Surviving the First Year: Two books to help you understand baby’s sleep

For most new parents, sleep quickly becomes an obsession, their most precious commodity. Parents of a newborn will happily trade exercise, sex, and time with friends for a shot at catching some Z’s–kind of like how a rat with ad libitum access to cocaine will happily forgo food.

(Yep, this assumes you’re not in sleep-obsession mode already. If you are currently in third trimester insomnia hell, my condolences. Sadly, the situation is unlikely to improve when your baby arrives.)

In 1943, psychology researcher Abraham Maslow mapped out his now famous hierarchy of human needs. This is reasonable approximation of what most people’s needs look like before having a baby:

maslow

And this is what they look like shortly after having a baby:

Screen Shot 2017-10-20 at 10.24.49 AM

This is why, when expecting my first child, one of the best pieces of advice I got was to start reading up on infant sleep before baby arrives.

Of course, just because this was good advice, doesn’t mean I took it. I didn’t. Instead, I focused my pre-baby sleuthing on how to avoid a C-section, which meant I  ended up frantic Google searching baby sleep while so sleep-deprived that I could barely remember my computer password. Don’t do this!

Have I convinced you yet?

If so, let’s move on to next question: What should you read about baby sleep? The options can feel endless and overwhelming. There’s the “no-cry” solutions. There are the people who tell you that introducing solids will get your baby to start sleeping a blissful 8 hours. (It won’t!) There’s the co-sleep until age 7 camp.

Everyone has an opinion. Trying to wade through all the opinions to get to real, evidence-based solutions while so tired you can barely string a sentence together is less fun than dealing with a newborn blowout on a stroller walk in the dead of winter. In short, it sucks.

So let me save you the trouble. Below are two excellent books on baby sleep that do the work for you. They are grounded in real data and offer clear, practical solutions for busy, tired parents.

1. Precious Little Sleep by Alexis Dubief.

Not only is Precious Little Sleep a great sleep reference for parents who want to be able to quickly look something up, it is also a fast easy read and often laugh out loud funny.

Like so many parents, Alexis Dubief began researching baby sleep after giving birth to her first child, a boy. Her son refused to sleep without being held. This is a pretty common newborn sleep demand that works great for your baby. But for you, not so much.

Now, after years of researching and helping tired parents, helping others get their babies to sleep better has become her self-proclaimed super power. And it really is.

Her book outlines how to get babies to sleep better using a variety of methods. She delves into both “no-cry” and “cry it out”–two terms she personally eschews, noting (correctly) that babies often “fuss” during no-cry methods and that babies experience lots of parental presence and soothing during “cry-it-out” methods. She instead calls these SWAPS and SLIPS.

Throughout her book, Dubief draws on a mix of research and direct experience to talk about which strategies work best for which babies (they’re all different!) and at which ages. This is super helpful, because teaching a 4-month-old to fall asleep on their own requires very different tactics than those used with a stubborn sleep-fighting toddler.

Although newborn sleep is what sends most parents into a deep zombie-like fog, Precious Little Sleep also covers naps and strategies for bedtime with older kids.

As a parent of older children, now 4 and 6, I appreciated her no nonsense, practical tips for ending the endless cycle of bedtime requests (more cuddles, more water, more stories): Fill their emotional bucket before bed, set firm limits, and starting an hour before bedtime, move them from high energy activities and bright light to low energy activities and low light.

Her book is full of clear guidance like that, making it a wonderful go-to reference for your baby’s later years as well.

Get it here: Precious Little Sleep: The Complete Baby Sleep Guide for Modern Parents

Or order the Kindle edition (a steal at only $2.00!): Precious Little Sleep: The Complete Baby Sleep Guide for Modern Parents

2. The Science of Mom: A Research-Based Guide to Your Baby’s First Year, by one of my favorite bloggers, Alice Callahan.

With a PhD in nutrition and postdoctoral training in fetal physiology, Alice Callahan is obviously super smart, but in a totally low ego, unshowy way.

In this book, she delves deep into the scientific literature on hot button parenting topics like breastfeeding, introducing solids, and vaccines, then surfaces to interweave her evidence-based conclusions with practical experience in a clear, sensible, and nonjudgmental voice.

This means that for navigating common parent concerns, Callahan is the ultimate trustworthy guide. She provides copious references, clear examples, and lots of practical tips. Her writing on infant nutrition, in particular, is bar none.

But back to sleep… While her book covers a lot of common first year questions, her two chapters on sleep (“Where Should Your Baby Sleep?”) and (“In Search of a Good Night’s Sleep”) provide the best data-based summaries I have ever encountered on how to reduce the risk of SIDS and how to help your baby to sleep better, longer and to fall asleep on their own (what Callahan calls self-soothing). Those two chapters are worth their weight in gold. (Or more to the point, worth their weight in long extra hours of uninterrupted sleep. Wouldn’t you trade gold for that?)

Parents who want to know the data behind the recommendations, to get advice without being talked down to, and who want to understand why they’re being told what they’re being told by their pediatrician should check out The Science of Mom.

Get it here: The Science of Mom: A Research-Based Guide to Your Baby’s First Year

The Middlemiss Study Tells Us Nothing About Sleep Training, Cry-It-Out, or Infant Stress

Last week, I wrote a post about sleep training and stress, in which I argued that everything we know about stress suggests that sleep training is not harmful.

In response, some people objected that sleep trained babies continue to experience elevated cortisol and significant distress, even after they have stopped crying. In their view, sleep training teaches babies that crying does not help. They haven’t learned to self-soothe or to fall asleep on their own, they’ve simply given up.

What a heartbreaking thought. And one that surely strikes fear in the heart of many parents.

So it’s important to realize that this claim comes from a single small and deeply flawed study of 25 babies, led by Wendy Middlemiss, a researcher at the University of North Texas’s College of Education.

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Back Sleeping During Pregnancy and the Sydney Stillbirth Study

Pregnancy can be cruel. Just when you are at your most swollen, bloated, and exhausted, sleep proves frustratingly elusive. Every night, you toss and turn, trying to find a comfortable position, your back aching, and your belly pressing down on your bladder. And then, as you finally start to drift off, you realize you need to pee.

To make matters worse, despite having an enormous bowling ball attached to your stomach, you are told you cannot sleep on your back:

“After 16 weeks of pregnancy, experts advise women to not sleep on their backs, but rather should lie on their sides, ideally the left side.” – mamalette

Who came up with this idea?

This advice stems three studies that have linked back sleeping with late stillbirth (pregnancy loss after 28 weeks). (Interestingly these warnings predated the three studies, so they are not exactly the reason women are told to avoid back sleeping)

I described the first two studies, one conducted in Ghana, the other in New Zealand, in an earlier post, and concluded that not only did they provide no reason for alarm, they certainly do not justify blanket advice again back sleeping.

In 2015, a third study came out linking back sleeping with late stillbirth. Does it change the overall picture?

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Bedsharing and SIDS: Why I Chose to Bedshare with My Second Child

How risky is bedsharing with your child? And if you choose to bedshare, how can you do so as safely as possible?

My second baby slept in bed with me, all night, every night, from the time we took her home from the hospital until she was 3 months old. At first, I was almost too terrified to fall asleep, for fear that I would roll over and suffocate her.

After all, nearly all major medical organizations warn against bedsharing, on the grounds that it increases the chances of Sudden Infant Death Syndrome (SIDS).

“The safest place for your baby to sleep is in the room where you sleep, but not in your bed. Place the baby’s crib or bassinet near your bed (within arm’s reach). This makes it easier to breastfeed and to bond with your baby,” according the The American Academy of Pediatrics.

Statements like these sound definitive. But, in fact, considerable scientific controversy surrounds the role of bedsharing in SIDS.

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Let’s Face It: Formula-Fed Babies Sleep Better

Breastfed babies tend to arouse from sleep more easily and sleep for shorter periods of time. Nearly all babies who sleep through the night by 3 months are formula-fed.

Breastfeeding is a major battleground of the modern mommy wars. In her widely discussed piece in The Atlantic, Hanna Rosin called breastfeeding the “new sucking sound”–replacing vacuuming as the task that shackles women to the house, promotes the unequal distribution of childcare and household duties, and prevents women from reaching the upper echelons of professional success. The benefits of breastfeeding have been oversold, she claims, and–just as significantly–the costs to women’s sleep, time, and career progress have been downplayed.

On the other side of the debate, the American Academy of Pediatrics states that the benefits for the infant in terms of reduced risk of infection, adult obesity, allergies, and asthma are so great that breastfeeding must be viewed as an “investment in your child’s future” rather than a “lifestyle choice.” Some lactation consultants fall into this camp too, needing to be reminded to suppress their impulse to sigh when yet another mother complains of exhaustion and lack of sleep, for fear they alienate her–and fail to convince her to keep breastfeeding.

On both sides, well-intentioned but overzealous advocates twist the evidence on breastfeeding, cherry-picking among studies to support their preexisting views.

This is especially true when it comes to one of breastfeeding’s major downsides: disrupted sleep.

Consider the post, 5 Cool Things No One Ever Told You About Nighttime Breastfeeding, which claims that the number 1 coolest thing about nighttime breastfeeding is “breastfeeding moms actually get MORE sleep than their formula-feeding counterparts,” and concludes with the rhetorical question: “Did you ever think, when you hear your baby rouse at 2:00am, that they are actually giving you the gift of MORE sleep…?”

To which I would like to respond: No, never, not only because it does not square with my own experience, but also because the research on this topic is clear: breastfeeding moms, on average, get less sleep, not more.

Almost without exception, studies on formula feeding, breastfeeding, and sleep find that breastfed babies wake up more often than formula fed ones at night, and breastfeeding mothers therefore get LESS uninterrupted nighttime sleep.

Nighttime Wakings in Formula-Fed Versus Breastfed Babies

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