A Father’s Grief

This is a reposting of my latest fatherhood blog for Dad Central Ontario. Paternal grief is an important, but neglected subject, so I thought I’d post the blog here as well.

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At their very last routine prenatal check up, just one week before their baby was due, Rob and Leslie (not their real names) got the worst news expectant parents can ever get. There was no heartbeat. They were sent straight to the hospital where more sophisticated equipment confirmed that their boy had died in utero.

Those of us who haven’t been through something like this can only imagine what it must felt like. The life with a new little person, one that you had been planning for a long time, suddenly isn’t going to happen.

Unfortunately, that was just the beginning of a very tough and sad series of events over the next few days. Here’s something you might not have thought of. Still reeling from this dreadful news, this gobsmacked couple are told that Leslie’s labour has to be induced right away because of the risk of infection.  She still has to go through labour and birth, except without the payoff a mom usually gets at the end.

Can you imagine?

Most of us would prefer not to imagine. This is an aspect of parenting we don’t like to talk about.  It’s so sad. So unfair. It’s so hard to find a way to talk about this stuff.  I don’t want to scare expectant parents with the worst things that can happen: in-utero death, stillbirth, sudden infant death, miscarriage. But we need to talk about these things because they are real human experiences that should be acknowledged and honoured.

Rob and Leslie’s story is a long tough one. It also included several miscarriages, the heartbreak of an adoption that fell through at the last minute and, ultimately the birth of a daughter who is now four years old and the light of her parent’s lives. I don’t have space to do it justice. So I’ll let Rob’s words speak for themselves. Here are a few snippets from our long and poignant conversation. Rob hopes that by sharing his some of this window into his family’s experience, another father or bereaved couple might be helped in a small way.

Later that day

“We had to be at the hospital for quite a while – waiting for Leslie to be induced, going through labour, and afterward for a while. Everywhere you go in the maternity department you see glowing parents – happy people celebrating. And you’re just right at the bottom. I remember at one point noticing a rack of pamphlets on a wall. There were pamphlets on all sorts of topics for new parents. There was no pamphlet for us.”

Wise advice from a sister

“My sister sent me a very important text message. She said, ‘After the birth, take some time with your baby. Do the loving gestures. Hold him. Dress him in the clothes you bought for him, if you want.  Because it’s the only time you’ll ever have with him.’ Leslie’s first reaction was, ‘Why would I want to hold my dead baby?’ But we did what my sister suggested. We took the time with Alex. We dressed him. I held him and talked to him.

Looking back, I’m really grateful to have done that. Because we did have a relationship with Alex. I’d felt his hand pushing back when I put my hand on Leslie’s belly. He had reacted when I’d played my guitar and sang for him.  He had reacted to my voice when I talked to him in Leslie’s belly.  Doing the loving things, as my sister suggested, was a huge thing for us. I’ve heard bereaved parents say, “if only I could have held him in my arms.” So that memory of the time we took with Alex has been a comfort at times, even now, eight years later. I know that he felt our love for whatever time he was able to be aware of it.”

On supporting Leslie

“In the immediate aftermath I had to push my grieving aside so I could be there for her.  She was the priority. What happened to me was nothing compared to what happened to her. She still had to give deliver her dead child. You’re trying so hard to keep control because you can’t be falling apart all the time. After we got home I tried to look after her, bring her food and things like that. All you can really do is be there.”

Another good piece of advice

“One of my friends is a clinical psychologist. He said, ‘Whatever you do, try not to let this make you bitter.’ He was right, because it would be easy to become bitter. Going through grief like this is sort of like carrying this baggage around with you all the time. And that can make you bitter about other things that happen, or even resent other people’s happiness. At times I’d have to stop myself say, “OK, Rob, you’re being bitter and it’s not doing you any good.”

On people’s clumsy attempts to say the right thing

“People said all kinds of things that were well-intentioned but weren’t helpful. One thing I learned was that people have this need to compare other people’s grief to their own experiences. It’s really not helpful. I’ve learned that you just have to accept that people need to do that and that you don’t have to feel obliged to say anything in return. But I also learned that there were times when I had to cut people off. I learned it was best to do that quickly to avoid the conversation I didn’t want to have.”

Counting his blessings

“It gets better, very gradually. Eight years later life is good. We have a wonderful daughter. Leslie and I are still together and we love each other. It doesn’t work out that way for everybody.”

On long-term grief

“It never goes away. We’re happy now. But the weight can come back just about any time. It catches you off guard. I’m sure it will still happen when I’m 70. And every time that happens you sort of unpack your grief baggage and look at it again. But the good part is that every time you unpack your luggage, you sort it. So the load gets manageable.”

Thanks for sharing your story, Rob and Leslie.

Postpartum depression is a Dad Thing Too

OK. So it’s my first Uncommon Sense blog post in over a year.  In case anybody wonders about my absence, I’ve been blogging for other people, particularly Dad Central Ontario.

My most recent blog for DCO was about postpartum depression in fathers. And we really wanted to get a discussion going on this important topic.  So I’m posting the same blog here as well.  I’d be really interested in comments.  I know that most of my followers are women. I’d be grateful if you shared this blog post with men who might be interested.

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When we hear the words postpartum depression (PPD), we usually think of mothers. But fathers get it too; maybe not as often as moms, but it happens. Some experts estimate that up to 10% of men experience some level of depression after the birth of a child. And sometimes maternal and paternal PPD are linked. One study found that between 25% and 50% of fathers with PPD have a partner who also has it. But I don’t want to just throw a bunch of stats at you. The point is, if you’re a new dad and you’re feeling depressed, or just not yourself, you’re not alone.

What I mostly want to do in this blog post is help bring paternal PPD out into the light a little bit.  The best way I can do that is to have one father tell his story.

Meet Billy, a father of two with another child on the way.  Here’s what he had to say about what he went through after the birth of his second child a year-and-a-half ago.

Billy’s Story

“The best way I could describe my mood in the first few months after the birth of our second child is that I felt withdrawn. I withdrew from my family, my friends, my work. It was like all of that was more than I was capable of dealing with. I remember one time when I went out for a bike ride. But it was more than a bike ride. It was like this big exit. I was thinking, ‘This is too much for me right now. I need to get outta here.’  I had those thoughts a lot of times during those few months.”

I don’t mean that I was always leaving the house. I wasn’t withdrawing from my kids, I was withdrawing from my wife. She was the one that took the brunt of my depression. I was very, very irritable. I don’t remember feeling guilty about wanting to withdraw so much. I feel guilty about it now, but at the time I felt put upon. I often wanted to go out with my friends or out for a night with co-workers. And when I couldn’t do those things I would lash out at my wife, because she was stopping me from doing what I wanted to do.

It wasn’t that she was asking too much of me. She needed my help so she would ask me to do things that needed to be done. That wasn’t what bothered me. I’ve always accepted those responsibilities. I enjoy doing things like changing diapers, bathing and caring for my children because they are really great bonding moments with your children.  But when I look back I realize that I wasn’t 100% capable of really feeling those warm moments when I was depressed.

At the time I didn’t think about that. I just wanted to withdraw. I never considered what I was doing to be wrong. I always thought that what was being put upon me was what was wrong. I was in denial for a long time.

But then I had a couple of turning point moments. One was when I started avoiding my neighbour. I have this neighbour who is the friendliest guy in the world. I always looked forward to talking to him as I was going to work in the morning. And all of a sudden I started going out the side door to avoid seeing him. And around the same time I can remember thinking, ‘My life sucks. My life isn’t good.’ I wasn’t seeing the joy in my family, my work and even my neighbours.  I realized that if I was feeling like this something was wrong. I wasn’t myself.

But the biggest turning point was probably when my wife said to me, ‘It’s not acceptable to behave the way you’re behaving. I think you should speak with somebody. You have some things going on inside, which I can’t help you with right now.’

So I arranged to speak to a counsellor. I was nervous to open up about it. Not everybody wants to hear a father with two beautiful boys complain about how his life sucks. But I knew he would understand. It was a huge relief to talk to him and I planned to talk to him more.  But then something happened. My wife’s PPD kicked in and that kind of took over. She’d had PPD after our first child and I knew I had to rise to the occasion. My wife didn’t put that on me. But it was like, ‘I’m feeling bad, but what she’s feeling is way worse.  So I need to be there for her.’ So I didn’t go back to the counsellor. But he also facilitates these twice a month dad meetups and I went to some of those and talked to him there a couple of times.

But knowing my wife really needed me to be there for her sort of gave me a sense of purpose. I feel good about myself when I’m helping out, like when I’m looking after the newborn. But after our second baby was born I felt like my role was sort of diminished. Here’s my wife looking after two kids now, and she’s doing awesome. And what am I doing? I go to work. I come home.  I have the kids for an hour before they go to bed. I didn’t feel like I was really contributing all that much.  But when my wife started to have her feelings I felt like I had purpose again. I wish I could have felt that way earlier earlier. I wish I could have recognized that I always had purpose – an important role to play. But I couldn’t see that because my thoughts were clouded.  Anyway, after I got my sense of purpose back I gradually began to come out of it. It was still hard, because of what my wife was going through.  But things gradually got better.

I don’t think what I went through was as bad as what some people go through. But I want people to know that fathers can get PPD. Fathers’ PPD is a pretty taboo subject. It’s important to bring it out in the open.”

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Thanks Billy, for sharing your story with us.

This is one man’s experience. It’s not meant to be presented as typical or anything like that. It’s just what it was like for one guy. Like Billy, I think it’s important to bring fathers’ PPD out of the shadows a little bit.

If you want to learn more about postpartum depression in fathers here are some options. One is a video made by the Community Counselling Centre of Nipissing. https://www.youtube.com/watch?v=xmKKr6VlUts

Another is the website postpartummen: http://www.postpartummen.com/gethelp.htm

And here is an article that you may find helpful: When Dad Gets the Blues

Lastly, while this post was about the postpartum period some men experience depressive symptoms during their partner’s pregnancy – 13% according to a recent Canadian study.

 

The Researcher Who Help Coined the Term Self-Soothing Weighs In

Yesterday I was thrilled to discover that Dr. Thomas Anders himself, whose e-mail I quoted in my original blog post about the myth of self-soothing (as one of the inventors of the term), made a comment on one of my blogs.  I salute him for his willingness to engage in dialogue with parents. And I really appreciated his thoughtful comments, so much so that I wanted to share them with my readers. Dr. Anders us a rare window into what a researcher thinks  about what his research  really means in terms of our insight into how infants sleep and our understanding of parenting. I have always found that what researchers say in conversations is far more interesting and useful that what the  rules and language of scholarly discourse allow them to say in journal articles.

Thank you Dr. Anders!

Here are his comments.

Dear uncommonjohn, Let me begin by stating that I am a newcomer to your blog. A former student/research assistant of mine recently delivered her first baby and has been following you closely. She recommended that I read your post on self- soothing which I did. In fact I read the several posts on self-soothing, self- regulation, sleep training and the review of Steve Porges’ vagal brake research several times. I even agreed with your quote of me stating that there was very little, if any, research on quantifying actual behaviors that self soothe an infant who awakens in the night and does not cry.
I believe that we may be in agreement that infants often awaken briefly and return to sleep without crying. It was this observation made from time-lapse video recordings of infant sleep in the 1970s that led me to the conclusion that hardly any infants, if any, actually “sleep through the night” as had been described in pediatric text books of the time. The construct of sleeping through the night after six months of age had been embedded in pediatric lore since the writings of Drs. Gesell and Spock, but our videos demonstrated that infants at 6 months rarely slept more that 5-6 hours uninterruptedly without an awakening; that brief unobserved awakenings and arousals were common at all ages including in adult sleep; and that expectations of young infants’ sleeping from 8:00 pm to 6:00 am, through the night were unrealistic.
As the original observers of this phenomenon (because of our video cameras), we were at a loss to describe these “silent” awakenings. Everybody was aware of the awakenings associated with crying, but the non-crying awakenings, in our review of the extant literature, had not been previously described. As you suggest, it may have been better to call them crying vs. non-crying awakenings. Since we did see some awakenings that were accompanied by fingers/thumbs in the mouth at 6 months of age, and some that were accompanied by the use of a fuzzy blanket or toy at a slightly older age, we chose the terms “signaled” awakenings vs. “self-soothing” awakenings. The latter term was meant to imply a developmental trajectory on the road to self-regulation, although this term was not widespread in the 1970s.
In subsequent longitudinal studies we made three further observations. In repeated video recordings from 1 month to 12 months of age, we noted that 1) there did seem to be a developmental trend to these two kinds of awakenings. Crying awakenings decreased as the children matured but the non-crying awakenings did not. Yet, in some children, the crying awakenings did not decrease, or if they decreased between 3-5 months to 9 months, they recurred after 9 months. We also noted 2) that when we tried to introduce a self-soothing prop (a soft t-shirt impregnated with the mothers’ pheromones) only a very few (not statistically significant) number of infants seemed to reduce their crying awakenings. In short, we concluded that a self-soothing prop was ineffective. However, we did note 3) that infants who fell asleep on their own (when put into their cribs awake) in contrast to infants who were placed into their cribs already asleep were more likely to have fewer crying awakenings later in the night. Similarly, we noted that infants who used a pacifier or fuzzy prop as they were falling asleep at the beginning of the night were more likely to re-use these “sleep aids” in association with a non-crying awakening and return to sleep. In other words, infants who routinely fell asleep on their own with or without a sleep aid at the beginning of the night tended to repeat their falling asleep behaviors after a middle of the night awakening.
These were our observations of the development of sleep patterns in infants over the first year of life. I believe that other investigators around the world have replicated many of these core observations. But, as you suggest, it is the interpretation of these observations and, perhaps the inadvertent use of misleading terminology that may have led to unintended consequences.
Our research always emphasized the transactional nature of the sleep process. The transactional model of sleep-wake state development (with Prof. Avi Sadeh) defined both proximal factors such as the infant’s and parents’ state of health and well being, and more distal factors such as family support, external stresses and cultural influences etc. that impacted on the dyadic interactions that occurred between parent and infant around bedtime and during the night. This transactional model was developed to inform sleep clinicians that “one size does not fit all.” Careful and comprehensive evaluations (assessing all of the domains in the model) were necessary before prescribing an intervention. Our group has always focused on individual differences and individual family friendly recommendations rather than on boiler-plate interventions. It is also important to note that in all of our publications we have stressed that our observations were made on solitary sleeping infants and that we had no knowledge about the developmental trajectory of sleep in co-sleeping or bed-sharing infants. We also noted that the developmental trajectory for nursing vs. bottle fed infants differed.
Some final thoughts—The term self-soothing may have led to some unintended consequences, but as a definition of an observed behavior it is not unlike “vagal brake.” Vagal inhibition no more resembles the braking mechanism of an automobile than self-soothing resembles mechanisms of self-regulation. Moreover, as the vagal brake learns from contextual, consistent and comforting/discomforting experiences, so too self-soothing behaviors learn from the same contextual, consistent and comforting/discomforting experiences. In summary, I hope you might look more kindly on the term “self-soothing” It distresses me that you are so distressed by the term. Best regards and keep up the good work.
Thomas F. Anders, M.D.

More about self-soothing

I got a really interesting question from a reader today in response to something I said in my two- part blog Real Self Soothing.  Here’s her question.

Hi – really enjoying these posts on the myth of self soothing. I am unclear however as to why the vagal brake would be off during breast feeding? The way I see it, nursing is a time of security not threat (such as being chased by a wild animal). But you stated that nursing “places demand on newborn’s resources” and because of that the vagal break is turned off? Can you clarify this issue for me? Thanks!

Here’s my answer:

It does seem counter-intuitive that the sense of security that nursing can provide would be associated with the body responding in the way it does when responding to a threat. I don’t claim have a full understanding of all the workings of the vagus nerve, but, based on my reading of the work of Dr. Stephen Porges (and others), and with the help of a quick e-mail correspondence with Dr. Porges, I can make a couple of points.

First, helping us respond to threats is by allowing an increased heart rate is no means the only thing the vagal “brake” (as it’s sometimes called for brevity’s sake) does. It helps us manage other sorts of demands on our resources as well. And those demands are different for a newborn than an adult, or even a 6-month-old. Actually it’s not breastfeeding per se, but rather sucking itself, at a breast or bottle, that places metabolic demands on a newborn’s resources. So the vagus would enable an increased heart rate during bottle feeding too. This is completely normal given how neurologically immature human babies are at birth. It is important to clarify that this stops happening as the baby matures. At some point — I don’t know exactly when, and, most likely it varies from baby to baby – the infant’s physiological and neurological development progresses to the point where its brain and body would sense that the vagal brake no longer needs to come off during sucking. This working of the vagus nerve is one part of how the body is designed to help the newborn adjust to the demands of being out in the world instead of in the womb where everything the fetus needs comes directing from the mother’s body. In other words, the baby develops the physiological capacity to suck without the support of an increased heart rate. Interestingly, Dr. Porges told me that with preemies, the vagal brake comes off during sucking, but it doesn’t go back on when he baby is finished (or at least it stays off for longer, presumably it goes back on at some point). That’s because preemies are less physiologically mature and they have to work harder to suck and recover from the effort of sucking. Because of their greater physiolocial immaturity they also need need more medical support (and as much bodily contact as they can get) to manage being out in the world.

But breastfeeding does appear to play a role in helping the vagal system (for lack of a better word) to “learn” how to operate the way it should in a broader sense. Dr. Porges describes the the removal and re-instating of the vagal brake during sucking as a wonderful “neural exercise” for a newborn. He says this ability to remove and reinstate the vagal brake gradually helps the baby develop the neural pathways and enable it to calm even after major disruptions (upsets). That doesn’t mean the baby is calming entirely on his own without help from a caregiver (although that might happen sometimes). What it means is that the baby’s brain and body have the ability to work with (so to speak) the caregiver who is trying to comfort the baby with body contact, movement, soothing sounds or whatever.

And, as many people know from experience, babies differ quite markedly in how easily they can calm down or be calmed. As I’ve posted before, some babies are born with more efficient vagal regulation (meaning the vagal brake works better in helping the baby stay in and/or return to a state of calm). Lots of research has shown this. And it’s probably one, but by no means the only, explanation for why some babies are fussier than others.

Dr. Porges told me he was working on a paper based on his research that found that babies who are extremely fussy and difficult tend to have inefficient vagal regulation, meaning the operation of the vagus nerve (including its brake function), doesn’t work as well as it does in unfussy, calmer babies. This helps explain why some babies are so much harder to soothe than others. It’s not anybody’s fault, they were born that way, and they need even more external regulation from caregivers than other babies. However, Porges and his team found that at age 6 months this relationship between inefficient vagal regulation and fussiness was seen only in bottle fed babies. The breastfed babies were still fussy, but they showed efficient vagal regulation, which is undoubtedly good for them in the longer term, even if they remain fussy in the short term. The bottle fed babies who were fussy still had inefficient vagal regulation. What’s interesting is that non fussy babies had efficient vagal regulation whether they were bottle fed or breastfed. I don’t think that necessarily means that fussy bottle fed babies can never ever achieve efficient vagal regulation, although it may take longer and require a little more ongoing responsive, sensitive care from their parents. But it does support the idea that there is something about breastfeeding that helps the baby physiologically in ways that go beyond nutritrion (as many breastfeeding proponents have been saying for years).

Dr. Porges also says that the muscles (and nerves) involved in early feeding behavior help develop the facial muscles and nerve pathways that are involved in social behaviour such as smiling, and the ability to engage in responsive social communication with a caregiver. Obviously bottle fed babies develop these abilities as well, but it seems that breastfeeding – in addition to being the way babies were designed to be fed – is also part of the way babies were designed to develop social abilities. Does that help?

*For any bottle feeding mother or father (including gay men whose parenting partner is another man) who happens to read this and feels yet another a stab of guilt, remember that human babies are also designed to be adaptable and resilient. They have the capacity to survive and thrive in all sorts of circumstances. The love, care and responsiveness your baby gets from you (and dad, other mom, other dad, grandparents and other people) are the most important things in terms of helping your baby’s social engagement system to develop. And loving physical contact, eye contact and soft vocalizations that parents provide if they hold the baby while giving a bottle would definitely help “teach” the vagal brake to work properly.

The challenge for the parents of the fussier, harder to calm babies (I know what it’s like, we had one!), is to accept that you are probably going to have to put more work into calming than parents of other babies (or even your own other babies). And try to remember that there is research that strongly suggests that, even when it seems like your efforts are doing much to calm the baby in the moment, you are undoubtedly helping her over the long term.

Pregnant Moms! Get Your Husband to Read This!

Want to be a good dad?

The best way to start is by being a good partner to the mother of your children. Yes, the relationship you have with your children is very important. But the social support you provide to their mother is just as important and it’s also where fatherhood begins. A recent, very interesting Canadian study gives us a little window on one of the ways this works.

Researchers in Alberta are doing a big study on prenatal nutrition, birth outcomes and child development. It’s called the APRON (Alberta Pregnancy Outcomes and Nutrition (APRON) study. (Nice acronym.) One of the things I like about this study is that it pays attention to fathers. So many child development studies still don’t do that.

The most recent paper from this study is about the impact of partner support (all partners were men in this study) on pregnant women’s’ stress, specifically their levels of cortisol. Cortisol is a hormone that is part our body’s physiological response to stress. It is often portrayed negatively because researchers use cortisol levels as an indicator for the negative impact of stress. But actually, cortisol does a lot of good things for us, like helping us regulate the levels of glucose in our blood. Cortisol also helps us deal with stress and then, very importantly, get back to feeling normal when the stress is over. It’s chronic exposure to high levels of cortisol (usually from chronic exposure to abnormal amounts of stress) that becomes a problem.

Excreting cortisol is not our only physiological response to stress, but researchers like to use it because cortisol is easy (and non-invasive) to measure using saliva samples.

In the “APRON” study they tested pregnant women’s cortisol levels at certain points during pregnancy and asked them to rate their level of psychological distress at the same time. Women were also asked how much social support they generally got from their partners and how effective it was.

Women with better social support tended to report less psychological distress. No surprise there. Social support is one of our important buffers against psychological distress.

But here’s the interesting finding. Even the moms with better partner support were distressed at times. But when they were distressed they had lower increases in cortisol than the moms with less social support. In other words, even when these women were having a tough time, parts of their brain that they don’t consciously control were, in a sense, able to tell that they weren’t going to need that much cortisol to help them. It’s as if their brains had learned these women’s partners would support them.

The researchers spun this as showing that father involvement is good for babies. The thinking is that Dad’s support for Mom could prevent the fetus from being exposed to too much cortisol from Mom’s body, which could harm the baby’s developing brain.

Theoretically that could be true. But I’m much more interested in the father’s influence on the mother herself. Because anybody who pays any attention to early mothering knows that good support for mothers is crucial. Science has proven this, but people – well, women – have known this for centuries. All cultures have had their ways of supporting new moms because they knew that supporting the mother helped babies survive and thrive. Traditionally, that support came from women – grandmothers, mothers-in-law, sisters, aunts, and female neighbors. It still does. However, in Western society, women are not always as available as they were in the past to provide the pregnancy and post birth care and support that all mothers need. So fathers need to step in and fill some of the gap. And they have, although I suspect that many guys don’t realize how important this support is these days. One way I like to put it is, if it takes a village to raise a child, a father is a more important villager than he used to be, or at least, important in a different way. Obviously, that speaks to the importance of father-child relationships, interaction and care.  But it also applies to the care and support fathers provide to their spouses.

This study looked at the impact of partner support on pregnant women. But I’m quite sure you’d find a similar positive impact of Dad’s support after the baby is born. I’m equally sure you’d find the same effect in same-sex parent couples and that support of other relatives and friends has a biological impact on mothers. I mean, doesn’t everybody do a better job of dealing with challenges and stress better when they feel supported?

But – key point here – talk to your partner about the kind of support she wants and needs. It’s not always easy to figure out exactly what kind of support a mother wants. And we guys sometimes guess wrong. Most of us are fixers by nature – “Just tell me what needs to be done and I’ll do it. That’s very useful sometimes, but it’s not always what a new mom wants. Sometimes they just want to be heard; sometimes they want their feelings acknowledged. Sometimes, as my wife put it, they just want us to be nice to them while they cry. (It took me three babies to really learn this!!).

So, to sum up.

1. If you didn’t already know it, an important part of being a good dad is supporting your partner, because that support helps her be the best mom she can be, which is good for your kids (good for you too).

2. Your support has a biological impact on your partner even when it isn’t obvious to you. So stick with it even when the going gets tough and your partner may not be giving you the positive feedback you’d like to get.

3. Even if you’re finding it a little hard to find your feet as a new dad hands-on caregiver, by supporting your partner you’re making a useful, and biological, contribution to her well-being, and  your child’s well-being.

 

 

Sleep training techniques that allegedly teach “self-soothing” don’t work for half the parents who try them: newly published study.

Regular readers of this blog know of my disdain for the term self-soothing when used in the context of “teaching” babies to sleep through the night. They also know that one of my big concerns about sleep training methods that involve leaving babies to cry on their own is the way their proponents (I’m talking about professionals here, not parents) try to push these methods on all parents and imply that “teaching” babies to sleep independently is necessary for their well-being. But what I want to talk about today is another one of the lies about sleep training, which is that it usually works.

Oh, it works sometimes, for some parents, but not nearly as often as some experts imply. Anecdotally I always knew that sleep training wasn’t nearly as successful as the liars make it out to be.  It wasn’t true for my family 29 years ago and lots of other parents have told me they tried sleep training without no success. Or it worked briefly and then their baby got a cold, or started teething, or the family went on holiday and things were back to square one.

These parents feel doubly bad. They feel bad because their baby still wakes up a lot and they now feel even worse because they have “failed” with a technique that experts have told them is effective and necessary for proper development (plus they’ve been fed the lie that nightwaking is abnormal).  What’s more, conventional sleep experts don’t offer these parents any alternative. So they are left to struggle and feel bad about themselves. This is harmful. And if there is one thing those who advise parents should strive not to do it’s make parents feel worse than they already feel. That’s why I’ve always wanted sleep training proponents to support parents who aren’t comfortable with (or can’t/won’t do sleep training) and also to admit that their methods aren’t necessary for optimal child development and, most importantly, that they don’t work for all families.

Actually, even the studies cited to buttress the idea that sleep training is “effective” show quite clearly that it doesn’t always work.  Even in clinical studies, where parents get instruction on how to do controlled-crying, as researchers call it, and support in implementing the technique, the technique doesn’t always work. But researchers tend to downplay this, even sidestep it, in their papers.

What’s more, most parents do sleep training on their own, within the messy realities of their own homes, and their own beliefs and interpretations, without professional support. How well do those parents do? Well. I can tell you that a study that I helped design shows that more than half of them don’t succeed. A paper, that I co-authored, was just published in the Journal of Reproductive and Infant Mental Health. It came out of a study led by Dr. Lynn Loutzenhiser, of the University of Regina. We did an internet survey where we asked parents about their experiences with night waking and sleep training. Had they tried it? How often? For how long? What was it like? Did it work for them?

We surveyed 411 mothers of 6 – 12 month-old babies. Half of them had tried sleep training (which we referred to as controlled crying; parents call it Ferberizing or crying it out). Most likely some of those who didn’t try it never needed to because their babies started sleeping through the night (or at least, going back to sleep on their own) without any particular effort on the part of their parents.

I can’t show you the whole paper for reasons of copyright (the language is pretty academic anyway). However, I can a provide a link to the abstract (synopsis)) and tell you  – in everyday language – what we found.

Let me get right to the most important finding. Controlled crying didn’t work for more than half the parents who tried it.

In fact, only 14% said it eliminated night waking completely, while 24% said it reduced night waking significantly.

However, 42% said sleep training didn’t make any difference at all! Some of them had tried it four or more different times!  Ouch!  That’s a lot of pain for no gain, and a lot of parents who, along with feeling guilty, probably were kicking themselves for not being able to succeed with a technique that they been told was “effective,” and important.

Another interesting finding was that lack of success (or success) with sleep training was related partly to parents’ own beliefs and perceptions. For example, parents who felt that their babies would feel abandoned if left alone to cry, were more likely to report that sleep training didn’t work. Those who rated sleep training as stressful for their child were also less likely to succeed. And, in a really interesting finding that wasn’t reported in this paper (for complicated reasons), parents reported different intensities to their babies’ crying upon awakening. A little over half said their babies weren’t that upset at first, but got more upset as time went on (if the parents didn’t respond right away). That’s the picture that sleep experts usually paint. But some said their babies got to crying hard very quickly. A small, but sizable minority (16%) even said that their babies appeared to be crying hard even before they were really awake (something we experienced with one of our kids). I ask you, how is an infant in that state suppose to “self-soothe?” As you would guess, mothers of intense criers were less likely to get anywhere with sleep training.

So what does this boil down to?

First, sleep training proponents should admit that their methods don’t always work, and that they may not be  (aren’t) the ideal strategy for some families. Second, they should pay attention to parents’ feeling that sleep training is stressful for babies (and themselves). Because that feeling affects both the likelihood of success and also how parents feel about themselves after trying sleep training and failing at it, as our study shows, many of them do. And most importantly, parents who want to try sleep training should go into it with the understanding that it doesn’t work for many parents. So, if it doesn’t work for you, you didn’t fail, the technique failed.

Sleep training proponents should also acknowledge that parents of night-wakers are caught between conflicting sets of advice. On one hand they are told – quite universally – that responding to babies’ distress quickly is important, and to breastfeed on demand. Then on the other hand, they are told to not respond to babies’ distress during sleep training and/or not to nurse this baby who is accustomed to nursing for comfort (as well as nutrition).

It’s quite clear that the sleep trainers have been very successful in making many parents thinks that they should used controlled crying to teach babies to sleep through the night. Or maybe parents just do it because they want a good night’s sleep and this is the technique that they’ve heard about.

But please, don’t just tell parents that sleep training “works.” Because outside of the unreal world of clinical studies, it doesn’t work very well for most people. In fact, I’m convinced that there are some babies (and parents) for whom it will most likely never work. Thus, parents should be supported to live and cope with night-waking if they want, or co-sleep or do whatever else they need to get through the night and get enough rest. That would be a lot more productive than making parents feel like failures and insisting that they try a technique that has a spotty record of success.

Note added July 28, 2014. For another take our research findings by a very knowledgeable blogger check out Evolutionary Parenting.

Alfie Kohn is right!

This morning I read a nice little article that you just might want to print out and stick on your fridge to read when you’re discouraged. It’s an interview with Alfie Kohn, published in Canada’s Globe and Mail newspaper. I’ve been aware of Alfie Kohn’s work for years, primarily his criticism of the value of  homework and standardized testing. Now, he’s written a book that takes on the entrenched notion that today’s young people are a bunch of lazy, spoiled, narcissistic brats who have been coddled all their lives. I haven’t read the book (I just heard about it today), but every single thing he says in this short Q & A is absolutely bang on, and really needs to be said. Actually, it will need to be said over and over and over and over, because there is no shortage of people who seem bent on casting doom and gloom about the current generation of parents and kids. This older generation (I’m part of the “older” generation by the way) penchant for hand-wringing goes back at least as far as Socrates and Plato, and probably further. And, as Mr. Kohn points out, it’s amazing how quickly each generation forgets that most of what they are saying about the younger generation was said about their own generation 30 or 40 years ago.

That’s why there will always be a lineup of people eager to tell you that you’re being too nice to your kids, or that you aren’t firm enough with them, or that you shouldn’t let them into your bed, or that you must teach them to “self-soothe” or that the reason your young adult child is having trouble finding a job is that you didn’t let him fail enough.  Actually, I especially thank Mr. Kohn for attacking the cherished notion that failure teaches kids how to succeed.  My observation has been the opposite. For the most part failure tends to teach kids how to fail – that they are incapable, not very smart or that there is no point in trying.  Of course, it’s not black and white. Nothing is. There is a level at which people can learn from failure — or, more to the point, trying to do something and not doing it as well as you’d hoped to — but failing not nearly as great or reliable a teacher as many people make it out to be, especially for young children.

Anyway, print this column off  stick it on your fridge, and reread it every time someone tells you the parenting sky is falling. It may help you feel a little better. And, as I’ve said before, when parents feel a little better, they usually parent a  better.

If you want to know more about Alfie Kohn and his book, The Myth of the Spoiled Child, check out his website.

 

 

Bringing some much needed levity to the discussion of how the media is “wrecking” parents

Someone was kind enough to forward me the link to a New Yorker article that may just put smiles on the faces of parents who are frustrated with the media. The study it references seems to be a hoax. But no matter, gotta love it!

This article may have the side effect of putting you in a better mood. And according to me, that makes you a better parent.

It’s Not Parents Who Need to Relax. It’s The Hotheads Who Give Them Advice

I feel sorry for young parents today. I really do. There’s never been a time when the world was so full of advice givers, all competing for your attention, all trying to outdo each other with the alleged crucial importance of their counsel.

I’ve been concerned about this for years and I’ve written about it many times before, most often in the column I once had for a Canadian magazine called Today’s Parent. Sadly none of that did any good. The problem is getting worse not better.

I got so sick of deconstructing media parenting advice BS that I actually stopped blogging for six months.

What prompted me to write today? Oddly enough, it was a newspaper story that I mostly agree with… except for one sentence. And that one sentence in this largely bang-on article exemplifies the problem. The article in question was about the importance of teaching kids to cook – something I agree with. We could debate about exactly how and at what age this needs to happen, but I think that if all young people could cook several meals from scratch by the time they left home we’d have a healthy, leaner and possibly happier populace. One of the things I’m most proud of, as a father, is that all my (grown-up) boys like to cook. They even call me for advice sometimes, which is really cool. Sometimes they give me good cooking advice, which is even cooler.

But here’s the sentence that got me riled up in the story about the importance of teaching kids to cook: “Every day that we call our kids to dinner, rather than asking them to help get the meal on the table, we are failing them.”

Failing them. Come on. That’s a classic example of the kind of overblown statement thrown at parents pretty much every day.

A few months ago back to basics math pundits managed to create a media-induced moral panic because Canada had slipped a few notches in international math test scores. We were “failing” our kids because we weren’t making them memorize their times tables, or so they say.

More recently came the breathless revelation that a new study had reportedly shown that breastfeeding didn’t make kids smarter after all (i.e. why are you knocking yourself to breastfeed and/or why are you feeling guilty if you didn’t,  you silly people).

I could go on. But my point here is not to deconstruct individual media stories. What I really want to talk about is parents’ anxiety. Anxiety seldom helps parents parent better. And there is way too much going on in our information society that makes parents anxious.

It’s not any one story that’s the problem. It’s the constant onslaught.   Take breastfeeding for example. Let’s say you think breastfeeding is important and good for your child. Well, one thing you can count on is a steady trickle of media pokes to tell you that some of those benefits may have been exaggerated, and that you’ve been duped into doing something you didn’t really need to do.

Of course, if you didn’t breastfeed, there will be even more articles that make you feel bad because of all the “benefits” your baby didn’t get. Not to mention the occasional article that exhorts you not to feel guilty, which probably makes you feel guilty for feeling guilty.

If your baby wakes at night you’ll be told it’s your fault because you didn’t teach your baby to “self-soothe.” And if you did try to teach your baby to sleep through the night via one of the methods which are often (and often unfairly) labeled CIO (Cry-it-out) it won’t be hard to find suggestions that you were cruel or harmed your baby in the process.

If you breastfeed your baby in bed and then you and the baby both fall asleep (which is entirely normal, even inevitable, biologically), you’ll be told you’re putting your baby at risk of SIDS (which is shite). If you don’t share a bed with your baby someone out there may tell you you’re not fully into attachment (which is also shite).

Child care pundits will tell you, on one hand, that quality child care builds better, smarter children. Then they’ll turn around and say that most of the child care in Canada is mediocre. In other words, you need something that most of you can’t get. Lovely.

Parents can’t win, no matter what side of any ideological equation they are on. So increasingly I find myself thinking that parents should stop reading parenting advice. I really don’t think it’s doing much good. I can’t say that parenting advice never does any good. But on balance, it’s doing more harm than good these days.

A big part of the problem is the way experts and media writers compete so desperately for your attention. So they have to make everything they say or write sound as if it’s the new, more important truth that you have ever read. That’s never true. It’s just hyperbole from people trying to sell their ideas in order to stand out from the crowd.

Then, every once in awhile, someone chirps in with, “Parents need to relax!” Well, I’d suggest that the people who give parents advice should try relaxing.

Thus,  information – much of it anyway – is not your friend. My best advice – oops here I am giving advice in an anti-advice blog – to new parents would be surround yourself with supportive people. Good support will help you be a good parent. Information, I’m afraid won’t always do that. I’ve written about this before.

This information thing is not going to change folks. Actually it will change in some way. Everything changes. But I don’t see it getting better So my conclusion is that today’s parents need to protect themselves from advice – especially parenting advice that comes from the news media. Take everything – everything – including this blog – with a major grain of salt. If you’re reading something that makes you feel bad stop, and go hang out with somebody who makes you feel good about yourself. Parents who can manage to feel good about themselves and enjoy their kids (not necessarily every minute) will usually parent pretty well on balance.

Fifteen or so years ago I wrote a column for Today’s Parent where I cheekily declared that the secret to being a good parent was being in a good mood. I still believe that. So ask yourself, does the parenting info you’re reading put you in a good mood? If not, I’d stay away from it.

Bedsharing per se is not dangerous. The headline you didn’t read

Note added July 16, 2014

For those of you who may have seen news reports in mid-July of 2014 about a new study that allegedly reinforces the risks of bed-sharing and are wondering if that study negates what I’m saying here, it doesn’t really. For an excellent deconstruction of that study check the Evolutionary Parenting blog.

 

Original Post October 2, 2013

As a writer, I’m really quite stunned at how easily many journalists, some members of the news media in particular, allow themselves to be manipulated by the spin wizards who write media releases for researchers and medical associations. And I have to say, these spin wizards really are very effective at dictating the way the news media covers medical issues.  Recent case in point. The Journal of the American Medical Association (JAMA) published data from the National Infant Sleep Position Study, which was launched 1992 to monitor the impact of the Back to Sleep Campaign. (ie. Are parents really putting infants one their backs as they are advised to do to prevent Sudden Infant Death Syndrome (SIDS)?)

For some reason the recently published paper focused on bedsharing rather than back, front or side sleeping. That a bit odd, given the alleged goals of the study. Mind you it’s not all that surprising given the single-minded, almost maniacal, obsession some American physicians have with trying to get mothers to stop taking infants into their beds at night.

Anyway, this study found that between 1992 and 2010 the percentage of parents who sleep with their babies actually increased. It pretty much doubled as a matter of fact. This, I would point out, happened during a time period when the rate of SIDS  went down. Now, some might think that headlines would read “Reduction in SIDS rate linked to increased bedsharing,” or “Bedsharing rate rises as SIDS rate deceases.”  But, no, the headlines, which were eerily similar, all said something to the effect of “More parents bedsharing in spite of the risk.” And they quoted the lead author’s opinion that medical professionals had to work harder to get parents to stop bedsharing.

We must ask why. Why did all the coverage spin this data into yet another indictment of the family bed?I can’t say for sure, but, based on my experience, I’ll just bet a media release was sent out by either JAMA or the American Medical Association itself. And I’d guess it contained a headline, or at least line or two, that read very much like the headlines that framed most of the news stories about the study. Then, as often happens, the uncurious, and perhaps very rushed, media did more cutting and pasting from the news release than real research and writing. I can’t tell you how many media stories I have seen on issues like this that have almost the same wording, because journalists basically parrotted the media release. That’s how the media allows spin doctors to determine what you read in the news.

What’s interesting is that at the same time JAMA posted the article about the increase in bedsharing they also posted an editorial, an opinion piece, by Dr. Abraham Bergman, a Seattle pediatrician who has been involved in SIDS research and advocacy for many years.  His editorial bore the headline: Bedsharing per se, is not dangerous. In it he questions not only the evidence supporting the campaign against bedsharing, but also the accuracy of SIDS statistics, given the way the definition of SIDS keeps shifting. In a lot of jurisdictions, if the baby dies in the parents’ bed, medical examiners won’t call it SIDS, even if there was no evidence that the baby suffocated. But if a baby dies in a crib, which, of course, is the “approved” place, they call it SIDS, unless there is evidence to the contrary.

I was happy to see that a fair number of the media stories mentioned Dr. Bergman’s editorial, however that was usually buried fairly far down in the story. Some people don’t get past the headlines. And headlines create impressions and memories. That is what they are designed to do. So influencing headline is important part of a spin wizards’ job. Just try to find news headlines that say,  “Respected, experienced pediatrician questions his colleagues’ nutty views on the supposed dangers of bedsharing.”

Back to the documented increase in bedsharing  that is alarming some pundits. According to the study, bedsharing, as a regular nightly practice, is still rare (about 11% of parents admit to doing this). Earlier data from the same study suggested that almost half of parents do it sometimes, if not nightly.  In other words, bedsharing is an entrenched practice, one kind of normal in American families. Hardly surprising, as I have said previously, in a society that actively encourages breastfeeding (although, we are far better at telling mothers to breastfeed than helping them to do it.). The link between breastfeeding and bedsharing is a biological reality.

So the real news is that bedsharing is increasing, not in spite of the risk, but in spite of the vendetta against it. Maybe some of the anti-bedsharing crowd should ask themselves why. Maybe they should try to understand the parents who do it, rather than acting like the parents are just plain stupid.