knowledge is power: What does the research say about Infant sleep?
At The SleepEasy Club, I aim to equip parents with evidence-based truths, sleep science and the most updated research. This section is not meant to overwhelm you, but to give you the knowledge that can empower and help you make the most informed decisions surrounding tackling sleep. If you ever feel wavered by the conflicting information that you see online, please know that the information I provide is also available in trusted sources and is provided to you by sleep experts with years of experience in the field.
What do we know about the negative impacts of poor sleep issues?
Poor sleep affects daytime behavior, learning, increases family stress and impacts maternal well-being (Minde et al., 1993; Sadeh et al., 2015; Thunstrom, 2002; Williams et al., 2017; Ferber, 1987; Kataria et al., 1987; Richman, 1981; Scott & Richards, 1990a)
Sleep problems can persist and child may not “grow out of it” (Byars et al., 2012; Lam et al., 2003)
Sleep problems can impact attention and behavior problems, have higher risk of later obesity, hyperactivity, and more. (Sadeh et al., 2015; Williams et al., 2017; Chen et al., 2012; Touchette et al., 2009; Mindell, Leichman, Composto et al., 2016)
What do experts say about sleep coaching techniques?
White noise in combination with consistent, positive bedtime routines work (Borkowski et al., 2001; Mindell et al., 2009, p. 605)
There’s not just one answer: no intervention has been shown to work better than another. (Honaker & Meltzer, 2014, p. 337)
Sleep logs helped parents reflect on the natural patterns of sleep, and 38% of mothers resolved sleep issues without intervention. (Borkowski et al., 2001)
What do we know about Cry It Out (CIO) (esp. for babies under 6 months)?
Very limited research available for babies under 6 months
No research has been conducted on the need for intervention before 6-months
CIO effectiveness is split amongst studies. “Effective” is loosely defined in studies: including 15-20 minutes of continued tantruming or continued twice per night nightwakings. In one study, CIO only increased night’s sleep by 30 minutes ((Hiscock & Wake, 2002; Weir & Dinnick, 1988; Wolfson, Lacks, & Futterman, 1992; Symon et al. 2005)
Claims that CIO has no negative side effects come from a limited number of studies, all on children OVER six-months. (Crncec, Matthey, & Nemeth, 2010; Eckerberg, 2004; France, 1992; France et al., 1991).
Most studies had significant support and supervision during CIO intervention. (Adachi et al., 2009; Matthey & Speyer, 2008; Smart & Hiscock, 2007; Stremler et al., 2013)
Cortisol levels ie. stress hormone elevated during an extinction-based intervention for both mother and infant, and remained elevated for the infant even after the infant goes to sleep with little or no protest (Middlemiss et al. 2012). This is consistent with animal studies documenting similar findings (Coe, Glass, Weiner, & Levine, 1983).
A parent survey conducted in Canada on the use of graduated extinction for sleep found about 40% of parents said that the approach “didn’t work at all” (Loutzenhiser, Hoffman, & Beatch, 2014).
What do we know about a baby’s ability to self-soothe?
At birth to 3 months, newborns only have the most basic skills such as head turning, eye closing, and sucking (Kopp, 1989). They cannot self-sooth, and gets easily overstimulated (Sroufe, 1997).
At 3-4 months, self-calming skills only useful when distress is minimal (Kopp, 1989)
At 6-9 months, babies can increasingly direct their attention to help them manage distress (Mangelsdorf et al., 1995), and have more skills to regulate distress.
What do we know about how we can support our babies’ sleep?
Parental fading is favored by parents and is just as effective as CIO. (Honaker & Meltzer, 2014, p. 337)
Babies need parents/carers to be emotionally available for better quality sleep (Teti et al., 2010).
Response-based, gradual approach resulted in better sleep, even in cases of maternal depression and anxiety (Middlemiss et al., 2017)
Maternal/Parental Emotional Availability at bedtime is shown to improve sleep (Jian & Teti, 2016), reduce cortisol ie. stress (Philbrook & Teti 2016a), and help babies sleep longer with less distress (Philbrook & Teti 2016b).
What do we know about attachment and the parent-baby relationship?
Infants who received sensitive parenting over their first year of life developed secure attachments.
Sensitive parenting means that, at a minimum, the parent responds contingently, appropriately, and consistently quickly to the infant’s needs (Lamb and Easterbrooks, 1981).
Parents of secure children are also flexible, balanced and integrated (Solomon and George 2008).
What do we know about sleep coaching?
Support by itself improves sleep and mental health for families (Fisher et al., 2010; Holden et al., 1989; Rowe & Fisher, 2010)
This blog article will contine to be updated based on recent research.
