Can ‘alternate’ sleep training strategies help babies and kids sleep better?

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There has been a strong outcry (pardon the pun) by mental health experts against the ‘cry it out’ sleep training method that has gained popularity in modern western parenting over the last 10 years.

Whilst experts and families have long acknowledged short-term gain in sleep behaviour after sleep training (until the next bout of illness or teething spell), there has always been concern about the long-term effects of encouraging parents not responding to their young’s needs.

A new study out of Australia, “Five-Year Follow-up of Harms and Benefits of Behavioral Infant Sleep Intervention: Randomized Trial,” published on the American Academy of Pediatrics website followed 225 children from infancy through age 6 to track whether a behavioral sleep program had long-lasting effects on children’s mental health, stress levels, the child-parent relationship, or maternal mental health.

Parents who reported sleep problems in their 7-month-old infant were eligible for the study. Half the parents were offered a sleep program (lab rats) whilst the other half were not offered any advice (control group).

The lab rats were educated regarding the use of positive bedtime routines plus using one of two behavioral techniques:

  1. controlled comforting: parents respond to their infant’s cry at increasing time intervals to allow the child to self-settle (sounds just like the cry-it-out method, hey?)
  2. camping out: parents sit with the child as the child learns to independently fall asleep, slowly removing their presence from the child’s room.

Here is what they learned about these sleep strategies:

  • Both groups of lab rats who had used a bedtime routine plus either sleep intervention showed short-term improved sleep quality (yes, this makes sense).
  • Some showed improvement in the children’s and mothers’ sleep and mothers’ mental health as late as age 2.
  • However, by age 6 years, both the lab rats and the control group had similar mental and behavioural health, sleep quality, stress and relationship with their parents.

What these sleep strategies mean for parents:

  • This study shows that implementing a routine and trying to teach your baby to sleep better may help your baby sleep better.
  • If you do not teach your baby any sleep strategy, they will be the sleeping the same as any other sleep-trained baby by 6 years old.
  • The study was done over years with the lab rats leaving the lab and going home. It is impossible to know how often or in what manner the sleep strategies were applied by the parents (if at all).

Most importantly, the study does not define what ‘sleep problems’ are. Many parents worry that their babies have sleep problems when they are developmentlly normal. Feeding, holding and helping your baby to calm regularly are good parenting practices and should not be avoided due to fear of spoiling the child’s sleep.

For more from the American Academy of Paediatrics about how to know if your baby has a sleep problem follow this link.

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