I’ll never forget her words that day. And I’ll be forever grateful for the powerful influence her seasoned conviction has had on my journey as a new mother.
All our midwife said was, “He’ll sleep with you”.
I was thirty weeks pregnant and like most new mothers I was enthusiastically nesting; scrutinizing the pros and cons of the countless baby items I needed to become a good mother. I wonder if I rationalized that the more stuff I had, the more prepared I would feel for motherhood.
Of all the items we collected, our son’s crib felt the most symbolic. I remember dedicating hours upon hours to analyzing the components of baby mattresses, into finding a crib that used forest certified wood and organic, non toxic paint that promised to keep my baby safe and reduce the risk of SIDS.
When we found our perfect crib I savored slowly making my baby’s bed for the first time as I quietly anticipated his arrival.
But, our midwife shattered my reality that day and opened an enchanted door to an otherworldly possibility. I didn’t realize sharing our bed with our son was even an option. How would it work? Would he roll out? Was it safe?
With my curiosity ignited, I immersed myself into the world of attachment parenting. The deeper I explored, the more excited I became about motherhood. While the methods were unquestionably unconventional when measured against our cultural norms, my maternal instincts rejoiced and I felt a positive paradigm shift take place.
Since then, names like Dr. James McKenna and Prof. Helen Ball have become legendary in our home. Their approach to infant sleep makes sense and is backed by rigorous science, evolutionary history, anthropological evidence and most importantly they reinforce a kind, empathetic and compassionate attitude.
Because, when it comes to night time parenting, it seems as though we lose our ability to empathize; modern day parents are peer-pressured into denying their baby’s needs. When babies don’t conform, rather than listening and responding to their desperate protests, we set timers, use ear plugs and create special names, like controlled crying or spaced soothing, for the tactics we exploit. Ultimately, society persuades parents that their actions are serving a noble cause; teaching babies how to sleep.
But the truth is, babies don’t need to be taught how to sleep, just as they don’t need to be taught how to breathe or walk or talk.
Through cultural osmosis we’ve become entangled in a web of confusion surrounding sleep that attempts to merge scientific truths with cultural beliefs; convincing ourselves the two are one and the same. As a result, articles regarding mother-infant room-sharing and sleep outcomes based on results from the recent INSIGHT study are born.
The authors of this new study set out with an admirable aim; to investigate key factors that may predispose children to obesity. But, some of the conclusions drawn have provoked many people, including myself, to question not only the validity of the study but the underlying intentions of the authors.
Why? Because, with incomplete science, they’ve made the wild assertion that the recommendation for babies to room-share with their parents by the American Academy of Pediatrics’ is unfounded and has possible negative consequences for sleep.
What is their assertion founded on? On data that has been assessed from 230 mother-infant dyads participating in an ongoing, prospective, randomized, controlled study. One of the findings of the study is that “room-sharing at ages 4 and 9 months is associated with less nighttime sleep in both the short and long-term, reduced sleep consolidation, and unsafe sleep practices previously associated with sleep-related death.”
In short, the authors claim that the earlier infants sleep alone, the more likely they are to experience longer stretches of continuous sleep. These results may seem to support the authors’ position that babies should sleep alone, but the science and conclusions are flawed. Here’s why.
Firstly, bed sharing mothers and infants were excluded. 279 mother-infant pairs were recruited but only 230 pairs were reported in the study. This is partly because mothers who elected to bedshare with their infants were excluded.
Why? No plausible reason is given in the Pediatrics article, but it may be because studies at the Mother-Baby Sleep Laboratory at the University of Notre Dame, and others, have shown that bedsharing mothers receive more sleep in minutes than solitary sleeping mothers (Mosko et al 1997).
But, isn’t this study about the number of minutes babies sleep, not mothers? That brings us to the second and fundamental flaw of the study.
Infant sleep was parent reported. Research has shown that when compared to actigraphy, a non-invasive method of monitoring sleep/wake cycles, there is a vast difference between what parents observe and what actually happens. In a Canadian study, parents reported their infants woke on average three times per night whereas actigraphy showed their babies were actually waking eight times per night.
Interestingly, this study also compared infant night waking to parent perception of sleep “problems” over a six-week period. While there was no change in babies’ sleep patterns (waking 8.2 times at baseline vs. 7.9 times at six weeks), the parent perception as to whether their infants had a sleep “problem” dramatically decreased from 86% to 31%.
This is reaffirming news for bedsharing parents as solitary sleeping parents often claim that their babies sleep through the night. It simply isn’t true. Parents may be sleeping for longer periods, but their babies are not.
A little sleep training and a pair of earplugs cannot undo millennia of evolutionary blueprinting.
Dr. McKenna also reports that bedsharing mothers often underestimate the number of times they wake to nurse their babies by as much as 50%. When bedsharing mothers and solitary sleeping mothers were asked about their quality of sleep, 84% of bedsharing mothers said they’d experienced “good” or “enough” sleep whereas only 64% of solitary sleeping mothers said they’d had “good” or “enough” sleep.
This is also supported by research by Kathleen Kendall-Tackett who reports that in a study involving 6,410 mothers of infants aged 0-12 months, women who exclusively breastfeed reported significantly more hours of sleep, better physical health, more energy and lower rates of depression than those mothers who formula fed.
In an interview with Pinky McKay, Kendall-Tackett expanded on these results explaining that exclusive breastfeeding is almost universally associated with bedsharing (breastsleeping). Mothers who breastsleep find it much easier to fall back to sleep after waking owing to a myriad of biological and hormonal reasons and therefore feel less tired in spite of more broken sleep.
Babies in the study were sleep trained. Parents were encouraged to follow non-responsive techniques to train their babies NOT to communicate their night time needs. These methods included no feeding to sleep, encouraging “self-soothing” as a means to fall asleep both initially and through the night, moving babies to their own rooms by three months of age and avoiding night time feeds by 4 months of age.
It is important to recognize that non-responsive sleep training is not about helping babies sleep longer, better or more peacefully. It is about conditioning babies to be silent through the night which is at odds with what babies are biologically programmed to do.
This adds another confounding layer onto the way in which these results misrepresent the realities of normal infant sleep; babies who were silent in this study didn’t wake their parents because they were sleeping but because they’d been trained to remain quiet.
This approach would be similar to studying the stereotypical behaviours that captive mountain gorillas develop in order to survive the confines of a zoo, labelling these abnormal behaviours as “normal” and then being confused as to why wild gorillas behave differently in the wilds of East Africa.
When we mess with nature and place artificial limits on our babies’ ability to express their needs, we break their spirits and we lose their trust. We may get a little more sleep, but is it worth it? Don’t our children deserve more consideration and compassion than that?
WHAT IS THE REAL PROBLEM WITH MODERN INFANT SLEEP PRACTICES?
I once heard that if all we needed was more knowledge, we’d all be healthy, happy and wealthy. Because knowledge is readily available. When it comes to parenting, we know how babies are designed to sleep safely. We know the best way to nourish their growing minds and young bodies. And we know that honoring ancient wisdom and following our instincts can contribute to greater maternal happiness.
Knowledge isn’t the problem. The problem is acceptance.
Western society categorically resists accepting the fact that babies don’t fit into adult timetables, that they need to be held, that they crave sleeping next to us and that it’s normal for babies wake often, nurse and seek the reassurance of their protectors in the wee small hours of the morning.
The manmade disconnect between biological needs and cultural norms places impossible expectations on parents, fuelling mommy wars and shrouding senseless guilt on new mothers.
But, what if we take a step back, recalibrate our perspective and accept the realities of babyhood?
Perhaps we’d realize that there isn’t a problem with infant sleep and that the real issue is unrealistic adult expectations. What if instead of resistance we chose acceptance? What if we authentically supported mothers, so that they can give their babies what they need?
If we chose acceptance maybe the authors of this study may have dedicated their resources to exploring ways in which we could increase breastfeeding rates and longevity. After all, we know that there is a dose-response effect between breastfeeding duration and the risk of childhood obesity.
Or maybe the authors may have researched ways in which to promote safe cosleeping environments. After all, we know that non responsive sleep training methods, most often associated with solitary sleep, results in elevated cortisol levels, which in turn are associated with an increased obesity risk.
Or perhaps the authors may have looked at the global correlation between the lack of support for new mothers, in the form of maternity leave and its inverse relationship to breastfeeding rates and childhood obesity.
But, the reality is, this study like many others, isn’t about science. It’s about politics. And there has never been a better time than this to call bullshit on misguided politics.