Infant sleep (and the sleep of their parents) is a huge topic with tons of books, websites, businesses, Facebook groups and other resources devoted to the topic. One of these resources are free online infant sleep summits, one of which ran from September 11 to 14. I couldn’t watch all the presentations, but the ones I did were interesting. Here are some key insights from Little zzz’s infant sleep summit 20231.
Dr. Laura Gainche
Dr. Laura Gainche is a scientist with “a Masters in Neuroscience/Genetics and Ph.D. in Sleep physiology” and a sleep consultant2. He website is sciwom.org. She also publishes videos on the LauraGainchePhD YouTube channel.
Dr. Gainche stressed that the better you support your child to go back to sleep at the beginning, the better they’ll be able to do it themselves over time. And that doesn’t just mean in the first few weeks. Emotional self-regulation (which is needed for self-soothing) only starts appearing around when a child is 2 years old and then it takes years to really see more of it (usually until they’re around 7)1. You can watch her explain more about the skill of self-soothing in this short video on YouTube.
Dr. Greer Kirshenbaum
Dr. Greer Kirshenbaum is a neuroscientist, doula and coach with a PhD in “Medical Science and Neuroscience”3. Her website is nurture-neuroscience.com.
Dr. Kirshenbaum explained that it’s actually quite rare for humans to sleep alone – it’s just not how we are wired. Thus, it is tremendously beneficial for children from birth to at least 3 years old to sleep close to a parent, which provides a calming experience of smell, hearing the loved one’s breathing and touch that signals to the infant it’s safe enough to go to sleep. Practicing deep, slow breathing is helpful, too. She also highlighted that the parent’s emotional states are contagious – if mom is all stressed out at bedtime, it’s unlikely the infant will fall asleep easily1. You can read an interview with her about infant sleep here.
Jessica Guy
Jessica Guy is a PhD candidate in child development and “Infant and Family Sleep Specialist”4. Her website is infantsleepscientist.com.
She critically discussed the marketing of a lot of sleep consultants and how it doesn’t line up with scientific evidence. What better way to have a large client base than trying to set up expectations so unrealistic that the vast majority of infants are classified as having problems? She especially focused on a study by Kahn, Barnett & Gradisar (2022)5, which didn’t rely on parents’ reports of wakes etc. but instead monitored the infants’ sleep with audio-video-somnography (n=2090). The study showed that despite some statistically significant differences, there’s no real practically significant benefit to the infants’ sleep. I looked at the article results, too.
If you round to the nearest full wake, even infants suffering through the harshest form of sleep ‘training’ (which is basically completely ignoring your child’s cries even if s/he cries for hours, called unmodified extinction or cry it out) still had the same number of wakes (4), on average, as those receiving no sleep training at all (3.6 vs. 4.1). Those using ‘parental presence’ sleep ‘training’ had the same average number of wakes (4.1) than those not being sleep ‘trained’. Since infants slept just a bit less than 10 hours on average, that means that no matter what, the infants woke up roughly every 2 to 3 hours on average5,1.
And based on the study5,1, infants going through unmodified extinction sleep ‘training’ also only slept less than 20 minutes longer a night, on average, than those who didn’t have any sleep training at all. Those in the ‘parental presence’ sleep training group even had a slightly lower average sleep duration than those in the no sleep training group.
And when you look at the self-reported parental sleep quality measure, there was no significant difference between the groups. So the study showed that sleep ‘training’ the infant does not lead to better sleep for the parents5.
Jessica Guy1 also critically discussed some of the limitations of the study, such as which infants were included, e.g., they needed to sleep for a certain number of hours in a crib or differences in the group composition (e.g., 5 those in the unmodified extinction group were older than those in the no sleep training group, on average 10.3 vs. 7.6 months). Since sleep changes over time, the slightly longer sleep duration might simply be because the infants were older. The groups also differed in other characteristics, such as how many of the infants were breastfed or slept in the same room as the parents.5 Jessica Guy1 also highlighted that the abstract only focused on a small part of that information, trying to paint sleep training as ‘safe and effective’. She also stressed the role of parents’ values/ who parents are as parents when evaluating evidence – even if the results would show a larger difference, is ‘cry it out’ what you want to be as a parent?
Tracey Gillet
Tracey Gillet used to work as a veterinarian, but now writes at raisedgood.com, advocating for natural parenting6.
She argued that breastfeeding and sleeping close to one’s baby is how our own bodies (and our baby’s) expect to parent/ be parented. She also discussed how crucial being attached to their parents is for children – that they will even change who they are in an attempt to stay attached to you. She has a lot of articles on infant sleep and the science behind it on her blog such as this one discussing how nighttime closeness affects brain development, one on what “normal baby sleep look[s] like” and one on the developmental milestone of self-soothing.
Overall
The presentations showed again and again how big the range of normal is for infant sleep and how sleep develops over time. But people in the sleep business, such as sleep consultants, often benefit from setting up unrealistic expectations. And unrealistic expectations around infant sleep are very common in Western cultures, such as in the U.S., as are practices that aren’t in line with infants’ needs1.
References
1 Little zzz's infant sleep summit https://thezzzhive.com/infant-sleep-summit/ (last checked Sep 22, 2023)
2 Gainche, L. (n.d.). about. https://www.sciwom.org/en/about (last checked Sep 22, 2023)
3 Kirshenbaum, G. (n.d.) about me. https://www.nurture-neuroscience.com/about-me (last checked Sep 22, 2023)
4 Guy, J. (n.d.). about me. https://www.infantsleepscientist.com/about-me-how-i-became-an-advocate-against-non-evidence-based-trends-and-sleep-training (last checked Sep 22, 2023)
5 Kahn, M., Barnett, N., & Gradisar, M. (2022). Implementation of Behavioral Interventions for Infant Sleep Problems in Real-world Settings. The Journal of pediatrics, S0022-3476(22)01000-9.
6 Gillet, T. (n.d.) about https://raisedgood.com/about (last checked Sep 22, 2023)