Good Enough Night-time Parenting Styles
Hey everyone! Back after a long blogging break! If you visit my Twitter and Facebook feeds, you know that in February, I fell on the New Jersey ice and got a mild concussion. I was trying to work at my usual pace, but the doc suggested I pretty much stop reading and writing to allow my brain to rest! Tough order! But it sure helped alot! It’s April and I’m coming back slowly!
To continue my review of current infant sleep methods, today I take a look at Marc Weissbluth, MD’s book, Healthy Sleep Habits, Happy Child. Dr. Weissbluth is a practicing pediatrician based in Chicago, Illinois. He is also the founder of the Sleep Disorders Center at Children’s Memorial Hospital in Chicago. Dr. Weissbluth believes that by creating reasonable sleep patterns early on in infants, then a family can prevent the development of a sleep disorder which can persist into toddler-hood, early childhood and beyond. He has a family-systems and preventative approach.
Well, all I can say is if you want an overview on the research about the negative effects of sleep deficit (on infants, adolescents and adults), you’ve come to the right place. Dr. W states lack of sleep is a global health issue (just to add something else to this list!). He describes our overworked, over-scheduled, stressed-out, chronically tired and guilt-ridden society and its negative effects on infants, children & families!
General Dr. Weissbluth Messages:
The negative effects of sleep deprivation and there is more than one path to positive night-time parenting
I see two messages standing out in his work. His main message is that sleep-deprivation in our children is bad for their physical and emotional health and this in turn creates stress in parents and families. He culls information from his wide and varied roles as researcher, scholar, pediatrician/practitioner, and father/grandfather. His mantra is: small but consistent sleep deficits wreak havoc on the brain, resulting in problems in growth, and behavioral and emotional instability.
A second message coming across is that there are three ways to approach being a good parent regarding night-time parenting: no-cry, some cry (graduated extinction) and let cry (extinction). Also that night-time parenting should be tailored to the individual baby and family’s needs. Dr. Weissbluth believes families should use different flexible methods regarding baby/child sleep management, and free themselves from the guilt and rigors of attachment parenting. He is an advocate of flexible and good-enough parenting, as different parenting (albeit loving) practices can produce securely attached and emotionally secure babies/children/adults people just as well.
A Few Dr. Weissbluth General Sleep Facts:
Research indicates not getting enough sleep:
negatively impacts the optimal waking state
inhibits the development of concentration
produces a mindbody state mimicking jet-lag syndrome (overall fatigue, general grumpiness, cognitive disorientation)
causes fatigue-induced tantrums
results in diminished brain growth
results in higher cortisol levels, in turn increasing the occurrence of obesity
in teenagers, results in more drug & alcohol use and daytime sleepiness
in mothers, causes or exacerbates postpartum depression
A Few Baby-Specific Dr. Weissbluth Sleep Facts:
Babies have high sleep needs
Sleep behaviors developed in infancy can carry over to toddler-hood, childhood, adolescence and adulthood
Do NOT sleep-train infant under the age of 4 months. As their brains are not yet developed
From one – two weeks old, through six weeks, newborns go through a developmental phase whereby they have several hour periods of fussy, gassy behavior. This is normal and is generally not a result of maternal anxiety, poor parenting, or lack of breast milk. It is from newborns having an undeveloped nervous system. It passes as the brain matures.
80% of babies have common fussiness, 20% have extreme fussiness
Of the 20%, 56% of these are at risk to have difficult temperaments
Families with babies with extreme fussiness plus a difficult temperament are at highest risk for sleep problems after four months
This small percentage (post-colic babies) have the most persistent sleep problems & lots of family stress
Usually, even colicky babies settle down around the four month mark
Hunger does not affect infant sleep patterns; even babies who are hooked up to continuous feed IVs have wake & sleep cycles.
Rather, a complex interplay of sleep rhythm is established in sync with cycling levels of body temperature, melatonin and cortisol
Melatonin, which induces drowsiness and relaxes the muscles around the gut, begins to be manufactured in the maturing brain at about 3 -4 months. This is when day/night confusion and colic begin to disappear.
Body temperature rhythms mature about 12 – 16 weeks as well, this contributes to sleep consistency.
Add in cortisol rhythms, established between 4 and 6 months, peaking in the early morning and lowest at night to sleep patterning.
Adults fall asleep for longest periods of time at peak (or just after peak) of temperature cycle.
Sleep begets sleep, meaning that naps help create more and better nighttime sleep, so naps are an integral part of physical & mental health
From 4 months on, infant/child sleep schedules are impacted more by external factors (parental scheduling, guilt, etc) than by internal factors (biology, temperament, etc)
A Few Dr. Weissbluth Infant Sleep Method Guidelines:
Preserve the sleep, to preserve emotional and physical health
Tailor your approach to your individual baby’s fussiness level & temperament type and to your parenting style
There are three approaches, no-cry (attachment parenting), some-cry (graduated extinction), let-cry (extinction)
No-cry may be tiring, but if it works for you & your family, so be it, but do not judge others; it’s not the only way to be a good parent
Some-cry may take longer to achieve goal of baby self-soothing to sleep than let-cry
Let-cry might be necessary in extreme cases to help mom get some sleep, to prevent postpartum depression and to prevent health problems in baby
Use small shaping behaviors to move slowly towards & achieve sleep consistency
Practice consistency in parental approach and sleep times
Establish a sleep schedule based on baby’s sleep cues
Sleep cues are subtle, a lull in activity, staring off, rubbing eyes
Don’t wait until the baby/child is overtired, as it will be harder for the baby/child to fall asleep easily or fall asleep at all
Develop and maintain a consistent soothing-to-sleep routine, using such cues as gentle infant massage, darkening the room, rocking, swaddling, nursing, pacifier, holding, etc
Letting the baby/child practice falling asleep makes it effortless over a period of time
The entire family is impacted by lack of sleep if one person does not sleep
Working parents should not expect their schedules to impact their child’s schedule
Cut back on activities as too much over-scheduling impacts the family’s health
In some cases, recommends letting baby/child vomit and also putting a lock on the door
What do I take away from this method
If you are a mom who is not having any trouble with your baby’s sleep, and are managing ok, then don’t bother reading any of these books (unless you are helping a relative or a friend out!).
As a therapist who sees new parents and depressed moms, I can definitely incorporate some of Dr. Weissbluth’s messages and methods into my work. His well-researched information about the natural patterns of infant development, the nature of infant fussiness and the statistics and description of infant fussiness and temperament is an invaluable source when working with new parents. I would recommend this book to people wanting solid information about the nature of infant development.
I think that over-tired and depressed parents would have trouble reading such technical material and could use some help, such as a pediatrician, a postpartum doula, a grandmother in implementing a sleep change.
There is so much pressure for parents! They feel like they are not good-enough! I also commend Dr. Weissbluth for suggesting there are many ways to be a good parent and that infants thrive and develop secure attachments under many (of course, loving) conditions. He indicates the well-being of the entire family should be considered and cites the mother’s emotional state as important to her own and family functioning.
The thing that really bothers me is the letting the child vomit and the locking of the doors. I cannot recommend these methods at all to anyone as I feel they are dangerous and extreme. I want to believe Dr. Weissbluth is a good man and has a lot of experience with very difficult families and situations, but this part of his method seems dangerous and extreme to me and I would not be able to recommend this to parents in my practice.
But I do think it is good practical advice for moms to know that there are several ways to be a good-enough parent. Depression is fed by lack of sleep, so it is a good thing to put Mom’s needs into the mom-baby equation. Be kind to Mom, help her practice self-care.
All in all, I was prepared to dislike Dr. Weissbluth. But after meeting him in his book, I do not. He comes across as a balanced family man, advocating for babies by presenting solid information about their true nature, advocating for breastfeeding, but inclusive of all parents because, as a pediatrician, he does serve a broad population.
I just don’t understand the vomiting and locking the door thing. Not for me,.
At the end of the series, I plan to put together a consolidated overview of the current thinking on Infant Sleep. Thanks for going through this process with me!
Please let me know what you think!
References
Babson, K. A. et al (2010). A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension. Journal of Behavior Therapy and Experimental Psychiatry, 2010;41(3):297-303). Retrieved March 5, 2011 from Academic Search Premier Databases.
Weissbluth, M. (2005). Healthy sleep habits, happy child. New York: McGraw-Hill.
Sohr-Preston, S.L. & Scaramella, S. (2006). Implications of timing maternal depressive symptoms for early cognitive and language development. Clinical Child and Family Psychology Review, 2006,;9(1), 66-83. Retrieved February 15, 2011 from Academic Search Premier Databases.