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.