Tuesday, March 24, 2015

"The Gentle Sleep Book" and Other Recent Releases

A Review of Three New-ish Baby Sleep Books



Is it just me, of have there been a slew of books about babies and sleep hitting the market lately?

It's probably just me, actually, lost in my own little bubble of being a book reviewer. But there have been several new ones out in the past few months. Lots of parents worry over the way their babies sleep. Does their baby sleep too much? Not enough? Should they be this noisy? How often should they wake up to feed? When can they stop feeding them at night?

Many authors are willing to step in and help parents answer their questions, but unfortunately not all of them have good advice to give.

The first in my rundown of recent books on baby sleep is The Good Sleeper by Janet Krone Kennedy. I'm not going to give this one too much space here because, to be honest, I hated it. (If you'd like somewhat more detailed thoughts, read my full review of The Good Sleeper over at San Diego Book Review; it hasn't been posted yet, but the link will be updated once it is.) Does the world really need another book touting harsh sleep training methods? Apparently some people think so. But in reality, this is just another typical book by another typical sleep trainer, offering the same tired old ideas for forcing your baby to sleep more by ignoring their cries until they give up and shut down. Babies sleep trained in this harsh way don't learn to sleep better so much as they learn that mommy and/or daddy aren't going to come help when they're needed in the night. The method used by this book is the typical Ferber method of sleep training, where you leave your baby to cry by itself for consecutively longer periods of time every night, until baby learns to "self-soothe." Supposedly, every night baby should cry for shorter periods of time, and before you know it, they're truly sleeping like a baby! (I'm being sarcastic here; in reality, the thought of parents willfully ignoring their baby's pleas for help makes me want to cry myself.)

What really galls me about books like this is how they recommend starting when baby is three or four months old, and it usually goes hand-in-hand with complete (or at least partial) night-weaning. We wonder why so many women don't meet their breastfeeding goals. Early night-weaning is most likely a contributing factor, since cutting out nighttime nursing can dramatically reduce a mother's milk supply. In reality, there is no arbitrary age when babies no longer need to be fed at night; that age is different for every baby, and night weaning also might damage baby's growth.

I also don't want it to seem like I'm bashing people who sleep train (although it should be abundantly clear by now that I do not agree with it). I know plenty of parents who have sleep trained their babies, and I certainly don't think it means they love their babies any less than I love mine. But I also believe there is a lot of misinformation out there about baby sleep, about what's normal, about the wide range of ages when babies should "sleep through the night," about what sleeping through the night actually means (the technical definition is a five hour stretch, not an eight hour or longer stretch like many books would lead you to believe), about age appropriate ways to encourage more sleep. A lot of parents mistakenly believe sleep has to be one extreme or another: you let your baby cry until they are forced to learn to sleep without you, or you tend to their every sleepy need for years until they gradually learn better sleep on their own.

"It's an awful truth, but some babies vomit when they cry hard or for long periods of time... If your baby does throw up, clean her up and go back to letting her cry. Vomiting might slow down the learning process, but if you persevere, your baby should be falling asleep with minimal or no crying (which means no vomiting) soon." (from The Good Sleeper)

But it doesn't have to be that way.

Enter The Happy Sleeper by Heather Turgeon and Julie Wright. (You can also read my review of The Happy Sleeper over at San Francisco Book Review, if you're so inclined; it hasn't been posted yet, but I will update the link once it is.) For a parent who has reached the end of their rope and feels that they absolutely have to do something NOW to make their baby sleep more or else they will go insane, this book offers a much gentler approach to sleep training. This is now the book I recommend to people who are determined to sleep train; the people who don't believe (or refuse to believe) that their baby will ever sleep on their own without sleep training; the people who just don't have the time and/or patience to wait until their baby figures out sleep on their own. (And even then, I only recommend it after trying to gently convince them to consider not sleep training at all.) The authors don't recommend any kind of sleep training for babies younger than four months (I personally think it should be at least six months), and they offer a variety of ideas for soothing your baby in a way that promotes sleep without being draining to mommy/daddy.

This book thoroughly discusses the importance of making a safe and comfortable sleep space, how to develop a bedtime routine (and why babies absolutely thrive on routines and patterns), and explains why good sleep is important for everyone. The point out that pitting cry-it-out (CIO) sleep training against attachment parenting is a bad idea, because it makes it seem like baby sleep has to be entirely one or the other. (Note that the first book mentioned above made a point of doing just that; the author seems to have taken quite an issue with attachment parenting in general and Dr. Sears in particular, which shouldn't be surprising, considering her profession as a sleep trainer.)

The actual sleep training method (because it is sleep training, although the authors shy away from that term) is called the Sleep Wave, and it does involve letting your baby cry, but never for longer than five minutes at a time. By checking on baby regularly, on the clock, babies will soon detect a pattern (according to the authors), and even if they are distraught for short periods of time, they will quickly learn that you will be coming back soon. They will understand that you will never be gone forever, and this understanding will comfort them enough to help them relax and begin to figure out falling asleep on their own.

This book also has a ton of information on dealing with regressions, naps, early wakings, and other sleep issues, including how to help parents get better rest too. I love that this book doesn't demonize bedsharing, that it encourages parents to continue night feeding during and after using the Sleep Wave (although this method will still most likely reduce the amount of night feeds and potentially damage a nursing mother's milk supply). I love how it's not an all-or-nothing approach, that they offer gentle ways of helping baby sleep that can work alongside or independently from their Sleep Wave. I love the pleasant, conversational tone of the book, and how friendly it feels to parents. I love that it address sleep through toddlerhood and all the way up to school age children.

"This is why we use the term 'attunement' instead of 'attachment' - so we can be clear about the goal. To be attuned is to be present and curious, so you can watch your baby and know when to help and also when to give her space. Attuned parents are responsive, while also having clear expectations." (from The Happy Sleeper)

But in the end, it's still sleep training. What about parents who truly don't feel that sleep training is right for them? I was one of those parents, and while I was relatively confident that I was doing the best thing for my son by letting him figure out sleep on his own schedule, I still faced frequent doubt that I was doing the right thing.

For parents like this, for parents like me, for all parents everywhere, really, my new favorite baby sleep book is The Gentle Sleep Book by Sarah Ockwell-Smith. This is the book I wish I had had when my son was a newborn, squirming and making strange baby noises. This is the book I wish I had had when I struggled to understand why some babies slept for 5-6 or more hour stretches, but mine continued to wake up every few hours well into his second year of life.

What is the most common complaint one hears from new parents? My baby still wakes up a lot. My baby is not a "good" sleeper. But perhaps your baby's sleep patterns are not a "problem" that needs to be "fixed" with harsh, potentially traumatic sleep training methods. Perhaps the fact that so many parents feel this way about their baby's sleep is indicative of a deeper cultural misapprehension about how babies are supposed to sleep.

To put it another way, your baby does not have a sleep problem. You, the parent, have a problem: misinformation and unrealistic expectations about normal baby sleep. Don't try to fix your baby; fix your own understanding of how babies sleep.

The Gentle Sleep Book is, in my opinion, the best book out there about the way babies, toddlers, and preschoolers sleep. One of the biggest points she tries to convey is how so many people, including supposed experts, really don't understand how babies naturally sleep.

You know those charts you see in every baby book ever, as well as in occasional magazine articles or blog posts, the charts that list the number of hours a baby should be sleeping at a certain age? Those recommendations are not based in fact. When you compare them to studies that document how babies actually do sleep (Ockwell-Smith cites a good deal of solid research in her book, both about this and so many other things related to sleep), the recommendations in those charts almost always overestimate how much sleep a baby "should" be getting. It's worth remembering that you can't apply such singular standards to baby sleep any more than you can apply them to milestones like walking and talking.

The first few chapters of this book focus on helping readers to understand more about the process of sleep. The way that a baby's sleep cycle differs from that of an adult (hint: it's much, much shorter). The fact that, throughout much of history, humans tended to sleep in two chunks, with a period of wakefulness in between; when you consider this, it's perfectly normal when your baby wakes up at 1:00 A.M. and is ready to play, since humans did that for a long, long time. The fact that a traumatic birth can impact sleep in a negative way long after birth actually occurred. The way that diet can affect sleep, including how breastfed babies naturally wake more often than formula-fed babies, as well as the fact that early weaning does not improve sleep.

"Scientific research doesn't support the idea that weaning a baby onto solid foods will help them sleep through the night. Research has consistently found no difference in the sleeping habits of babies who had been weaned onto solids or were given baby rice prior to bedtime. Weaning before six months of age carries several risks for babies, including an increased risk of asthma, eczema, allergies, and digestive problems. Bear these risks in mind and don't be tempted to try to wean your baby early in an attempt to get more sleep, particularly given the evidence showing it makes no difference." (from The Gentle Sleep Book)

Ockwell-Smith also tackles the problems inherent in traditional methods of sleep training (such as the kind advocated by The Good Sleeper), namely the fact that small babies and toddlers are not actually capable of learning to "self-soothe." Seriously. Their brains are just not that developed yet, and won't be until they're at least four or five years old.

To put it gently, self-soothing in babies is a myth. To put it more bluntly, it is a lie.

But that doesn't mean that you can't help baby sleep better. There are many ways you can encourage better sleep that are appropriate to a baby's age and developmental stages. These are not magic bullets that will suddenly net you long chunks of sleep; they take time to work, and they can do nothing if your baby, at this age, just needs less sleep overall or more frequent feeds at night.

"It is biologically, neurologically, and physically impossible for a baby, toddler, or even perhaps a pre-schooler to be able to 'self-soothe'. Their brains are too immature. It's like trying to teach a three-month-old baby to walk or a one-year-old to have a full-on conversation with you. We accept the physical and neurological limitations of children in almost every other sense, apart from sleep. What we expect of babies and children when it comes to sleep is, in my opinion, impossible." (from The Gentle Sleep Book)

But there are things you can do.

The author lays out her general ideas for helping your little ones sleep better using the acronym BEDTIME. This includes:
  • Bedsharing or co-sleeping - many babies just sleep better with their parent(s) nearby, and there are guidelines you can follow to make it safe for you and baby; did you know that keeping baby in the same room as you until they're at least 6 months old reduces their risk of SIDS?
  • Expectations - chances are good that your expectations of how much sleep your baby needs, how often they should wake up, whether/how often they should need to be fed, etc. are wrong; that's probably not your fault, but understanding what's normal for your baby will help in a major way; this section also covers the importance of routines before sleep
  • Diet - this includes understanding the differences between breastfed babies and formula-fed babies; acknowledging that most babies really do need to be fed at night for much longer than many experts believe; and being aware that allergies and food intolerances can affect sleep
  • Transitional objects - teddy bears, security blankets, or similar things that can help calm a baby when you're not immediately there to snuggle; learn how to (try to) condition your baby to use one
  • IT or screen time - most children are exposed to too many screens anyway, and when it's too close to bedtime, it can inhibit sleep
  • Me-time - you need to take care of yourself too!
  • Environment - consider how things like lighting, scents in the air, and sounds can either prevent sleep or make it easier

If this all sounds a little vague... well, you ought to consider picking up a copy for yourself, since I certainly can't give away all of the ideas here! (The Gentle Sleep Book has actually not been released in the U.S. yet, but I was able to purchase a copy through Book Depository, which ships free worldwide.) Ockwell-Smith delves into each of these topics in depth in the book, especially with relation to different age ranges.

In fact, the latter chapters of the book are dedicated to exploring sleep at different age ranges. Ockwell-Smith first gives readers an idea of what to expect with regards to specific sleep patterns for each particular age group, then follows that with general guidelines creating a good sleeping environment for that age. More helpfully, she follows up with several case studies for each age range, real stories from real parents who were struggling with their child's sleep. The author describes the ideas she offered to those particular parents; these case stories help readers understand how to apply different parts of the BEDTIME solution to different issues, while reinforcing the fact that there is no single solution, no quick fix, and that the answer will be different for every situation.

All in all, this is an amazing book. Like The Happy Sleeper, it offers ideas for children up to five years old, but the ideas are all gentle and designed to foster trust in a way that sleep training, even in its least aggressive form, can not. The Gentle Sleep Book is so empowering, offering lots of reassurance and so many different ideas that parents can immediately begin to implement (even as it stresses that it will likely take at least six weeks for any improvement to show). Best of all, it empowers parents to come up with their own sleep plan, tailored to their individual child and family situation.

This book doesn't just give you a one-size-fits-all solution; it gives you tools and support and reassurance, and then trusts that you are smart enough to figure out how to make it all work for your family.

3 comments:

  1. This was a fascinating synopsis! :I was shocked at the first book, promoting letting a baby scream until they puke all over themselves and then cleaning it up and letting them go back to screaming. How can anybody justify that?!! Good grief.

    The third book sounds utterly fascinating! I nene read anything about sleep and since he slept and nursed in bed with us, I never felt the urge to do any research since we didn't have any problems or conflict with it. But your description of the book is so engaging and interesting that I want to look it up!

    I recently read an article by an anthropologist who said when his child was born, and he started reading about sleep and care advice, he was alarmed because based on the science and research he lived with daily, studying cultures from around the wield, he couldn't see any of it being based in fact and saw that it was, in fact, just cultural expectations and needs! We need baby to sleep so we can leave in the morning, we need baby to stop nursing so we can be separated all day. This isn't normal but it is Western.

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    1. Sadly, the first book is pretty similar to what most "sleep training" books advise (mind you, I haven't read any others all the way through, and the only reason I read this one was because I was reviewing it... but I have read enough articles and things written by other people who have read those books that I feel I can state that with confidence). I don't even understand how anyone could be comfortable with letting their baby cry for any substantial length of time when that baby is clearly in distress.

      That book also offered coping mechanisms for the parents to help them "survive cry-it-out:" don't watch the baby on a baby monitor because it will "undermine your resolve," distract yourself with movies or video games, take turns being there ("Because you don't yet know how long your baby can cry, the first bout of crying can be the hardest to endure. If you need an escape, go for a walk, go to a bookstore, go to the gym while your partner holds vigil."), drown out the crying (earplugs, anyone?). Why should any of that be necessary??!? Why not just soothe your baby and let them learn to sleep on their own?

      Also, why do I still have this awful book? (Probably because I certainly can't bring myself to sell it or trade it on Paperback Swap. So it's going in the trash. Right now.)

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    2. Also, are you referring to the James McKenna article that was making the rounds recently? That man knows what he's talking about!

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