Show me the research!
Aside from working with children and babies, I’ve basically spent my whole career undertaking additional study. I am incredibly passionate about the research and science behind sleep. I see so many unsubstantiated claims made around baby and infant sleep, many based on a parent’s anecdotal experience. All this does is confuse parents, leaving them questioning what or who to believe.
My approach is firmly based on removing the confusion and gadgets and getting back to basics, supported by a number of scientific studies that have been undertaken over the years. I’ve included below a few of the key papers that are relevant to my recommendations, along with a brief summary for those who don’t have the time or headspace to read the whole paper themselves! 🙂
Graduating from my first degree in 2000
PARENTING AND INFANT SLEEP
Infant sleep changes dramatically during the first year of life. This occurs naturally as they get older, but is also highly impacted by their environment and parental behaviours. A key finding from this study is the negative effect of increased parental involvement at bedtime, particularly soothing routines and interactions, which leads to more broken sleep. Simply, the more you “help”, the more you actually hinder natural sleep and your baby’s natural sleep instinct. This is a key element of my approach; we support your little one while they learn to settle and sleep independently.
PRACTICE PARAMETERS FOR BEHAVIOURAL TREATMENT OF BEDTIME PROBLEMS AND NIGHT WAKINGS IN INFANTS AND YOUNG CHILDREN
Bedtime issues, including frequent night wakings are becoming more common in 21st century infants, toddlers, and preschoolers. A key finding in this study highlights that sleep disruption and/or insufficient sleep have long term potential negative effects on children’s cognitive development, regulation of attention, health outcomes, and overall quality of life. This study also suggests that sleep problems in infancy may become chronic, continuing into the preschool and school-aged years. I can show you how modifying parental behaviours (building to no parental involvement in bedtime settling) is effective in creating calmer bedtimes, which will also result in fewer night wakings and better restorative sleep for your little one/s.
NIGHTTIME SLEEP-WAKE PATTERNS AND SELF SOOTHING FROM BIRTH TO ONE YEAR OF AGE: A LONGITUDINAL INTERVENTION STUDY
This study highlighted that sleep aids have no major effect on natural sleep or self soothing behaviours. However, the three variables identified as significant predictors of the capacity to recognise biological cues and induce self-soothing at 12 months included sleeping frequently in their cot across the first year of life, high levels of quiet sleep at birth, and longer parental response times to infant awakenings at 3 months. The high levels of quiet sleep at birth is an important point as this also connects to the theory that in order to relax their nervous system they need less environmental noise and movement. This supports my approach of recommending NOT using sound machines, red lights and other sleep aids as props to induce natural sleep.
PROSPECTIVE ASSOCIATIONS BETWEEN INFANT SLEEP AT 12 MONTHS AND AUSTISM SPECTRUM DISORDER AT 24 MONTHS IN A COMMUNITY BASED COHORT
This study is significant as it found a link between sleep problems in infancy and autism spectrum disorder (ASD). The researchers followed a group of 1096 babies from birth and concluded infants with more sleep problems at 12 months old, especially those waking often during the night, showed an increased number of early ASD symptoms a year later. I can work closely alongside your family to ensure your child/ren get to experience quiet natural biological sleep that will encourage safe neurological development.
SLEEP AND THE DEVELOPING BRAIN
This study highlights the importance of sleep in the first three years of life. The findings showed that short sleep duration in the first 3 years of life were associated with hyperactivity/impulsivity and lower cognitive performance on neurodevelopmental tests at age 6. This is very important because it highlights how sleep in the first three years of life prepares the neural pathways to be connected and ready for ongoing developmental windows. The researchers found a link between quality of sleep at 2.5 years old, and some cognitive deficits and high hyperactivity at 6 years old (even though the children’s sleep quality had improved between 3.5 and 6 years of age).
This suggests that insufficient sleep during the first few years of life may have long-standing consequences. I would love to support your family on the journey to ensure your child/ren get the quality sleep they need to ensure they become the best little people they can be.
LONG-TERM SLEEP DISTURBANCES IN CHILDREN: A CAUSE OF NEURONAL LOSS
This study shows that poor sleep in infancy can have long term impacts on the brain and nervous system. It reinforces that sleep is a necessity for growth and development (and even more so during developmental periods!). When they don’t get the right amount of sleep, their melatonin production is reduced. This affects their circadian rhythms (specifically the waking and sleeping within each 24-hour day). Melatonin also supports and protects the growing brain, which is why sleep is critical for infants’ long term development.
We can make a number of changes to your child’s sleep patterns to encourage quality natural sleep, ensuring your child’s long term healthy neural development.
SAFE SLEEP GUIDELINES AND NEUROLOGICAL DEVELOPMENT
One of the key elements of the current SIDS guidelines is the recommendation to sleep babies on their backs. This has been an area of personal interest for some time, as some babies simply cannot achieve quality sleep wrapped up on their backs like a burrito, and this can have a huge impact on their neurological development.
Unfortunately some babies are genetically more likely to be impacted by SIDS. Research is currently being undertaken around this, including the potential for a heel prick test at birth to help identify those babies who may need additional or more cautious care. The SIDS guidelines state that tummy sleeping allows babies to enter deep REM sleep, which is when a SIDS incident is more likely to occur. Therefore, to minimise the risk of SIDS, they suggest maintaining back sleeping, which in turn stops a baby from entering the deep, restorative sleep phase. It is my genuine belief that having the ability to identify those babies who are not at risk of SIDS, and allowing them the opportunity for deep, restorative and safe sleep on their tummies, will have significant positive impacts on our children and their developing brains.
There is a body of research lead by Dr Nils Bergman (Clinical Pediatrician) that highlights increased rates of autism in children coinciding with the times that the recommended sleep position has changed (eg. from tummy sleeping to back sleeping). While the studies do not suggest that back sleeping causes autism, it may increase the presence of autistic behaviours in children who are genetically susceptible.
So, in summary, there should be no ‘one size fits all’ recommendation in regards to safe sleep positions. Whilst the guidelines are there as a means of protection, they aren’t necessarily applicable to all children. If your baby is more comfortable and content, achieving more quality sleep on their tummy, there are ways to do this safely. Most babies will actually choose to sleep on their tummy when they are physically able to roll, as it is a more natural position for them.
Please feel free to contact me for a confidential chat if you have a little one who struggles to sleep on their back. My approach includes a holistic review of your situation, ensuring bub has a full tummy, tight awake times and the right environmental cues. Once we are confident that these factors have been addressed we can consider safe tummy sleeping, offering your little one the opportunity for more quality sleep, and long term growth and development.
HYPOTHESIS ON SUPINE SLEEP, SUDDEN INFANT DEATH SYNDROME REDUCTION AND ASSOCIATION WITH INCREASING AUTISM INCIDENCE
CONTROLLED CRYING
A review of the Position Paper – Controlled Crying by the AAIMHI.
This paper focuses on the negative aspects of a sleep training method socially known as ‘Controlled Crying’. The overarching message (or opinion) of the paper is it claims “Controlled Crying” MAY have unintended negative consequences on the emotional and psychological health of an infant.
However, having read the paper, it is noticeably outdated, having not been updated in 10 years, and also explicitly notes that its reference list does not include any studies at all on the impact of the sleep training method; it’s simply an opinion and there are no actual facts referenced. The paper mainly references sources that focus on attachment parenting to support their main argument and also supports bed-sharing and co-sleeping. It claims at the age of three only then should children be left alone at bedtime for short periods. So my argument is “it’s okay for a child to experience ongoing fractured sleep for up to 3 years on the opinion that some noise will emotionally scar a child for life”??
Interestingly one of the referenced sources (they only used the words “recent studies” within the paper) is actually a study that explicitly found how fractured sleep caused by parent behaviours in infancy, are the same children who scored remarkably less in tests conducted at the age of 6 years.
So let’s put this into some context. Long-term severe stress, such as a baby sitting in a cot in an orphanage would constitute emotional neglect and abuse and is likely to experience induced long-lasting changes in neural development having determined ‘crying’ is not a communication tool to have needs met. Logically, this can not be used as the same argument for a baby living in a loving Western household whose biological needs are met every minute of every day. What needs to be focused on is a baby “knows” how to sleep, it’s like the saying “sleeping like a baby”, its the misinformation around “crying” and what really constitutes emotional stress that needs to be unravelled so parents are no longer held hostage to a societal opinion which actually prevents their baby from sleeping.
I can show you through the use of strong scientific evidence-based studies that continuous fractured sleep in the first 24 months of life is more likely to place your child at long-term emotional and neurological risk. I should add that I do not actually endorse the phrase “cry it out” or controlled crying” as they are two societally constructed phrases that are clearly taken out of context to portray an opinion. I work on a focused biological approach first and foremost to reduce every biological reason for a baby to make any noise and only then focus on improving their sleep behaviours. I DO NOT sleep train babies, sleep is a basic biological instinct, I arm parents with rational, relevant, biological, factual information (not opinion!) to ensure their behaviours equate to lifelong purposeful neurological sleep for their child.