• Sleep Training: What if She Cries?

    Natalie Nevares of Mommywise answers the common questions and worries that parents have about sleep training.

    By Natalie Nevares

    1406636617I grew up in the 70’s, an only child of young hippies. We lived in a commune where free love was abundant, mothers breastfed until their kids were in Kindergarten—thankfully not mine!—and sleep training happened at parties with loud music.

    I grew up taking cross-country road trips in caravans of vans with cassette tapes and sing-alongs with tunes ranging from the Beatles to the Eagles, and occasionally a random kid tape. My favorite was “Free to Be You and Me,” especially Rosey Grier’s song, “It’s Alright to Cry.”

    Fast forward to 21st Century Urban America, in the age of Too Much Information, the parenting culture is a bit different. Okay, a lot different (my mother would probably be incarcerated for the second-hand smoke alone). The backlash against laissez-fair parenting has swung so far to the left, we have a number of names for it: Uber Parenting, Tigers Moms, Helicopter Parents, and of course, the Attachment Parenting movement.

    Now, we live in a world where mothers are racing between work and family, overthinking and overdoing everything, compulsively reading forums about what they should and shouldn’t do to perfectly parent their kids. In the fertility clinic waiting room. Before there are even eight cells or a fetus. I am one of these women. I fell into that trap, and now, I help other women crawl out of it. I preach about putting the parenting books down and trusting your instincts; and I coach parents to look and listen to their babies more than the internet.

    Naturally, the politics of how to teach your baby to sleep in this parenting environment is politically charged because there are so many experts and methods and systems and critics of sleep training in general—new parents haven’t a clue about how to get their babies to sleep through the night—or if they should simply accept a life of child-centered depletion and chronic sleep-deprivation.

    On the one hand, all clinicians at Tribeca Pediatrics (with over 14 offices in the Tri-States and two new ones in California) tell their patients to night wean and sleep train at eight weeks. Their standard clinical advice, led by founder Michel Cohen, MD, is to put the baby down, walk away, and come back 12 hours later. Answers to the anxious new parents questions are typically, Yes the baby will cry, and no you don’t need to feed them. They even send you an email reminder before the 12 week well visit, with a “friendly warning” about what will happen if you don’t sleep train by 12 weeks.

    Along with Tribeca Pediatrics, there are numerous other credentialed MDs nationwide who advocate sleep training based on the science-based benefits of uninterrupted sleep, both for the baby’s brain development and parental mental health.

    That said, all of the sleep training methods are branded as some version of “Cry it Out,” which sounds alarmingly cruel to new parents. To add to the conundrum, none of these MDs exactly agree about when and how to sleep train a baby. Dr. Weissbluth says walk out and stay out (“extinction method”), Dr. Ferber says let the baby cry, but go in and out at increasing intervals to pat and reassure (“controlled crying” or “graduated extinction”), until the baby stops crying. Then there’s Pantley’s “No Cry” brand (she’s not an MD, by the way), which I know from experience creates more tears than I ever knew were possible. Like, babies vomiting because they cried so long and hard. Apologies—I try to stay neutral and non-judgmental, but this one really gets my goat.

    On the other side of the sleep-training spectrum, there’s Dr. Sears, and his well-branded Attachment Parenting theory, who advocates co-sleeping (not recommended by the AAP), baby-wearing, and my all-time favorite, “nighttime parenting.” In his infamous Baby Book, Dr. Sears warns that sleep training (i.e. “letting” your baby cry) will “have harmful neurological effects that may have permanent implications,” and will ultimately, emotionally cripple your child. There is no science-based research to support his claims.

    If you’re as confused as every other new parent, you’re in good company. Everyone with a newborn wants to know this magic secret. If this is you, and you’ve already read the aforementioned sleep training books, you’re probably more confused than when you started. Right?

    I’ve been there. I know how confusing it is. I’ve read all of them. I spent many sleep-obsessed, cross-eyed years trying to sleep through the night, and get my life back. Now that my kids are 8- and 10-years-old—and I’ve been sleeping soundly for most of those years, because yes, I did let my babies cry—I now teach parents how to successfully sleep train their babies, and get back on track when things fall apart.

    So today, I’m going to share with you what I know. Because I don’t want you to get to go where I went. I don’t want you to get to a place of total depletion and desperation that it sets the tone for your entire family. Trust me, it’s not a pretty place.

    When someone asks me what I do, I say: “I help families sleep.” This usually leads to a series of questions about what that means, and how I do it. My answer is always the same. I say: “I give new parents with babies permission to put the baby down awake.”

    It sounds too simplistic, but that’s pretty much the secret to sleep training a baby. There’s no magic powder. I have no system or method or strategy; I just guide new parents to put the baby down awake, with a huge dose of emotional reassurance that they’re not bad parents. I help new parents trust that terrible things won’t happen if they put their baby down awake—even if there are a few tears in the beginning. If the baby cries (yes, this is usually the case, and if anyone else tells you otherwise, they are lying), I remind parents that their baby is fed, dry, safe, loved, securely bonded, and that they’re not abandoning their baby by allowing her to learn how to fall asleep independently. Instead, I encourage parents to watch on the monitor, listen, and learn what their baby is trying to say. Usually what I hear is: “Wait, what? This is different than what I’m used to!” Or: “I’m tiiiiired, and I want to sleep but I don’t know how!” Or, for an older baby, he might say something angry like: “WTF, mom! Usually you rock me to sleep!”

    Because I’m not emotionally attached, I’m able to observe, and help parents understand what’s really happening. I teach them to understand the difference between responding to a real need, or reacting based on their deepest fears that they’re doing something wrong.

    I don’t ever hear hours of crying. I have never seen a baby vomit. It’s usually minutes of crying. Worst-case scenario, up to an hour. It stops and starts, goes up and down, and under the right conditions (when a baby’s well, not in pain or febrile), I see cross-eyed parents go from trying to soothe an inconsolable baby many times through the night, to baby sleeping soundly in their crib, night and day, in a few days, without many tears.

    Of course this is easier said than done. I escort parents through the whole process—before, during and after they put the baby down. I often sleep over with NYC families to coach them through the night (here’s an insider’s glimpse of what that that looks like). I watch and listen and reassure parents that all is well, and guide them to respond if their baby truly needs something. But mostly, putting the baby down awake is all you need to do to sleep train your baby. You don’t need to go in and out. You don’t need to pat and shush. You don’t need to pick up and put down. You don’t need to do anything but stand back and get out of your own way. Because that’s just confusing, and babies cry louder and harder if you do all that.

    Now, even though this sounds really simple, if you’re a new parent, you know it’s not. You know that if you put your baby down awake, she will cry, and you’re conditioned to believe that crying is bad. You shush your baby whenever she cries. You probably even suck up your own tears if you cry. But if you don’t ever let your baby cry, you’ll never ever know what she’s trying to say.

    Obviously, you don’t want to hear your baby cry. Not responding to your baby’s tears goes against all of your parenting instincts, and you’ll do anything to make it stop, regardless of why your baby is crying.

    So, what can you do?

    Caution aside, if you want to sleep train your baby, if you and all other caregivers are aligned, and you’re ready to night wean, here’s my step-by-step Sleep Training prescription, before, during, and after this frightening journey!

    Before:

    • Put the books down, get off the chat boards, stop talking to your parent friends about sleep, and try to tune out all the noise about what you should and shouldn’t do to teach your baby to sleep
    • Prep your nursery with white noise, a video monitor, a night light, and a “lovie” if your baby is roughly 4+ months
    • Talk to your partner (if applicable), get aligned about when and how you’re going to teach your baby to sleep; put a start date on the calendar, and emotionally prepare
    • Rule out any clinical issues, get a green light from your pediatrician

    Days 1 – 3:

    • Connect with your partner or other caregivers who live with you; make a pact that you will not fight in the middle of the night. Bonus points for extra hugs.
    • Be mindful of your energy, and try to remain calm, upbeat and confident throughout your bedtime routine.
    • Regardless of how old your baby is, tell your baby lovingly, confidently, that something different is going to happen, right before you put her down. She may not understand your words, but she understands your tones and energy).
    • Put your baby down awake at bedtime, and one of you (ideally not a lactating mom), take responsibility for watching the monitor with the volume on low
    • Watch, listen and learn what your baby is really saying; respond if there’s a real need (i.e. your baby’s stuck, there’s sustained crying without pauses, or your gut is telling you that something just doesn’t seem right), but try not to react out of fear.
    • Rinse and repeat for three days and three nights, remaining as consistent as possible, putting your baby down awake in her crib night and day. However: If your baby gets sick or develops a fever or begins crying harder or louder without stopping after you’ve begun sleep training, give yourself permission to scrap it, do what you need to do to comfort your baby, then start again when you’re 100 percent sure you’re your baby’s healthy.

    After:

    • Notice any shifts in naps. Once your baby learns to sleep 11-12 hours per night, she may need less sleep during the day
    • Understand it takes a few days for babies to “catch up” on sleep, and they may appear extra sleepy for a few days, yet only nap for 45 minutes at a time. This is normal.
    • Take good care of yourself. Give yourself a bedtime routine, and go to bed early until you get caught up on sleep. Try a pre-bedtime media diet, take a long bath and read a book before you doze
    • Turn down the light and the volume on your baby monitor, Stop watching the monitor all night. When you’re confident your baby is safely sleeping, give yourself permission to turn down the screen and the volume, and let yourself sleep
    • Believe that you now know the difference between your baby’s middle of the night habits and needs, and respond if your baby suddenly has a real need during the night. You’ll get back on track after that need is met.

    If you feel you could use more support, please feel free to download my free e-book Three Vital Steps to Teach Your Baby to Sleep, get inspired by what I do, browse my YouTube video library, or schedule a Complimentary Call with me to get clear on what’s not working in your family, what you want, and how I might be able to help you get there.

    Natalie Nevares is the founder of Mommywise, a company whose mission is to help parents with babies sleep, feel happy, rested, balanced and connected as couples, and have an identity beyond baby. To learn more, visit mommywise.com!

     

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