Sleep Schedules
We get asked a lot about how Batelle compares with other sleep training methods (especially the most well-known method, cry-it-out), and where we sit in relation to the more anti-sleep training sentiment. So, we’ve decided to explain how Batelle’s program fits into the sleep training matrix by comparing the top 5 questions on parents’ minds about sleep training.
Contents: How do sleep training methods approach my child’s sleep issues? | How should I think about crying in the context of sleep training? | Is sleep training beneficial or harmful? | I’m getting mixed messages about why my baby wakes up…What’s the truth? | Is sleep training a moral question?
Let’s start with how we view children’s sleep. On the one hand, traditional sleep training methods see sleep as a ‘learned skill’ and as something that can be taught. This view is widely understood and promoted by sleep experts and caregivers alike. On the other side of the spectrum, we have the anti-sleep-training camp – who disagree. They say that sleep cannot be ‘learned’ and is instead a biological need.
Both views have truth to them – but both are incomplete (1). A child’s sleep has both learned (behavioral) and biological components. Sleep is indeed a biological need (2), (3). Sleep also has biological underpinnings – a newborn doesn’t need to be taught how to sleep on day one, they do it as naturally as they breathe. Furthermore, when and how much sleep a child needs (ie. what sleep schedule they have) is also based on biology (4).
However, that’s not the full picture. Being able to sleep well is also a question of behavior (5). When a child is around 4 months old their circadian rhythm begins to look more like an adult’s sleep. This is when you start to see instances of sleep regressing (often labeled either the 4 or month sleep regression). They also go through a number of developmental leaps at this age and begin to become more attached to certain sleep associations, such as co-sleeping, breastfeeding, or cuddling before bed. And this is the learned component.
Our view at Batelle is that sleep is both a biological need and a learned behavior. There is an inherent need for sleep that’s fundamental to human health and well-being. But learned habits also have a significant impact. In order to truly resolve a child’s sleep issues, you need to address both the biological and behavioral components.
There is varying advice on when a parent should think about sleep training, and also conflicting views on whether you can sleep train while regression is going on.
Sleep training is can be seen as a reset of behaviors. A sleep regression is a period of fluctuation and change, so while it may take longer for your baby to settle into good sleep habits (just as it does it you sleep train while your baby is teething), you can still work on these behavioral aspects.
In fact, because sleep training is so much about how a parent interacts with their child’s sleep, regression is usually the time of peak motivation (and pain) by the parent. This means parents are more likely to follow through as they are desperate for a solution. One of the most common reasons sleep training fails is that a parent isn’t able to follow through. So you can use this period of time to your advantage, get your partner on board, and really work on laying good sleep foundations for your child that will help avoid future sleep regressions.
A lot of parents seek medical advice from their pediatrician when their baby starts having sleep problems. Pediatricians usually recommend a cry-it-out approach, which can be tough on younger babies. The more incremental and supportive sleep training methods are usually better suited for these younger little ones as they receive more co-regulation and support from their caregivers. Remember that some children develop later than others, so it’s safer to err on the older side of 4 months – usually 5-6 months – than sleep training at the 4-month mark. With a slightly older baby, a parent is also more confident as they feel more secure in the knowledge that their child is able to self-soothe and sleep for longer stretches without being fed.
Babies’ sleep is super controversial for another reason: the question of benefit and/or harm. There are a number of sleep training techniques of particular controversy, including the Ferber method, the chair method, and of course the cry-it-out method. There are also more “gentle sleep training methods” that come in multiple forms – like the pick-up put-down method, bedtime fading, and the camping-out method of sleep training. While they have a slightly better reputation for being more “beneficial”, they do not escape the controversy altogether.
In short, there are two, very polarizing views on this question, held on the one side by sleep training advocates, and the other by anti-sleep training proponents (see here for an article discussing the debate and why as an industry we need to stop ‘sleep shaming’):
Argument one is that sleep training babies is beneficial for a child, as it leads to better sleep for all involved. Pediatricians or the American Academy of Pediatrics are often cited to back up this line of reasoning, as they recommend sleep training as an effective intervention from about 4 months of age. While there is plenty of research out there showing the benefits of having a good night’s sleep, there is no evidence currently showing sleep training is actually beneficial in the long term. In fact, there is a study that refutes this argument, showing that most sleep training methods have had no impact on a child’s sleep and health by age two (although, mothers did have improved health outcomes and were less likely to report clinical depression symptoms).
The second argument is that sleep training is harmful. While this is a common belief, there is no scientific evidence backing this claim up either. Nonetheless, new parents are guilted into believing that when they need help with their child’s sleep problems, doing sleep training will in some way be detrimental or harmful to their child. Not only is this belief unsubstantiated, but it fails to define what it means by “harmful”, therefore overlooking any positive gains to a child and the family unit from getting more sleep.
This polarization leaves caregivers in a Catch-22. The reality is that depending on how you define “benefit” and “harm”, data can be constructed to argue both sides.
We have tried to take a data-driven, more objective view of this question, having built out the largest observational database of sleep training in the world. Our view is that sleep training is neither inherently “good” nor “bad”, but that if approached correctly, it can be a wonderful learning and bonding opportunity for parents and children.
It’s also deeply dependent on the family context, circumstances, and the trade-offs of doing sleep training. For example, a baby who has multiple wake-ups in the middle of the night and inconsistent naps, may be contributing to postpartum depression in the mother. This coupled with the lack of a consistent bedtime may also be preventing her from returning to work and causing a rift in the parent’s marriage.
Looking at the overall well-being of the child (nevermind the parents), you can conclude that solving the sleep problems in this instance would greatly benefit the child – not only because they will have better quality sleep – but because they would have healthier caregivers who had a more productive relationship. As another example, doing sleep training may be the reason caregivers start fighting, as only one parent is on board. For instance, the mom may be very against night weaning and swaddling, whereas the dad may want to just optimize for nighttime sleep. In this case, the disrupted sleep may be overall better (even considering the health impact of lower-quality sleep) given the particular familial context.
The other nuance is that not all sleep training methods are alike. Different methods have different trade-offs: whether it’s time invested, money spent, long-term efficacy, or level of responsiveness. For example, cry-it-out is free and simple to implement but doesn’t have good long-term efficacy and requires total non-responsiveness from parents. This is often misaligned with modern-day parenting approaches.
Alternatively, you can choose a more expensive versions of these programs, where more time needs to be invested (there is more info to digest) and the level of responsiveness increases slightly, but there are still timed check-ins that require periods of non-responsiveness. While we can’t speak to the long-term efficacy of such programs, over 60% of families who come to us have tried other methods previously.
Finally, Batelle. It’s more expensive and also requires more time and effort from caregivers. Why? The reason is that to be truly engaged and connected to your child, you need to learn how to respond to their needs so as to both create deep trust and also solve the issue at hand. Further, we are also much more responsive, offer far greater levels of support and guidance (once you sign up, you have expert access for 5 years), and also have longitudinal data proving the efficacy over the span of multiple years. We will publish this as the first study proving long-term efficacy and health benefits for children over the next few months.
Whether a parent chooses to sleep train or not, and which method to use, is a deeply personal choice. Bear in mind is no right or wrong answer when it comes to the harm/benefit questions, there are just trade-offs. And it’s no one’s place to judge a parent for whatever choice they decide to make.
One would think that at least biology wouldn’t be in dispute, right? Surely this one is clear-cut…? Unfortunately not.
The first view is that if a little one is waking up at night, this is ‘biological’ and therefore also ‘biologically normal’. In part, this is true: a child – just like an adult – has sleep cycles, which means they cycle between fully asleep and partially awake throughout the night. These partial awakenings are very natural and designed for us to be able to ensure that our sleep environment remains safe.
So all humans – babies and adults alike, have periods of wakefulness throughout the night. However, here is a big insight – these partial awakenings only result in night wakings if there is something detected in the sleep environment that indicates something has changed/isn’t safe. If you are in a lighter cycle of sleep and hear a noise, you as an adult will wake up fully to check your surroundings.
The same is true for a child. Let’s take the example where they went to bed in your arms with the sound of white noise, and you put them in their bassinet with silence. After a period of time, they will enter the wakeful part of their sleep cycle, and notice their sleep environment has changed. This will cause them to wake up and seek reassurance from you as their caregiver because they aren’t sure if the change in their environment is safe.
What does this mean? The final part of the sleep > fully awake equation is behavioral in nature, a nuance that is often missed. And as the caregiver, you control the sleep environment and can therefore ensure you have an intentional bedtime routine that promotes good sleep habits for your little one that doesn’t depend on conditions that change throughout the night.
To interpret the question as binary: wake-ups are normal, or wake-ups are abnormal, misses the nuance. As with anything, the nuance is the most difficult to convey quickly. You’ll see that even we fall into this binary trap in places, saying your child will ‘sleep through the night’. And while we do explain the nuance, – which is that children naturally wake up during the night, and cry if they need reassurance – that’s not a particularly catchy statement for a description…
Parenting is often a balancing act of different needs, priorities, and objectives. Infant sleep is one of the places where a parent’s needs and a child’s needs can seemingly become most in conflict. For example, a breastfeeding mom may have to give her baby frequent night feedings to get them to stop fussing. While her child gets what they need to feel safe (breastfeeding), the mom no longer gets the healthy sleep she needs.
It’s very easy to say that it’s a parent’s job to put a child’s needs ahead of their own. It’s equally easy to argue that sleep training is good for the whole family because having a rested parent is a net positive for the child (they will be ‘better parents’), plus the child gets better sleep.
However, the reality – as with most things we’ve discussed, is more nuanced. First of all, a caregiver and a child’s sleep don’t need to be in conflict if you teach a child the right sleep patterns and habits. If you are speaking to a sleep consultant who is asking you to choose – run a mile. And secondly, this is not a moral question of whose needs should take priority, but again one of context.
Our view is that parenting is hard enough without the shaming, especially around sleep. The demands of a modern-day parent have evolved and changed so much over the years, with less time, more pressures, and statistically less sleep. Adapting to a changing environment is part of our DNA as humans. We believe that there are tradeoffs in any decision, including whether to sleep train your child or not, or which sleep training method to use. You are best placed to decide your path forward for you and your little one. Our job in the sleep training industry is to present the best data we have to inform your decision, and then support you on whatever decisions you make.
