Lots of “experts” say that using extinction aka cry it out (CIO) to sleep train your chld will destroy your bond with your child, and possibly even destroy your child’s faith in humanity.
These experts range from the opinionated woman at the grocery store to Dr Sears to your best friend/sister/aunt/daycare provider. Dr. Gabor Mate, “renowned for his expertise on trauma, addiction, stress and childhood development,” says so.
During the course of my child sleep certification program, I had to write a paper on the risks and benefits of sleep training. In order to do so, I found an anti-sleep training article written by none other than Dr. Sears, founder of the Attachment Parenting movement, himself. If you aren’t familiar with his work, Dr Sears encourages bedsharing and babywearing pretty much constantly during a child’s early years.
I systematically went through Sears’ list of references that he used to “prove” that sleep training is harmful. And here’s what I found.
There was not a single article there that looked at children who were being sleep trained.
His article referenced 21-day old rat pups separated from their mothers or children in long-term stressful situations, like living with domestic violence or homelessness.
Sears was trying to extrapolate from that not-particularly-relevant data to “prove” his point.
Meanwhile, studies have been done on actual children being sleep trained. And not a single one showed any permanent damage to children.
The conclusion of a meta-analysis (comparing results between studies) of 52 studies done by the American Academy of Sleep Medicine found that "94% of sleep interventions were effective with 80% of infants showing improvements in sleep for 36 months."
Negative side effects of sleep training were was not found in any of the studies and in fact, “infants who participated in sleep interventions were found to be more secure, more attached, more predictable, less irritable and to cry and fuss less following treatment [sleep training].”
In other words, sleep training was not found to be harmful and in fact, babies who were sleep trained were found to be more securely attached and less fussy than babies who were not! Also, 80% of babies showed a positive effect on their sleep for thirty-six months. That's a pretty long benefit for a few nights of crying!
Anecdotally, I fully support this conclusion. I have not worked with a single family over the course of two years who said, at the end of their two weeks of coaching, that their child was harmed in any way by sleep training.
In fact, nearly every family has remarked that their baby or child was actually happier after sleep training.
It makes total sense.
With a securely attached and healthy child, the parent remains attuned to the needs of the child during the day. So their connection is continually reinforced during the day despite crying at night. And the child finds, yes, by crying herself to sleep, that she is capable of independent sleep. Which means the child feels pride in herself and ends up getting a lot more high-quality sleep. And a well-rested child is a happy child.
(I do not recommend less-than-gradual methods for a newborn in the first 6-12 weeks of life, a foster child or newly adopted child, or any child who has recently experienced trauma. These children can still be sleep trained in most cases, but they need their adult to be much more involved.)
If you have been hesitant to sleep train your child, fear not. Your child, assuming he is not in the situation of the paragraph above, knows that he is fiercely loved. Continue loving him and being responsive to him during the day and get him the rest that his body desperately needs (even if he doesn’t know that) during the night.
But you don't have to go it alone. Sleep training can be nerve-wracking and stressful. Set up a free discovery call and we can discuss if having a sleep coach would help your family get the sleep you deserve. I'll also give you solid advice for free to start addressing your situation, whether you decide to work together or not.
"Before working with Abby, my three-year-old nursed. All. Night Long.
It was affecting both of our sleep, and also negatively impacting his teeth.
I worked with Abby to create a really clear plan to wean my son off nursing at night.
She took the time to really hear my goals and understand our relationship. She understood my priorities.
She gave me guidance on how to gently prepare him for the transition so that he felt like a participant in the transition. He understood the change that was coming so that he could get on board and be excited.
I had been dreading the transition for months and months, and had been wanting to make the change for a year... but avoiding it because I just didn't know how.
Within one night, we made the transition and it changed everything for us.
I'm getting better sleep, Jude's getting better sleep, and his teeth are healthier.
Abby's way of working with people is incredibly nurturing, customized, and effective."
Parents of anxious children face a conundrum. They know that better sleep can only help… and they don’t know how to get there. Because insisting on new sleep boundaries is only going to make both sleep and anxiety worse, right?
Sleep training does not have to be traumatic. It does not need to make anxiety worse. In fact, successful sleep training can really help anxiety.
I’ve worked with two children with anxiety in the past two weeks and sleep training was a huge success for both.
Here are their stories. After that, some tips for working with anxious children. (Note: all young children are anxious at times, and you don’t need a diagnosis of anxiety to struggle with these issues, or to use the technqiues outlined below.)
First, Liam. Liam was a skin picker when he felt anxious. He had multiple scabs on his body as a result. His parents worried that sleep training would make things worse. It was a battle to keep bandaids on him and they were worried about the risk of infection.
Here’s what his mother said after our two weeks working together,
“To my shock, his skin picking didn’t get any worse with sleep training.
And what’s more, I actually saw that setting clear boundaries around sleep really helped him. As a result, I started setting more clear boundaries at other times and you were right, when he had a tantrum about a boundary I set (he wanted more bread and I said no), I just waited. Afterwards, I didn’t discuss it with him, I just said, “do you want a hug” and he did, and after that, he was calm. I couldn’t believe it!”
Child number two, Layla. Layla is almost two-years-old and has always had a fiery temperament, unlike her even-tempered twin sister. Layla’s mother was nursing her all night long, in an attempt to get Layla the rest she desperately needed, even though it was physically painful for Mom. Any time that Layla’s mother tried to refuse to nurse, Layla got furious. She would leave the family bed and go sit in the corner of their bedroom and refuse to come back. She also had night terrors.
Less than a week after starting sleep training, Layla is peacefully sleeping through the night. In the family bed. Her night terrors have disappeared. She is sleeping many more hours, and goes to sleep peacefully at bedtime as well as nap time. While she still has a fiery temperament, her mom can see a huge change in her – Layla is more easygoing and happy now.
Tips for working with anxious children:
1. Anxious children need extra time to prepare for big changes. I recommend starting to prepare toddlers and preschoolers three days ahead of time. Have a family meeting, make a social story to help explain the upcoming changes, and continue to remind them of the upcoming changes over the three days prior to making them.
It’s important to talk, talk, talk about what is going to happen… even if your child gets mad. The anger is actually very healthy, because it means she is starting to process the changes ahead of time, which means the day you make the change will be that much easier. So don't stop talking when she gets upset!
Also, if someone took away your beloved morning coffee or evening Netflix, you’d be mad, too. You like your routine… and so does she! Let her have space to be mad…. And show her that you will love her through it!
2. Anxious children may need to make changes more slowly. This requires extra patience from you. In Layla’s case, we had her dad stay with her at bedtime to get used to not nursing to sleep. Once she was used to that, he started to gradually withdraw his presence after lights out. With zero tears.
3. Anxious children need boundaries even more than other children. It is an act of love, not cruelty, to establish and maintain boundaries. When children rule the household, it gives them the scary feeling of too much power. Young children don’t want that… even though they resist boundaries. Know that it's a child's job to test boundaries -- it's his way of figuring out how the world works -- and it's your job to maintain them. Even in the presence of meltdowns.
4. Emotions are never a problem. Let her have her big feelings… without changing the boundary. Stay close during a tantrum, stop talking, avoid eye contact. Just sit down and wait. Let her yell and cry. Stay silent. When it’s over – I promise it won’t last long, even if it feels like an eternity – quietly offer a hug. And be amazed that your child feels better after releasing those big emotions.
I know it is scary to set new boundaries with anxious children. You don’t have to go it alone. Set up a free discovery call and find out how much happier your entire family will feel – most especially your anxious child – when you all get the sleep you deserve.
Two-and-a-half year old Liam’s sleep was finally improving. After months of bedtime protests, he was going to sleep independently and easily.
But there was a catch.
Liam still had one more tool in his toolbox. The potty.
You see, Liam had successfully potty trained during the day, and was dry most nights, despite wearing a Pull-Up. Both Liam and his parents were excited by his progress… and that made them reluctant to ignore Liam’s requests to go to the bathroom…. Even when it was only 15 minutes since the bedtime bathroom trip.
Liam was also requesting lots of water at night. He actually slept with his water bottle in his bed! He also drank water somewhat compulsively during the night, but not during the day. (So we knew there wasn’t a medical issue going on.) And the frequent refills were, of course, making Liam need to go to the bathroom more often. Disturbing his sleep and his parents’ sleep.
But Liam's parents were loathe to tell him that he couldn’t have water at all. Both because they didn’t want him to be genuinely thirsty, and also because Liam would throw a massive tantrum if they took his beloved water bottle away. It seemed to be like a security blanket for him.
So here’s what we did. We set new, very clear boundaries.
Liam got two “pop-up cards” each night. He decorated them with marker and stickers so they felt very special to him. He actually loved them so much he carried them around the house with him!
After lights out – which was dictated by a timer set ahead of time – Liam could trade in his pop-up cards to have his parents come back. Just twice. His parents warned him – ahead of time, so there was no middle of the night conversation – that when the pop-up cards were gone, they wouldn’t come back, no matter what.
Because the presence of the water bottle was so soothing to Liam, his parents decided to keep the water bottle but gradually decreased the volume of water in it, so that it was less likely to create another bathroom visit. And then instead of refilling the water bottle, which took more time and thus created more engagement, they kept extra water bottles at the ready, outside his room.
So when Liam invariably used a pop-up card to request a trip to the bathroom, they also handed him a new water bottle, with only about an ounce of water. No negotiating for more.
Liam’s mom asked why he was still waking up twice a night near the end of the two weeks, and we realized that they were probably inadvertently reinforcing the night wakings with too much attention, even though it was so much less attention than he had received prior to sleep training.
Handing him a new water bottle instead of refilling the old one helped. I also instructed them to reduce the nighttime conversation to zero. They would silently take him by the hand to the bathroom, help him use the potty and wash his hands, silently escort him back to his bedroom, and silently point him in the direction of his bed. No more tucking him into bed in the middle of the night. Even the time and attention of tucking him into bed was reinforcing his night wakings. I asked his mom to act like a robot. Zero interaction, beyond escorting him and providing physical attention in the bathroom.
In case this sounds cruel, remember that this is only in the middle of the night. I encouraged his parents to actually give him extra attention during the day, in the form of roughhousing before dinner, so that he felt extra supported and loved. The idea is to give attention at appropriate times. When a child’s night wakings are rewarded with attention, though, it creates more night wakings, and everyone suffers, most of all the child, who becomes overtired.
Love and attention are critically important… but they should only happen during the day. Give extra attention during the day to make up for the lack of attention during the night.
If you are ready to set more clear boundaries around sleep but aren't sure where to start, set up a free discovery call and discover that your entire family really can feel well-rested.
Abby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and former NICU nurse. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico.