As a firm advocate of gentle parenting, infant and child mental health, attachment, bonding and breastfeeding, I sometimes encounter confusion from my like-minded colleagues! Many people do not understand the need for gentle sleep solutions – it is sometimes seen as conflicting with attachment parenting and breastfeeding. Yet, I disagree! Here are the most common reasons for the confusion, and my answers to them:
- Babies generally do not have any underlying sleep pathology
Absolutely. I totally agree with this. No arguments! Babies are probably sleeping no differently now than they were thousands of years ago. However, there are problems with this simple viewpoint. First of all, most of my clients have much older babies – my most common client age group is 10-20 month babies and toddlers. 99% of the time they are totally normal, beautiful, lovely children, with fabulous, gentle, responsive parents who are committed to gentle parenting. Yet, these parents usually call me because their child is taking hours to settle every evening, many do not nap at all, and most of them wake at least every 1-2 hours all night long. Some of them wake up and stay awake for 2-3 hours in the middle of the night. Is this normal? Yes. Totally. But is it easy to live with? For a year? With no support, local family, or the village that we so desperately miss? Absolutely not. These parents are exhausted, frazzled, often with fraying mental health, and difficult marital relationships. These parents desperately don’t want to need my help, but they call because they know if they don’t get some sleep soon they will start to really struggle to keep a lid on their temper, their patience, and their relationships.
- This is a phase, and it too shall pass
It will pass, for sure. I promise every parent I meet that this will definitely resolve at some point, even if they do nothing about it at all. I have no idea when! For some babies, they seem to ‘get it’ by about 6 months. Other babies would carry on with their sleeping patterns for years. I honestly think for many parents, if you could just tell them their child will sleep well around 18 months, or 2 years, they would be okay with that. I really do encounter many parents who just can’t take the uncertainty. They need to have some sort of idea of what to expect. When there is no apparent end in sight to fractured nights and disrupted evenings, or they still cannot go out for a meal in the evening when their toddler is 2 ½ they begin to get quite frustrated and angry.
- Parents have unrealistic expectations of their babies and children’s sleep
I think this phrase does parents a great disservice. Most parents understand and embrace the need to keep their babies close, in the same room as them, and respond promptly when they are very small. They are sensible, well-read, and have asked around for what to expect. Many of them don’t just pick up a book that advocates strict routines and follow it rigidly. I perhaps have a controversial view on this – my belief is that the time to gently tackle a child’s sleep, is not at any particular age, but when parents have realistic expectations, yet they are struggling to cope. That might be a 7 month old baby who is waking 4 times a night, or it might be a 2 year old who takes 3 hours to bed every night. Everybody has a different level of patience and tolerance. From a family-centred point of view, if parents are beginning to unravel because of their lack of sleep, then that is no good at all for their child and family. The family is a unit, so if something isn’t right for one member of the unit, the whole system can fall apart.
- Denying babies night feeds can sabotage breastfeeding
As an IBCLC, whenever I work with families who are breastfeeding, I always have to balance the parents’ wishes, the baby’s needs, and my code of ethics. Tricky! But this comes back to expectations: most parents I work with understand the need for night feeds, and are not looking to eliminate them in a baby under about 9 months. They do sometimes want help to eliminate night feeds in their toddler, or reduce them in a baby who is feeding very frequently (for example every hour all night). But honestly, it is perfectly possible to reduce night feeds and improve sleep in older babies with established milk supplies without ruining breastfeeding.
- Trying to force independence on babies before they are ready can negatively impact attachment and bonding
There is a tricky balance here. Young babies (6 months and under) should be in the same room as their parents to reduce the risk of SIDS, and any sleep coach who recommends anything to the contrary is flying in the face of current evidence! However, gentle sleep solutions do not recommend wrenching babies and children away from the security of their parents before they are ready! Good sleep consulting should prioritise attachment and bonding, foster trust and security, and promote parent-infant relationships. Sleep can still be improved whilst considering ALL of these important factors.
- We should be focusing on supporting parents to understand their babies’ sleep behaviours, not trying to ‘fix’ problems that don’t exist
I totally agree with this! Much of my time is spent helping parents to understand sleep architecture, so that they can understand the subtle clues and signs their child gives them. This is often an enlightening and important part of sleep coaching, as it empowers parents to be able to spot their child’s sleep problem for themselves. Whilst babies and children usually do not have a significant sleep pathology, many of them are overtired, not napping at suitable times, or have an underlying problem such as a feeding issue, allergy, nutritional problem or unmet need. Once these problems are eliminated, sleep often improves organically.
- Sleep consultants are exploiting exhausted parents
It’s absolutely true that the field of children’s sleep consultants has exploded in recent years. Is this is because lots of (usually women) are opting to have a career where they can work from home? Is it because we have become a society where we just throw money at problems? I don’t know the answers, but I do know that just as in any profession, there are good and bad professionals. Some are making obscene amounts of money, and some others are under-qualified. Some are highly qualified, have a wealth of experience, and are charging fairly for their time and support. All I can suggest is that parents need to do their research! Look for what training your sleep consultant has, and how experienced they are. There is as yet, no regulatory body or code of ethics, but recent research suggests that most sleep consultants would actually welcome some kind of regulation – so watch this space!
- Sleep coaching is just another word for leaving babies to cry
Absolutely not. Coaching is a process that enables people to achieve their full potential. It is about learning, empowerment, and improving. My gentle sleep consulting work focuses on helping parents to feel confident that they understand sleep so that they can make changes by understanding the process of sleep. It is also important to help parents to feel more confident in their own parenting. For children, it is about learning to feel confident about sleep and bedtime, helping to feel positive about emotions and behavior. It is also about helping to unpick all the possible factors that may be having an impact on sleep, and addressing them holistically.
With all this in mind, my current frustration is that exhausted and well-meaning parents often end up in a sleep situation that they are finding intolerable, but are in a position where they cannot access appropriate help and gentle sleep solutions. In the UK, the professionals parents are most likely to turn to for help with sleep are their community health visiting team or their GP. As a registered health visitor, I know first hand that many health visitors are extraordinarily knowledgeable, compassionate and generous people. I know vast numbers of kind-hearted, clever and well-read GPs. There are some problems though:
- GPs and HVs often do not have the time to spend unpicking a sleep problem,
- Whilst there are some amazing practitioners, there are also others who have had very little or no training in paediatric sleep. This is not their fault.
- Some practitioners will defer to their own experiences with their children, which may or may not be evidence-based
- Other practitioners will do an amazing job of normalizing and encouraging parents with their sleep situation, but not actually be able to improve it
- Sometimes, when parents do not find the answers they are looking for, they will seek private sleep consultants to help them
This is where I come full circle: Since parents alone know what they can cope with, if they cannot deal with their sleep situation, they will take steps to address it. It therefore is essential that gentle sleep coaching exists for these parents. They need to be able to access quality, evidence based information which is supportive of infant and child mental health and protective of parent-child bonds.
My book is out soon, and will holistically and comprehensively cover many aspects of sleep biology, sleep hygiene, nutrition, health, allergy, sensory needs and feeding problems, as well as behavior, development and gentle sleep strategies. It is aimed at health professionals who are supporting families with young children, in order to equip them to be able to offer sound, sensible and practical information to parents.
The book is also being developed into a comprehensive online gentle sleep consulting course. Please email me if you would like to added to the mailing list about this course which will be commence for the first time in early 2018!
Lyndsey Hookway is a paediatric nurse, health visitor, IBCLC and gentle and holistic sleep and behaviour coach. She works privately at www.feedsleepbond.com as well as for the NHS and as an independent lecturer and trainer. She offers webinars and bespoke training for health professionals, childcare, sleep and maternity carers and parents.