worked out well for you. However, sleeping with a parent who is sleeping is a risk factor for SIDS and is not recommended as per the American Academy of Pediatrics. A recent position paper is here
Hi. I am so sleep deprived! I thought I was doing okay, but it turns out I just hadn’t gone out for a while and had only interacted with my husband, who is equally sleep deprived. I had breakfast with a friend on Sunday and realized I was almost unable to carry on a conversation! My five and a half month baby girl starting waking up a lot around 4 months old and the past couple weeks has been waking every 1-2 hours. So, I brought her to bed with me (with every safety precaution I could think of, including husband kicked out to the couch) and things are a little better (but not much). So, tonight I took your advice of having husband read her a book and put her to bed. Boy, she had a time getting to sleep! I thought I was doing right by nursing her right before bed all these months because I was still putting her down awake – but she was still associating sleep with nursing. So, after two hours of intermittant patting she is finally asleep 🙂 I think I am going to continue bringing her to bed when she wakes up at night and nursing her, and just work on the going to bed process for a while. Is that okay? Thanks!
For safety reasons I can’t recommend bed sharing; however, I applaud your plan to work on her sleep and agree that if you fix bedtime, the night time awakenings will gradually improve regardless of what you do. Best of luck.
Thanks so much for your response. I love your site and have found it to be one of the few sleep advice sites that doesn’t seem like it is trying to sell something or have some kind of underlying agenda (other than better sleep). So, bedtime with daddy/without nursing is going much better – we’ve done it for 3 nights and now she has gone to sleep without crying for the past two. However, nights are just as bad (up every 90 minutes and must nurse to sleep). Too soon for improvement? Am I headed to middle of the night cry-it-outs-ville? At bedtime, daddy is cuddling her until she is just barely awake and then putting her down in the crib – should he put her down more awake, even if this leads to a melt-down? I won’t continue to badger you with questions but if you could give me your 2 cents one more time I would be so very grateful! Thanks again!
Give it a week. And a bit more wakeful at bedtime might be helpful
Thank you!
I completely agree with your thoughts on this matter. I have just written a post about attachment parenting being too extreme as it believes co-sleeping is necessary for a secure attachment. I have since had a number of comments disagreeing. It would love it if you would read my post and leave your thoughts as an expert.
No problem. I enjoyed your post!
Thank you for this post! I am in the midst of sleep training my son and am feeling confident in my choice in large part because of the support of other parents who have completed sleep training and who I know are kind, compassionate people. My biggest advice would be to seek those types of parents out to prove to yourself as a parent that sleep training is not only a good idea but will ultimately provide a vital gift to your baby and to your family. It’s also SO helpful to have someone to call or text when the experience becomes overwhelming.
What a great idea. Sleep training is like quitting smoking- it is stressful and people need support.
After essentially 19 months of broken sleep, my husband and I are back on board the sleep training, erm, train.
I have been a huge advocate for gentle parenting and so terrified of breaking any attachment my son has to us that we decided against doing any kind of controlled crying. I basically stopped driving unless I’m absolutely ok to (rarely). At one point, I’d driven only twice in eight weeks. My husband works from home and both of us are on our knees with exhaustion. We don’t go out together as we don’t get enough sleep, and because our son’s sleep is so erratic, we don’t feel we can leave him with a babysitter.
I had a lightbulb moment today where I realised that to be the mum I’d like to be (one that doesn’t exist from nap to nap!) and for us all as a family to function then we need more sleep. It isn’t doing any of us any good.
So, we’re on night 1 of “controlled crying”, working at a level we are comfortable with. Tonight it took 34 minutes (down from the hour this afternoon at nap time). I’m hoping that in a week we will all be getting rest.
Thank you for your post – it blows my mind it was an abnormal night for you! I can’t imagine sleeping all night ever again.
Best of luck to you and thanks for sharing. I have found that the things that I needed to be the best dad I needed to be have changed and evolved as my children have gotten older.
Hi!
I posted a few months back regarding my son and his frequent nightwakings. I found your tips very helpful with tackling bedtime!! He is now 7.5 months old and has been falling asleep at bedtime on his own for about 3.5 months without any issues whatsoever. He goes to bed around 7pm every night with a solid and consistent bedtime routine. His nightwakings have slowly decreased (as you said they would!) and most nights he is only up once, twice at the most, for a bottle feeding and then goes right back to sleep on his own. He is usually up for the day by 5-6am. He has slept through the night sporadically maybe 5 times since he was 4 months old. The pediatrician has recommended that we eliminate night feedings by letting him just CIO. Do you suggest weaning the feedings down before we let him CIO? We used the extinction method for bedtime and post-night feedings, and I am comfortable with that, but I imagine the night feedings are really just habit at this point and foresee lots of crying if I ignore him at his usual feed time (between 2-4am). He is 18 pounds and eats about 28 oz. of formula per day plus solids 3 times a day. Any help is appreciated!
Thanks so much.
I absolutely recommend a gradual wean of the night feeds. 1 oz/day then get rid of it after you hit 2 oz. Congratulations; you are almost there.