A few years ago, I was at some close friends’ house and their baby was sleeping in his room. Suddenly, while we were having dinner, he started crying. He went on and on and my friends did not react.
After a while, I started feeling stressed and asked why they would not go to him. They said it was all fine, and that we should not worry about it, as this is what they had been told to do to help him sleep better in the long term. They also said that, in the beginning, they found it very stressful to not respond to the baby's crying, but eventually they managed to stay strong and get through it since this was in the baby's best interest.
Picturing the baby's desperation and helplessness to do anything, I felt very sad. These parents had been taught to stop their natural response to their baby's distress, despite how we all found it stressful and felt the urgency to respond. Eventually, probably prompted by my evident discomfort, they went and picked him up.
In my previous articles, I have talked about how responding to the baby’s needs (such as the need to maintain physical contact with the caregiver and receive comfort when crying) is associated with long-term benefits for the baby. On the contrary, leaving the infant crying is not good for their development. Therefore, sleeping techniques that recommend leaving the infants crying may not be the best option for the baby’s wellbeing. A baby's brain is in fact still very immature and, therefore, the baby is not yet ready to carry out a complete regulation of emotions and behaviours without the help of their caregiver. Please consider reading the previous articles for a more comprehensive overview.
We need to avoid sleeping techniques that recommend leaving the infant crying
Over the past few years, many different techniques have been developed in an attempt to improve infant sleep. Some of these techniques recommend that the baby is left to-cry-it-out, without their parent’s help and response. The idea is that, in this way, the baby will gradually "learn" to self-settle, fall asleep independently, and sleep through the night.
Despite the evidence showing the potential negative long-term consequences of leaving an infant crying for prolonged periods of time, these techniques are too often still suggested to parents, under the guise of helping to prevent the development of infant "bad habits" and behavioural problems, as well as protecting the mother from postnatal depression. However, as we have previously said, little babies don’t have "bad habits" but actual needs that have to be met.
Furthermore, there is evidence that these techniques don’t improve maternal and infant outcomes, but on the contrary, they may be associated with some risks for both of them. In fact, they may lead to premature breastfeeding cessation, increased maternal anxiety, and even possibly an increased risk of Sudden Infant Syndrome (SIDS) if the baby sleeps in a separate room. Also, this approach doesn’t prevent sleep and behavioural problems later in childhood and doesn’t protect against maternal postnatal depression.
Waking up during the night is physiological for babies (as well as for adults), as it also functions to keep them safe and healthy. Therefore, applying these sleeping techniques does not guarantee that babies won’t wake up. Some babies continue to wake up and, indeed parents report no improvement in night awakenings. Others may eventually stop crying when they wake up, so it may seem that the aim has been achieved as they fall asleep independently and sleep through the night. However, unfortunately, as previously discussed, from an attachment point of view, this may not be a good thing. This may mean that the infant may have given up asking for help as they have learned that people around are not available and will not respond. The infant has therefore started relying on themselves for regulation, at a time when their brain is not yet ready for this. These babies may learn to "suppress their feelings" as they understand crying is not effective in getting a response from the environment. However, this does not mean they are necessarily not experiencing stress; they may have just learnt to stop showing it. Studies in fact show that, on the third day of the sleep training program, infants continue to have high levels of a stress hormone called cortisol, even if they have stopped crying.
This also goes against the fact that babies are programmed to communicate their needs by crying, and caregivers are programmed to respond to them to guarantee their safety. Indeed, many parents find such sleeping techniques very stressful, and many regret having used them. This powerful blog written by a mother who has used them is definitely worth reading.
Relying on others for help is normal, even for adults
Relying on others is indeed normal for every human being (and for many animals as well) and even more so for little babies, and it is difficult to conceptualise how to selectively decide not to respond to a baby crying.
Let’s imagine the situation in which we, grown-up adults, are going through a difficult situation. We may disclose our feelings and start crying in front of a friend, a partner, a family member, or a health professional. In this situation, we would expect some form of comfort. Imagine, instead, that the person listening stays still or even leaves the room and tells you that you need to deal with your problem alone and learn to be independent. How would you feel?
Then imagine another situation: you are sleeping and have a nightmare, you are frightened and need to receive some reassurance, but your partner/friend/family member doesn’t do anything and just leaves you there alone. How would you feel?
As adults, we can deal with difficult situations alone, but on many occasions, we still rely on other people for advice and support. If we are doing this, why would this not be normal for a new baby, who does not even have the brain maturity of an adult for dealing with stress?
We need to remember that, for children, there is no independence without an initial relationship of dependence.
Some practical advice
It is true that broken nights are very demanding as sleep is a vital need without which it is difficult to cope, so parents are often desperate to find a solution. This is completely understandable, but different solutions and techniques that don’t leave the infant crying need to be found.
First of all, it is important to be aware that waking up during the night is physiological for all babies. You are not alone! But it will get better: most babies, growing up, will naturally sleep for longer stretches of time. However, every time there are major changes or developmental milestones (e.g., the introduction of solids food, the baby starts crawling or walking, or the mother returns to work after maternity leave), the baby tends to wake up more frequently. Being aware of these times makes you more in control of the situation. Also, every baby is different - some babies will sleep more, some less - there is no right or wrong, so avoid making comparisons with other babies.
Furthermore, here are a few pointers to keep in mind:
Make sure you know the maximum time a baby can stay awake, according to their age and do your best to make the baby sleep enough. If a baby stays awake too much during the day or goes to sleep too late, it is likely that they will struggle to fall asleep and will wake up more frequently. Contrary to what is commonly known, a tired baby will not sleep better at night! This is because, to stay awake, they have produced high levels of the stress hormone cortisol, which will keep them awake.
Be aware of the baby’s tiredness cues, so you can put them to sleep as soon as these appear.
Pay attention to the level of stimulation the baby receives, to avoid overstimulation, particularly in the evening, as this could significantly impact their sleep.
After the first period, it is good to introduce a wind-down bedtime routine, which involves calm activities performed in the same order and requiring emotional connection with you (e.g., brushing teeth, putting the pyjamas on, reading books, cuddling). Consistent routines are calming and reassuring for babies and help them prepare for bedtime.
If you are breastfeeding, make the most of its "powers". Breast milk contains substances that induce sleep in both mother and baby. If you are formula feeding, alternate night feedings with your partner, so you can sleep for longer stretches of time.
If, during the day, the baby sleeps best in physical contact, consider accommodating this need so you can also take this opportunity to relax. Co-sleep can also be an option, but you need to strictly follow guidelines for safe co-sleeping.
If possible, delegate house tasks and ask for help with the care of the baby, so you can sleep when the baby sleeps and have some time for yourself.
In conclusion, sleeping techniques that recommend leaving the infant crying are not the best option for the baby's wellbeing. Therefore, it is important that parents find different and more gentle solutions and techniques to improve infant sleep and to better cope with night awakenings during the first months postpartum. In fact, as much as parental wellbeing is very important, it is equally important that babies are also protected in their needs and in their relationship with their parents.