That’s it. As clear as it can get. If you’re comfortable with that, you can sign off now. If not, let’s talk about it a little more, shall we?
When you pick up a book by an “expert” telling you how to get your baby to sleep more, cry less, or stop night feeding, you are hearing a “one-size fits all” approach. Despite what may be promoted by the individual author, it doesn’t work for all sizes because all babies are different.
In turn, the questions we should be asking are:
(1) For what children do these techniques work? And, are these techniques appropriate even if they work?
(2) For those families for whom these techniques don’t work, what can they do?
Let’s first talk about question #1. When “experts” promote certain techniques, oddly these techniques are often aimed at those easy-going children that make up a sizeable proportion of the baby population. When you are told that in a matter of two days you’ll have a baby who sleeps more, goes down without a fuss, goes longer between feeds, they are talking about a subset of the baby population who will respond to these methods quickly. It’s true that some babies are seemingly content in almost any situation, including responding to things like sleep training without – externally at least – a lot of fuss.
But not all babies. I know of several parents who have what we would call ‘high-needs’ babies who have tried these techniques and they do not respond kindly to them. They scream until they vomit. They don’t “give in” but rather continue to resist for much longer (weeks or even months). And if they do happen to give in, parents may report a noticeable change in their child after; they seem less responsive in general or less happy, or if the child is older, they may see situations in which one would expect the child to get the parent in distress, but instead the child remains solitary and apart from the parent because s/he has learned that nighttime is a solitary time. Often you’ll find these are the parents who now speak out against these methods and are often met with the accusation that they “did it wrong”. As if somehow this one-size approach does fit for everyone and therefore the problem must lie with the parents, even if they followed the rules and guidelines to a tee.
So, to answer question 1a, these techniques often work for easy going babies, but not higher-needs babies. The question is why? Briefly (and you can read more about it here), it seems higher-needs babies need more from their parents in terms of affection, touch, proximity, and regulation (yes, these babies are being regulated by their parents and the expectation that they can do it themselves is wrong). They are the babies who are shaped far more by their environment than how they were born and, in turn, different parenting techniques have longer-term and far-reaching consequences. Easy-going babies, on the other hand, seem to have a temperament that withstands the usual fluctuations in parenting.
This brings us to question 1b: Are these techniques appropriate even if they work for a subset of the population of children? My answer, from a promotional point of view (i.e., broadly-speaking, not specific cases), is no. I say this because these techniques not only ignore infant biology (yes, these easy going babies are still doing what is biologically normal by night-feeding and rousing at night – only a select few families have babies that don’t do this on their own which is their normal, but you can’t hold your baby to another baby’s expectations), but because these babies are easy-going, other gentler techniques will often work just as well, even if not as quickly or with such dramatic results (e.g., getting a baby who still wants to nurse at night because that’s what babies do, but you can reduce the number of feeds and increase sleep time). This means that the baby can avoid any potential trauma that can result from techniques that shut a child off from their parent, especially in times of distress (see here for further discussion).
If these popular approaches only seem to work well for the easy-going babies and are more likely to create traumatic outcomes for the higher needs babies, what do parents of these higher-needs babies do? Obviously sleep is an issue in our society (why we have a preponderance of these books out there) and parents are consistently looking for help. Well, first, parents need to realize that their higher-needs infants often need them in ways that others don’t. These children may need greater regulation – both emotionally and physiologically – because their systems are unable to handle certain events on their own. Often higher needs children are more sensitive children as well and it is possible that their hypersensitivity to myriad stimuli is what makes it so difficult for them to settle independently.
Let me elaborate… For an easy-going baby, most stimuli will arouse them slightly, but much of the time they will quickly settle themselves simply because their arousal level is small. In this sense, the infant is capable of calming from certain stimuli; however, we must not mistake this as a skill that can be forced, but rather, these infants have an internal capacity for this minor regulation in place, something not all infants have (for a discussion of self-soothing and its development please read this). Any infant that experiences strong arousal will not be able to self-soothe, as evidenced by parents actively soothing infants that have undergone painful or uncomfortable procedures like shots or even physical exams. No one suggests we leave infants after something we know to be traumatic because we acknowledge their limitations in self-soothing. However, for a highly sensitive child, stimuli that we believe to be mundane may actually elicit significant arousals from which the infant cannot soothe without assistance. For these children, the acts we may see as normal or non-eventful are anything but, and as such, they need our help to calm and recover from them.
So what do we do for these infants? First, I believe that parents of these children need to be aware of the calming and helping effect they have on their baby’s physiology as sometimes this information alone can help a family deal with temporary sleep disruption (yes, it’s all temporary). Second, we need to fight for better community and support for these parents because they should not have to make the choice between their sanity and their baby’s well-being (and that is exactly what many of these one-size fits all propositions involve). Third, parents of ALL babies with sleep problems need to look at underlying causes. Often we forget that sleep disruption is more likely a symptom instead of a cause (see here for some of the most common reasons for sleep problems) and parents should be aware of things like tongue-tie, silent reflux, and food sensitivities, to name a few. Finally, the gentle sleep solutions shared earlier are perfect for these children too, precisely because they work with the child instead of against him/her. Parents should be aware that changes will often take longer, may require a few more steps in between, or longer periods at each step, but that these changes are possible if a family needs change.
In sum, when you pick up a book by a baby “expert” telling you that their wonderful method will get you all the sleep you desire while having a happy baby, be skeptical. Look through and see how flexible the plan is. If you see schedules and things for you to time, put the book down and walk away. If you’re in need of help, look for the books that speak about child temperament, that acknowledge the uniqueness of all babies, and that offer flexibility in their approach (such as those suggested in the gentle sleep solutions links). Your baby wasn’t made with a cookie cutter and any advice you take shouldn’t assume as much.