Infant sleep “training”

The truth is that infant sleep “training” is a very controversial issue from a scientific point of view. The only scientifically documented knowledge on the issue so far, is that breastfeeding during the night, and co-sleeping, enhance the duration of breastfeeding for the scientifically documented objective, which is at least two years.

The “various methods” of training  an infant to fall asleep alone, and the “various books” frequently mentioned by many people, are all the same, just with variations that are profitable for their authors, and have the following as a common component: “Controlled crying”.

The international scientific community – and not just “soft” parents who cannot implement it – is concerned about how the risks of “controlled crying” affect infants psychologically, as well as about its controversial long term result. Babies who are “trained” to sleep alone prematurely, may later, after the first 2-3 years of life, regress, wake up, develop sleep disorders, phobias etc.

It is important to inform parents that, from the moment they have a child, they should not expect to return to the previous” luxury” of uninterrupted, eight-hour sleep , at least during the  pre-school years.

If it is not to breastfeed, they may wake up during the night to give a hug, formula, or water to their little one, to cover her, to change a diaper. Later, maybe to take her to the bathroom, to comfort her from a cold, to hold her while she falls asleep so that her coughing stops, because she is teething, she had a nightmare, because they just want to listen to their baby’s breath while she sleeps, or simply because they are getting older and their own sleep deteriorates.

The parent’s “luxury” really doesn’t have to do with uninterrupted sleep, but with the happiness he or she gets from children, along with the whole package of how hard it is to care for them. The “necessary eight hours of luxury” is not a reality.

It is amazing, that many ideas, practices, and perceptions about our babies, have no scientific basis, but are remnants of a past culture, including the bottle feeding culture. Up to a certain degree, that’s normal, because new scientific knowledge always takes time to become acceptable, and established social perceptions change with difficulty. It is also amazing, that if a practice, no matter how unscientific it may be, is widely spread and accepted, we don’t require proof about it, but we require proof to be presented from those who question it. Consider this: someone tells you that he can go to the moon and return in one day, without any problems. Wouldn’t it be rational to demand that he supports what he says? However, if this person has managed to convince the whole world, then we don’t doubt him, but we require proof from the people who do doubt him. If you were told that your baby should take medication, on which no research had been done, and which had no package leaflet, would you give it to her? And yet, controlled crying during infancy is an intervention, like drug administration, probably far more important and with long term side- effects, without any scientific support. And instead of asking for a package leaflet and for scientific studies that support the efficacy and security of this intervention, we ask the people who doubt its application to prove to us that it is damaging and it is not effective. It is the person who recommends something that needs to have proof, not the person who doesn’t accept the recommendation. And, of course, proof not only of the narrow frame of whether the baby will sleep more during the next few weeks, but also of the level of stress caused, the activity of the stress hormones, long term consequences on sleep until adulthood, any relation with phobias, neuroses, building relationships etc. Only then does someone have the right to support an intervention that concerns the psychological state of a baby.


Stelios Papaventsis MRCPCH DCH IBCLC 2011

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