by Pamela Douglas
“But does the research really prove sleep training’s efficacy?
Senior figures continue to argue forcefully that it does, despite the failure of large randomised controlled trials to back these claims …, and despite systematic reviews showing no improvement in night waking, nor reliable impact on maternal mental health … Parents continue to be warned that their child is at risk of poorer sleep and cognitive development if they allow “bad sleep habits” to persist, yet large studies fail to show that sleep training improves sleep habits in later childhood, or that longer sleep durations are linked with improved developmental outcomes … . Many parents do not want to use first wave behavioural approaches, but are led to believe it’s necessary for their own mental health and for their baby’s best outcomes.
Over the past decade, sleep training programs have been wrapped in the language of “responsive parenting”, “secure attachment” and “gentleness”. These words acknowledge the importance of responding to the baby’s cues for secure attachment and optimal brain development: few health professionals recommend leaving infants alone to cry for indefinite periods these days. But parents soon discover that these sleep programs nevertheless promote patterns of not responding directly to, or ignoring, various baby cues over and over throughout the day and night (see Table), resulting in parent–baby communication confusion.
The UK has a cultural tendency to delay responses to the baby from birth. London newborns whose parents practice delayed responses cry for about half an hour in the night at 2 weeks of age, with a greater chance of a 5-hour block of uninterrupted sleep at night by 3 months of age. But this occurs in the context of the worst breastfeeding rate in the world. London babies also cry twice as much as those of Copenhagen parents, who have high breastfeeding rates and a cultural tendency to more responsive care… . Both not breastfeeding and cry–fuss problems are linked with increased risk of postnatal depression.
In the meantime, sleep training ignores underlying factors that lead to excessive night waking. First wave behavioural strategies may worsen night waking over time, due to disruption of the circadian clock caused by an emphasis on long daytime naps… . Sleep training not only fails to identify those breastfeeding problems, which commonly result in excessive night waking in the first months of life, but worse, it undermines breastfeeding success due to feed spacing.”
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