Is the Lure of Baby Sleep-Training Culture Fueling Postpartum Anxiety?
Over the past year, Macall Gordon, a sleep coach and senior lecturer at Antioch University, has talked to hundreds of new parents. They call her hoping to get their 3-week-old babies started "correctly" on sleep. They're wondering how to fast-track a sleep-through-the-night miracle and they worry about starting "bad habits." As she puts it, they're "all wound up in knots."
It only makes sense. Follow any baby-related Instagram account and you'll see perfectly curated posts detailing how to get your baby to sleep through the night—and fast.
Wake windows. Naps. Bedtime routines. Swaddles. The Merlin Suit. The Snoo. Co-sleeping. Safe sleeping. It's information overload. But with pretty promises of eight hours of sleep at eight weeks and plans with 98 percent "success rates," it's also hard not to subscribe.
I did. As a mom of two under 2 and a religious nine-hour-a-night sleeper myself, I followed sleep routines for both of my girls—and it worked: Both of my daughters slept just about 12 hours a night by 12 or so weeks (with the usual hiccups along the way, of course).
But what I don't always talk about is how this focus on "perfect" baby sleep contributed to my anxiety.
And I'm not the only one.
Experts say the infant sleep business—with its pricey courses and consult calls—could be fueling something more than sleep: mental health issues in new moms. And so, the calls to Gordon and other sleep specialists around the country continue.
The Pressure for a Perfect Sleep Schedule
The sleep deprivation of new parenthood can be crushing. Sleep deprivation, in fact, is one of the strongest independent risk factors for mental health issues in the postpartum period. It can contribute to postpartum depression (PPD) and postpartum anxiety (PPA)—the most common mental health issue for new moms. PPA rates have also increased throughout the pandemic.
To some extent, worry is normal postpartum. After you have a baby, the parts of the brain that are alert to threats become very activated. "We naturally start to think, is the baby OK?" says Lucy Hutner, M.D., a reproductive psychiatrist in New York.
And anxiety can sometimes make you feel like you want to put everything into neat categories. There's no guidebook to parenting, but sleep courses can feel like the closet thing to it. New parents follow the schedules and hold on tight to the hope that if they do it right it will make things easier.
"I think people can sort of feel vulnerable to these messages of, you have to do things one particular way and you have to do it perfectly or you're not a good mother," says Dr. Hutner. Of course, nobody's actually saying that, but "those are the messages that are easy to glean." And applying a rigid or "perfect" idea around anything onto an enormous set of dynamic changes postpartum "is a little bit of a recipe for more anxiety," says Dr. Hutner.
Here's another issue: Much of today's promise-heavy sleep advice is really behavior-based. There's a big emphasis on what you do as the parent and what your baby does in response. And when you feel like your baby's sleep is based on your actions and behavior, experts say there can be a vicious circle of internalization, self-blaming, and wondering why your baby isn't sleeping.
Worse? "Parents can think if I don't do x and y, my baby's never going to sleep, or, I'm going to set them up for failure, or, insert scary thing here," says Maisie Ruttan, a pediatric sleep and family wellness clinician in British Columbia. She tells me that many parents who seek her sleep consulting services hold onto behavior-based sleep strategies "like gospel." She adds, "They wind up watching the clock instead of their baby. It feels like they just don't trust themselves to make decisions."
The Truth About Babies and Sleep
Infant sleep wasn't always such a dicey topic.
For young babies, night wakings are normal, healthy, essential, and protective, explains Kathleen Kendall-Tackett, Ph.D., IBCLC, a psychologist, researcher, and lactation consultant. "This idea that you have to be so rigid and that you have to control things doesn't make sense," she says.
Young babies need to feed around the clock. And even as they grow and when they no longer require middle-of-the-night meals, just like you, they still wake up from time to time. Some babies wake throughout the night through the first few years of life. Sometimes they can put themselves back to sleep. Sometimes they can't.
A more anthropological view of sleep globally and throughout history reveals that babies everywhere sleep in all different ways and all different styles. "In cultures where people just kind of roll with it, babies don't have tons of sleep problems," Dr. Kendall-Tackett adds.
Jodi Mindell, Ph.D., one of the country's foremost experts on infant sleep who has been studying the topic since the 1980s, says there's no real way to compare modern-day sleep programs to one another. There are some things, Dr. Mindell says, that years of research and clinical work have shown. For instance, a baby's ability to self-soothe, bedtime routines, and early bedtimes help them sleep more soundly. There's a certain amount of sleep that babies need in a 24-hour period (but that number varies wildly). And while naps tend to be spaced relatively evenly throughout a day, that's not necessarily best for all babies all of the time. (Just like you, some days babies are more tired than not.)
It's also worth noting that in many studies on infant sleep, sleep interventions work for maybe 50 percent of the sample.
Plus, on top of behavior, development, physiological changes, a baby's temperament (which can be incredibly variable), and family values also impact sleep.
Go Easy on Yourself
Before I hang up with Dr. Kendall-Tackett, she hears my 8-month-old daughter in the background. She tells me that those early postpartum months of sleep deprivation? They're hard. And that support around sleep (someone who can watch the baby while you nap or someone who can take over a night feeding so you can get a decent stretch) matters. It's healing.
The biggest take-home message, though? As Dr. Kendall-Tackett points out, your baby is their own person with their own unique needs and preferences, just as you are your own person with unique needs and preferences. Despite the catchy marketing schemes and sky-high promises of a sleep program, the reality is that there are no guarantees when it comes to baby sleep.
"Sleep develops as the brain develops," says Gordon. Most babies begin to secrete the sleep hormone melatonin around 3 months of age. And remember, while you can set the stage for healthy sleep habits, you can't make a baby sleep. Sleep is a biological function. Eventually, it happens.
That's not easy to hear when you're in the throes of sleep deprivation, but I kind of wish someone reminded me of it.
And ultimately, early parenthood is about a navigation—learning; getting to know your baby; things that you pick up along the way; things you put down while finding your way. And there's a big difference between finding a routine that works for you (and, if you're like me, being home for naptime because you know no one will sleep in a stroller) and self-blaming and hyper-focusing on your child's sleep. There's also a big difference between feeling like something works for you and feeling like it doesn't. Dr. Hutner reminds me: There's not a problem if there's not a problem—no matter what you're doing.