Does a new study really support leaving your child to cry?

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baby-crying-cribOnce again I find myself having to take apart research that has managed to make the rounds that is being held up as proposing that crying-it-out is good for babies.  That they need it to learn how to sleep.  That they need to be left alone to learn how to self-settle.  And it’s sickening.

Babies need us to be honest about the data we collect and report.  They need researchers not to bend their results to support theories that may sound nice or fit with what is popular these days to give themselves press.  They need journalists to actually read the articles and have someone explain exactly what was found so they can accurately report it.  They need this because they are the ones paying the price for our need to sell papers and build a reputation as “experts”.  In fact, they aren’t the only ones – parents pay the price for this too as these findings continue to undermine them and their instincts.  Telling them that listening to their child cry out for them is really okay, even when it breaks their hearts.  This causes them to doubt all they do, and when they doubt themselves, they are forever stuck looking to someone else to tell them how to parent their child.  Always wondering if what they are doing is right, especially when it feels right.  This has to stop.  But in the interim, I will continue with breaking down the research as it is written up for publication and hope that enough people read articles that truly tell parents what is going on so they can avoid the horrid interpretations that get the popular press salivating.

So, what is this new research?  It’s an article by Masha Weinraub and colleagues on sleep patterns, notably night wakenings, in children aged six months to three years[1].  Now, let’s ignore what the popular press has reported and actually look at the study itself…

The first issue that strikes me in this piece is in the introduction where it suggests that night wakings and needing comfort to return to sleep is a precursor to “later problems with physiological, emotional, and behavioral self-regulation” with eight citations to support this claim.  Having never read such a claim before, what did I do?  I checked out each and every one of these eight citations.  And here is what they said.

The first, by Ronald Dahl[2] is a conceptual piece, meaning it is hypothesizing a model to explain the development of regulation of sleep and arousal and is not an experimental piece with a study showing this causal pathway, thus it does not actually provide evidence for this claim.

The second by Eric Dearing and colleagues[3] discusses the relationship between poverty and maternal depressive symptoms.  There is absolutely no measure nor discussion of infant arousals or later regulatory problems thus I’m not entirely sure why it’s here at all.

The third is a piece on how sleep affects the development of the visual cortex[4].  This particular study was done with cats and the degree of sleep deprivation given to them would most definitely suggest a problem for an infant and is not at all indicative of the night arousals that many infants experience.  So yes, this study does suggest that there is a possible effect on synaptic plasticity in the brain of cats when severely sleep deprived; how that relates to infant and night arousals, I will leave to you to determine.

The fourth is a large, population based study from the Dunedin Multidisciplinary Health and Development Study and examines the question at hand – long term implications of sleep problems[5].  However, the youngest age at which sleep problems were examined was five years of age.  Nothing from infancy and toddlerhood.  So while the researchers did find that persistent childhood sleep problems were associated with anxiety in adulthood (but not depression), we have no idea if these were problems stemming from infancy or even toddlerhood.  Furthermore, there is no clue as to what these specific problems are as the questions were very vague (“Sleep problems last night?”, “Typically has sleep problems?”, and “Does child have sleep problems?”) and thus may not have anything to do with arousals at night.

The fifth is a review piece by Katherine Karraker[6], in which she reviews the literature on factors that predict night waking in infants beyond the first few months of life.  Importantly, at the very start of her piece, she mentions that the interest and importance of night wakings to clinicians is because of their effects on the parents, not the infant.  She also mentions that at a year of age, approximately 20-30% of infants regularly signal at night to their parents and that many parents who reported infants sleeping through the night see a resurgence in night wakings when infants are between six and 12 months.  What is relevant here is that the research does support that there are a subset of infants who show early signs of behavioural dysregulation who also show frequent night wakings and this seems to follow them into later years.  However, the researcher who has done this work (DeGangi) suggests that the effect is more correlational than causal: Infants with behavioural dysregulation show sleeping problems because of their general heightened arousal and that this heightened arousal is what leads to behavioural problems later.  But that is the only information in this article to suggest night wakings are related to (but not the cause of) later behavioural problems.

The sixth is an article looking at whether sleep problems (defined as night wakings or bedtime struggles) in children six months to four years of age are related to other features of the family[7].  Again, as with the findings in the Karraker piece, the findings are correlational not causational, but they found that sleep problems were associated with any of five factors: an accident or illness in the family, unaccustomed mother absence during the day, maternal depression, co-sleeping, and maternal ambivalence towards the child.  If there were longer term repercussions, I would imagine that, again, we’d be dealing with these factors (minus co-sleeping) as the root cause of both night wakings and later behavioural problems, but this particular piece does not address this.

The seventh is another brief review[8] and the only discussion of a link between sleep problems and behavioural problems is the following sentence “In one survey, 12.5% of 3-year-old children had settling problems, and one-third of them also had a generalized behavioural difficulty”.  That is it.  No reference to causation or any link to earlier night wakings.

And finally, the eighth article is relevant as it examines sleep problems in infancy and later development of ADHD[9].  The study did find that severe sleep problems were predictive of ADHD at age five and half.  However, severe sleep problems were found in only 27 of 2089 children and only seven of the 27 met the criteria for an ADHD diagnosis.  So at the end of the day, only 1.3% of children were diagnosed as having severe sleep problems, a far cry from the 40 or so percent who report night wakings.

Well… that took a while, but hopefully it’s clear that the link between night wakings later self-regulation problems for infants isn’t really established at all, especially outside of any concurrent behavioural problems.  Why is this important?  Because when an article starts off with such a harsh and frightening claim, we have to be certain of its veracity.  Telling parents that their child will have later emotional and behavioural problems because of night waking will lead parents to do whatever they can do avoid that even when it’s not necessarily the truth.

The second issue is that this article presupposes that infants learn to self-soothe by being left alone.  I won’t go into detail here but will suggest you read the following two pieces if you actually believe that this is the case:

1)      From my own site: Educating the Experts, Part Four: Self-Soothing

2)      From Uncommon John (Canadian journalist and now researcher John Hoffman): Self-soothing.  Possibly the biggest lie ever foisted on parents.

If, after reading these pieces, you still believe that infants learn to self-soothe on their own (as opposed to learning through guidance from parents) or that this “self-soothing” in infancy is an active and intentional act, please email me.  We need to chat.

Now, to the study at hand.  The data was collected in 1991 – over 20 years ago – but I would imagine that not much has changed since that time.  Children were assessed at 6, 15, 24, and 36 months of age and children had to have at least two times points to be included.  As with other studies, a large proportion of infants were night-waking at least 3 nights per week at the various time points, including the later time points, which suggests to me that this remains normal child behaviour into the second and third years of life.  The results suggest two groups of sleepers, one made up of approximately 66% of the sample who from six months on experienced night wakings between one and two nights per week and this remained steady until 36 months.  The second, made up of the remaining third, were deemed “transitional sleepers” and they began with night wakings seven nights per week, but by approximately 18-21 months of age, averaged less than one night a week of wakings.

What’s amazing to me is that this natural course, as found by these researchers, shows that by 3 years of age, almost all children are sleeping through the night with few problems to do with night wakings or sleep disturbances.  A third of children took longer to get there, but they got there.  The authors point out that certain variables distinguish between the two groups and make it more likely that the child is a transitional sleeper: child sex (being male), difficult temperament at six months, breastfeeding at six months, breastfeeding at 15 months, maternal depression at six months, health of mother’s partner at 24 months, and health of mother’s partner at 36 months.  However, none of the effect sizes for these are practically significant and seem to be due to the very large sample in the current study (over 1,000 families).  Because they are practically meaningless differences (and the only effect size that was above .01 was breastfeeding) it is difficult to conclude that any of these factors truly influence sleep patterns.

So how do we get to the idea that we should leave children to cry?  After all – the articles in the media have titles like “Don’t get up if your baby cries at night: Mothers SHOULD leave their babies to ‘self-soothe’ says leading expert” so doesn’t that imply crying-it-out is being supported?  I honestly don’t know where this came from given the actual article. In the discussion, the authors state that “there appear to be two distinct patterns over the first 3 years of life that characterize the sleep awakenings of healthy, community-living children”.  They go on to acknowledge that “by 18 months old, not only are the Transitional Sleepers able to sleep through the night without awakening their parents, but they are indistinguishable from the children who, from the beginning, had frequently slept through the night”.  As for the argument that breastfeeding to sleep might cause problems, the authors state “the finding that infant awakenings decline steeply with declining incidence of nursing suggests that it may not be, as suggested, that breastfeeding contributes to diminished capacity to self-soothe, or we would have found that breastfeeding early in life continued to contribute to sleep awakenings even after the incidence of breastfeeding diminished.”  One of the other findings that is notable is that mothers who were more sensitive had children who showed greater night waking.  The authors take this finding to suggest that maternal sensitivity may be reinforcing these negative behaviours (akin to what Karraker suggests, see [6]), but yet, the failure to see this continue with age suggests that’s not the whole story.  (Personally, I see it as a case of maternal sensitivity allowing the child to express his or her biological needs more readily – including, for some babies (but not all), the need to rouse at night and receive comfort.)  But NOWHERE is there the idea that parents should leave their infants to cry at night.  Nowhere.

The final implications, as stated by the researchers, include that for infants older than 18 months of age who are still waking at night, “interventions may be necessary”, BUT the reason is that the parents reported the behaviour as problematic for them and the family and the first suggestion is to consider a more nuanced bedtime routine.  The authors also acknowledge that their “findings are indeterminate in regards to supporting specific expert recommendations for optimal infant sleep patterns concerning greater bedtime ritualization, discouragement of parental intrusion, and encouragement of infant self-soothing to promote sleep that is more continuous”.  Again, a far cry from leaving your child to cry.

All in all, though I don’t like the initial framing of the work, the findings themselves are actually quite helpful to those of us who are against sleep training.  Nowhere do the authors suggest that leaving a child to cry is best (though comments from Dr. Weinraub to journalists could suggest otherwise, though I believe her comments were taken out of context in that saying not to respond immediately can mean waiting a single minute to see if a child settles without response).  In fact, the research supports what many of us have said time and again: Children will sleep through the night at their own pace.  Even at three years, 6% of children were still waking regularly, and there was no evidence that night wakings were problematic for children at the time or later.  Not all children are the same, and some need more time to adjust to sleeping through the night.  Why we need to be looking for problems where there are none is beyond me.  My advice?  Ignore the popular press and know that the article does not suggest leaving children to cry is best, in fact, it does suggest that children will end up sleeping on their own in their own time.  And if that’s 6 months or 3 years, they are all healthy and normal.



[1] Weinraub M, Bender RH, Friedman SL, Susman EJ, Knoke B, Bradley R, Houts R, Williams J.  Patterns of developmental change in infants’ nighttime sleep awakenings from 6 through 36 months of age.  Developmental Psychology  2012; 48: 1511-1528.

[2] Dahl RE.  The regulation of sleep and arousal: development and psychobiology.  Development and Psychopathology 1996; 8: 3-27.

[3] Dearing E, Taylor BA, McCartney K.  Implications of family income dynamics for women’s depressive symptoms during the first 3 years after childbirth.  American Journal of Public Health 2004; 94: 1372-1377.

[4] Frank MG, Issa NP, Stryker MP.  Sleep enhances plasticity in the developing visual cortex.  Neuron 2001; 30: 275-287.

[5] Gregory AM, Caspi A, Eley TC, Moffitt TE, O’Connor TG, Poulton R.  Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood.  Journal of Abnormal Child Psychology 2005; 33: 157-163.

[6] Karraker K.  The role of intrinsic and extrinsic factors in infant night waking.  Journal of Early and Intensive Behavior Intervention 2008; 5: 108-121.

[7] Lozoff B, Wolf AW, Davis NS.  Sleep problems seen in pediatric practice.  Pediatrics 1985; 75: 477-483.

[8] Richman N.  Sleep problems in young children.  Archives of Disease in Childhood 1981; 56: 491-493.

[9] Thunström M.  Severe sleep problems in infancy associated with subsequent development of attention-deficit/hyperactivity disorder at 5.5 years of age.  Acta Paediatrica 2002; 91: 584-592.

Comments

  1. John Hoffman says

    Great post Tracy! Loved the way you took apart the alleged “evidence” that nightwaking in babyhood is associated with negative outcomes later in life. You noted that Dr. Weinraub’s data is 20 years old and that not much has probably changed since then. Actually, what has changed is American breastfeeding rates. According to data collected by Ross Laboratories, who tracked breastfeeding rates for years, only about 19% of American babies were still being breastfed at age 6 months in the early 90′s, when Weinraub’s data was collected http://kellymom.com/fun/trivia/ross-data/.
    Currently, according the the CDC’s national immunization study, the rate is 47.2% http://www.cdc.gov/breastfeeding/data/NIS_data/

    Given, Weinraub’s finding that breastfeeding at six months was associated with later night waking, I’d guess that fewer babies might be in her “Sleepers” category if she had collected her data over the past three years.

    Uncommon John

    • says

      Hey John,

      I acknowledge the breastfeeding rate, but they included breastfeeding in the study and found practically meaningless differences :) I know it was statistically significant, but an effect size of .03 or .02 might as well be zero! If the effect sizes were similar… well, that would be something else. And frankly, I think the conclusions that a sizeable minority don’t sleep through the night early holds for babies regardless of breastfeeding – I worry that people might only associate it with breastfeeding and that might turn people off breastfeeding, which would be awful.

      Cheers,
      Tracy

  2. Nancy says

    I was linked to your post by a friend on Facebook. There are so many things I’d like to comment on, but I will try to keep it basic.

    1. Your writing shows a lack of understanding about the research process. You will not find causal relationships in any studies about this because it is impossible. You can never control for all the other variables that affect sleep patterns, some of these you referred to in the last study. To control all the variables, you would have to send the babies off to a lab somewhere, some with & some without their parents, for a certain length of time. This type of study would not be approved, and parents obviously would not consent. Therefore, correlations are all we have to draw on.

    2. I do commend you, however, for looking into each of these cited “studies”, which themselves are not studies, but are literature reviews. It is quite ridiculous because none of them seem to have really looked at the issue in the media title you reference. One mentioned something about parents letting babies learn to self-soothe for their own benefit, not the babies. This brings me to my next point.

    3. I don’t know if this is your website, or you were a guest writer, but your viewpoint is extremist in nature. I am from the position that you do what is right for you and your family as a whole, and sometimes it is a difficult choice. Some people function better on little sleep than others. I have some chronic health issues, and it was imperative that I get a decent nights sleep for my functioning during the day. I talked to the pediatricians, waited until they doubled their birthweight, and never ignored them when they were sick. We used a gradual method, though it still was difficult at times (for me, emotionally). However, it works, and they are fine, well-adjusted, loving, and bonded kids (11 & 13). There are many, many reasons why a parent may need a good night’s sleep. Please do not presume that what worked for you will work for everyone.

    I think the issue is NOT about whether “parents SHOULD let their babies cry it out”, but rather, “parents CAN let their babies cry it out if that’s their choice (assuming a healthy baby), and everyone will be OK.”

    How old are your children? Do you think they are healthy and don’t have behavior problems because of they way they slept? Is everything you do worked around your child’s schedule, or do you take other people’s needs into account? Nothing ever comes down to one thing. There are many acceptable ways to parent, feed, and raise your children. Much of what they turn out to be like is more genetically determined than anything. If you want to do an experiment, I would challenge you to have your next baby, if there will be one, go through the Ferber method, and see how wonderful it is when everyone in the house gets a good-night’s sleep. I know you’ll never do it, just thought it would be fun to suggest!

    Thank you for taking the time to read my comments. I appreciate it.

    • says

      Nancy,

      Thank you for taking the time to write. I will address your points one by one…

      1) I have a very clear understanding of the research process seeing as I am involved in in myself. Yes, you will never have a true experimental study to definitely discuss causation, but you can suggest causation when certain research methodologies are used. First it needs to be longitudinal in nature and second, the behaviour needs to not be present at time 1 and be present at time 2, there has to be a theoretical reason to suggest that the behaviour stems from the earlier measure, and you need to ensure that you have similarly matched groups (as best as possible) for which the variable in question is different. Even with this, you will not have pure causation as a third variable, unmeasured, but different between the two groups, may be at play, but you get much closer. As we see with smoking – we can’t do causal studies, but we are quite certain of the causal nature between smoking and cancer because these other factors have been tested with positive findings and replicated numerous times. One thing you seem to forget is that no one is arguing definitive cause in that 100% of children will experience X, but rather, like with all research, increases in risk for various behaviours and outcomes. The problems to do with causality in the research as I’ve written of in here is that it doesn’t fulfill any of these criteria, thus causality cannot even be suggested.

      2) Not all of the articles are reviews – only those listed. Some of them are research papers. Not sure what your point is there.

      3) This is my website and crying-it-out is something I feel quite strongly about and is not supported as being beneficial in the research literature (for more information on that, I recommend you check out ISIS – Infant Sleep Information Source which is run out of Durham University). But my writing is not personal in nature – I do believe families do what is best and if you look around more, the impetus for me is that we have better support for families so that people do not have to resort to crying-it-out. And yes, much of the research supports that infant sleep isn’t a problem for them, but it is a problem for parents. Not to discount that, but again, why don’t we focus on making this friendlier for parents?

      As to your suggestions, the idea of genetics determining more is not supported by the research. An interaction between genetics and environment is key though. And the more we understand how some children will react to things like sleep training, the more I hope we understand that it may not affect all children, but it can be hugely detrimental for some (I recommend you read my general piece on crying-it-out to know where I’m coming from). The idea that all babies will be OK after being left to cry-it-out is simply wrong. Some will show no real problems. Some it will dramatically affect. But in no case have I seen it be positive for babies, and definitely no more positive than a society which provides more support for parents and families.

      Tracy

    • Laura says

      I am so sorry to hear you had a chronic pain condition. The whole “Cry-it-out” straight from the book. I don’t support or at least what I have heard. I also have a chronic pain condition. I breastfed my only child daily for 29.5 months and then even to 3 years 2 months sporadically when sick and did child-led weaning. Around 10 months of age, I didn’t just run to the room and pick my son up. I waited no longer than 10-`15 minutes and headed up and picked up my son from the crib. Often times within less than 5-7 minutes he would fall back to sleep because he had lost his pacifier. I didn’t want to do pacifier but did it with recommendation of a LC because the beginning with a posterior frenulum and due to rough beginning my son couldn’t comfort suck because of high flow volumes which did eventually even out. So he was on a pacifier. So if he lost his pacifier he’d cry and look around and go back to sleep. The only times I didn’t wait was when I heard his hunger or pain cries. I will say I only met one mother whom said she never heard a difference in a babies cry. If you can’t distinguish the difference in cries.. Then you shouldn’t do anything. My son never puked himself. He’s a very happy bumble social 3 1/2 year old. He loves to interact. I don’t think I scarred him or neglected him. From what I have seen there are extremes on both side of the aisle. One mother in a group told me that because my child stopped crying themselves at 5 minutes that I was selfish and that I didn’t make my child my priority. I worked 40+ hours as a teacher and had a 45 minute commute in the morning. Woke up midnights to add pumping sessions to make the required amount. Was barely getting sleep and trying to do the best I could. I resented that. It was a SAHM whom said that. I think you do what is right for your family. I don’t think the prescribed booked version of Cry-it-out should ever be followed by law. Just as I don’t think a mother should necessarily run and pick up the moment the baby cries (but I think you look at the age of the child). I think this whole judging and making one feel. Both arguments I’ve seen as flawed with research. To me its pathetic the arguments that get tossed both directions. Don’t feel like you have done anything wrong. You have healthy children. People will throw things around and just ignore them.

  3. Nancy says

    I forgot to add that in the news last week it was reported that falling asleep at the wheel is the biggest cause of car accidents. Sleep is important for so many reason, please don’t underestimate it.

    • josie says

      being responsible enough to realize you are not in the right state of mind to drive is the moral I would take from that story, what exactly was the point of that?

      • Lily says

        Good response but I think that would require Nancy to change her schedule and plans to suit her child’s normal sleep patterns which is out of the question. So many people whine about lack of sleep due to their babies and yet they still stay up late watching TV or on their computers instead of thinking how they can change their day to allow for night waking. Its sad that tiny humans have to change to suit us even though we are the ones who are able to help ourselves without tears.

        • Jay says

          That is true to some extent Lily, but one shouldn’t discount the importance of time spent alone after the children are asleep as it relates to parental mental health and happiness. It is vital for some people to spend time alone to recharge in order to be emotionally available through the night wakings and the day, and for people in relationships to stay connected.

          • Laura says

            I agree. Sadly because I had to add additional pump sessions and prep for work the next day.. I didn’t have the luxury of just say nod my head. I woke even when my son didn’t to add pumping sessions. Trust me if I got any time to watch tv or do something other than work.. Those moments are what helped me from breaking. Those often were on weekends.. Its sad that people assume what they know why someone isn’t getting enough sleep and don’t understand the value of downtime as well.

  4. Jespren says

    I didn’t even bother to read the original news article, but as soon as I saw it I thought ‘i wonder when Tracy will respond to this tripe?’ Glad to see you had time for it.
    Frankly, from as much real-world data I’ve been able to collect from first and second hand sourced whenever I hear ‘my kid(s) slept through the night from infancy’ it automatically translates into ‘i slept through them waking up and crying’. Until they *do* monitor the mother/child dyad by a third party and they use those monitored occurances of sleep/waking for their data I’ll continue to think any ‘sleep study’ on infants says far more about how the parents sleep than the infants!

    Btw, I loved you ‘email me. We need to talk’ line. Cracked me up.

  5. Jay says

    Thank you for taking the time to read and review the literature relied on in the initiating research. Prior to my daughter’s arrival I thought sleep training and strict schedules were essential to good parenting. Boy did that unravel quickly!
    Responding to the proliferation of articles by ‘experts’ who suggested failing to rectify sleep ‘problems’ occurring in infancy would lead to life long sleep and emotional issues for my daughter, I struggled with guilt that I was somehow failing her if I didn’t force her to self soothe. I naively tried sleep training (CC) when she was about 6 months old and discovered waiting just 30 seconds to respond to my daughter’s cries would have her hysterical and sometimes vomiting in distress, requiring several minutes of comforting just to return to a calm state. And worse, following episodes of controlled crying to sleep, she would push me away and shun me for at least an hour after she woke (AT SIX MONTHS OLD!). Clearly it did not work for her, and certainly was damaging to our trusting relationship.
    So… thank you for reviewing and responding to the false claims and media misinformation. I hope other mums find and read this information and respond to their babies respectfully and attentively.

  6. Melanie says

    I also take issue with problemitizing of ‘night awakening’. You and other researchers often debunk this in discussing what ‘normal’ biological sleep actually is, but what’s equally absurd is the apparent lack of any standards in infant ‘sleep disorder’ research in defining what a ‘night wakening’ actually is, at what point that becomes problematic, and how they can be disentangled from parent-infant sleeping arrangements and existing patterns of parental responsiveness.

    Case in point in Weinburg’s methods: the frequency of nighttime sleep awakenings and duration of awakening were reported and self-assessed by parents as problematic or not on a 1-3 scale. First of all, the frequency of sleep awakenings (NIGHTS SA) was used as an indicator of sleep problems because they were positively correlated with maternal ratings of how problematic they were. All analyses were then run with NIGHTS SA as the outcome variable! Why? Why wouldn’t you run them on frequency of ‘problematic wakenings’, and moreover, why wouldn’t you first try to assess from all the other variables collected IF there’s any relationship between demographic and maternal factors/perceptions and perceptions of these awakenings?

    Secondly, the current method and history of parent-child sleep arrangements and responsive patterns were not included as confounders. These factors would likely explain a good chunk of the relationship between frequency and duration of nights SA, as well as the perception of problematic awakening. For example. if my baby wakes up at night and is in a crib in another room, does the subject get out of bed and go pick her up or let her cry, or is the baby sleeping right next to the subject and does the subject roll over and nurse her and both fall back to sleep? Has the baby recently been transitioned to a new sleeping arrangement (own crib, own room, or from own/crib room to the parents’ bed?) and is this affecting duration or frequency of awakenings and parent’s perceptions? If parents’ beliefs about infant sleep patterns HIGHLY influence parent-child sleep behaviors and perceptions of problematic patterns, how can you fail to include those beliefs as confounders in the outcomes you are studying?????

    Finally, perhaps most infuriating, while breastfeeding is included as a variable predicting frequency of awakenings, it’s actual relationship to infant-parent sleep and perceptions of problems is not.

    For example in my case, were I a participant in the study I’d be a breastfeeding mom reporting that my baby wakes up 1-4 times a night for very short durations (though I would rate this a 1 in terms of how problematic it is because (1) I know that this is totally normal behavior and (2) we both fall back asleep immediately and (3) I’ve done this since my baby’s birth and intend to keep doing this for quite some time. How many of the subjects breastfeeding beyond 6 months are like me, and how many subjects mistakenly believe that there’s something problematic about nursing a baby to sleep or frequent night nursings, and were therefore more likely to report frequent night awakenings as problematic. NOT THAT IT WOULD EVEN MATTER BECAUSE PARENTAL PERCEPTIONS WEREN’T ACTUALLY ASSESSED. We’d all be lumped together as data points supporting the completely non-contextualized relationship between breastfeeding and frequency of night awakenings, which then becomes a positive relationship between ‘breastfeeding and infant sleep problems’. It doesn’t even matter if the effect of the relationship is small– if any subjects rated frequent awakenings for nursing as NOT PROBLEMATIC, THEY SHOULD NOT HAVE BEEN INCLUDED IN THE MODEL. And that should have been true for any non-problematic night awakening.

    Am I missing something here?

    • says

      On a general level, you are totally, 100% correct. For this particular study, the goal was to simply assess night wakings regardless of parental perception which is why it wasn’t assessed. This is part of why I took issue with the introduction because it *implied* that night wakings were problematic, but when you hit the goals, it seems that was assessed but not of concern. And it’s good to have research on both night wakings per se and what leads to their being problematic!

  7. Cynthia Lonsbary says

    Thank you for your continued careful discussion of such matters, including analysis of research methods. As a social psychologist, this is something that always bothers me about “news bites” of research. :)

    As to sleeping through the night… I always wake up once or twice more than one night a week and always have according to my mom. My 2 year old still wakes up to nurse and my husband’s and my only complaint is that our Queen sized bed is getting a bit cramped to share with an active toddler! :)

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