Lottie is three and a half months old and is sleeping through the night fairly consistently. She goes to bed around 6 – 7pm depending on the timing and length of her last day sleep. I’m giving her a dream feed at 10pm and then 6 out of 7 nights a week for the past fortnight, she has made it through to 6-7am. As you can imagine, dropping the overnight feed is a very welcome change. The only downside, and I’m saying this totally as a ‘first world problem’ without, I hope, sounding too smug, is that now that I’m getting a full night’s sleep, a good 8 hour stretch is my new normal, just like it was before I had a newborn. So suddenly on the odd occasions Lottie does wake early, say around 4am, and definitely needs a feed, I find it very difficult to wake up, get out of bed and attend to her. In my head I’m screaming ‘come on Lottie! You know how to get all the way through, you should be able to do it every night!’. Quickly my expectation has changed from accepting that night feeds are just a part of life, to expecting night feeds to be no longer. But is this necessarily a bad thing? I don’t think so. Let me explain why.
Last night Lottie woke at 4.50am and was yelling out. This is a nasty time of night and I was deeply asleep before I was woken. I checked on the cot-cam to see whether her yelling was hysterical or calm. Even though I can usually hear the difference between the insistent-not-going-to-stop-until-she’s-fed yelling and benign calling out, I find having a quick peep at her from the comfort of my bed a much more accurate way of deciphering where she is at. The expression on her face is an obvious giveaway – wide mouthed with scrunched up eyes or just staring around. So is her body language – flailing arms and kicking frantically means she’s hungry, but fairly still is a good sign she’ll go back to sleep. Last night I could see all the signs that Lottie was absolutely fine and so I didn’t get out of bed. Her eyes were shut and the calling out lasted only about 30 seconds so I suspect she was either yelling in her sleep, or waking ever-so-slightly between sleep cycles. Once she found her hand and started sucking it, she self-settled and slept through until 7am. Suffice to say I was really glad I didn’t get out of bed and go in there. If I had, I probably would have woken her up completely and then she definitely would have needed to be fed before going back to sleep; my getting up would have been a self-fulfilling prophecy. But since my expectation was that she had had enough to eat from the last feed before bed and the dream feed, and that there should be no reason for her to need a feed at 4:50am since she’s proven many times she can make it through to morning, we got through the night again without an overnight feed.
When I was pregnant, one of the most common warnings from some friends and colleagues who were already parents was that I should prepare myself for the most painful part of motherhood: sleep deprivation. There’s no doubt sleep deprivation is tough and leaves you feeling muddy in the head, a bit sick, headachey and in my case, close to tears or hysterical laughter or both. There is also scientific evidence that mothers whose children have sleep issues are more prone to post-natal depression, so the impacts are very serious for some families. This is why I really believe we, as a society, should do new parents a favour and stop setting the expectation that sleep deprivation is a normal part of parenthood that lasts until children become toddlers, or even older. As I’ve seen proven in my own family and amongst many of my friends who also sleep-trained their children to self-settle, there is absolutely no reason why night feeds and spending time getting babies back to sleep should be keeping parents up at night past the 3-4 month mark. If my baby can be taught to self-settle and can get enough food into her belly to sustain her for an 8-9 hour sleep, there is absolutely no reason why, barring illness, another baby of a similar age can’t do the exact same thing. I understand there will be times in the future where Lottie won’t sleep all the way through the night; she might get sick, she’ll go through growth spurts and be extra hungry, solids might mess things around a bit, teething is a difficult period and when she is big enough, she might jump out of her cot in the night for a range of reasons. But overall, once a baby can self-settle and the expectation is set that they can, and should, sleep through the night, there is no good reason to make parents think anything else is considered ‘normal’. Why suffer from sleep deprivation if you don’t have to? The only thing I ever feel like doing between the hours of midnight and 6am is sleeping, and I’m setting the expectation that my child should feel the same way.
Whereas this post is based on my experiences as a new mother with one child, so a very small sample, I found it interesting to read this paper from the Journal of Paediatrics and Child Health called ‘Sleeping like a baby? Infant sleep: Impact on caregivers and current controversies’. As I’ve written about previously on this blog, there are two schools of thought when it comes to baby sleep management: attachment and behavioural management. These are two ends of a continuum with most parents sitting on one side but not at the extreme ends. The paper is discussing the controversies around care-givers advice to new parents about baby sleep, where care-givers I assume are midwives, general practitioners and paediatricians.
The authors explain that attachment parenting is the method where babies are ‘parented to sleep’ with intervention such as rocking or being worn in a sling and where ‘waking overnight is regarded as adaptive and not to be discouraged’. They say evidence supporting this method ‘is predominantly personal and clinical experiences, informed by theories about parent–infant relationships and reports of care-giving practices in traditional societies. There is limited systematic evidence’. This is a polite way for scientists to say there is no credible, peer reviewed research to back up this method of sleep management.
Conversely, behaviour management methods are described as, ‘after excluding health-related explanations… parents [use] active strategies to respond to infant sleep problems’ and that this method ‘argues that infant behaviour can be shaped or modified by the caregiving milieu’. In other words, sleep training, which includes ‘parent education about infant development and capacities, providing the baby with a separate safe sleep space, and a predictable environment with regular routines of care and ways of responding to the baby’s crying and settling that ultimately encourage the baby to self-settle to sleep’. The benefits, or successful results, of the behavioural management approach, unlike attachment parenting, are proven ‘from research published in peer-reviewed journals but is also informed by clinical experience’. Don’t you love it when science backs up your pre-conceived notions! I think one of the key words in this quote is infant ‘capacities’; the capacity for the infant to sleep through the night should be something caregivers advise parents about, rather than setting the expectation that many months and possibly years of sleep deprivation is just part of life. The conclusion of the paper states that ‘Infant sleep problems are common, impact adversely on maternal and paternal mental health, and are amenable to behavioural management strategies. Future research needs to determine if there are long-term harms or sustained benefits of these interventions using rigorous, objective measures. Robust research delineating the benefits and harms of [attachment] approaches is also needed. In the meantime, clinicians should ask about infant sleep and maternal and paternal well-being, educate parents about normal sleep patterns and, if appropriate, offer behavioural management strategies to parents to implement (or not) as they see fit’.
So put simply, the authors found that more research is needed into the benefits and harms of both methods, but there is enough research already, and enough proof of detrimental impacts on families from lack of sleep, that caregivers should, ethically, at the very least make parents aware of what ‘normal’ sleep patterns are (that is, set the expectations of when a baby should be sleeping through the night’, and when appropriate, provide information about behavioural management strategies that parents can try if they choose to improve their child’s capacity to sleep. Amen to that!