Improve Infant Sleep Without Sleep Training: A Baby-Led Sleep Approach
EPISODE: 43 | DATE: May 20, 2021
“Our approach is about respecting the needs of both the parent and the baby. I think unfortunately there is this real divide where you have Cry It Out on one side and on the other side you have Wait It Out. I don’t believe in either one of those.”
What is Isla Grace & the Baby-Led Sleep Approach?
- Isla Grace was created to provide parents with an alternative to helping their babies sleep without feeling the need or the pressure to sleep train.
- I felt pressured to do the cry it out method with my oldest and I did it, but I didn’t feel good about it.
- I want to start changing the messaging around infant sleep
- In hindsight, I would have named our approach the Dyad-Led Sleep approach, meaning respecting the needs of both the parents and the baby.
- I think that’s the unfortunate real divide between the Cry It Out Side and the Wait It Out Side – and I don’t believe in either one of those.
- My approach is to meet in the middle
What are some of the most common questions you get from parents around their baby’s sleep?
- I hear a lot, “Why is my baby waking up every hour all hour night long?”
- That is a huge red flag for me because there is so much that happens that impacts a baby’s sleep. I feel like those things are being dismissed or ignored when we do sleep training.
- Unfortunately, if a parent asks that question to their pediatrician, the doctor will tell the parent that the baby is waking up every hour because the parent is still breastfeeding at night and you have to stop that and sleep train.
What do you find is the most frustrating about the sleep training industry?
- I find it interesting that it’s the first thing anyone suggests to a new parent as a solution for every child’s sleep issues or challenges.
- This is fascinating because no two experiences of sleep training are ever going to be the same.
- For some people who do the cry it out method, it “works” within hours or days, for others, the crying can go on for weeks and weeks and sometimes even months and months and it leaves parents feeling like they’re somehow not doing it right or that they have somehow failed because their child isn’t doing what they are “supposed” to do.
- Additionally, no one is talking about why sleep training actually works, how it works, and if it really does work at all.
Does sleep training work for every baby?
- There is some interesting research out there from Macall Gordon, a certified pediatric sleep consultant. She’s been researching sleep for 20 years, and what she has found with the cry it out method is that it actually doesn’t for all the children (upon my own further investigation into her work, her research shows that it depends on the temperament of the child, to oversimplify it).
- She also said that babies who did do the cry it out method actually only sleep 5 minutes longer than babies who don’t.
Why we sleep train
- We sleep train because we don’t have support. We don’t have a village, we don’t have a community.
- Most parents are forced back to work way before they are ready .
- And on top of that, being a parent today is incredibly isolating and difficult.
- We were never meant to raise a baby with just one or two people. We were meant to do it with a community. And add a pandemic and it’s just crazy.
- So naturally, parents are looking for solutions so they can function.
The challenge with our modern lives and parenting
- Every family has a different set of circumstances
- Parents in the US have to go back to work sometimes 2-6 weeks after having a child, but babies aren’t designed to be away from their parents at that stage.
- At that point, they’re still waking a lot – which is what you want them to do because that is what keeps them safe.
- So by waking a lot, your baby is doing exactly what they are supposed to be doing, but that doesn’t work for the parents who have to get up and go to work.
Informed consent & Sleep Training: The Missing Piece
- I look at sleep training the same way I would look at a prescription drug: if you’re going to do it (or take it), you should know how long to take it for, what the potential side effects are, what you can expect, and when you’re supposed to stop.
- We are also sharing information about what should be expected from babies and sleep with babies who don’t sleep in close proximity to their parents.
- But it is recommended that babies sleep in close proximity to their parents for the first few years, which makes no sense.
- And if you’re a breastfeeding parent, you may as well just throw all that information out the window.
- If you are sleeping with your baby close to you and if you’re breastfeeding, those numbers and studies are irrelevant. Your baby won’t sleep like that and that’s by design.
- We are asking parents to sleep in close proximity to their babies because we want them to wake up because it reduces the risk of sids. But then telling parents their child should be sleeping 6 hours only ends up making parents whose children don’t do that feel like failures. When actually, their child is just doing what’s expected.
The Highly Sensitive Child & Sleep Training
- I come from a family of highly sensitive people.
- I’ve come to realize that when I sleep trained my oldest, it “worked” in two days because she’s a highly sensitive being
- About 20% of the population are considered to be highly sensitive.
- Highly sensitive people have a hard time regulating themselves, and that may be because we didn’t have years of coregulation where our parents helped us regulate ourselves.
What are some realistic expectations around infant sleep?
- In the first 6 months – possibly longer – babies will likely wake every 2 hours or so, on average. This is the biological norm.
- They might not sleep in a crib
- If they nap, it’s probably not going to be for 2 hours. It might be more like 30-40 minutes.
- It’s important for us to have these honest conversations and expectations around what to expect from infant sleep so we don’t feel like failures as parents when things don’t go according to plan.
- Having realistic expectations around infant sleep may effectively help more mothers enjoy the first year of motherhood much more.
What are some red flags when it comes to infant sleep? What should parents look out for?
- Snoring, mouth breathing – I can’t tell you how many babies do that.
- There are some big airway health issues that also then can cause feeding challenges that need to be addressed and ruled out before parents even start to go down the road of thinking of making changes to sleep.
- So there are a lot of feeding related issues – whether it’s tongue function or tongue ties, whether it’s airway health, whether it’s parents bringing solids in too early so baby is not getting enough milk and then is up all night, whether it’s low ferritin levels causing restlessness.
- There is also the sleep environment: it it too hot or cold?
- And there is temperament – do you have a highly sensitive child? Are there tags on their pjs that are making them uncomfortable?
- I’m over simplifying this for the sake of the podcast but when we work with parents we like to start with what’s normal, what’s not normal and let’s start from there.
- Then we talk to parents about the bigger issues which is the fact that so many of the challenges we have that we think are sleep problems really aren’t.
- They are often issues with emotions.
The emotional connection to parents, baby’s and sleep
- Most of us were brought up to believe that when we had big feelings or emotions – sadness, anger, frustration – it was too much. Our parents would send us to our room or put us in a time out.
- As adults, we have a hard time being with big feelings – like infants crying in the night – and so we want to sleep train our kids.
- Unfortunately, in my experience, this has nothing to do with sleep but rather a fear of emotion.
- In fact, dealing with emotions is at the center of our approach at Isla Grace.
- For example, we’ll meet with a parent who says I’m bouncing on a yoga ball with my child for an hour at bedtime and I can’t do it anymore.
- My first question is: Is your baby even tired? What if you started bouncing 45 minutes later? And then you only bounce for 15 minutes – would that bother you?
- There is nothing that’s actually a problem unless it’s not working.
- My next question to the parent would be: why don’t you stop bouncing?
- The answer is usually, well because then my baby would cry.
- Well, that’s not a sleep problem. That has nothing to do with sleep. That has to do with our own fear of emotion.
- So if we build patterns for our babies and we go to change them, just like if we were to change some of your patterns, you would be upset and frustrated.
- Babies communicate that frustration through the only way they can – which is to cry.
- This crying triggers the parent. So they think, “Oh I’ve got to start bouncing again because I don’t want them to be upset.”
- When really, you could just talk to your baby and say, “I’m just going to hold you, cuddle you, talk to you.
- We need to treat our babies the same way that we’d treat any other person that we love who’s having a hard time.
- We end up sleep training because we are uncomfortable with the crying and we want to fix it and we can’t.
- Anything you can do with sleep training, you can do without.
- Sleeping is really just about supporting emotion.
How much sleep do babies really need and can it impact cognitive development?
- There is a relatively newer study that just came out that looked at babies who are 3 months old and they followed these babies through into toddlerhood.
- And they said that at 3 months old some babies were getting 9 hours in 24 hours and others were getting 20 hours in 24. In either case, it in now way impacted their development.
- In fact the only thing it dictated was if they were going to be a lower sleep total or a higher sleep total baby.
- We also have interesting studies on toddlers that most toddlers get way less sleep than we think that they need, which is probably closer to 9-10 hours at night. And they often will wake up about 4 times. And of those 4 times, often times it will take them around 20 minutes to fall back asleep.
- I think it’s crazy to put these ideas into parents’ heads that babies at 1, 2, 3 months need these periods of sleep and they don’t. That’s not what they’re supposed to be doing. They’re supposed to be waking up a lot.
- The other thing that I find interesting about all of these sleep training studies is that we have this belief that we need these methods and approaches for our children but that it’s ok because children are smaller than we are.
- We treat children as less than. And these studies are a perfect example. Why on earth would we take babies who can’t speak and children who can’t tell you how they’re feeling and subject them to studies on sleep training?
- And being left to cry when we could do the exact same study on an elderly person who has dementia who doesn’t know that when you leave you come back, who can’t take care of their basic needs, who is relying on the care of a caregiver. – we would never do that to them! We would never replicate a study like that on them.
- Babies can’t talk, so we can’t possibly know what they are feeling.
The role of attachment
- Attachment is all about inviting our children to exist in our presence – day and night, not just for 12 hours.
- Attachment is about letting our children see our eyes light up when they come into the room. For them to see that they matter to us, that they are important.
- It’s about tuning into their cues and responding with empathy.
- Attachment is about things that would be important to any relationship.
- We don’t need a piece of research to tell us that this will be a good method of parenting our children. And if we did, we’d do the research on someone who could actually tell us.
Can babies really self soothe?
- This may be triggering for some parents to hear, but no, babies cannot self soothe.
- What you’re saying when you say that babies can calm themselves is that they can self regulate. To be able to calm from crying to stopping is a self regulation technique. And babies don’t have that.
- In fact, self regulation doesn’t even start until between ages 5 and 7.
- That explains why you see some toddlers can’t control their hitting. They don’t have the ability to stop themselves because their brain isn’t mature enough to do that.
- So if you’re thinking your baby was crying and calmed themselves down, that is emotional regulation, and that doesn’t start until between 5 and 7 and it also comes after years and years of coregulation.
- The term “self soothe” was actually created by Dr. Thomas Anders who observed a number of babies and called one set of babies who signaled at night “signalers” and the babies who didn’t signal “self soothers.”
- But the babies who soothed or who were “self soothers” weren’t trained to do it. It was – more of a temperament trait. Some babies are just happy to wake up. Maybe they grab their blanket and kick their legs and rub their head and go back to sleep. The other babies signaled for their parents.
- Since publishing the research, Dr. Anders has made it clear that it was never intended to be used the way we have used it in the sleep training industry, which is to say that your baby can be taught to self soothe.
So why does sleep training “work” for so many babies? Assuming that it “working” is them no longer crying and going to sleep.
- It’s not that they have learned to self soothe. It’s a phenomenon called the shut down.
- It’s important to understand that when you leave say a 6 month old baby in a room alone, they don’t understand that you’re coming back.
- What happens is children move up the arousal scale and they finally hit this point of being flooded.
- Babies can’t upregulate themselves. They also can’t downregulate themselves. They rely on the parent in order to be able to do both of those things.
- When they are separated from their parents and don’t know they’re coming back – that creates a stress response.
- This is even more jarring for babies that may have done bed sharing and are suddenly put in a room alone in a crib they aren’t familiar with. Now all of a sudden the parent decides not to respond, and that’s a really scary thing for a baby.
- So what happens is the baby moves up the arousal scale and essentially what happens is the brain shuts the baby down. It’s called shut down.
Can you elaborate on shut down?
- It’s what happens when your body is burning all of this energy and you’re not getting the desired result.
- In the case of a baby crying, ideally the desired result is that the parent is coming, that this is going to stop, that they will help you calm down.
- Babies can’t keep burning that energy crying. If it did, it would be depleted. So the brain steps in and shuts the baby down.
- Babies can’t calm from this state of stress on their own. Because again that’s self regulation. And so that’s not what’s happening for babies. When they stop crying, they are shutting down.
- Dr. Stuart Shanker has an entire center dedicated to self regulation. When I was in his foundation course, he said it’s the brain’s last defense against severe energy depletion.
- I want to be clear that I don’t share this information to shame parents. There is no shame in this – we are all trying to do the best we can.
- I just want to empower parents to make informed decisions.
You mentioned the Polyvagal shut down – what is that?
- Dr. Stephen Porges describes something called the polyvagal shut down.
- He described babies in the NICU who get placed back into their incubator and have a procedure done. And he describes the whole process of crying and flailing and then just stopping and lying there almost as if they’ve soothed themselves.
- But he measures the cortisol levels and they are still showing that they are elevated.
- So for anyone interested in this – it’s hard to read but he describes this. It’s really quite fascinating in a sense because we’ve twisted it to make it seem like that baby soothed themselves and they didn’t.
Are there any studies that show how doing these sleep training methods can impact a child later on in life?
- We don’t have any information about that and I never want parents to go down that road of thinking that they’ve permanently damaged their child. I
- We just don’t know and it would be unethical to do it now.
- At the end of the day it’s never too late to choose responsiveness.
- I think the harm happens in using separation to get a desired outcome as a quick fix. When you do it once it can be the go to. Like using time outs.
- When we use time outs, we still haven’t dealt with our fear or emotion, so we don’t then support our children’s emotion (which is the reason they performed whatever behavior that got them the time out in the first place).
- If you can navigate sleep in the beginning with empathy and responsiveness and dealing with your own demons – sleep is a beautiful way for this to open your eyes and heart to a lasting relationship in parenting versus I just have to do deal with this right now. And so I need a quick fix.
- Things are going to keep coming up in parenting so it’s important to address your own fear of emotion in order to parent effectively and have harmonious relationships with our children.
Keeping it simple: treat your child as you would anyone else you love
- We know need to overcomplicate this: treat your child the way you would treat anyone else you love.
How to make the first year of motherhood more enjoyable:
- Set realistic expectations around what babies are and aren’t capable of doing and go from there
- Know that your children are inherently good. They aren’t trying to manipulate you. They don’t know how to do that until they are between 5 and 7 years old.
Resources mentioned in this episode
Article in Scientific American: You Can Get Through This Dark Pandemic Winter Using Tips From Disaster Psychology
Book: The Explosive Child by Ross W. Greene
Book: How to Stop Losing Your Shit With Your Kids by Carla Naumburg