Baby sleep: Alternatives to ‘cry-it-out’

Host Jessica Rolph welcomes Certified Pediatric Sleep Specialist Lauren Heffernan to the second episode of our new season, Perspectives. In this season, you’ll hear curated perspectives on topics like sleep, feeding, and parenting philosophies, so you can make informed choices for your family.

It is rare to find a new parent who doesn’t wish for more hours of sleep; long nights seem to be part of the bargain. When those long nights start dragging on, it can feel like sleep training is the only way out. Lauren proposes a different approach. She is the founder of Isla Grace: Attachment-Focused Sleep. She prefers to avoid separation and the cry-it-out method of sleep training.

Key Takeaways:

[1:31] Lauren speaks about her own experience sleep training.

[3:56] She explains how that experience informs her practice as a sleep consultant.

[6:35] Supporting your babies’ emotions when you are sleep deprived is challenging.

[8:20] Why it’s difficult for parents to sit with those big emotions from their child.

[9:26] Lauren answers a question from a listener: My baby only falls asleep when I breastfeed him and wakes up throughout the night for more breastfeeding; how can I stop this without the cry-it-out approach?

[12:48] What happens when night weaning gets derailed.

[13:38] Bed-sharing and how to practice it safely.

[16:08] Lauren explains “bridging” between crib and toddler bed.

[17:04] How to reframe inconsistent napping.

[19:45] If you are getting extremely frustrated and exhausted, try a shifting pattern or ask for someone to support you.

[21:06] Lauren’s bottom-line advice to sleep-deprived parents.

Mentioned in this episode:

Isla Grace: Attachment Focused Sleep

Transcript:

It’s rare to find a new parent who doesn’t wish for more hours of sleep. Long nights seem to be part of the bargain. And when those long nights start dragging on…It can sometimes feel like sleep training is the only way out. Our guest on the show today has another approach.

As part of our new Perspectives series, we are speaking to Lauren Heffernan. She is the founder of Isla-Grace, Attachment Focused Sleep. She prefers to avoid separation, or the “cry-it-out” method of sleep training. 

So with that, here is my interview with Lauren.

Sleep training babies around the world

Jessica: So lots of parents lean into sleep training, particularly in North America. Did you sleep train your child? 

Lauren: I have a really kind of different community on Instagram, I have families from all over the world, and one thing that has become very apparent to me and one thing that I really take into my approach is looking at sleep around the world. I think when we look at the way that other parents put their babies to sleep or sleep practices around the world, I think it opens our eyes to the fact that, A, sleep training is not a common practice around the world, believe it or not, a lot of parents are kind of surprised to hear that we use sleep training here, and I personally do believe it is because of the lack of community and support for new parents.

Lauren: So I absolutely… I sleep trained my oldest daughter using cry it out, and I did it because I felt a tremendous amount of pressure around me from other people that it was just… It almost seemed like you just have to, of course, everybody has to sleep train their child, they hit six months they’re not sleeping through the night, and you have to sleep train your child.

Lauren: And so again, I do believe that a lot of it comes from this misunderstanding of what normal infant sleep looks like, but I also think it comes from the fact that we just don’t have that village or a community of support to be able to help us out, a lot of us are returning back to work really early, and parents are getting really frustrated with, especially babies who are waking up frequently. When I sleep trained my oldest daughter, I did so because she was waking up almost hourly all night long, and it was the fact that she had, I later learned, an undiagnosed tongue-tie that was leading to her mouth-breathing, discomfort, gas, not eating enough necessarily during the day, and so all of this was culminating in a baby that was waking up so frequently at night, and I got so frustrated that I just I went ahead and I did cry it out.

Lauren: The interesting thing is I actually didn’t do it with my youngest. So once I kind of opened my eyes to the way that babies… Other babies were sleeping around the world, bed-sharing became a natural solution for us, but I also realized that I could do everything with my youngest and get the same stretches of sleep with my youngest that I could with my oldest all without sleep training, just in shifting those patterns and staying with her.

Understanding newborn and baby sleep patterns

Jessica: So how have you applied those learnings from your own experience as a mother to your practice as a sleep consultant?

Lauren: So, the way that I start with families is first of all, help them to understand what normal infant sleep looks like, and I think that that’s… It’s really important for parents because we have this idea of how babies sleep because we have lots of books and experts that talk a lot about infant sleep. What you will find is that a lot of the experts, a lot of the information that we have around infant sleep is actually really dated. So a lot of the studies that we did came from the ‘50s and ‘60s, and a lot of those studies were done on a formula feeding solitary sleeping babies. Those babies sleep very differently than babies who are breast-fed and babies who are sleeping in sensory proximity to their parents.

Lauren: And so we take these ideas of these solitary sleeping, formula-fed babies, and now we take the recommendations by not only the Canadian Paediatric Society, but the American Association of Pediatrics, which is now saying, Hey, we want you to co-sleep, meaning room share, for the first, ideally six months, but even better a year, so that we’re reducing the risk of SIDS and then these babies wake up more, they don’t sleep like the babies that we originally were kind of studying. And so, we have these expectations of infants at six months sleeping through the night and then we are room sharing and our babies aren’t doing that. And so parents are feeling frustrated because their baby is waking up every two to three hours at night to feed or for comfort and closeness, and that is what babies typically do.

Lauren: So, a lot of what I start with parents is helping them to understand actually what your baby is doing is what most babies do, so it’s normal. And then also helping them to identify if their baby is waking hourly, there might be some red flags of something else going on, whether it’s an airway health issue, whether they’re uncomfortable with gas or discomfort, and so we really help parents to find some of the reasons that their baby might be waking up more frequently, but if it’s normal and it’s working, keep doing it. And if it’s not something that’s working for you, then we help parents to shift patterns. And that’s really the core of what it is. It doesn’t need a method, it doesn’t need an approach. If you don’t want to bounce your baby at night, let’s work on slowly moving from bouncing to rocking. How do you feel about that? If rocking isn’t working, let’s move from rocking to holding and supporting emotion along the way with our little ones.

Managing big emotions

Jessica: And it can be so challenging to support those big emotions when you are sleep deprived!

Lauren: I feel like the majority of the frustration that most parents are feeling is just the lack of community and support, right? So it’s all fine and good to listen to what’s normal for infant sleep but the reality is, is that so many parents are returning back to work at six weeks, at six months at a year, and so their baby is doing what’s normal, but that doesn’t work because they’re exhausted. And they have to go back to work, right? And so parents, it’s okay to say something isn’t working and I want to make a change.

Lauren: And so again, we tend to then start to look for methods of how we do it, but if something’s not working for you, then the answer is, we’re going to shift this, we’re going to change this, we’re going to take into account and be empathetic with our baby, understanding that their brains rely on patterns, so whenever we shift a pattern for our baby, they’re going to be upset and they’re going to cry, but then the answer to that is that we treat them in the same way that we would treat any other person that we love who’s having a hard time. We sit with them, we look at them, we talk to them, I know this is really hard.

Lauren: I know normally I bounce you or I nurse you or I do whatever it is that I normally do in the middle of the night, and I know I’m not doing that. But guess what, I’m right here. We’ve gotta shift this, we’ve got to change it, it’s not working and I’m right here. Now, oftentimes I hear parents say, “But my baby cries more when I’m there.” Yes, they do, because you are their safe place, you’re their safe place to express all of that emotion and all of those feelings. And I think one thing that I talk a lot to parents about is it’s oftentimes not… Has nothing to do with sleep. It oftentimes has to do with a fear of emotion, so if you were to ask a parent when they get to this place of being so depleted, like why are you still bouncing on that ball for an hour? Well, I’m bouncing because if I don’t bounce, my baby is going to cry. So it’s not a sleep challenge, it’s a fear of emotion, and I think so many of us were brought up by parents who did fear that emotion, right? Whenever we had big feelings where we were frustrated or were angry, we were sent to time out or we were told to be quiet.

Lauren: So this is so programmed in us that these big feelings aren’t okay, and now we have children and we struggle to support those big feelings and those big emotions, but the thing that’s really beautiful in the beginning is that if you can get to a place of just being able to support your child through those feelings without needing to fix it, it really is the answer for any kind of challenge that comes up, if you have to make a change or you have to shift patterns.

Wean night feedings

Jessica: So helpful to hear, and ‘cause the feeding and sleeping through the night is such a tricky balance. So, I’ve got a question from our community, My baby only falls asleep when I breastfeed him and wakes up throughout the night to feed. How can I stop this without the cry it out approach, can I wean him off night feedings? 

Lauren: I also have a lactation background, and there’s so many kind of more, I guess, complex issues as it relates to changing patterns around feeding, depending on the age of the baby, and also what’s happening during the day. So it is important to remember that babies up until about 10 months should be getting still six to eight… If you’re breastfeeding, six to eight breast feeds in 24 hours.

Eating enough during the day

Lauren: There are points in time where babies are really distracted and they’re struggling to eat during the day, if they’re not getting those feeds during the day, they’re going to be up overnight looking to make up for the feeds that they’re not getting. Oftentimes us parents introduce solids, sometimes we can get a little bit carried away and we’re giving three, four meals of solids at six, seven, eight months, and then babies aren’t taking milk, so they’re up over night.

Lauren: There are also other reasons as well that sometimes, especially in the early evening our prolactin levels dip a bit, and so if our supply is low for whatever reason, if there’s been some issues with tongue function or scheduled feeds, sometimes babies won’t be really eating much at that time, and then at night when our prolactin levels come back up and it’s quiet and it’s dark, then oftentimes we’ll be… Our babies are up all night trying to take in that milk.

Shifting the pattern

Lauren: So as it relates to changing, feeding at night, it really… It’s a bit complicated because the first place that I always recommend that parents start is if you are breastfeeding or bottle-feeding, my first go-to is to speak to a lactation consultant just to make sure that baby is gaining, make sure that there’s no issues with feeding before you start making changes to not feeding overnight. But it’s… Again, it’s not about a method, oftentimes what I’ll say to parents is, if you’ve had that appointment with the lactation consultant, and let’s say you’ve got five feeds overnight and your baby’s 10 months, let’s support some emotion and change the pattern just with the first wake up after bedtime.

Lauren: So if it’s been two hours, I know that normally I feed you, but I’m not going to be feeding you tonight, I’m going to snuggle cuddle, kiss, rock, bounce, whatever it is that I need to do to shift that pattern, and then slowly as they get more used to it, you can pull back on maybe not needing to bounce or rock or any of these other things, because you’re more comfortable supporting emotion and your baby will accept the new way of falling asleep. But again, the feeding piece is a little bit more challenging ‘cause the feeding is about so much more than just calories, there’s also the connection, the comfort, any discomfort that baby is having that sucking is actually moving the body from the sympathetic nervous system into the parasympathetic nervous system, which is a place of calm, so it also helps them pass gas, it helps with teething pain, there’s so much going on as it relates to the feeding piece.

Jessica: So there’s that moment where, let’s say you are going back to work and you work at night and you need to get your baby down to sleep without nursing, because you’re going to be handing them over to someone else at some point to get them down to sleep. What does this look like if you… They’re crying and then you ‘give in’ and you do nurse them again, and then… I feel like there are all these rules… And then it just ends up making us feel bad and we’re failures, but then we’re in that really heated moment with our baby and it’s just too much, we just have to go back. I’m speaking for myself.

Lauren: There are going to be times when you’re changing patterns and we have this idea that once we start, we just have to keep going, you know? Okay, I started, I committed, I said I was doing it tonight, so I’m going to keep going. The minute you don’t feel calm as a parent, your child doesn’t feel calm. So it’s about being in that moment to knowing when your child has had too much and saying, “Actually, I can see you’re having a really hard time, we’re going to nurse tonight and maybe tomorrow we’ll try again.”

Jessica: Yeah, giving us permission. Thank you for that. I feel like there’s not a whole lot that tells us that that’s okay.

Lauren: Yeah, yeah.

Co-sleeping and bed sharing with babies

Jessica: So I really appreciate that. Can we talk about bed sharing? Can you talk about some best practices when bed sharing, for example, with a small infant and then moving into maybe wanting to not bed share.

Bed sharing safety

Lauren: Okay, so bed sharing is a heated topic because there are obviously clear recommendations, specifically from the American Association of Pediatrics around whether we should or should not bed share, and I really believe that every family has the right to all the information so that they can make an informed decision. The reality is, the very fact that we are in a position to decide where our baby will sleep and how means that we’re in a position of privilege. So most families around the world do bed share and they do it safely, and it’s very much ingrained in their culture, and so even it’s interesting because you talk to a lot of parents, especially from Europe, and they… It’s recommended by their healthcare providers that they do bed share. So if a family wants to bed share, they need to make sure that they’re doing it safely, and there are lots of recommendations on Professor James McKenna’s website and there’s a great book called Safe Infant Sleep, and La Leche League also put out The Safe Sleep Seven. Just making sure that there are no blankets, pillows, that the mattress is close to the ground, that parents are not drinking alcohol, smoking marijuana, any of that, or taking any drugs that are sedatives.

Lauren: So just making sure that everything is set up for safe sleep for that family and if the family wants to bed share and they want to continue bed sharing, that doesn’t necessarily mean that you’re never going to be able to get them out of the bed, so if it’s not working for parents anymore, usually what I recommend doing is setting up a floor bed in their child’s room, if that would work for them, if they can baby proof their room and making the transition then into their own space that way, or even possibly… Some families will have a crib, a transition crib, where the mattress can sit flat on the floor so that they can get used to sleeping on the crib mattress before they’re put in the side back up. But also, I also like to tell parents, If you love bed sharing, again, keep it for as long as it’s working and then if it’s not working for you anymore, then you can make a change.

Reduce separation anxiety with bridging

Lauren: Another thing that I talk about a lot with toddlers and even babies is that when parents talk about protesting cribs or different spaces or being away from their parent, it’s just that they can’t handle the separation. So really great things to do, especially with toddlers, as they’re moving out of the family bed and into their own sleep space is to do something called bridging, which is helping them to hold on to the parent when they’re not with the parent. So whether that is asking them to hold on to my shirt, “Can you hold on this to Mommy’s… To mommy’s favorite shirt until the morning?”

Lauren: Doing things like, I’m going to tie an invisible string from my heart to your heart, telling them that you’ll see them in their dreams and then in the morning telling them that you actually did, setting up an activity before bed at night, and instead of saying, “Good night, we’re not going to see each other for 12 hours,” we’re saying, “I’m actually really looking forward to playing Lego with you that I set up,” or whatever it is that the activity is in the morning, so that again, we’re focusing and it’s not on the separation but on the next connection. It can also be helpful to sleep on their bed sheets so that they smell like them, whatever it is that they’re doing to help the child to be able to hold on while they’re not together.

Healthy nap habits

Jessica: Those are great tips. And then let’s talk about naps. So what do you recommend if a baby just is not wanting to nap or naps are really inconsistent? 

Lauren: Yeah, so the only thing consistent about babies is that they’re inconsistent. I always like to tell parents, I kind of look at… I see a lot of people using baby tracking apps and then they’ll post them and say, “Where’s the pattern?” There isn’t one.

Lauren: So it’s usually all over the map. One thing that we do have control of, I think that we as parents believe that we are somehow in control of our baby’s sleep. Sleep is a biological function, just like eating and eliminating. It can’t really be trained or forced and in fact, it will oftentimes backfire, if that’s what we’re doing. The one thing that we can control about sleep is that it’s a pleasant place to go and a safe place to remain. Part of one of the things that has come from very much those studies that were done a long time ago, is these babies that take two-hour long naps at six months and take these perfect schedule naps during the day. Most babies don’t do that. And in fact, there are some babies who sleep 30 minutes and that… This is really the purpose of the nap, we build up sleep pressure throughout the day and the nap is just helping to take a little bit of that sleep pressure off, and if they’re waking up happy and they’re ready to go and it’s been 30 minutes, that’s fine and that may be all that they need. But again, one thing that we are in control of is that sleep is a pleasant place to go and a safe place to remain.

Lauren: If we’re frustrated, they’re frustrated, they’re going to mirror back all of those things that we’re feeling, so if they’re not napping, A, maybe they’re not tired, or B, maybe we’re frustrated, and we’re trying to get them to nap and they’re feeling our frustration. So I love to tell parents if they’re okay with it, get out of the house, go for a walk, put your baby in a carrier, take all of the pressure off and trust that they know when they need to sleep.

Lauren: There was an interesting study that came out recently about how much sleep babies actually need, and they were looking at babies, I think they tracked babies and right up until age six, and they found that at three months, some babies were sleeping nine hours in 24, and others were sleeping 20 hours in 24, and neither side of this impacted their development in any way, just that it was kind of a predictor of whether they’d be a lower sleep total baby or a higher sleep total baby.

Jessica: That’s so honestly reassuring to hear that it’s all just normal…

Lauren: It is.

Jessica: We do want to find the answer, we want the answer, but they’re just constantly changing.

Find support

Lauren: The really important thing to remember for parents is that if you do feel like you’re getting to a place of being extremely frustrated and you’re exhausted, try some of the shifting patterns that I talked about initially, stay with your baby, support them through the pattern changes. The other thing is calling on, if you have anyone else who can support you. I think oftentimes, as parents, we feel like we need to be able to do it all, so if you have anyone else who can jump in and support you, I think that that would be… That that is a really helpful thing to do as well, and also understanding that the way that your baby is sleeping is probably normal, and that it’s… Your baby’s sleep is not a reflection of who you are as a parent.

Lauren: And then just making an informed decision around what works best for your family, and I think that that is one of the things that will help you moving forward in parenting when you are able to make that informed decision that you will not look back on any of your parenting decisions feeling guilt or regret or shame, or judged or any of that, because you will have made the decision that’s best for you and your family. But lastly, just if you don’t want to do it, you don’t have to, and that it’s not kind of a rite of passage, I guess you would say in parenting, and everything that you can do with sleep training, you can do without.

Advice for sleep-deprived parents

Jessica: If you can leave us with one nugget of advice for sleep-deprived parents, what would it be? 

Lauren: So I will say again, that the biggest thing when you’re sleep-deprived is A, understanding that you’re not in this alone, there are a lot of parents who are also feeling this way, you’re not a failure, ‘cause your baby’s not sleeping more than likely your baby’s sleeping exactly as they should be sleeping. The other thing is making sure that you’re calling in for support or for help as soon as you possibly can, if you have a partner, get them involved as much as possible.

Lauren: And then the last thing that I found was so validating for me is just let go of all of the rules. I find that the rules make us exhausted. If we just felt like we were in a place that, Okay, one night I need to do this, for my naps, I need to do this, I need to use the… Use motion, bed-share if I needed to, set up a floor bed if I needed to, have my partners step in for the first six hours of the night so I could get some sleep, like whatever it is that you need to do, just let go of all of the rules and know that eventually it will get better.

Lauren: But just do what works for your family and because your night-time parenting is no one else’s business.

Jessica: Lauren, it has been so wonderful having you with us, thank you for all this advice and perspective…

Lauren: Absolutely, and thank you again for being open to sharing this perspective, I really just hope that parents come away feeling like all these methods, all this stuff, we don’t need it all, we can parent with our heart and do what works.

If you have a baby who is waking frequently, you can learn more about Lauren’s approach on her website: Isla-Grace, Attachment Focused Sleep.