Precious little sleep, p.13
Precious Little Sleep, page 13
4. It is something you will have to redo on a regular basis.
When it comes to sleep, all kids have bleeps and blurps. This is not specific to CIO—it’s part and parcel of having children. Illness, travel, the arrival of a new sibling, because they feel like it... There will be rough sleep days in your future but that’s independent of how you teach your child to fall asleep.
5. Sleep training lasts forever.
Some parents will say things like “We’ve been doing CIO for months” when what they really mean is “We’ve been putting our child down awake at bedtime for months” or “Baby grumbles for a few minutes at bedtime.” This has created the perception that CIO takes an eternity. The truth is that, done correctly, it’s a relatively brief affair.
6. You don’t need to train your child to sleep—they’ll figure it out when they’re ready.
On a long enough timeline, your child will learn to fall asleep without you. Never in all of history has a child gone to college still requiring their mom to nurse them to sleep.
But how many years of sleepless nights and bedtime battles are you willing to wade through? Sleep associations, both good and bad, are incredibly persistent. Kids quickly grow out of their pajamas. They grow out of their interest in chewing on toys. They do not just grow out of unsustainable sleep associations.
7. It is unnecessary because plenty of gradual sleep-training methods will work just as well.
Some more gradual methods will work great for some babies. But they most definitely do not work for all babies.
8. No-cry sleep training involves zero tears.
This may be true, on occasion, for some lucky parents. But rarely. Babies’ reaction to “no-cry” sleep may range from fussing to screaming, but very few will not cry at all.
9. You cannot do sleep training and subscribe to attachment-parenting (AP) philosophies.
Attachment parenting has, unfortunately, become a bit of a predicament for families. Somewhere along the line, AP became synonymous with co-sleeping, breastfeeding, babywearing, baby-led weaning, using only locally sourced organic produce, and a whole host of other lifestyle choices. Deviating from this set of choices suggests that you are not an AP parent.
Which is ridiculous. We are all attachment parents. We are deeply attached to our children, as they are to us. Secure attachment occurs when parents are reliably tuned in to and meeting their baby’s needs.2
How you choose to be sensitive and emotionally available to your child is, of course, entirely up to you. Some people enjoy co-sleeping, nursing, babywearing, etc., which is fabulous, as they’ve found methods of parenting that work for their family. You can also be entirely sensitive and emotionally available while using formula or expressed breast milk, having your child sleep in a crib, etc. All of these are entirely valid parenting and lifestyle choices. The bonds between parent and child are forged when you are emotionally and consistently responsive to their needs, not by how you respond.
Similarly, AP and sleep training are not contrary ideologies. Sleep is a basic human need3—a need that, when met, enables your child to grow and thrive, and a need that, when met for parents, lets them be emotionally available to their children. If you decided to use sleep training, you have come to the rational conclusion that it’s the best way to meet your child’s need for sleep. And having a well-rested child (in addition to being well rested yourself) will further enable you to have the emotional reserves to be available and sensitive for your child throughout the day.
10. It is a cure-all for baby sleep woes.
Sadly, no, CIO is not a baby sleep Swiss Army knife. It has a very specific purpose: to break out of unsustainable sleep associations and establish independent sleep. There are plenty of sleep problems (night weaning, waking too early, crappy naps) that can’t be readily solved with sleep training.
Unfortunately, the negative mythology of CIO is so pervasive that it can be hard to unpack it all. Which is why I reached out to Dr. Ruid to share her clinical perspective on parent–child attachment and sleep training.
Rebecca Ruid, PhD, is a licensed clinical child psychologist in practice for 10 years at the University of Vermont Medical Center. She also offers parenting services through a community health team at a local pediatrics practice. Dr. Ruid specializes in working with parents to resolve concerns with behavior (including sleep!) as well as with children and adolescents dealing with both internalizing and externalizing concerns. She lives with her two young boys and husband in Williston, Vermont.
Attachment and Sleep Training:
A Psychologist’s Perspective—Dr. Rebecca Ruid
My parents gave my sisters and me a framed statement when we were very young, and this now sits in my older son’s bedroom. It reads, “Parents may try to make your world better, but the only thing they can truly give you is life and love. The rest you must earn for yourself.” Perhaps it was this parenting style, in addition to my training and professional development, which led me to be the type of clinician and parent that I am. Though some may interpret and equate “love” with co-sleeping and other attachment-based parenting practices, I do not view it in that way. To me there is not a specific list of behaviors that demonstrate our love for our children.
I am neither for nor against attachment parenting as a general concept. It is a valid and appropriate practice for children who have a history of trauma, for example, and one that I recommend in my work with such families. However, I believe that many people adopt attachment parenting because it limits child distress in the moment, a popular concept in our current parenting climate. In this context I struggle to see how this accurately applies the attachment theory upon which the practice is based, or how this approach will ultimately benefit our untraumatized children. I do not believe that attachment theorists would argue that we should not allow our children to experience distress or that there is a list of very specific practices necessary to lead to healthy attachment. I feel that theorists such as Bowlby4 may argue that, barring adverse experience that interferes with attachment (on the part of the parent or the child), attachment naturally deepens and strengthens over time. To me, this will look different in different homes.
I am a great believer in encouraging children to recognize that they, and only they, have control over their thoughts and emotional functioning (the ability to regulate emotional states is closely linked to our ability to fall asleep independently). We encourage recognition of this by modeling and teaching coping skills, and then providing space for them to be used. A parent is not able to manage emotions for their child; it is an inside job. I strongly believe that part of being an emotionally healthy individual includes feeling a multitude of emotions (over time or even, sometimes, all at once!), recognizing they are normal and healthy, and being able to cope with all of them. To learn how to do this, we need to be given the space to practice—we need to feel sadness and disappointment as much as we need to feel happiness and joy, anger as much as love. We need to be able to screw up how we handle those emotions and learn from that. We need to feel pride when we handle them independently, and recognize that we have that skill. If a parent never allows their child to experience distress, that child never learns that they can experience distress and, ultimately, resolve it (whether they do something to make that happen or it happens organically). All feelings come and all feelings go—I think of them like passing clouds. Unfortunately, this is as true for the good emotions as for the bad. So it is my opinion that teaching a child to self-soothe for independent sleep is one of the first ways we can teach this, and a great gift we can bestow upon them.
There is ample evidence that sleep training or CIO doesn’t scar children or cause issues with attachment.5 A multitude of factors inhibit or lead to healthy attachment: abuse, neglect, and loss of a primary attachment figure in early life, on the one hand, and support, love, and consistency, on the other. Not responding to our child every time she experiences distress is not going to ruin a bond. If done appropriately and with confidence, it can do something very different. It can send a message that you are safe and okay because I have set the stage for that and you can trust me to ensure your well-being (this message is strengthened when I do respond when necessary). It can send a message that we are separate entities, however connected we may be, and that you do not “need” me 24 hours a day every day. In this way it begins establishing important boundaries. It can send a message that I have confidence in your ability to manage this task successfully. On a concrete level, it sends a message that nighttime is a time for sleep, which is a solitary act—there are so many other hours in the day to be socially connected. It sends a message that sleep is important!
To SLIP or Not to SLIP
For both clarity and specificity, I’m going to call this strategy the Sleep Learning Independence Plan (SLIP). Because that’s what it is: a plan to learn to sleep independent of parental involvement, because parental involvement is no longer helping or is possibly hindering your child’s ability to establish healthy sleep.
SLIP is a mindful parenting strategy used to foster independent sleep for older babies that generally involves some degree of tears or complaint and that is appropriate for families who have not met with success using SWAPs or for whom severe sleep deprivation is causing such significant problems that the timescale of the SWAP is not reasonable for physical or mental health.
Is SLIP for your family? Here’s a 10-point checklist that will help you and your partner reach a conclusion. If the answer to most of these questions is “yes,” SLIP might be appropriate.
1. Baby is 6 months old or older.
For younger babies, you have many soothing sleep tools in your arsenal and you should use them with wild abandon. With SLIP, generally, older is better. Note, however, that this is not a hard cutoff intended to suggest that using SLIP with your 5-month-old makes you an ogre, or that even if things are a total misery you should simply slog it out until your child hits the magical 6 months. It’s simply a guideline.
2. Baby is chronically sleep deprived.
If your baby is getting significantly less sleep than they should or is waking excessively during the night, then they’re probably sleep deprived.
3. The root issue is lack of independent sleep.
SLIP is a technique to foster independent sleep. It sometimes is applied to night weaning or excessively early waking, but it is primarily for issues related to an inability to fall asleep alone.
4. You’ve tried everything possible and it hasn’t worked.
SLIP is generally the option of last resort. You’ve tried everything—made a committed effort with one or more SWAPs—yet nobody is sleeping.
5. Baby doesn’t have any medical complications.
Colds, fevers, and reflux will exacerbate your child’s inability to sleep independently.
6. Baby is in a safe place.
Ideally, this is the crib, although co-sleeping parents can also use SLIP.
7. The vote is unanimous.
This is not the time to have a marital squabble or to guilt-trip each other. If you and your partner are in vehement disagreement about how to approach sleep training, you aren’t ready to do it.
8. You’ll be able to maintain a consistent schedule.
Sleep training is not something to launch into the weekend before you hop on a plane to Morocco. Find a few weeks when you’ll be able to maintain a consistent schedule and sleep location for day and night sleep.
9. You have a night vision monitor.
This is not an absolute must, but it’s helpful. These expensive items answer the essential question, “Is she asleep yet?”
10. You are committed.
“Do or do not. There is no try.” —Yoda
#10 is the most important item on the list. This is a good time to go to a quiet place and have an honest conversation with yourself. It may go something like this:
“Hey, self, how’s it going?”
“Truth? I’ve been better. You?”
“Pretty haggard, if I’m being honest.”
“Ayup.”
“So, are we doing this? Like, for real?”
“I don’t know. What do you think?”
“I guess we could try...”
“Like, put our love nugget down at bedtime and see how things go?”
“Yeah. That sounds like a good plan.”
No. No it doesn’t.
There is no try. There is no “let’s see how things go.” Do or do not.
Go for a quiet walk by yourself and really listen to your inner voice. If you or your partner will rush in to “rescue” your crying child after 20 minutes, you aren’t ready. And that’s totally okay. In fact, it’s great that you know you aren’t ready. It just means this strategy isn’t for you—at least not right now.
If, instead, you understand that your child doesn’t require rescuing, that they’re capable of figuring out how to do this, that you have confidence in them, then you’re ready to move forward... then SLIP is for you. As long as you and your partner are ready to fully commit. Like, “getting a tattoo”-level commitment.
How to SLIP at Night
As with our SWAPs, it’s best to start with SLIP at bedtime due to the powerful biological drive for sleep at that time. To be clear: you SLIP into sleep at bedtime. It’s not fair to cheat the system by helping your child fall asleep at bedtime and then hoping for SLIP to salvage things later. How your child falls asleep at the start of the night is essential.
When you’re ready to SLIP...
Make naps happen by any means necessary. You want your child well rested going into bedtime because tired kids sleep poorly. Does your baby take great naps in the car? In a stroller? Great! For the next few days do what you need to so those naps happen. For the moment, you are not concerned with independent sleep at naptime, simply with ensuring that reasonable naps happen.
Corollary: Avoid catnaps. Catnaps undermine your goal of quality nappage. Don’t drive to the grocery store at naptime: that 5-minute car nap is working against Step 1. Further, don’t begin SLIP when your nap schedule is likely to be wonky.
Do your relaxing, consistent bedtime routine but leave out the final “soothe to sleep” step. Whatever you’re working to wean off—rocking, cuddling, nursing, eating—should be entirely removed from the process. If the sleep association you’re working to remove involves food (bottle or boob), it should occur 20 minutes before your child is put down to sleep: thus “bath, books, boob, bed” routine will now be “boob, bath, books, bed.” If you have historically rocked or bounced but not cuddled your child to sleep, remove any rocking or bouncing from the routine; quietly cuddling while reading books is fine.
If Baby is swaddled, continue to use the swaddle as long as you are confident that they can’t or won’t flip over. If your child is older and potentially capable of flipping onto their stomach, swaddling is inadvisable for sleep training.
If your child has been using the pacifier, now is the time to stop. While some children can fall asleep with the pacifier and happily sleep all night, eventually pacifiers tend to cause sleep association problems.
Ensure that baby’s sleep location is absolutely safe. Are there dangling cords within reach of the crib? Unprotected outlets? Can baby climb or fall out? The crib should be clear of any possible entrapment hazards—no stuffed animals, blankets, bumpers, or pillows. The only thing allowed in there other than your baby is a small lovey—if Baby is old enough to use one safely. If your child is old enough to sleep in a big-kid bed, put on your anal-retentive hat and look at the whole room. Does the furniture present tipover hazards? Are there toys that could break into sharp pieces? Choking hazards?
If you are co-sleeping and intend to continue, an adult will need to remain with the child at all times. An adult bed is not a safe space for a child without direct parental supervision. (See “SLIP and Co-sleeping,” after this list.)
Make sure you are putting baby down to sleep at the appropriate bedtime. This should be the time your child has historically been falling asleep (now is when the Goddess of Consistency will reward your devotion). The key word here is sleep. If you’ve been bouncing your child on a yoga ball for 60 minutes every night, his bedtime is not when you begin the bouncing, but when he’s a limp piece of bacon sleeping in your arms.
Use your consistent bedtime words. Your baby’s receptive language develops far earlier than their expressive language:6 they understand what you are saying long before they can speak themselves. Use the same words every night as part of your bedtime routine. “It’s time for you to sleep, buddy. Mommy and Daddy love you. We’re right next door. We’ll see you with big hugs and kisses in the morning. But for now we’re going to leave so your body can get the sleep it needs to be strong and healthy. I love you, little dude!” Be firm, loving, and consistent.
Put Baby in their bed and leave the room. Some strategies suggest that camping out in the room is preferable because your loving presence can provide helpful soothing. In my experience, staying in the room has the opposite effect, making Baby more upset: “Why aren’t you picking me up! HELLO?!? I can see you sitting RIGHT THERE!” It also has the potential unintended consequence of creating a new object permanence problem for you, in that Baby will expect to see you sitting there when they wake up at night. For these reasons I suggest that you put Baby down and leave.
