Infant Sleep Development and Challenges: How is it Working for the Whole Family?

Marin Mommies is presents another great guest article, this time by Marin parent coach, infant/toddler sleep researcher, and family therapist Angelique Millette. She works throughout the Bay Area and across the country supporting families and helping them meet life's challenges. You can learn more about her and her services at www.angeliquemillette.com.

Working as a sleep consultant, parent coach, and infant-toddler-child therapist intern, I am always struck by how often I hear questions—that cross cultural and demographic lines—related to infant/toddler sleep issues and how infants and young children are affected by sleep challenges. Many parents report they are confused by conflicting suggestions and opinions in the various sleep books. A meta-analysis looking at 40 different books not only found conflicting information on how to treat sleep problems, including contradictory recommendations about co-sleeping and acceptable crying methods, but also that many books (approximately half of those in the study) had a first author with no professional credentials at all. What, then, is a sleep-deprived parent to do?

One of the first questions I ask families when we begin working together is: “How is it working for the whole family?” How is the sleep method or location of the infant or young child working for each member of the family? New research shows that sleep challenges for infants and young children may be related intrinsically to their ability to adapt to information from their caregivers, specifically their mothers, to help them to learn to settle and fall sleep. When mothers are sleep deprived, depressed or anxious, they may be less able to respond to their infant’s need to sleep and have more difficulty “reading” their infant’s sleep cues. Alternatively, research shows that some babies of sleep deprived, depressed and anxious mothers may develop less organized sleep cycles. 

When babies aren’t sleeping well, parents aren’t sleeping well either, but this may be only half of the picture. In my practice, I want to find all the possible reasons why the baby or young child isn’t sleeping well before we look for the solution. Otherwise, it is likely the sleep problem will resurface.

Why “It” Happens?

One of the most common reasons babies aren’t able to “sleep well” is that the part of the brain that organizes sleep is just beginning to form in the first three to six months. This includes the development of circadian rhythms, those interesting little biological temporal rhythms that help our bodies “know” a 24-hour day and the difference between day and night. Babies are born without fully developed circadian rhythms and actually are dependent on their environment, vis-à-vis their caregivers, to provide Zeitgebers, environmental cues necessary to the development of rhythms. Parents can help their babies cue their circadian rhythms by bringing them outside, opening the shades in the nursery and other rooms where the family spends time, feeding frequently during the day and playing actively afterwards and instilling sleep and other routines.

Can We Fix “It?”

When establishing sleep schedules, I want to be clear that this is not an absolute by-the-clock program. I ask parents to commit to the following: (1) try to keep track of when your child last napped and when the next feeding might take place, (2) learn a little bit about a baby’s developmental sleeping milestones and, finally, (3) become aware of your own baby’s sleep cues, which are the cluster of non-verbal signs that alert you to your baby entering a sleep window.

Common sleep cues include yawning, eye or ear rubbing, red eyes, gaze avert (when a baby looks into space for extended periods of time), disorganized or jerky movements and sleep-crying (or sleep grousing). Babies use sleep cues to communicate that they are not only tired and over-stimulated, but are entering into a sleep window, and if you start the nap or bedtime routine, your baby or young child will be able to fall asleep much more easily than if you wait and, consequently, miss the window. It’s paramount for parents to aid in healthy sleep pattern development by ensuring that during the first months of an infant’s life they follow a consistent pattern of routines and thoroughly watch and understand their baby’s sleep and other cues. This combined effort can help lead to critical brain development that facilitates greater self-soothing in infants and young children.

But what if it doesn’t? What happens when the combination of following consistent routines and observing your infant’s sleep cues doesn’t result in the development of organized sleep? Because sleep imprinting (or an infant’s sleep associations) begins on day one, a baby who needs a lot of rocking, movement, shhhing, patting and bouncing to fall sleep will likely continue to need those sleep associations, even though he or she could become more capable of self-soothing, using techniques like sucking hands, fingers or a blanket, rolling onto the stomach or making going-to-sleep sounds to settle down. As their baby approaches ages four to six months, parents can do a little less rocking, patting and bouncing to help the baby develop new self-soothing skills for settling down to sleep.

If So, How?

Parents use a myriad of techniques to try and help their babies to sleep, and when they don’t work, they look for help. When I work with parents, I make suggestions that bare in mind parenting philosophy, parental overwhelm, depression and anxiety, along with infant temperament, development and age. While the sleep books will have you believe you either can be a co-sleeping, no-cry parent or a crib-sleeping, cry-it-out parent, the real truth—and studies confirm this—is that most parents are doing combinations of all of the above, just to help their babies and young children to sleep.

Which brings us back to the question: “How is this working for the whole family?” A “sleep problem” for one parent may not be for another parent. All parents have their own threshold, as well as level of willingness to try to solve the problem. The essential difference between using crying-it-out (versus non- or low-crying) methods is that they tend to work very quickly, approximately three to 14 nights, while the non- or low-crying solutions can take two to 12 weeks or more. However, leaving one’s baby to cry is often a big departure from one’s parenting style. If the sleep solution does not feel right to the parent, it likely won’t work. It’s important to note that limits to all successful sleep solutions include illness, teething, developmental milestones, growth spurts, travel and consistency.

Parents will see they can help their babies to sleep well by responding to their sleep cues, building positive associations with sleep, being consistent and following sleep routines and a schedule. Ultimately, babies learn best how to slow down their bodies from activity with the help of their parents. There are many solutions for helping parents and babies to get the sleep they need, and parents can feel good about making sleep changes while still following their parenting philosophy.

Angelique Millette (PhDc, MFTt, PCD/CD [DONA]) is a parent coach, infant/toddler sleep researcher and child therapist intern who has worked with families across the Bay Area, the United States and Europe for the past 10 years. She specializes in infant/child development and how parents can meet their own sleep needs while helping their young ones meet theirs. Angelique does not follow one specific sleep program, but rather helps families by taking into account family schedule, infant/toddler development and parenting philosophy, all while keeping an eye on sleep deprivation, parental overwhelm, depression and anxiety. Angelique’s doctoral research addresses the correlation between infant sleep location and methods, postpartum depression and anxiety and attachment. This research contributes to her forthcoming book and infant swaddle product.

Online resources

• Natural Resources (www.naturalresources-sf.com): A great place in Noe Valley for merchandise, classes and meeting new moms
• DayOne Center (www.dayonecenter.com): A great source for merchandise, classes and lactation consultants
• Mamas Resource Network (www.mamasresourcenetwork.com): A network of professionals passionate about mothers, babies and their families
• Hand in Hand Parenting (www.handinhandparenting.org): Local non-profit provides services to families (English and Spanish languages are spoken here)
• Zero to Three (www.zerotothree.org): Excellent resource for infant/toddler development information
• Postpartum Support International (www.postpartum.net): Resource for mothers with postpartum depression and postpartum adjustment disorders
• SOLACE for mothers (www.solaceformothers.org): A resource for mothers who had a challenging birth
• Children’s Council of San Francisco (www.childrenscouncil.org): A childcare resource and referral network

Here is a list of upcoming workshops/lectures:

Monday Oct 27th 6:30-9pm
Southern Marin Mom’s Club Sleep Lecture “How to Help Babies and Toddlers Sleep”
Corte Madera Community Room 770 Tamalpais Drive, Suite 201
Non-SMMC member welcome for small fee

Sat. Nov 8th 3-5:30pm
Birthways workshop “How to help Babies, Toddlers and Parents Sleep”
1600 Shattuck Ave. Suite 122 Berkeley
Cost $100 plus follow up guidelines and sleep solutions specific to your parenting philosophy and sleep situation
Class size limited to 8 families

Sun. Nov 23rd 2:30-4pm
Day One San Francisco location
“Let’s Talk About Sleep”
3490 California St. 2nd Floor, Suite 203, San Francisco
cost ranges from $29 for members, $45 for non-members

Tues Dec 3rd 6:30-9pm
Birthways workshop “How to help Babies, Toddlers and Parents Sleep”
1600 Shattuck Ave. Suite 122 Berkeley
Cost $100 plus follow up guidelines and sleep solutions specific to your parenting philosophy and sleep siutation
class size limited to 8 families