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.

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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2 Responses to More about self-soothing

  1. Thomas F. Anders says:

    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.

    • uncommonjohn says:

      Hi Dr. Anders: Thank you so much for your thoughtful comments. I am very pleased that you have added something to this. I always sort of wanted to create this kind of dialogue between researchers, advice-givers and parents. I think your comments give parents a better idea as to the ways in which researchers have been trying to help parents. Much of the time it is the way research is interpreted (misinterpreted) by advice-givers, and often the media, that is the problem. So it is not the term self-soothing that is the problem it’s what people think it means. And as with most things to do with human development, the truth is messy, and, as your group suggests, many contextual factors need to be taken into account. I appreciate your contribution to knowledge about infant and child sleep and your understanding of the varying needs of families.
      Regards, John

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