2.19.2012

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 :) 


7 comments:

  1. Again, loved this. All of my kids slept in our room, even our bed, except our youngest. . .but he co-slept in the same room with his 4 older siblings. All my kids are so independent, I joke that they don't even need me at all anymore. And people constantly comment on how well adjusted and independent our kids are. Now I have some research that shows WHY. I just thought it was because we were such awesome parents, ha ha. It's just b/c they had the comfort of my snoring, apparently.

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  2. Nice, Sarah. I keep trying to view my husband's snoring as comforting...maybe it will work someday, right? My kids sleep with us, too. It's easier, the babies don't wake up the older kids, and I don't have to get out of bed to feed them. I wish I had read some of these articles before I had kids. Of course, we've gotten "meaner" with the more kids we have. We usually let Averie cry for about 10 minutes on her own if she wakes up in the middle of the night. If she's not back asleep by then, we go get her and bring her in bed with us. But most of the time she sleeps well. Jameson was the hard one. He didn't sleep through the night until he was 5 and he still has a hard time falling asleep on his own. I think that he secretly wants me to rock him to sleep like we did the first 3 years of his life. I tried that once when he came down stairs and told me that he couldn't get to sleep. While I marveled at how big he was, he just thought I was nuts.

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  3. Thanks for your comments ladies! I'm glad that despite being told otherwise you did what you felt was best for your babies :)

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  4. Very interesting. I have had a different experience than the other commenters, but I still feel like I didn't mess my kids up...not yet, at least :) I cannot cosleep. I wake up to every little noise, and I wind up getting next to o sleep. It even worse if they are in bed with me--I'm paranoid I'm going to roll over on them and smother them (seen it happen at work.) so, after they are about one week they go in their own room, but I get up to nurse them when they wake up in the night until they naturally start sleeping through the night. For the boys that was around 11 months, Lydia was way sooner,an angel sleeper. And I use pacifiers for my kids too, I don't know if that makes a difference.

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  5. You thought I was done, but I'm not, you can't escape me. My computer froze up. One more observation from me--I also thought it was good for Tyler and I to still have one area of our life that wasn't taken over by the baby--our bed. It seems like the baby consumed all of our waking moments and my body and pretty much everything else. It was nice to have one place that was still ours, just the two of us. I'm sure it's different for each couple but for us that was what worked. It will be interesting to see what you find works for you, Aaron and baby when the time comes. In the end everyone just has to do what is best for them and all their relationships

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  6. Ashley, I should have taken the extra space in my post to clarify the 'crying it out' I'm talking about; it's when a parent regularly puts a young infant in another room, shuts the door, puts ear plugs in, and ignores their cries for most of the night. Ignoring their crying is the root of the risks I talk about in my post, so the actual location of their sleep doesn't matter as much as the consistent response you have to their crying. Every single one of the methods I have read about (including Ferberizing) state that you need to choose a method based on your baby's temperament and your needs as a parent. Since every child and parent is different, there really isn't one right way to raise every child. Honestly, all of your children exhibit signs of secure attachment, so whatever you're doing is working great! Thanks for your comment!

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  7. Oh, one more thing Ashley,
    There is this funny thing called the "executive alliance" (intense name for spousal relationship:)) If a family is experiencing problems the first thing the therapist will do is attempt to strengthen the parental relationship. The family is only as strong as the executive alliance. So if you feel like sleeping is a special time for you and Tyler, then you should keep it that way :)

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