Is Sleep Training Bad For My Baby?….Should I Sleep Train My Baby?

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Dr. Mom explores the evidence behind sleep training and the research benefits and harms for children.

When I went through my medical training I thought putting your infant to sleep was as simple as putting your baby in the bassinet or crib. In fact, even when my patients came in complaining of how difficult it was to get their infant to sleep, I just thought to myself: Put them down and that’s that! I had heard about sleep training and contemplated if I should sleep train my baby, but I didn’t know how to sleep train. It was after I had Madi that I learned how utterly exhausting it can be to get your baby to:

  1. Sleep In their own crib/bassinet and
  2. Sleep for several hours in a row.

The first 4-5 months of Madi’s sleep were challenging, but I expected it. Doctors tell patients that most infants do not sleep through the night until 4-6 months. I had to breastfeed Madi to sleep and very gently place her in her bassinet in our room; often this transfer would cause her to wake up and we would do this process all over again. AND she would wake up every 3 to 4 hours. I was tired but didn’t think it was a big deal as after 6 months, infants can sleep through the night and if I could make it til then, I would get my restful sleep.

Six months later and I was still tired. In fact, Madi continued needing to be breastfed to sleep, but now she refused to go into her crib whenever we tried to transfer her. She ended up sleeping with us in our bed until she was 11 months old. And I was now beyond exhausted. (Co-sleeping is controversial and I’ll be writing another post on this!)

 

…………………………………………………………………………………

 

So I turned to Sleep Training.

I have assured patients that sleep training is safe as long as periodic checks are made. However, as a mother I couldn’t follow my own advice. I read blogs by other mothers saying that their children grew up to have attachment disorders because they were left to cry in their crib and the infant felt alone and unsupported. The thought of Madi feeling alone and unsupported stopped me from “practicing what I preached”.

NOW for the medical evidence…

At 11 months I was on call and beyond exhausted. I was torn, as a mom I couldn’t stand hearing my daughter cry herself to sleep and as a physician I knew it was the safe thing to do and that a well rested baby was a happier baby. What I did that very night after I finished call was look up the medical evidence. Published by the Ontario College of Family Physicians was a summary of sleep training published on October 2, 2017.  “Sleep training improves infant sleep problems, with about 1 in 4 to 1 in 10 benefitting over no sleep training, with no adverse effects reported after five years. Maternal mood scales also significantly improve, with patients having worse baseline depression scores benefitting most.” After not sleeping through the night for 11 months, I started the process of sleep training. Madi is now 20 months old and sleeps from 8pm to 7:30am. She is a happier baby when she is rested and I feel like a new person with a full night of sleep.

However, I must say the sleep training process was hard!

Learn More from Dr. Mom
Going on vacation without your baby? What to do…
Is spanking bad for you child?
What are the best ways to discipline your toddler?

 

15 COMMENTS

    • I too have had a very similar sleep experience as what you described with your daughter, and would love some tips and specifics for how you went about your sleep training, and whether it was done in your room or if you transferred her to a nursery for the training!

      • Hi Serena, I’m on vacation right now, but once I’m back I will start working on a post describing how I sleep trained Madi! For sleep training, Madi was in her own bedroom. Thank you so much for following 😊

    • Hi Joanna! Thank you so much for following 😊. I’m on vacation right now, but I will definitely start working on a post describing what I did to get Madi to sleep at night 😴

    • Hi Joanna,
      I finally had some time this past week to write up a bunch of sleep posts discussing 1. Methods of sleep training 2. Why your child isn’t sleeping 3. How I sleep trained 4. How to transition from 2 to 1 nap per day 5. What happens to the sleep schedule when we travel and time changes. Sorry it took me so long to write up the posts!!

  1. Is there another post about how/what you did? I’m still nursing to sleep my 20 month old and we co-sleep as he wakes through the night to nurse very briefly.

    • Hi Kayla. Thank you for your message! Dr. Mom thinks this is a very important topic and we are working to have a new article up this week about her experience and more medical evidence behind sleep training.

  2. I feel like it’s a bit misleading to promise “relevant up-to-date medical evidence,” yet you only cite one summary article here, which seems a bit biased when I read the bullet points, as they were looking for evidence to support sleep training and reviewed just a handful of articles that supported it.

    How about looking at the other side of the issue as well?

    http://evolutionaryparenting.com/mythbusting-sleep-training-claims-science-style/

    This article mentions 3 studies and 1 review that all found sleep training to be ineffective for improving infant sleep, and numerous studies that found that it did not alleviate maternal depression, and findings that it was actually correlated with parental anxiety and maternal depression 3 years later.

    • Hi Kennedy, thank you for your interest in this article, I think discussions is great! It is my opinion that the efficacy and safety of behavioral interventions for sleep has been shown in many studies, so long as the caregivers are educated and supported through the process to be safe. However, I will say that sleep training is a personal decision and it is totally ok if parents do not want to sleep train!  

      The article you are referring to refers to 25 studies, most of which I am aware of.  I can tell you that my research reflects analysis of 30 studies, including randomized control trials, that are related to child and infant sleep, sleep training, and sleep behaviour.  One example would be a review of 52 treatment studies, which concluded that behavioral therapies do in-fact reliable changes for both bedtime resistance and night waking in young children.  Ninety-four percent of these 52 studies on infant sleep have reported that behavioral interventions were in-fact effective. More than 80 percent of the children treated  demonstrated clinically significant improvement in sleep.

      None of these 52 studies have reported detrimental effects.  A number of these studies also found positive effects of sleep interventions on secondary child-related outcome variables, including daytime behavior (eg, crying, irritability, detachment, self-esteem, or emotional well-being).

      Different studies have different parameters, and also are designed with different qualities.  There have been two studies that specifically examined effects of behavioral interventions on child development and found no adverse effects. In a randomized study in infants, behavioral interventions (graduated extinction and bedtime fading) had no adverse stress responses in the infant or effects on parent-child attachment one year later.  

      One of the studies in particular the article you referred to states “In two studies that compared the effectiveness of controlled crying on infant sleep outcomes, neither found any improvement in infant sleep at all compared to the control groups; that is, infant sleep remained exactly the same with or without sleep training. What did change was their signaling to their parents which led to differences in parental report of sleep.”   I reviewed this study and am of the opinion that this study finds that sleep-related behavioral intervention did led to improvement in the well-being of the parents with effects on mood, stress, or marital satisfaction.  Again, different studies have different parameters and require the assessment of a skill medical professional to make an analysis that is appropriate for their patients.  

      Similarly, a study that looked at these same behavioural interventions for sleep training found no evidence of negative effect on child mental health, sleep, psychosocial functioning and stress regulation, child-parent relationship, and maternal mental health and parenting styles, measured when the child was six years old.

      Thank you very much for your interest in this article!  I think it is very important as a patient to do your research and make sure that the decisions you are making for your family you feel comfortable with.  I have listed a few of these studies below if you are interested in a further read.  

      1.Mindell JA, Kuhn B, Lewin DS, et al. Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep 2006; 29:1263.
      2.Morgenthaler TI, Owens J, Alessi C, et al. Practice parameters for behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep 2006; 29:1277.
      3.Wolfson A, Lacks P, Futterman A. Effects of parent training on infant sleeping patterns, parents’ stress, and perceived parental competence. J Consult Clin Psychol 1992; 60:41.
      4.Gradisar M, Jackson K, Spurrier NJ, et al. Behavioral Interventions for Infant Sleep Problems: A Randomized Controlled Trial. Pediatrics 2016; 137.
      5.Price AM, Wake M, Ukoumunne OC, Hiscock H. Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial. Pediatrics 2012; 130:643.
      6.Combs D, Goodwin JL, Quan SF, et al. Insomnia, Health-Related Quality of Life and Health Outcomes in Children: A Seven Year Longitudinal Cohort. Sci Rep 2016; 6:27921.
      7.American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed, American Academy of Sleep Medicine, Darien, IL 2014.

  3. Thanks for this blog on sleep training. Is there a way to get a copy of the study done by the Ontario College of Family Physicians?
    Also- I just heard you onCBC – great job!! You mentioned that your husband is doing research on sleep. Is there a department or someone I can contact at the U? (l can’t remember if it’s UofA or UofC). Thanks so much! Ive just discovered your blog and I’m binge reading it. I am thrilled to have a science based resource at my fingertips. Keep up the good work. You are needed!!

    • Hi Janet! Thank you do much for listening in on CBC, really appreciate the support ❤️. My husband is doing a sleep medicine fellowship at Emory university in Atlanta, GA currently so is not working at the UofA yet.

      This is a link to the article and you should be able to click on the link in the post too. http://www.cfp.ca/content/64/1/41

      Also, I love that your binge reading the posts 😆 thank you again for reaching out!!

  4. 20 years ago I sleep trained my daughter, and that was the best decision in my life. First, she would get a nice long bath, where I would play with her to get her tired, followed by a nice massage with baby oil. Then a good supper – I think she was eating baby cereal in a bottle by that time) and it was off to bed. If she woke up during the night, I would give her water or some tea, and put her back to bed. I found that moving her to her own room (adjacent to mine) and bed was helping with her sleeping longer as well. Finally, during the day, I would have the radio in her room playing soft music, and at night, it would be all quiet.

    • Hi Joanna – i’m so happy to hear that sleep training was helpful in raising your daughter! Every family is different and what works for some doesn’t work for others. Dr. Mom will be posting a new article soon about how she sleep trained so please stay tuned and let us know what you think! We are interested to hear more about what worked for you and what didn’t in the sleep training process.

  5. My little one just turned 6 months and we are having the exact same problems. Would love to hear what you did for sleep training!
    Thanks for writing this blog!!

    • Hi Kelsey, this week is sleep week on my blog and I have written a bunch of posts explaining the different sleep training techniques and what I did with Madi.

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