Posts Tagged ‘ sleep training ’

Red-Hot Parenting Recap (Sept 2012): Play, DNA, And Sleep

Sunday, September 30th, 2012

Three big themes in the world of parenting stimulated discussion this past month. Here’s a recap of these along with links to posts that take them on. 

(1) The critical role of pretend play – long cherished in the academic literature and embedded in childhood education – was, to a degree, challenged by a somewhat provocative review paper. To some, it seemed like the article’s primary goal was to suggest that pretend play may be overrated as a promoter of cognitive development in general and creativity in particular, and hence should be reconsidered in a school’s curriculum. My take was a little different.  I thought the paper did a good job of highlighting the aspects of development that are positively influenced by pretend play – especially social skills – while suggesting that the cognitive aspects may in fact not be the primary benefit:

“Is Pretend Play Overrated?: The Take-Home Messages From The New Provocative Review”

The big thing for me was that, contrary to what you might have read about this paper, there was support for different types of play in the educational (and home) lives of young children (rather than suggesting to eliminate play). To wit, I also discussed a new study which revealed how drawing (particularly copying shapes) in toddlerhood predicts reading achievement in kindergarten even after accounting for traditional indicators of cognitive maturity:

Try This With Your Toddler: How A Particular Type of Drawing Is Associated With Reading Achievement In Kindergarten” 

(2) DNA was in the news in a number of ways. There was lots of interest in the recent link made between paternal age and risk for autism in offspring. Much was made of the idea that men, as well as women, have a biological clock. In response, I described what that may mean biologically, and how men (like women) may have to factor in rather inconclusive probabilities when making complex choices about having children at different ages:

Dads, DNA, And Choices

DNA and moms was also a hot topic. A study was characterized in the media as identifying “the mom gene” – implying that a woman either has, or hasn’t, a gene which would make her want to be a mom. I pointed out that genetics doesn’t typically work like this in humans, along with the, um, difficulties in making the jump from a study about female mice who had the function of a gene experimentally disabled to the human female:

Is There A Mom Gene?

(3) Sleep was also a big topic. While you may have read that a new study showed that it’s okay to let your baby “cry-it-out” the actual take-home messages were more fine-grained. In particular, the study was really about 2 types of sleep training methods, their utility in reducing infant sleep problems, and their lack of effects – positive or negative – 5 years later:

That “Cry-It-Out” Study: 5 Important Take-Home Messages You Should Know

I especially encourage you to check this out because we are finally seeing actual scientific studies on sleep training, rather than just debate. And the implications for parents are quite reasonable and, to my way of thinking, very important to know, given that all parents wrestle with figuring out how to get their babies to sleep.

 

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That “Cry-It-Out” Study: 5 Important Take-Home Messages You Should Know

Sunday, September 30th, 2012

In response to the publication of the recent study on sleep training methods in Pediatrics, many of the headlines focused on the conclusion that the cry-it-out method does not harm kids. In reality, the implications of this are more nuanced than those headlines would lead you to believe. Here are 5 things you should know: 

1) This paper was important because there are few studies that have evaluated sleep training methods using scientific designs. This one is especially interesting because the research team followed 225 7-month-olds – reported by their parents to have sleep issues – for 5 years. This longitudinal design permitted the researchers to examine short- and long-term effects of sleep training.

2) The study examined 2 types of sleep-training methods – controlled comforting and camping out. Controlled comforting is a variation on what you might think of as cry-it-out (or pure extinction). In contrast to pure extinction (which is let baby cry until they fall asleep – however long that is), controlled comforting involves settling a baby in to sleep, leaving the room, and establishing short intervals of tolerated crying (say, 2 minutes) before going in to soothe the baby. These intervals can be increased slowly with the idea being that baby will stop crying and fall back asleep. Camping out involves starting off in the room with baby – typically next to or near baby – and waiting until baby falls asleep before leaving. After a period of success, the parent then changes the routine by sitting in the room, but not right next to baby, and again staying until baby is asleep. And here the idea is that parent can get to the point of leaving the room before baby falls asleep. In the study, 3 conditions were used. Some parents could choose to be trained (by a nurse) in either controlled comforting or camping out (conditions 1 and 2) – and some parents were offered just general advice but received no sleep training.

3) The results were that either sleep training method was successful in improving the babies sleep and reducing levels of maternal depression – both conditions produced better results than no sleep training. So in the short term sleep training worked.

4) The positive effects on sleep did not extend out for 5 years. This is not surprising, as each developmental period raises new sleep challenges. In terms of kids’ outcomes – behavioral and emotional – there were also no differences across all 3 groups. Sleep training (either method) had no positive or negative effects. The headlines here were that “cry-it-out” didn’t harm kids. Well, not exactly. Controlled comforting did not have negative consequences 5 years later – and neither did camping out. The camping out part of this was typically left out of many news stories.

5) The key takeaway is that when parents are trained in reputable methods, they work to reduce sleep problems and indirectly help parents sleep better and feel better. Parents can feel comfortable choosing either controlled comforting or camping out, based on the results of this study. What didn’t work so well was not receiving instruction in sleep training – in the short term, these families continued to experience all the negative stuff that happens when baby won’t sleep at night. Keep in mind the point made above – the sleep training will certainly take for awhile, but sleep problems could happen again during different developmental periods (e.g., age 2, age 5). The inference to be made, however, is that sleep training will work again, but it will of course be somewhat different and tailored to the age of the child.

This study is a welcome addition to the scientific literature and also to the endless debates about sleep training that we all have. Modern sleep training methods work – especially if parents are trained to use them properly and stick with them. And you can feel comfortable picking a method that suits your style. Just remember to talk to your pediatrician (or other experts) when you are ready to start – and also remember that these kinds of sleep training methods are typically recommended for infants at least 6 months of age.

Image of adults sleeping – via Shutterstock – as a reminder that when baby sleeps, parents sleep too! 

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Fia’s Not Sleeping Through The Night Anymore: Why Do Toddlers Do This?

Thursday, November 17th, 2011

My fellow blogger Jill Cordes recently shared that her daughter Fia is waking up at night, after nearly 20 months of sound sleeping. And as a parent who dealt with this myself not that long ago, I had a good (sympathetic!) laugh at Jill’s take on Fia’s new sleep tent. Although Jill’s family is in the middle of big transitions (like moving from the East Coast to the West Coast), what caught my eye was Fia’s current age – she’s 23 months. And the reason for that is toddlerhood is a developmental period when the biology of sleep starts to change dramatically, and as a result, sleep methods often need to be revisited. Here’s why. 

When babies fall asleep, they tend to fall into the REM phase – which is the part of the sleep cycle where you can dream, but your body doesn’t move (you are zonked out). As babies turn into toddlers, they start to adapt more adult-like patterns of sleep, in which they cycle between light and deep sleep. The result is that the perfectly sleep-trained toddler (it doesn’t matter how they have been trained) starts to experience the part of the sleep cycle when they wake up out of nowhere – sometimes repeatedly. It can be very disorienting for them, particularly since they don’t have much experience in getting themselves back to sleep when they wake up from light sleep. So they do what any rational toddler would do – they cry for you. (Click here if you want to read more about kids’ sleep issues).

As Jill discussed, there are lots of other things that go on with toddlers that can mess with their sleep. In addition to life transitions, the newly independent toddler may want to rebel against sleep (amongst other things). But it’s good to keep in mind that there is some biology that is driving this, and so even though it’s discouraging when it happens, it’s not unusual. And one more thing – what worked before doesn’t necessarily work as well now. So sometimes those inclined to use Ferber find they need to modify it some as their kid gets older (not all do, of course). And some who used alternate methods sometimes gravitate more to the Ferber end of the spectrum (not all do, of course). I’m no sleep expert, but this is why my mantra is “sleep outcomes – not sleep methods – matter most” – whatever gets kids to get the amount of sleep they need is good for them and good for their parents.

So I hope things go well for Jill and Fia. I look forward to following their story. I’d like to offer some specific tips or advice, but the thing is, when I was dealing with this, we ended up throwing our hands up in the air and headed for the nearest pediatric sleep clinic. It worked wonders.

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