There’s no question about it--babies* need to be physically with caregivers. Here are a series of questions I received recently about babies and sleep training from a set of parents in Israel.**
What is your message to parents who just had their first baby?
Know and provide what a baby expects as babies have built-in needs that guide their development in an optimal way. They are smart! It’s really important to realize that babies are born 18 months early compared to other animals, and have lots of systems that are shaped by post-birth experience. So it is important during this time period to avoid distressing the baby in any extended way (also recall that young babies often don't have the capacity yet to stop crying, so it is best not to let them start). (See Five Things NOT to Do to Babies.)
The way to avoid distressing the baby is to meet the baby’s needs. What are those? Here are two key ones:
1) Rapid responsiveness to needs—which means you have to learn your baby’s signals. A good way to learn to do this is to carry the baby skin to skin regularly. Don't make your baby cry to get its needs met--move in before then. You will be more likely to foster an agreeable personality.
2) Nearly constant responsive touch and, sometimes, movement. Stay in touch with your baby, literally. Your baby needs your physical energy and signals from your body’s systems to learn to self-regulate. And these are best transferred through physical touch.
Remember that babies are not like dogs. If you mess up early training with a dog, you can often reteach them how to behave (as dog whisperers show). Humans are much more complex and sensitive periods of development come and go. If you miss providing what baby needs early on, you are setting the child’s whole trajectory off kilter for everything that develops after that. The foundation will be “slippy” and “gappy”, though you may not notice till adolescence when key developments rely on those earlier ones.
Is there a difference to the baby between sleep training with empathy and the "cry it out" sleep training?
First, babies should not be “sleep trained” in the usual sense of the term, which means being taught to sleep alone. It is painful for a baby to be alone and is not good for their proper development. Again, in terms of maturity they should be in the womb another 18 months, so that time period after birth should be pleasant and calming. Why torture them? Figure out a different way to be with them—babyhood does not last that long but will engrave the body and mind of the child forever. It’d be better to have a sleeping surface next to the caregiver’s bed when the baby is very young and otherwise co-sleep. At least, that is our human heritage.
“Cry it out” means letting a baby cry until they stop—until they give up hope that you will come to relieve their misery. Do you want your child to give up hope toward you? That’s not a good beginning to a trusting relationship with you or with their own needs. It’s like creating a neurobiological foundation of quick sand. You are creating gaps in what should be growing at that time because you are creating toxic stress that decreases growth and even melts synapses (neuronal connections linked to intelligence) when the stress hormone, cortisol, gets too high for too long. (See Dangers of Crying it Out.)
When a child is older, maybe age 3, you can work with him/her to learn to sleep in his/her own bed. It’s best to let the child direct this move.
What is your replay to the popular sleep training statement "my 6-month-old baby is only waking up at night because he is used to it, and not because he really needs something"?
As I said earlier, baby needs the physical touch of mom/dad to feel okay and to grow well. The baby is waking because of a real need. Babies are not deceptive. They don’t have ulterior motives except to feel good and well—and that happens in caregiver arms, next to the caregiver’s body. We know from experiments on animals that when a mammal baby is separated from the mother, growth slows down and systems get dysregulated.
We have to relearn what traditional people know, that babies grow best when they are in the arms of their caregivers.
How is it possible to balance our babies needs with the social demands (like work)?
I feel very strongly that if you are going to have a baby, you need to figure out a way to be with the child during the first three years of life. Do you really want to send them to strangers during the sensitive time period when the foundations for their intelligence and sociality are being set? If you only want to have a baby (like having a car) and not be with the baby, maybe think twice about being a parent. And if you yourself were treated more like a possession than a person by your parents, get some healing before becoming a parent or you are likely to treat your child like an object too.
Giving care to a baby is not a solo task. A baby should have multiple responsive caregivers (the same people over the early years), people whom the baby grows to trust. Ideally, you have a home with at least one parent and a grandparent or otherwise compassionate adult in the home that care for the baby. The child needs to feel multiply supported—and so does the mom! When my Chinese colleagues have a baby, their parents visit for 6 months and then the parents-in-law visit for another six months—for at least the first year of the child’s life. This is a wise tradition.
Is there an age when sleep training or any other behavior therapy isn't harmful to the child? Meaning it will just be unpleasant for the child but will not cause any long term/irreversible damage?
It is hard to say. Maybe age 6, when the first adult tooth emerges—a sign of cognitive development. But throughout life, we all need affection; bedsharing with someone is a good way to get it.
There are some theories that long term breastfeeding and co-sleeping can prevent the child the feeling of a separate individual person from his mother thus preventing him the opportunity to develop his own self. What is your opinion on this theory?
In traditional societies (nomadic foragers) where they breastfeed for around 4 years and cosleep throughout life, individuals are very independent. So, those practices are NOT making people dependent. There are a lot of things that go into a child’s confidence and independence--not meeting their built-in needs will make them less confident. And there are all sorts of ways parents can interfere in the child’s autonomy, for example, by trying to control the child’s actions. Remember your child is built to learn without your direction. If you keep guard on everything a child does, the child will never learn self-control and self-trust. Instead, the child will learn to need to be dependent all their life. It is better to put young children in safe environments, with compassionate older kids, and let them figure out things for themselves.
What is the maximum age for co-sleeping (if you think there is one)?
In traditional Japan, a child always slept with someone (e.g., grandma) until they started to masturbate. In Italy sometimes adolescent friends take naps with each other (no sexual stuff). All over the world, people cosleep (without abuse). We need to rethink what is normal, and what is good for children.
How, in your opinion-can parents manage when each parent has a different approach about baby sleep and sleep training-without causing confusion/lack of trust for the baby.
This is a difficult area. I would encourage the pro-cosleeping parent to give lots of information to the con-cosleeping parent (e.g., www.cosleeping.nd.edu or from Attachment Parenting International). When birth is natural and no trauma is induced, the mother will not want to let go of the baby. This is our heritage. She will feel magnetically connected, so sleeping with the baby will seem natural.
When and in which age/condition can we determine that a child has an actual sleep disorder, and that his not just "acting like a baby"?
It’s important to understand what is normal for human beings. First, everyone wakes up through the night—many of us are just not aware of it. So if you are using that as a measure of disorder, we are all disordered!
Second, babies and children are meant to and expect to sleep with their caregivers. It’s a way to children to feel protected and actually be protected from real and imagined dangers throughout the night.
Sometimes children who have been sleeping on their own see something scary during the day (e.g., a movie or show or news not appropriate for them) and need extra comfort for days or weeks to get over it.
I would not label anyone as “acting like a baby” because the way they are acting is expressing a real need. (Maybe a 40 year old who needs to sleep with his mother? But then that means he has an unusual relationship that I would not necessarily blame on him.)
If there is a sleeping disorder (assuming that the origin and reason for the disorder in this question is not yet known), what is the best way for parents to handle with it and take care of it?
A sleep disorder in a child to me would be a child that cannot sleep at night no matter what you do. You would need to try to reestablish circadian rhythms in the child’s body (e.g., sunlight in the morning, dim lights at night). But I know one therapist who suggests that sleeping problems are like a fever—they indicate there is a problem in the parent-child relationship (lack of mutual responsiveness probably) that needs to be repaired.
If sleep training is so harmful (according to up to date research), why is it still legal and, even in most countries, recommended by the department of health?
Health departments and academies, at least in the USA, are concerned about parental sleep. It’s hard to be a good parent when you are exhausted. So these organizations tend to put parents’ need for sleep as a priority. This is because, unfortunately, so many young parents are far from their extended families who would otherwise be helping with child care and ensuring good rest in the parent(s).
Another concern in the USA is with Sudden Infant Death Syndrome. There is a belief that cosleeping is related to this outcome –specifically when the adult is drunk, smoking, or obese. So the pediatricians in the USA encourage getting babies to sleep alone, hence, sleep training. But this is a very messy area of research and counter to baby needs. See James McKenna’s website for more information.
Is there research that proves sleep training can cause long term damage?
Babies have high needs for maternal touch and responsiveness (as well as breastfeeding). If they are missing these things during the day, they may have more difficulties at night.
We cannot do longterm experiments on sleep training, for ethical reasons. The experiments that have been done in the medical community do not inform us about longterm effects on the children. They are often very sloppy from scientific standards, so I would not trust any sleep training studies. Here are a couple of examples:
And please read these before you decide to have a baby:
*Babies are children under about 2.5 years
**The Israeli group that submitted the questions is The Realistic Baby Sleep Guide, led by Shirley Faitelson. The questions were submitted by Idan Stiklaro.
ADDITIONAL POSTS ON SLEEP
NOTE on BASIC ASSUMPTIONS:
WHEN I WRITE ABOUT PARENTING, I assume the importance of the evolved nest o developmental niche (EDN) for raising human infants (which initially arose over 30 million years ago with the emergence of the social mammals and has been slightly altered among human groups based on anthropological research).
The EDN is the baseline I use to examine what fosters optimal human health, wellbeing and compassionate morality. The niche includes at least the following: infant-initiated breastfeeding for several years, nearly constant touch early, responsiveness to needs to avoid distressing a baby, playful companionship with multi-aged playmates, multiple adult caregivers, positive social support, and soothing perinatal experiences.
All EDN characteristics are linked to health in mammalian and human studies (for reviews, see Narvaez, Panksepp, Schore & Gleason, 2013; Narvaez, Valentino, Fuentes, McKenna & Gray, 2014; Narvaez, 2014) Thus, shifts away from the EDN baseline are risky and must be supported with longitudinal data looking at multiple aspects of psychosocial and neurobiological wellbeing in children and adults. My comments and posts stem from these basic assumptions.
My research laboratory has documented the importance of the EDN for child wellbeing and moral development with more papers in the works (see my Website to download additional papers):
Narvaez, D., Gleason, T., Wang, L., Brooks, J., Lefever, J., Cheng, A., & Centers for the Prevention of Child Neglect (2013). The Evolved Development Niche: Longitudinal Effects of Caregiving Practices on Early Childhood Psychosocial Development. Early Childhood Research Quarterly, 28 (4), 759–773. Doi: 10.1016/j.ecresq.2013.07.003
Narvaez, D., Wang, L., Gleason, T., Cheng, A., Lefever, J., & Deng, L. (2013). The Evolved Developmental Niche and sociomoral outcomes in Chinese three-year-olds. European Journal of Developmental Psychology, 10(2), 106-127.
We also have a paper in press showing the relation of the EDN to adult wellbeing, sociality and morality.
Narvaez, D., Wang, L, & Cheng, A. (in press). Evolved Developmental Niche History: Relation to adult psychopathology and morality. Applied Developmental Science. 10.1080/10888691.2015.1128835
Here are some theoretical review papers:
Narvaez, D., Gettler, L., Braungart-Rieker, J., Miller, L., & Hastings, P. (2016). The flourishing of young Children: Evolutionary baselines. In Narvaez, D., Braungart-Rieker, J., Miller, L., Gettler, L., & Harris, P. (Eds.), Contexts for young child flourishing: Evolution, family and society (pp. 3-27). New York, NY: Oxford University Press.
Narvaez, D., Hastings, P., Braungart-Rieker, J., Miller, L., & Gettler, L. (2016). Young child flourishing as an aim for society. In Narvaez, D., Braungart-Rieker, J., Miller, L., Gettler, L., & Hastings, P. (Eds.), Contexts for young child flourishing: Evolution, family and society (pp. 347-359). New York, NY: Oxford University Press.
Also see these books:
Evolution, Early Experience and Human Development (Oxford University Press, 2013)
Ancestral Landscapes in Human Evolution (Oxford University Press, 2014)