Friday, June 11, 2010

Sleeping Safe and (Psychologically) Sound

This post is part of the 2010 API Principles of Parenting blog carnival, a series of monthly parenting blog carnivals, hosted by API Speaks. Learn more about attachment parenting by visiting the API website.

Bedsharing is an ancient concept. Still practiced all over the world, bed sharing has become a subject of controversy in the United States. Often the debate centers around the safety issues regarding bed sharing (if you would like to read more on safe sleep practices, click here). While this is important, the real danger every child encounters during the night is psychological.

Modern developmental psychology is based on Maslow's Hierarchy of Needs, a simple structured look at what needs must be met to move forward in development created by Abraham Maslow in the 1940s.

Maslow believed that human growth and development occurred through building upon a basic foundation of met physiological needs.  All lower-order needs (physiological and security) must be met before higher-order needs (self-esteem and self-actualization) can be achieved.  If a person achieves a higher-order need and then loses a basic need, they can revert back in their development.

Infants require their two lowest-order needs to be met for them.  They must be provided with food, shelter, care, and safety to grow physically and develop psychologically.  However too many parents are pressured into practices which compromise an infant's ability to achieve these foundations.  Popular practices like cry it out and bedding baby in an isolated nursery can undermine development, creating developmental hang-ups that can lead to difficulties forming attachments or decrease self-esteem.  The entire attitude surrounding infant care focuses on meeting basic physiological needs with too little attention paid to the psychological needs of the child.  At baby showers, mothers are given clothing, blankets, and diapers to meet the physical needs of the child and then are bombarded with well-intentioned advice regarding sleep and scheduling of infants.  The question every new parent is asked repeatedly - how's baby sleeping? - presumes all parents to be desperate to achieve pre-infant sleep.  We are preoccupied with infant sleep, and yet, American attitudes toward sleep ignore the very foundations of healthy psychological development.

Rather than considering the psychological and emotional needs of infants, there is push toward sleep training in the United States.   Parents become obsessed with baby sleeping through the night often allowing an infant to cry it out, or employing the Ferber method or Babywise.  Recent research has shown that allowing an infant to cry it out can hamper brain development, because during intense crying the infant's brain releases Cortisol, a stress hormone, that interferes with normal development (BBC).  Therefore an infant who is left to cry in an isolated room, in an effort to be trained, is at risk of brain damage from the overload of toxic chemicals.  Parents are often told that these practices are for the best because an infant must learn how to sleep and self-soothe.  Infants do not need to learn how to sleep.  A child that is tired enough will always sleep.  Allowing them to cry it out only teaches them that they are alone and their need for safety and security is not being met.  The infant does not learn from the experience, rather their psychological and emotional development is stunted as only their basic survival needs are met.  They wear themselves down until they are only capable of sleep.

The focus on sleeping through the night also prevents the infant from meeting the basic need of food.  Recent disturbing developments in infant formula manufacturing boast advances in slowing the digestion of formula and thus allowing for deeper, longer periods of sleep.  An infant is not physiologically programmed to go 10-12 hours between feedings.  The need for an infant to eat every few hours is likely a survival mechanism.  SIDS has been linked to deeper sleep in infants and some researchers believe an infant's metabolism is designed to wake the child frequently to prevent long periods of deep sleep, which could prove dangerous to infants still learning to regulate their breathing patterns.  An infant left to sleep on their own is therefore in survival mode, attempting to meet his or her most basic needs.

Many attachment parents subscribe to the philosophy of "nine months in, nine months out," the premise of which is that human babies are born considerably underdeveloped due to the reproductive design of the human female.  Therefore infants require more sleep, feeding, and care before significant physical milestones are met.  Rather than rushing infants towards crawling or walking, infants are fed on demand, carried close to the mother or father, and allowed to sleep with their mother.  These principals allow the infant to develop in a nurturing, healthy environment.

Nowhere are the principals more important than in the area of infant sleep.  Since a considerable amount of a baby's day is spent sleeping, allowing the child to fulfill this basic need while meeting the secondary need of safety and security allows for optimal emotional and psychological development.  Parents can meet this need by bedding close to baby.

Breastfeeding mothers are uniquely in tune with their infants during the night and can safely co-sleep as long as safety measures are met, see link above.  This arrangement allows the infant to feel the warmth of their mother, nurse easily, and have their needs responded to quickly. In my experience, a slight startle is easily calmed by my child reaching and feeling me next to her.  We both are aware of the momentary waking but not disturbed and easily drift back to sleep.  For more info on breastfeeding and bedsharing, I recommend the work of Dr. James McKenna at Notre Dame's Mother-Baby Behavioral Sleep Laboratory.

Mothers who do not breastfeed, as well as fathers and other caregivers, can share their infant's sleep by using a co-sleeper or a bassinet placed near the bed.  This allows them to quickly reach out to a startled infant or pick the child up for a feeding.

By rethinking the predominant attitudes regarding infant sleep, we are able to better meet our children's developmental needs.  The first step is to change our perspective from training, convenience, and accepted social norms, and instead view sleep as a precious, fleeting opportunity to nurture our children during the most vital stage of their development.

Recommended reading:
The Family Bed, Tine Thevenin (excerpt here)
Safe Co-Sleeping, Mother-Baby Behavioral Sleep Laboratory.


Maman A Droit said... [Reply to comment]

It's really interesting to read about the science behind what seems like common sense (that it's not good to just let the baby cry). I also wonder sometimes how it impacts the psychological health of the mother to not respond to a crying baby in a different room. I'd be a nervous wreck! I remember in the beginning sometimes waking up and just watching my son sleep for a few minutes, then drifting back off into cuddly sleep listening to him breathe. Even now it's nice to know he's right there where I can hear his breathing and know he's okay!

Jenn said... [Reply to comment]

I feel the same way! I can't handle hearing my baby cry. My instinct is to comfort and protect. I don't understand why anyone would advocate going against a mother's instinct.

ErinKate said... [Reply to comment]

Late to the game here, but with a question.

I formula-feed my son. We also bedshare. Why does so much of the literature (including this piece) say that mothers who do not bedshare should use a bassinet or co-sleeper? Is there any research behind that?

I do know that formula-feeding is a known SIDS risk factor (possibly for socio-economic reasons, that's not clear), but is that why bedsharing and FF aren't supposed to match? I'm curious to read more....not that I'm likely to stop bedsharing after 7 months of bliss. :)

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