Part 2: Real Self-soothing.(It’s not what sleep experts say it is)

This is the second of a two-part post. If you haven’t seen Part one I suggest you read it first.

When I left off I was talking about self-regulation in children and how its early development begins with parents “regulating” babies externally.

Another great piece of concrete scientific evidence on how this works comes from Dr. James McKenna’s co-sleeping studies, which some of you may be familiar with. Among other things, his work showed that sleeping next to a parent (mothers in his studies) helps to regulate a baby’s heartbeat, breathing, body temperature, sleep state and arousal level. The famous kangaroo care studies (by other researchers) have shown similar sorts of things. Near-constant physical contact with an adult body helps premature babies regulate their body temperature and breathing, and simply helps them to thrive.

So, as a parent, your body has a physiological, regulating impact on your baby.  You probably already knew that. I sensed it as a new parent but had trouble putting it into words. I touched on that in a previous post.

Back to the specific link between infant feeding and self-regulation, which I explained in my last post. Here’s a really cool thing you might not know.  Dr. Stephen Porges’ research (see Part one) has shown that along with providing nutrition and comfort, infant suckling also helps develop the facial muscles and other neural pathways that are essential for smiling and other aspects of social interaction. Some of these mechanisms start to become more functional at around the age of six months, when he says infants become able to engage in self-soothing.

Yikes! Doesn’t this sound like Dr. Porges is saying the same thing as the sleep pundits whose mantra is that infants become capable of self-soothing around sleep at age six months?

Not at all. Which leads me to the even cooler part.

The self-soothing that Porges is talking about is not a solitary pursuit. Rather it’s the enhanced developmental ability to seek out the social interaction that is an infant’s primary source of comfort. Babies have ways of getting us to interact with them before age six months – crying, smiling, waving their arms and legs, looking cute and vulnerable etc. But at around six months they become more aware and consciously active participants in the process, plus they are more capable of being comforted by things other than feeding and physical contact (although those remain important), such eye contact or your soothing voice. Here’s how Porges puts it in one of his articles:

“For humans, maturation does not lead to a total independence from others, but leads to an ability to function independently of other people for short periods. Moreover, humans, as they become more independent of their caregivers, search for appropriate others (e.g. friends, partners, etc.) with whom they may form dyads capable of symbiotic regulation.”

In other words, self-soothing is not about a little baby lying there crying for comfort and then somehow having this eureka moment where he thinks, “You know, I don’t really need Mom or Dad to get back to sleep anymore…. Zzzzzzzzzz.”

It’s more like, “Hey, I’m starting to figure this thing out about how to get Mom or Dad or big brother or Grandma to interact me. And, come to think of it, I’ve noticed that sometimes I can get by just knowing that Mom or Dad is there and paying attention to me.”

Six-month-olds don’t really think like that, of course, but you get the drift. If there is such a thing as “self-soothing” between 6 and 12 months of age, it is the beginning of an enhanced ability to manage the way you seek out social sources of comfort and support. Improved internal biological calming mechanisms, which the baby does not consciously manage, play an important role. They help the baby stay in the calm and alert state which enables her to focus on and participate in back-an- forth social interaction.  This “social engagement system,” as Dr. Porges calls it, is a crucial mechanism for recovering from stress and, more generally, managing physiological, emotional, cognitive and social self-regulation (see previous post) throughout life.

Does this relate at all to the self-soothing sleep professionals talk about? Mostly no, but the confound here is that some babies do wake up and go back to sleep on their own. I’d guess that many are physiologically calm when they do so and that their internal calming mechanisms help them go back to sleep.  I can’t tell you why some babies are like that and others aren’t – although I’ll bet variations in vagal tone have something to do with it some of the time.  Dr. Porges’ research has shown that babies who cry excessively tend to have poorer regulation of the vagal brake. That could explain why some babies are less upset than others when they wake at night and why sleep training goes so much harder with some babies than others.

Bottom line, it’s safe to say that babies who go back to sleep on their own do not do so because they are employing self-calming techniques they learned while being Ferberized.

In fact research by Wendy Middlemiss, of the University of North Texas, suggests that in some cases at least, it’s the opposite. She monitored cortisol levels (cortisol is a hormone that helps mobilize our physiological resources to deal with a challenge or threat) in babies at a New Zealand clinic where they practice a sleep training technique that really does warrant the term “cry it out.” In this clinic, after mothers and babies went through their normal bedtime routine the babies were left in a room to, well, cry themselves to sleep, and the mothers were not allow to go back in (nurses went in to check on the babies but they didn’t offer comfort). Middlesmiss (who does not espouse controlled crying sleep training methods, by the way) and her team measured the babies’ levels of cortisol on the first and third nights of treatment. On the first nights, when the babies were wailing away, they had elevated levels of cortisol (and so did the mothers).  On the third night, most of the babies were going to sleep with little or no crying. But their cortisol levels were still elevated.

What exactly does that tell us? I couldn’t say and I not sure anyone really can. But at the very least it strongly suggests that these babies were not physiologically calm when they fell asleep, even though they weren’t crying. Actually, their stress response systems were active.

Now, this does not prove that the methods used in that New Zealand sleep clinic, or any other of the variations in sleep training methods, damages babies. Human beings are resilient and can recover from setbacks – the stress of sleep training is far from the biggest bump in the road a child can encounter. But if someone wants to use sleep training and self-soothing in the same sentence, the most scientifically accurate thing to say would be that ignoring a baby’s cry is a disruption of the social process by which babies learn to self-soothe. Dr. Porges refers to it as “a violation of the child’s biological expectation of safety from an external source.”

Keep in mind that all babies will experience these violations from time to time – not just in the context of sleep training, but for all the myriad reasons that parents can’t necessarily attend to babies immediately: having other children to care for, other responsibilities to attend to, being exhausted or frustrated or ill.  Children will also experience similar violations many times in interactions with peers and other people as they grow up. Babies are designed to withstand some of these violations, provided that for the most part parents do respond, not just to a baby’s distress, but also to their other bids for social interaction.

So with respect to sleep training, for me, it’s not a question of absolute right and wrong, it’s about a risk/benefit question for each family. If parents feel that their functioning is greatly compromised, or they are highly stressed by lack of sleep because of an older baby’s night waking (or that their baby is adversely affected by night waking) it’s not our place to second guess them if they want to try sleep training. Highly stressed, unhappy parents aren’t the best thing for babies either. So if a family tries sleep training and it works relatively quickly, and they don’t have to keep doing it over and over again, and the parents understand that the non-responsiveness required in sleep training is an exception to the rule, and if less interrupted nights help the parent(s) be happier and more responsive and sensitive to their babies, then sleep training could be helpful for a family.

But at the same time, if parents want to soothe their babies at night, because they think that’s what their child needs, or they find it easier, or because they’ve tried sleep training and it didn’t work (which happens frequently), sleep training proponents have no right  to tell them that they are failing to teach their babies to self-soothe. Science tells us otherwise.

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About uncommonjohn

I am one of Canada's top parenting writers. My areas of expertise and interest include debunking bad parenting advice (especially about sleep), self-regulation, fatherhood, child development, children's mental health, childbirth and breastfeeding.
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39 Responses to Part 2: Real Self-soothing.(It’s not what sleep experts say it is)

  1. Andrea says:

    Thanks for this. I have always followed my instincts and responded to my children in the night, and it did get tiring to read books and articles that implied I was “creating monsters” who would never be able to sleep without me. I just read a Q&A with a doctor in the G&M the other day that stated co-sleeping is basically always dangerous, and “most” babies will need sleep training because it doesn’t happen naturally. So frustrating to know new parents will read that.

    • uncommonjohn says:

      Thanks Andrea. That doctor’s comments seem to display a disturbing level of ignorance. It just shows that some professionals who give advice to parents have only a superficial understanding of normal sleep and child development and how easily they can be influenced by the sleep training crowd, many of whom essentially think that parents and babies sleeping together is maladaptive.

  2. Liz says:

    Thanks for this article, really interesting and helpful. What I find frustrating is sleep trainers condemning those of us that choose not to sleep train by saying our babies are chronically sleep deprived and we are irresponsible.

    I also find it incredible that ‘experts’ can think co-sleeping is maladaptive, when it’s only really North America and some of Europe that doesn’t practice it, and we have only not been practicing it for 100 years or so. It’s so utterly, utterly blinkered to rule it out and disapprove of it so heavily.

  3. remmus26 says:

    Very interesting post! I’m always so interested in the child development aspect of it all. Especially now that I have a six month old baby of my own who happens to co-sleep with us. :)

  4. I absolutely respect your ability to combine a truly scientific outlook with good writing and genuine empathy across the board. You address a previously unknown need for me, and I imagine many others. Beyond the sharing of information and thought, you are also creating space for dialogue. Thank you a thousand times over.

  5. Stephanie says:

    Very interesting reading. My 16 month old wakes frequently in the night (normally hourly, sometimes more) and I have debated CC as I’m so tired. IRL, everyone I have spoken to has done CC on their children because otherwise they “manipulate” you into picking them up. People think I’m crazy for “allowing” such behaviour and “still” cosleeping and breastfeeding. It gets very tiring to hear this constantly so it’s nice to read articles such as this one. The study you speak of has been mentioned a lot recently and it was also nice to hear more about it. I had assumed the babies were followed for longer than 3 nights. I would be interested to know if their cortisol levels are still elevated a week or a month later. To stop hourly wakings after 16 months, if it only meant 3 nights of stress, to me doesn’t actually sound that bad! I had assumed the stress went on far far longer than that.

    • uncommonjohn says:

      Hi Stephanie: Nobody can say what the babie’s stress levels were on subsequent nights because they didn’t measure (presumably the families went home after that).
      Good luck with your sleeping situation.

  6. Mammabe says:

    To teach to self soothe is usually to teach that a childs primary form of communication ~ to cry~ is not functional. This would tally up with the data that suggests Cortisol levels are still elevated three nights on from initial crying out. I assume that cortisol levels were taken before sleep training commenced in order to establish baseline?

    • uncommonjohn says:

      Hi Sandra: They measured cortisol via saliva samples taken at the start of the sleep routine, which would be before the babies were left alone. That would have been the baseline. Then they took samples again 20 minutes after the babies had gone to sleep.

  7. Catherine Edwards says:

    Fabulous article! I have four children, 20, 17, 16 and 6 months (yep, big gap!) The first co-slept very little (his choice as he simply slept better in his cot) the other 2 co-slept up until 3-4, not every night, and not all night, they were always welcome in my bed if they wanted too but often wanted their own space too. My little one sleeps in our room but doesn’t settle very well in our bed, but does in her cot. All were/are breastfed. I really do believe that the early relationship with our sleeping arrangement gave them the best possible start to life. It made them feel loved, secure, happy, content and safe. The 6 month has just started to fall asleep on her playmat (very sweet to watch!) when myself and her dad are nearby talking and has drifted off to sleep in her cot from around 4 months.
    I get quite upset when so many ‘experts’ her in the UK promote CC, so much so, that I want to become qualified in an area were I can help parents to have a positive experience with the whole sleeping experience and show them there is a safer, altogether more positive experience.

  8. Brittany says:

    Thank you for this post. I have been going back and forth with several methods from different backgrounds and this just puts everything into perspective. Thank you for the facts and the reassuring that I haven’t damaged my baby. We will keep moving forward and hope that our little 7 month old bundle will sleep more soon!

  9. Dee says:

    Brilliant!

  10. Rebecca says:

    Thank you – so much of this rings true for me. My daughter was born with a tongue tie and was a very uptight “stressed” baby. I knew there was something not quite right, as her heart rate and respiratory rate were always on the high side. Now I know it’s because she wasn’t able to access the calming effects of the vagus nerve. After the tongue tie was revised, she was able to enjoy bottlefeeding (she has never been able to breastfeed properly because of the tongue tie), she relaxed and for the first time, was able to fall asleep while feeding – before she had always been tense – furrowed brow and clenched fists. She still does not comfort suck though, sucking is still purely a functional way of getting fed. I am working hard at getting her back to the breast, not only because of all the nutritional benefits but because of the calming effects too, and because of the way it will develop the muscles and jaws.

    Interestingly, I was discussing something else with another mother of tongue tied children, and both my daughter and her children are phyically advanced. My daughter is nearly 4 months old now and can almost sit unaided, is rolling and can push herself in to a standing position in her bouncy chair. This other mother hypothesised that our children do this because the tongue ties make them tense and therefore they have to burn off this extra adrenaline… I have since directed her to your blog, as I thought you could explain it much more eloquently than I could.

    One more thing, I am so glad that my parenting choices – co-sleeping, carrying her in a sling, and generally being available for her – will eventually help her learn to self-soothe too. These parenting choices were something I felt instinctively were necessary for my little bundle of tension and energy. Now I have a proper explanation for what I felt instinctively.

    Again, thank you.

    • uncommonjohn says:

      Hi Rebecca: Thanks for your comments. I have no idea if tongue tied are more likely to be physically advance. I’d guess not, but who knows? I don’t even know that I’d assume your baby had low vagal tone, although I can see how that may be a possibility. But parents always have theories, don’t they. I had lots back in the day. Still do. I think it’s important to be open-minded about theories though. No harm in having them. It’s part of ths “scientific method of parenting. Just don’t take them too seriously.

      And, Rebecca, you gave me an idea for a blog. Thank you, thank you thank you. I’ve been bereft lately.

  11. stephanie says:

    Just wanted to leave an update. I recently moved my now 17mo to her own room and nightweaned her. Almost no tears at all and she loves her bed. It’s an ongoing process but last night she went to sleep by herself with daddy whispering reassuri g words from the hall. No tears. I believe 16mo ths of cosleeping and responding to her needs have allowed her to feel secure in this transition. Say no to cc!!

    • Stephanie says:

      At 20 months she was back in my bed and back bfing at night haha! I think she’ll be there for years – she loves it. Purchased a king sized bed and all is good with the world.

  12. Pingback: Do No Harm? | Evolutionary Parenting | Breastfeeding and Sleeping Arrangements - Science and History in Parenting

  13. Nancy says:

    Sleep training didn’t work for my daughter through her babyhood. We co-slept with her. But when I was pregnant with her brother (she was about 20 mos), I could no longer sleep in the same bed as her, so we moved her from our bed into her own bed in her own room. It took two nights of crying for about 30 minutes and she has slept happily in her own room every since. She has always liked sleeping with someone, though. She couldn’t wait for her brother to get out of the crib so he could sleep with her. Now they sleep in her room together.

    When we sleep trained her, we had to. It was a matter of sanity for our family. With her brother, we didn’t do any sleep training. We didn’t co-sleep with him either. Up until he moved out of the crib and into his sister’s room, he has always slept peacefully on his own. Every kid is different.

  14. Angela says:

    Thank you! I’ve been looking online for proof that babies can’t self soothe, all I found are articles saying you need to teach them by putting them to bed awake and letting them put themselves to sleep lol yeah ok. , I just don’t understand cry it out, my 6 mo old wakes every hr and he’s been doing this for almost 4 months, I’ve been dealing with it rather than letting him CIO , I guess I’d rather not sleep than let him suffer! I hope he grows out of this soon! He does sleep better when co sleeping, and so do I !

    • uncommonjohn says:

      Hi Angela: Of course, it depends on how one defines self-soothing, and whether or not it has been established that this is a teachable skill that all babies are capable of learning in infancy. As I’ve noted, some babies do go back to sleep on their own and sometimes, some babies will stop fussing on their own, sometimes by sucking on their thumbs or fingers. I’d call the latter (but not the former) self-soothing. what I’m not convinced about is that leave them to cry is a reliable (or ethical) way of “teaching” this so-called skill.

  15. Jenn says:

    Hi John: I can’t thank you enough for the research and writing you are doing. I have a 20-month-old son who has had, and is still having, some very serious issues. Your writing has helped me to “think outside the box” and just maybe I’ll be able to get his team of doctors to “think outside the box”, as well. I do have a question, though. Is there any research/literature that addresses how to strengthen or treat low-vagal tone and/or issues with self-regulation? Thank you a thousand times over!!

  16. H says:

    Hi John thanks for this post. I have a 7 month old who I co-nap with everyday. She sleeps on her own at night but is fed or rocked to sleep. She used to “self soothe” as she sucked her thumb and was able to put herself back to sleep when she woke up, unfortunately she no longer does this and I am up a few times every night with her. I am sick of everyone making me feel like I am doing something wrong by responding to her rather than let her cry. If I leave her on her own she becomes hysterical and I refuse to believe that it is ok to do that to her. I did read another good piece of advice which basically said no matter what you do eventually they will start sleeping through the night!

    • uncommonjohn says:

      They do all start sleeping through the night, but it takes some kids a long time. None of our children slept through until they were past the age of three. However, for the last year or so they weren’t waking up very much – once a night, usually for a short period. Many parents can live with that.

  17. Solenne says:

    Hi John, I’m really enjoying your blog, after finding it by chance when I googled “CIO didn’t work for my baby” (it was linked from another site). I’m so glad to find a voice of reason in this enormous interweb of “shoulds” and “shouldn’ts”. I have a 15 month old that needs to be rocked to sleep and everything I read either tells me I need to sleep train him OR it is absolutely wrong to sleep train him. All this leads me to feel is guilty and hopeless. Deep down I’ve known there are so many cracks in their arguments. Eg. sleep training proponents say if babies don’t go down awake, they won’t self settle through the night. But my son can often sleep long periods of up to six-eight hours without waking me up – doesn’t that imply he can “self soothe”? Critics of sleep training say to do whatever your child wants, but so many of those people have terrible situations of all night feeding and co-sleeping where no one gets any rest. I am impressed at their strength and stamina but know I want to try to encourage different habits.
    We just went through three weeks of a type of sleep training which involved checking in when the crying was a clear distressed cry. For the first few weeks it was getting better, and one night there was no crying at all. But then the crying got much worse, and my little guy just did not want to be put down on the bed awake. Why was he able to “self soothe” it a few weeks ago and not now? I have concluded it is not that he can’t. He just doesn’t want to. He has a strong will and, against a mother who doesn’t completely buy the whole “crying to sleep is crucial” thing, he is definitely going to outlast me. So what do the two sides say? Sleep trainers say don’t give in, let him cry for hours and it will eventually work. The others say comfort your baby and one day it will get better. Neither are acceptable options to me.
    My intuition – yes, finally tapping into this highly acclaimed but rarely “scientifically” examined resource – says something as basic as this: My son not wanting to put himself to sleep is very different to can’t. I think it makes the whole theory of sleep for people in our situation quite different to the two main perspectives available out there.
    Thanks John for actively bringing holes in these theories to the fore. I believe it gives parents the emotional and mental space to find their own path.

  18. themilkmeg says:

    Thank you for this! As an IBCLC I am continually asked by parents how to get their babies to sleep longer or fall asleep without breastfeeding etc. This article is a great resource for parents and you put it in a way that makes sense. Babies tell us what they need! Often times breastfeeding, cuddling and co-sleeping will bring a baby peace and comfort. This is the biological norm. Thank you!

  19. OneFitMom says:

    On the topic of debunking, have you looked at the Middlemiss sleep study in any great detail? I don’t think the study at all “proves” what it claims to prove: http://onefitmom.ca/2012/12/15/why-the-middlemiss-infant-sleep-training-study-doesnt-prove-anything/

    • uncommonjohn says:

      I have read the Middlemiss study and am confident re: the findings I reported, which may not pertain exactly to what the study claimed to prove. I haven’t read your blog, so I can’t comment on your views. I’ll try to read your blog when I get a chance.

      • OneFitMom says:

        If you don’t have time to read my (fairly thorough) debunking of the study, I’ll give you what I think to be the most salient point:

        The babies studied showed elevated cortisol levels on the first night of the study, PRIOR TO beginning the bedtime routine, and those levels did not show any statistically significant increase from pre to post-bedtime. Since infants could not have been stressed about a “cry-it-out” process that had yet to be initiated, their elevated cortisol levels were not caused by the sleep training itself, but by something else (being in a lab? being handled by strangers?). The study did not report increased cortisol levels as a result of the sleep training process!

      • Stephanie says:

        I haven’t read your debunking, but when I read exerpts of the study I thought it seemed strange too. Of course cortisol levels are going to be high! The infants aren’t in their own homes in their beds with their parents putting them down and there are people in white laboratory coats walking around! That’s going to increase cortisol levels in anyone. I still, however, believe that CC and CIO methods do increase cortisol levels and don’t think it’s healthy, or that it works long term. But – I don’t put any stock in that particular study. Have a read of “The Science of Parenting”. Very interesting info re: brain development.

      • OneFitMom says:

        Hi Stephanie,

        Thanks for your comment and your recommendation to check out “The Science of Parenting.” Looks interesting, and I will!

        CC and CIO methods can result in temporary increases in cortisol levels, however, temporarily elevated cortisol levels are a clinical finding only, and do not indicate that harm is occurring. Cortisol is not, in and of itself, a bad thing. Our cortisol levels cycle up and down throughout the day, and indeed, we experience temporary elevations in cortisol levels even after positive stressors such as exercise.

        Chronically elevated cortisol levels, on the other hand, are harmful to infant development, but a few nights of CC or CIO are not going to cause chronically elevated cortisol.

  20. Amanda Tapia says:

    Thank you for your posts. I have been struggling with trying to find a solution for our family and my son’s “problem” with not being able to self-soothe. This begins to clear up the issue. It is so hard to fee guilt…either I’m doing it wrong because I can’t bear to leave him alone to cry or I’m fostering a dependent child who can’t sleep on his own. What a challenge! After your posts I feel I must do what is right for him. I believe he struggles with his ability to calm himself and I have been helping and yet felt guilty mostly because my husband has read several books on child sleeping methods that all say I am harming him because I am not giving him a way to learn to soothe himself. While I thought the claims may be true, I didn’t feel in my heart hat it was right…thank u thank u thank u…

    • Stephanie says:

      Amanda – if you require further confirmation of your beliefs have a read of “The Science of Parenting”. I’m reading it now and it’s solidifying my belief in my gentle parenting method.

  21. Hazel says:

    Thankyou for the wonderful article. Im a 23yo mom of a 4mo old baby. I have been raising my daughter according to what i feel is best for her. Me and my hubby decided that i wouldnt go back to work untill she is 2yo because we want to focus on caring for her and providing for her needs. Everything is fine when we are at home, but when its time for our monthly visit to my parents house, im constantly being barraged with unsolicited advice on how to raise my daughter. I keep hearing, not just from my mom but also from our long time house keeper, how im spoiling my kid by responding to her every cry and that i shouldnt let my child get used to being carried all the time or by being rocked to sleep and even suggesting i stop breastfeeding and start training my daughter to bottle feed and even start at solids so that she wont be a picky eater because as they say, those are the things they did to raise me. They are also making me feel that im a lazy ass mom by choosing not to join the workforce and to just stay at home and care for my daughter. Bottomline is whenever were visiting my parents, they make me feel im a crappy parent just because im a young mom. It just feels nice to be validated by your article, that somehow, im doing something right for my kid, so thankyou.

  22. ElsMum says:

    Great blogs- thanks!
    I love your clarity and agree that self/ regulation is a better term. I had also been getting fed up with the rather snide attitude about co/sleeping, breast feeding to sleep and / or rocking to sleep, and responding to ones baby with hugs and comfort. I know this approach isn’t for everyone, due to the reasons outlined at the end of your blog, but I do resent being told I’m a bad parent.
    On a similar note, I had felt belittled by the term “human pacifier” in reference to comfort nursing or nursing my child to sleep which I encountered in some literature. Then I remembered that a pacifier is an artificial nipple, not the other way round.
    It seems to me that there is a lot of upside down thinking when it comes to parenting advice.
    What I will most take away from your blogs, is the idea that self regulation starts with being regulated by others and progresses to actively communicating needs to others long before it becomes an internal resource.

  23. Sawyer's Mom says:

    Simply
    Thank You
    I can’t ignore my son’s cries…..The adrenaline rush I get when I hear him cry even before I fully awake in the middle of the night is very telling to me. I am wired to be there for him.
    So both my son and I will struggle together and we both will sigh in relief together.

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