Sleep Training Your Infant: Part 2

Infant Development and Emotional Regulation

•  The maturation of an infant's brain depends on experience (Schore, 2001, p 207)
• Caregiver-induced trauma (neglect) is more potentially psychopathogenic (harmful to psyche) than any other social or physical stressor (aside from direct physical abuse on brain.) In an immature infant with underdeveloped and restricted coping abilities, the primary caregiver is the source of the infants stress regulation, and, therefore, sense of safety. (Schore, 2001, p 7) 
• This means that the infant is no more capable of controlling their bowels than they are controlling their emotions. 
• The rest of my citations are really hard to understand if you don't know the lingo, so I'll translate:
• Babies cannot control their emotions or their mental processes. This doesn't start to happen until two years old (this is why it's called the "terrible two's"); you can see them trying to learn self-regulation  when throwing tantrums.
• When a baby cries its body is releasing all kinds of chemicals and hormones, most of which cause stress. This causes more crying, and the cycle just gets worse and worse because the baby does not have the ability to trigger happy hormones on its own. How do they finally calm down? The parent holds them close, touches them, talks to them, and feeds them. By doing this, the body releases happy hormones that counteract the stress hormones. 
• What happens when the baby does not get calmed down by a mother/father? They continue producing stress hormones which takes a serious toll on the developing brain. It also affects the rest of their body (throwing up, shaking, etc).
• Some infants' brains can get so damaged by these hormones that they stop working, or shut down. This does not happen often, but when it does it is fatal. Many SIDS victims are found to have issues with their brain stem. This is brand new research, so there are not very many study results out yet. It is important to know that although long-term crying does not cause SIDS, however,  there is correlation between stress hormones, brain damage, and SIDS.
• "Prolonged and frequent episodes of intense and unregulated interactive stress in infants and toddlers have devastating effects on 'the establishment of psychophysiological regulation and the development of stable and trusting attachment relationships in the first year of life." (Schore, 2001, p 9)
• Why are long episodes of crying potentially harmful to your infant? "In contexts of relational trauma the caregiver, in addition to dysregulating the infant, withdraws any repair functions, leaving the infant for long periods in an intensely disruptive psychobiological state that is beyond her immature coping strategies... When infants are not in homeostatic balance or are emotionally dysregulated (e.g. they are distressed), they are at the mercy of these states. Until these states are brought under control, infants must devote all their regulatory resources to reorganize them. While infants are doing that, they can do nothing else. (Glaser, 1997, p 56) (Dysregulated is British :) )

Ferber Method

• The Ferber sleep training method or "graduated extinction" was developed by Dr. Richard Ferber
• Babies are "trained" to fall asleep without a parent being present
• Parents leave infant in crib when he/she is NOT asleep
•  Parent then leaves for a short period of time (usually only a few minutes), returns, then leaves again for a longer amount of time. Parent should NOT hold or comfort child. 
• Rocking, nursing, and comforting will create 'wrong sleep associations'
• Not appropriate for infants under six months of age, some professionals advise no younger than twelve months.
• Children with severe separation anxiety or who react strongly to being left alone (throwing up, panting, etc.) should not be left alone.
• As Richard Ferber himself acknowledges, the Ferber method doesn’t teach kids HOW to fall asleep on their own (Ferber 2006). Kids are simply denied access to their parents, and left to work it out for themselves.
• In his 2006 edition of Solve Your Child's Sleep Problems, Ferber acknowledges that his method is not right for all infants and all families. Co-sleeping and other methods may be more appropriate for different infants.
• Ferber also points out that his method does not involve leaving your child alone and cry her/himself to sleep, he specifies that his method involves intervals of parental absence that work up to complete independence of child when falling asleep.
• Parents choose the Ferber method to foster independence in their child; however, studies show that children who have been sleep trained are less independent than their co-sleeping counterparts.

• "Children in solitary sleeping arrangements fell asleep alone, slept through the night alone, and weaned at an earlier age compared to co-sleepers. However, early co-sleeping children, as preschoolers, were reported by their mothers to be more self-reliant and reportedly exhibited greater social independence (able to dress oneself, work out problems with playmates) than solitary sleepers." (Keller and Goldsberg, 2004, p 383)

Why is the Ferber Method not appropriate for all babies? Let's use the information we discussed earlier and apply it to this theory:

• Infants are biologically programmed to form attachments to their caregiver(s). This attachment is based on consistent response to the infants' needs (rocking and nursing are NEEDS). When parents pay attention to their infant during the day, but then do not respond during the night, this can lead to disoriented/disorganized attachment. 
• Babies brains are not fully grown and are instable, and thus they are vulnerable to stress hormones that are created during long and intense crying episodes. The fear of abandonment also creates large amounts of stress hormones in the brain. Large amounts of these hormones are harmful to the developing brain.
• Infants are not physically or emotionally capable of controlling their emotions, they need their caregivers to help calm them down and produce calming hormones. 
• Some infants have temperaments that are more able to self-soothe themselves back to sleep, while other infants need more help from their caregiver to get back to sleep. 

What are some side effects of disoriented/disorganized attachment?

•  "The quality of early attachment is known to affect social relationships later in life. Therefore, it is conceivable that the level of opiate activity in a mother and her infant may not only affect behaviors during infancy, but may also affect the development of an individual’s style of engaging and seeking out supportive relationships later in life." (Schore, 2001, p 5)

• "Early relational trauma serves as a matrix for maladaptive [inability to adjust to particular situations] infant (and later adult) mental health." (Schore, 2001, p 5)
  
  
• "The longitudinal study by Egeland and Erickson (1987) included a proportion of children whose mothers were neglectful and/or emotionally unavailable… Follow-up findings show the emotionally neglected children to be socially withdrawn, inattentive, and cognitively underachieving in their elementary-school years." (Glaser, 2000, p 98)
  

You're probably thinking, "How am I going to teach my baby and/or child to sleep through the night? Will he/she be sleeping with me until their ten years old?"

Although parents see results in their infant's sleeping habits after using the Ferber method, there are risks. If you are still not a believer in co-sleeping (you and your baby sleeping in the same room) there are alternative methods to sleep train your baby that studies show are effective and do not carry any risks. Once again, infants and children are unique and no one method will work on all your children. You know your child better than anyone, so find the method that works best for your child and adjust it as needed. Don't let the opinion of others determine how you will raise your children.

Here is a site that has alternative methods to Ferberizing:
Parenting Science

I tried to keep this as unbiased as possible and I hope that you find this useful in deciding how you will parent your children, and it will make you more informed of the amazing and important development that your baby is going through! If you have questions or would like my reference list, please email me at jessr90@gmail.com


UPDATE Instead of writing a new post on sleep training, I would just like to clarify a few things:

1. The crying it out method that I am addressing is the idea that you can start leaving your young infant (2-6 months) alone in a room and let them cry for over 30 minutes, WITHOUT checking back. Young infants do not have the cognitive capability to understand you are still in the house. It is better to at least let them know that you haven't abandoned them by going into the room and verbally reassuring them.
2. I don't want parents to feel judged based on these two posts; I simply want to share some research I have found based on neurological development.Parenting practices are deeply personal. My opinion is that each parent should be able to do what they feel is best for their children without feeling rejected and/or judged by their friends and family.
3. Each baby is different. I can't emphasize this enough. My parents tried CIO with me and I vomited and threw myself out of the crib. This is dangerous (duh). My brother, however, thrived sleeping on his own. When he was two he wanted his own room where he could be undisturbed by anyone else. he just naturally self-soothed without any sleep training. Same parents, same parenting practices, completely different children (and results).
4. There are so many books that outline similar, but different methods. Read and adjust as needed. There are quite a few books that offer more gentle options of sleep training, and I would encourage you to explore all the options before committing yourself to one :) 

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