One thing that fascinates me about the world of academic studies is the findings that don’t get reported, or at least, are not emphasized by researchers and thus, are not reported in media stories. This happened with the Temple University study on night waking which I blogged about last week. I want to tell you about a couple of really interesting findings that you may not have heard about.
And, just for some cheeky fun, I decided to do it in the form of a mock news story: the one I might have written if I parked my scientific objectivity and let my biases run rampant. Here goes.
Study shows that babies who wake in the night have better moms!
A new study by Marsha Weinraub, a psychologist at Temple University, suggests that night waking in babies may be a sign of good mothering.
Dr. Weinraub and her colleagues tracked 1200 infants for three years, measuring nighttime sleep awakenings when the babies were 6, 15, 24 and 36 months old. They also gathered data on other family characteristics, including breastfeeding and the mothers’ sensitivity.
Mothers were asked if they were still breastfeeding when babies were 6 and 15 months old. Breastfeeding is known to be beneficial for babies’ health and development. Health authorities advise mothers to breastfeed their babies for at least six months and encourage them to continue nursing for up to two years and even beyond.
The researchers also videotaped mother-child interaction in play sessions at each age and mothers were rated for their sensitivity. Maternal sensitivity has been shown to be a key factor in healthy child development.
Thus, breastfeeding and maternal sensitivity could be regarded as indicators of good mothering.
The study found that the single biggest factor associated with continued night waking was whether or not the mother had been breastfeeding when the baby was 6 months old. Since it is well known that breastfeeding is the biologically appropriate way to feed babies, this suggests that it may be normal for breastfed babies to wake in the night after the age of six months. This challenges the view, expressed by some pediatric sleep experts, that xis-month-old babies are developmentally capable of “self-soothing,” that is, going back to sleep on their own with out parental assistance, in the middle of the night.
Another key finding was that wakeful babies tended to have sensitive mothers. As Dr. Weinraub and her colleagues noted in their article, “Infants whose mothers display sensitivity during play and structured interactions are more likely to continue to awaken more frequently than infants whose mothers are less responsive.”
Thus, it appears that night waking may not be a sign of a sleep disorder, but rather an indicator of good parenting.
“This study is a clear indication that some pediatric sleep experts may need to completely re-examine their thinking about what constitutes normal in terms of the sleep and night-waking patterns of older babies,” said Biasus Maximus, a sleep researcher who was not involved in the study. “We may even need to give advice to mothers whose babies sleep through the night about how to be more sensitive and responsive to their babies.”
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Please, don’t take that last comment seriously. It would be judgmental, cruel, and downright wrong to suggest that mothers whose babies sleep through the night are insensitive. But that speculative comment is no more absurd, and in some ways, more justified by the data, than the statement made in news stories all over the world that the study shows that babies should be left to cry themselves to sleep. I just wanted to show how silly it can get when academics and media types try to turn their often hard-to-interpret data into instant rules for living, and how biases and assumptions can have a big influence on the way study results are spun.
And, in fact, even though the associations I chose to highlight between breastfeeding, sensitive mothering and night waking really were found in the study, concluding that night waking is a marker for good parenting is not justified. As my blogging colleague Tracy Cassels so adroitly explained in her Evolutionary Parenting blog on this study, the effect sizes in this study were very small, so small as to be virtually meaningless, even though, technically, the researchers can say there was a difference. (I also admire the way Tracy methodically picks apart the uber-shaky connection Weinraub and colleagues, and others before them, tried to make between infant night waking and poor outcomes later in childhood.)
But Dr. Weinraub did report (that quote I used is word-for-word from the journal article) that mothers of nightwakers, as a group, on average, tended to be a little more sensitively responsive in videotaped play interactions with their babies. I happen to find that interesting, but I can’t say what it means. But I think closer study of this association (and the association with breastfeeding) might shed some light on what I see as one of the big problems in advice for parents about night waking: the massive disconnect between what mothers are told about the importance of exclusive breastfeeding for six months, plus the importance of responding promptly and sensitively to babies’ distress in general, versus the way (some) sleep pundits tell them they need not worry about withholding or substantially delaying comfort to their babies’ cries at night in the context of sleep training.
I hasten to say that I am not aware of many sleep experts – certainly not reputable ones – who actually advise parents to let their babies cry themselves to sleep without ever going back in to provide at least temporary reassurance and comfort.
I’m starting to get some push back on my last blog. Good. Night waking/sleep training is a multi-layered issue that warrants a lot of discussion. I would like to see more of it aimed at identifying areas of agreement and cooperation between the “two sides” (for lack of a better term) as a opposed to a struggle for supremacy.
I’ve got more to say on these issues in future blogs. But please understand one thing. I do not have The Answer to sleep issues. And I can’t tell you what is the right way for you to handle it.
What I’ve been trying to do is expose some of the untruths so that we can get on with the important task of making sleep advice for parents more flexible, non-judgmental, realistic and helpful.
Uncommon Sense 
Awesome blog, very interesting.
My son is 2 years and 7 months and just went to sleep for the first time without nursing. Yes, I’ve nursed him to sleep all this time, and yes he still wakes up once a night to nurse. And I do feel its is time and he is ready to transition away from nursing. And here’s the proof- he went to sleep tonight all by himself, no crying, no screaming, just okay, love you, goodnight. It was everything I could have hoped for for us both. I have spent so much time in the past 2 years questioning my choices for exactly the reasons you’ve stated- am I holding him back from learning to self-soothe? Am I infantalizing him by nursing for this long? And yet, letting my child scream and cry for comfort just to learn that comfort wouldn’t come didn’t make sense to me. And now here he is, going to sleep all on his own, no problem, no trauma. Next step- sleeping through the night. It hasn’t always been easy- and yes I am exhausted sometimes. But my kid is a solid well adjusted roll with it independent amazing little guy, despite of or because of or regardless of the fact that he has nursed and never been left to scream and cry himself back to sleep. I love that he is transitioning into his new big boy sleep routine like a dream, I love that I just found this article tonight, and I wish your faux-article was real. It would have spared me all the judgement I’ve felt along the way.
Hi Amy: I think you’ve touched on a crucial point, which is the in which parents (mothers mostly) find themselves sort of betwixt and between on sleep. On one hand they a told to respond to their baby’s distress and their experience and hormones tell them that this is the right thing to do. On the other hand, there are persistent messages in our society telling mothers that babies can be (and ought to be) independent around going to sleep on their own and back to sleep on their own when they wake up. And some babies do do those things, often, as one commenter noted, without being taught – they just do it.
So, given that everyone would prefer to have uninterrupted nights, I think a lot of moms are conflicted, and sometimes I wonder if these conflicts are the most stressful part of it.
If a mom chooses to co-sleep, feels certain of that choice and it fits with her lifestyle, her partner is comfortable with it and the night-time nursing is relatively unobtrusive so she can get enough sleep, then there’s no problem, even if the child doesn’t start sleep through until age 3. But if she does all those things, and people keep telling her she is making her child dependent and she can’t shut out those voices, and then perhaps night-time nursing doesn’t go so smoothly, she may suffer a lot of self-doubt and anguish.
On the flipside, if a mother believes very strongly in her infant’s need to sleep independently and perhaps her own need for solitary sleep, and her approach to encouraging independent sleep (which does not always necessarily include leaving the baby to cry) goes well, and her baby seems to accept it, and she has a good responsive relationship with her baby, she’s going to feel OK, even if her baby starts waking (babies who “sleep through” often do this) and she has to go through a brief round of getting him used to going back to sleep on his own again – she’s OK, and I’d bet the baby is just fine too. But if that approach conflicts with her feeling of need to always respond, perhaps because her baby is difficult to soothe during the day, is crying hard as soon as he wakes up and/or cries so hard that he gets into such an aroused state that it takes a lot of time and effort to settle him again – is that mother going to feel OK about what she’s doing. I doubt it.
I suspect that is a huge part of the problem. Sleep experts have tried to frame night waking as a baby behavior problem. I can’t say that that is completely untrue, but I think it’s highly simplistic. I think night waking is often the mother’s problem. In a study I was involved in we found that many mothers had a baby who woke regular yet did not consider it a “sleep problem”. And while how often the baby woke and for how long, and how upset the baby was on awakening, were part of what predicted whether or not the mother defined nightwaking in terms of her baby having a “sleep problem” one of the biggest determining factors was whether or not she felt she got enough sleep and could function during the day. Quite a few mothers in our study felt they got enough rest and that they functioned fine during the day and those mothers were much less likely to deem night waking a “sleep problem.”
Amy, I too often questioned my decision to nurse to sleep and bed-share with my baby, and blogs like this definitely show that we are not alone in what we feel intuitively to be right for us and our babies. I also have friends who are very responsive to their solo-sleeping babies and their relationships are great, too, so I’m glad to see this blog post representing both “sides.” I actually just blogged about my insecurities related to co-sleeping. Maybe it would resonate with you? (And I mean that; this is not just a shameless plug for my blog.) So happy to hear you’ve nurtured such a strong, indepedent little boy. It will be interesting to see how my own co-sleeping journey ends.
Great to see someone pointing out the disparity between advice to breastfeed/attend to needs of child but to be less responsive at night. I struggled with night wakenings for a long time, but in the end changed the way I operate and started going to bed at the same time as my children (who started going to bed a little later) and getting up much earlier. It was revolutionary!
Things change when we become parents and I sometimes wonder if resisting this is the biggest cause of stress for most of us. Acceptance of the changes is made much more difficult by media reports and contradictory advice, plus lack of knowledge on the part of some medical practitioners (particularly on ‘normal’ sleep, but also regarding what is ‘normal’ breastfeeding behaviour for a baby/toddler/young child).
See my response to Amy below for more thoughts on this issue.
That’s what I do… Go to bed with my kids and (try) to get up earlier… Had a good routine going for a while but number 3 is 7 months old and waking 2-3 times a night…I co-sleep with all 3 kids (2 boys aged 4 & 6 now in a bunk bed pushed up beside me and little girl in the big bed… Night owl hubby in his own room where I can visit ;P) the kids and I are in bed around 9, and I used to get up at 4 to work from home… Was just starting to question myself because the night feeds are making it harder for me to wake up that early, and even when I do, bubs wants to get up at 5… Your tongue-in-check article cheered me up and reminded me how much I love doing this my way despite the difficulties. Before I know it the dynamics will change and I will have something else to worry about, so I’ll just settle back and enjoy this phase while it lasts 🙂 I will also try to remember that my 4 year old’s megalomania and my 6 year old’s hypersensitivity & lack of empathy have much more to do with who they are as personalities rather than whether I spoilt them, denied them the opportunity to learn to self soothe or made them overly dependent on me LOL
Oh… Not just their personalities, but also the age and stage they are at!
Thank you for this post. I got a lot of feedback from well meaning friends that I was ‘doing it wrong’ by cosleeping and breastfeeding my baby until he was nearly 3. He is now quite independant and sleeps all night in his own bed after a gentle transition.
I still lay with him until he goes to sleep but I think that is because I miss our night time cuddles 😉
Do any other co-sleeping mummas find they miss it too once you are no longer bed sharing?
I’ll be back to read some more
I have tried (half heartedly) to put my daughter into the co-sleeper crib – you know, one of those cribs that sits next to the bed, so your baby is literally only 2 feet away. I lie in bed and gaze at her longingly until she stirs ever so slightly and then I have an excuse to slide her in next to me…
Thanks for writing about such an interesting subject matter with the perfect blend of humour and sensitivity 🙂
“the massive disconnect between what mothers are told about the importance of exclusive breastfeeding for six months, plus the importance of responding promptly and sensitively to babies’ distress in general, versus the way (some) sleep pundits tell them they need not worry about withholding or substantially delaying comfort to their babies’ cries at night in the context of sleep training.”
This sentence really crystallizes something I have felt uncomfortable with ever since the birth of my daughter. It’s almost as though mainstream Western culture asks us to parent one way during the day and another way at night. Never made any sense to me, so I basically ignored it.
I wonder, too, if there isn’t so much variety among the sleeping behaviors of healthy infants that the range of “normal” is just impossibly broad. And even if “most” babies are sleeping through the night by x months of age – if mine isn’t, does that really mean I should take action to try to change that? Or is she just in a different spot on the continuum?
You’ve hit the nail on the head. Yes, IMO, the range of normal in infant sleep is impossibly broad, at least for one-size fits all advice and simplistic notions of what is normal. The ranges of parents experiences and philosophies – and lifestyles – are very broad too. The needs of a mom who is able to/chooses to stay-at-home and one who has to get up at 6:30 am to get to work, or who already has another toddler who wakes up, or has no partner, or has a partner who isn’t comfortable with co-sleeping, or who has to get up early in the morning – the list goes on, may be entirely different.
That’s why, IMO, sleep pundits (on all sides) simply must become more flexible in what they accept as normal and OK in terms of ways to handle night waking.
My now 11 mo started sleeping through the night around 3 months but eventually started waking again around 2 AM and usually again around 5. (As you mentioned in your last post, such changes are normal.) Since he goes right back to sleep when I take him into my bed and nurse him, I barely noticed the change and didn’t mind it at all — until our new pediatrician said that I had to night wean him because night nursing causes tooth decay. If LO nursed himself to sleep I was supposed to brush his teeth with a silicone brush or wipe them with a damp cloth. Yeah right — a baby who just fell asleep at the breast is going to let me jam something into his mouth. I tried that for a while and it was bad news.
Anyway, it occurred to me that I rarely see tooth decay mentioned in discussions of night nursing, and it turns out there’s a good reason: breastfeeding doesn’t seem to cause tooth decay:
http://kellymom.com/health/baby-health/tooth-decay/
http://www.nlm.nih.gov/medlineplus/ency/article/002061.htm
This is just another example of sleep advice based on bottle feeding rather than breastfeeding. It’s well known that formula is more filling than breast milk, so formula-fed babies have a better chance of sleeping through the night. But it cuts the other way, too: if you’re willing sleep-share, it’s easy to nurse a baby in your sleep, whereas bottle feeding at night can be arduous. So it makes sense that a bottle feeding culture would emphasize sleeping through the night, but we shouldn’t be regurgitating the same advice for breastfeeders.
More fundamentally, I agree with you that unless there’s good scientific evidence that a particular sleep pattern is associated with better health (which there isn’t), good sleep habits are whatever works for the parents and the kids. End of story.
Very interesting. Can you provide the link to the study you’re referencing? Thanks!
Hi: As it turns out this paper is online open access http://www.temple.edu/psychology/weinraub/documents/2011-1-Infant_Sleep_awakenings_fro_m6_to_36_months_of_age.pdf
Happy reading!
I know it may smack of an obstinate anti-modernity (or ante-modernity, as I prefer to call it…), but what has continued to bubble up through my thoughts for the last 12 years of kid-rearing, and in relation to sleeping in particular is — “What did our early modern human ancestors do with *their* babies?”. Don’t get me wrong, I know there is a wealth of important information we’ve gleaned over the last 2,000+ years of “scientifically” studying ourselves and life here on Earth. But when it comes to nurturing our young, I think we were most in our prime, and most in tune with the natural flow of development when we didn’t (seem to) think so much about it. I believe this is made evident when one considers that the most modern parenting movement on the planet, most in line with the largest bulk of current scientific data (particularly new neuropsychological data), and quickly becoming the most lauded methodology for raising children to be fully developed, mature, happy, and successful adults — Attachment Parenting (Natural or Connection Parenting in some parts…) — is based almost solely on bonding and relating with our babies in manners and using methods exactly like our early ancestors used. The best ways of nurturing our young are proving to be the oldest ways.
I think that’s true in part because we came by those ways naturally. Our early modern human progenitors weren’t theorizing too much about best parenting practices, to say the least. They were likely doing only what they’d seen done, what they knew and felt intuitively, and what worked. And it worked so well, in fact, that we became the most rampant species around! That didn’t happen because some scientist figured out how best to get our kids to sleep (or get connection) at night. The science of nurturing grew itself organically out of us and through us because the best nurtured were the best developed and thus the best able to live long enough to mate. It’s truly survival of the best nurtured. And we humans have historically been the most highly skilled nurturers on the planet.
If anything, we’ve only been clouded by our attempts to prove things about child-rearing, to codify it, and to prescribe ways of handling behaviors. That Behaviorism thing has really cost us in terms of how to experience parenting. Our children are not bundles of behaviors to be shaped, they are people developing naturally in need of assistance in order to grow and adapt to the current prevailing ideology(s). When we choose to see our children with this perspective, then the question shifts from “How do we get our kids to do what(ever) we say?” to “How do we work together to meet all of our needs?”.
So as a “Cro-Magnon Parent” looking to meet the most needs in our family — we sleep with our babies. We have a 5 year old in bed with us now. And when the older ones have a nightmare or some need of comfort in the night, they can come get in the family bed, too. We remodeled our home a couple years ago and stayed in a one bedroom studio during the construction — now, none of us would wish to be cooped up in a teeny studio instead of our lovely spacious home, but the truth is, none of us have ever slept so soundly as when we were all in the same room at night…
Thanks for your thoughtful post(s), John!
Be well.
Reblogged this on Charlie Foxtrot and commented:
Well this is a different take on things! I love it!