Is the Sleep Training culture contributing to the rise in Post Partum Anxiety and Depression?

As with most things I write, this goes against the mainstream narrative and will undoubtedly be brushed off as mere poppycock by those who subscribe to the popular Sleep Training culture but I’m going to say it anyway- Sleep Training culture strongly contributed to my Post Partum Depression and I don’t believe I am alone in this.  

a. ‘But Sleep Training saved my sanity!’

b. ‘I was heading down the path of depression so I used Controlled Crying!’

c. ‘My anxiety was crippling, I had to sleep train!’

Sound familiar?

I was heading straight for the (a) though because we ‘failed’ I was never ‘saved’ and (c) definitely featured in my decision to go the sleep training route. I get it, I really do but here’s where my experience as a ‘failure’ has helped me look at this situation very critically and I’ve come to the realisation that perhaps so many mothers have to be saved by Sleep Training because we are being groomed by the Sleep Training culture to feel like we are doing something wrong when our baby does not fit the ‘sleepy ideal’.

Sleep training culture is so pervasive, it is virtually impossible for a modern mother to remain untouched. It has come through a number of generations now and as such, the advice from older generations who we often turn to as new mothers is riddled with it. Health care professionals hail it as a ‘fix’ and with limited quality breastfeeding education as part of their training, many are ill equipped to advise on the normal development of feeding and sleeping behaviours in breastfed babies and toddlers.

Feeding and sleeping schedules that were so popular while formula feeding was the norm in the 50-70s have tainted what has become the benchmark and ‘norms’ for infant care.

First wave behaviourism struck fear into the hearts about ‘bad habits’, ‘spoiling’, ‘negative Sleep crutches’, ‘self soothing’ and Sleep as a taught skill.

Hands off, distant, independent, solitary sleep, restricted responsiveness, authoritarian, prescriptive and strict- all words that help describe what is valued when parenting very young babies and toddlers.

Being told when you can hold, nurse or comfort your baby is standard.

Being told when your baby should sleep, where they should sleep and for how long is standard.

Being told when you should respond to your baby’s cry and when you shouldn’t is standard.

Being told that your baby only wakes because of the way you help them find sleep is standard.

Being made to fear long term damage to your baby’s development and ability to achieve healthy sleep is standard.

Being made to fear that if you continue to comfort your baby in some way you’ll create a big old rod for your own back and you should break the habit now or expect you’ll have to do it this way forever is standard.

Being told that it is your responsibility to your child that you fix their sleep is standard.

This standard is what I believe is the crux of why so many mothers start heading down the path of depression and anxiety. I sure as hell did.

I bought into the standard and bent myself over backwards, forwards and inside out trying to reach it. The standard that I could not meet, the standard my baby called bullshit on, that standard left me feeling subpar as a mother every damn day.

Every day that I bought into the ‘shoulds’ for both myself and my baby was a day I finished feeling ‘less than’. We never measured up.

Every day of my baby refusing to accept anything less than the comfort and reassurance and assistance he needed drove a wedge into our relationship as I questioned again and again what was wrong with him and why couldn’t he do what he was ‘meant’ to do at his age?

It’s hard to not feel anxious and have your anxiety grow as the noise that surrounds you assures you that every day that your baby sleeps less than they say he should or wakes more than he should or asks for more assistance than he ‘should’ need is potentially affecting his long term health and development.

It’s hard to not feel depressed when yet again you are told it is because you nurse him to sleep and haven’t succeeded in putting him down drowsy but awake and you have to learn his cries that your getting this mothering and sleep business so terribly wrong- THAT’S why you feel so desperately tired and miserable. If you just follow XYZ, then you’ll get the sleep you need. When you’ve already tried these things in desperate vein for the 100 thousandth time to no avail.

It’s hard to feel light, relaxed and at peace with your brand new mothering experience when at every turn you are told you are doing it wrong.

For me and my darling wakeful little firecracker, the road to PPD was paved in Sleep Training culture bullshit.

How on earth I was ever going to get away without eventually succumbing while surrounded by all of this noise is beyond me.

Yes, there are many more factors that may well contribute to the development of PPA or PPD in each unique person but I refuse to believe this Sleep Training culture in anyway sets women up for success and healthy mental health and self esteem in their new identity.

So perhaps, instead of heralding and crediting Sleep Training with ‘saving’ so many mother’s sanity, we should look long and hard at how it took our sanity in the first place.

Mothers of today and into the future deserve so much better than this.

Re-evaluating, resetting and reestablishing the norms of infant sleep from a a biological and anthropological standpoint would be the first place to start.

Only once we can as a society come to a fuller understanding of the reality of infant and toddler sleep will we see a shift that is so needed to undo the damage and twisted accepted norms perpetuated by the current Sleep Training culture.

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When self-care just becomes another ‘thing’ you have to do

I’m getting on my ranty pants here because after reading yet another article on ‘self -care essentials’ doing the rounds, I realised that for me, back in the early days of mothering both of my babies, all of these lists of ‘essentials’ essentially gave me one more thing on my very long list of ‘things you have to do if you want to succeed at this mothering business’ and in all honesty, I didn’t need one more f#%^ing thing I was SUPPOSED to do as I already had more than my fill of shit to do with my time.

Does that mean I didn’t care for myself?

Hell, no!!

I f#%^ing cared. But sometimes, my self care was to just say, ‘you know what, I give myself permission to just do whatever the hell feels like the path of least resistance today’ and that sure as shit didn’t involve me scheduling in ANOTHER thing I had to do for myself that day (unless that thing was simply to make sure I ate something other than toddler leftovers or didn’t give a shit that the washing was wet and stale in the basket).

So many self care essentials focus on you needing to be ‘solo’ to care for yourself but despite me leading an extremely privileged life this was not always possible and was often impossible in the early days with my babies (so if it was hard for me, I’ve no doubt it is downright impossible for most).

I didn’t need to be told to block out time for ‘me’ when the only time I got to myself each day was the 15 minute shower I had once both kids were in bed each night … that WAS my ‘me’ time and heck yes, I savoured it but anything more took logistics, planning and forethought and quite frankly, I wasn’t capable of that when my mental lode was already at capacity.

That’s right, my mental lode.

I know for a fact, my first time experience would have been better had I been better able to filter out the bullshit, but as a chronic over-thinker and perfectionist, it’s no great surprise that I let in more than deserved to get in and I had more than enough shit to work out in there already, so when someone would casually suggest I have pamper day because I deserved a break, my reaction was genuinely perplexed! Of course I deserved a break but I’ll be f#%^ed if I could work out how the hell this would all work and the brain power I would require to make it work was too busy being exerted in other areas.

Even second time round, all of these self care options that required any kind of logistical planning were swiftly cast aside in favour of shit I could do for myself without having to work out the how, what, when, where and why.

My self care is often child free now and I relish it but self care back in the day was rarely so and you know what, I was taking very good care of myself.

Here are the ways I practice self-care without ever really needing to practice self-care-

#1. I found and applied an effective bullshit shield

That’s right, a bullshit shield. Until you get one, you are going to live in a perpetual state of confusion as conflicting advice comes from every angle. Once you can apply a bullshit filter, you will feel more comfortable with simply doing what feels right for your unique family based on the information and support that you have in that moment. If something feels wrong, it probably means it is.

#2. I followed the path of least resistance

In the land of ‘you need to do XYZ to be a successful parent’ the hoops you must jump and boxes you must tick often fly contrary to your baby’s natural behaviour and development. If you feel like you are pushing shit uphill or fighting against the tide, I give you permission to surrender entirely. Parenting and life in general go so much more smoothly when you embrace the natural flow and follow the path of least resistance.

#3. I learned to treat myself as gently as my children

I am human and I am really bloody trying to be a good one but, I am not perfect and I will slip up and I will need to put myself in timeout and I will have days where my parenting just plain sucks and I will take shortcuts and I will throw my hands up and just say ‘whatever!’ And I will not spend the rest of my time beating myself up and feeling guilty.

I no longer strive for perfection.

I will apologise where apologies are needed and I will move on.

#4. I surrounded myself with people I enjoy

We go out A LOT. And mostly that is to surround myself and my babies with people who help us all feel good. I am incredibly lucky to have found and nurtured friendships with some of the greatest people on earth and their presence in my daily life IS my favourite kind of self- care. We all love each other and our babies so much and there is nothing like the company of other mothers who ‘just get it’ to keep you sane on the toughest of days. They have seen me in all my glory they aren’t under any illusions and guess what, they still hang out with me even when my house is a tip, I smell and I’m crying or ranting the second I see them.

#5. We spend A LOT of time outside

The outdoors are plain good for the soul and when all is going to pot … out the door we go. Sometimes we go for a walk, collect rocks, jump on the tramp, make mud pies, play with water, draw with chalk, ride bikes and other times they stand there still whining or crying at me but somehow the earth in between my toes, the sun on my face seems to help me find my calm again when it seems to have left the building and many an ‘unsettled’ / ‘I have no idea what the f%^*ing problem is’ moment have been calmed with some cuddles in the great outdoors.

Being cooped up has never been good for my soul and being outside IS a helpful way for me to care for myself while I care for my babies.

#6. If I really want/ need to do something then I ask for help and do it

That’s right, I ask for and accept help. My hand goes up and I say to my family and support crew, this little duck NEEDS to do XYZ and they/ we make it happen. Getting more comfortable with being specific about what I need has been a journey of growth but it has helped me immensely and also allowed my relationships to grow as the favours I have been bestowed have been returned in kind.

And that’s it, that’s how I care for myself without specifically practicing ‘self care’.

So, if you, like me are feeling as though ‘self care essentials’ are nothing but another pain in your arse or signal that you haven’t got this parenting shit together, rest easy my friend.

Caring for yourself doesn’t have to be complicated or pigeon holed as another task for the day. It’s the many little windows of opportunities in your day where you can take the easier option to care for yourself. It’s the options you choose because they make your heart sing or keep the family calm which keeps you calm. It’s recognising the incredible lode you carry and patting yourself on the back while also cutting yourself some slack.

Self care is not a ‘thing’ you have to do, it is a way of being, living and feeling okay within yourself while the little people in your life seem to take up so much space.

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Why Responsive Settling Isn’t Truly Responsive

When in it comes to Sleep Training, there are extremes on the spectrum, with Cry It Out at the far end with complete withdrawal of response- shut the door at 7pm and do not open it again until 7am, with more ‘responsive’ techniques sitting somewhere in the middle, down to the gentlest, slow moving, truly responsive options at the far end. Responsive Settling proponents would have themselves down the ‘gentle’ end of the spectrum but as someone who has experienced the technique as the mother of a wakeful baby, I can say that gentle, it most certainly is not.

The sell is strong though and I believe that those who created the technique and those who teach and utilise it, wholeheartedly believe they are responding to the babies entrusted to their care but there is a massive gulf between any response and appropriate response. Responsive Settling whilst more responsive than no response, does not allow a parent to be appropriately responsive to their unique infant’s needs.

Why?

Well I will detail my experience more in a moment but I think first and foremost, the reason that Responsive Settling still so clearly misses the mark is that it still fails to recognise and respect normal infant sleep behaviours and instead works to pathologise and stage interventions on them when no ‘problem’ actually exists for the baby and instead the true problem lies with unrealistic sleep expectations, lack of support for very tired families and a society hellbent on ‘fixing’ anything that has been decided is undesirable or outside the accepted ‘norm’.

(Image: Gentle Parenting Memes)

But even if you don’t buy that, I will explain how the Responsive Settling technique looked in my reality and you can decide for yourself if it really could be responding to a baby in an appropriate way.

A little scene setting for you-

I was a First Time Mum. My baby was born wide awake. He was never a sleepy newborn. Not even the day he was born. He slept for brief bursts during the day, was super sensitive and startled incredibly easily. He hated being down. Ever. He wanted to be in arms or on a chest 24-hours a day.

He cried whenever we put him down and seemed to find the feeling of falling asleep very scary. He’d be all drowsy and relaxed with eyes drooping and then BAM screaming, as though that last little falling feeling you get as you drop off was the most terrifying sensation in the world. I had never heard of the Fourth Trimester. I had no idea that a baby wanting to be held close 24/7 was in the range of normal. All I knew was that everyone around me had babies who looked calm, relaxed, happy to chill out and slept for big chunks of time, flat on their back with little to no help from their mothers. My baby’s night time involved loads of waking but he was usually quickly settled by the boob. I was terrified of bedsharing and felt that I had already created so many ‘bad’ sleep habits already, I didn’t want to add anything more to our repertoire so I was insisting on getting up to him and tending to him in another room. I also had my head filled with the notion that although a newborn may wake frequently at night to nurse, this should lessen over time in a straight line, with him dropping feeds and sleeping for longer without my help.

My baby strongly disagreed.

And so, we became at odds with each other. He needed me intensely but I was convinced he wanted me but didn’t need all that he demanded.

By 3 months, I was exhausted and full of doubts.

By 4 months, I was a wreck. Cue our four-month health check with Child Health. The Nurse listened as I sobbed my heart out detailing my baby’s extremely wakeful behaviour and lack of day sleep. I was desperate for help. The nurse echoed my concerns. She told me my baby was Chronically Sleep Deprived and that she would refer me to The Mother-Baby Unit in our capital city for a stay to help me get the matter in hand. She knew there was a long wait for the public service but if we had Private Health Insurance then she knew the Private Facility in the same city offered the same program using the Responsive Settling technique.

She pointed me to the videos on the Public services website to allow me to have a try of the technique at home prior to our stay.

We attended the Private facility for a 5 day stay 2 weeks later. In the lead up, I tried to implement the strategies I had watched on the website, without any success and much distress for my baby and me. I grew ever more frustrated and intolerant of him as I came even more convinced that he was just being difficult and that he had to learn to sleep so we could all get back to being happy.

I went into the program with a desperate hope.

This HAD to work. I couldn’t for a moment consider it wouldn’t because I couldn’t fathom what my life would be or what we could do next if this didn’t work.

My enthusiasm was there but I had a dull ache in my heart the whole time leading up to the stay that remained throughout. I had never wanted to listen to my baby cry. Why o why couldn’t my sweet baby just find sleep like all the other babies? I didn’t want to do this to him but I couldn’t allow his lack of sleep impact on him anymore. No, I was stronger than that and I would do whatever I needed to meet my baby’s needs and if that meant having strangers keep me in check so I didn’t ‘give in’ too easily, then that’s what I’d do.

And so, the stage was set.

We started off with a meet and greet circle time. We had to tell each other why we were there. I could barely hold my head up as I confessed my child’s ‘sleep sins’ and my role in his ‘bad habits’; there were sympathetic head tilts, a knowing look in the eye, a shoulder rub and word of, ‘it’ll be okay, we can help’ offered up.

Then came the slide show that detailed the game plan. My 4.5-month-old was deemed too old for the ‘Comfort Settling/ Hands on Settling’ group which was for the two newborns present. We were instead with the older ‘Responsive Settling’ group.

We started when it was time for his afternoon sleep.

We had to implement a Feed-Play-Sleep routine and so I had to feed my baby and make sure he didn’t fall asleep, then read him a story, kiss him and tell him it was time to sleep, place him in his cot and walk out and close the door.

Then, I waited by the door, to see what, if any, response my baby would require to find sleep.

The nurses had zero interest in hearing what I thought he needed, or even what I thought may happen next. It was assumed I had never afforded my baby the opportunity or space to try and settle himself before and therefore, we needed to ‘just wait and see as I might be pleasantly surprised’.

Pleasant it was not. Initially, my trusting baby just kicked his legs around and chatted, no doubt feeling safe in the knowledge that mama would reappear soon. But she didn’t. He then started sounding worried. If he could talk back then, I’d say the sounds would roughly translate to, ‘Mama, I’m getting worried, where are you, I need you, where are you?’

I knew this, but I wasn’t allowed in. This was just him ‘grizzling’ because he was getting ready to sleep, apparently.

He then ramped it up. I explained that this only ever went one way and it most certainly wasn’t headed towards sleep and if anything, it was driving him ever further from it. The nurse assured me he was okay and suggested I move to the base level ‘response’ while we stayed at the door. We opened the door and ‘shushed’ loudly at him to let him know I was there but it was sleep time and he wouldn’t get picked up. My baby wailed on.

I told them it wasn’t working and they told me to persist a bit longer. He continued to cry.

We then crawled into the room (so as not to give him the false impression we would pick him up), and I patted the mattress next to his head and continued to ‘shush’ loudly, no eye contact was to be made. He cried even more.

I was then encouraged to place my hand on his chest and continue to ‘shush’ him. He was past hysterical by now.

The nurse then told me I could pick him up to calm him as we had to respond to that level of distress as it wasn’t good for him. I scooped him up and soothed my sweating hysterical baby. But, as if it wasn’t enough, once he was calm, down he had to go again. He immediately howled. I placed my hand on his chest and ‘shushed’ but my heart could take no more.

THIS is one of the key moments I look back on with great shame-

I could take no more, so I fled. I ran from that room, without my baby and sat in the hall and rocked in a ball crying my heart out. The nurse had picked my baby up at this point and she rocked him off to sleep as it was decided that was enough for that settle. I should have run WITH my baby, not away from him, but I guess this is testament to how crushed I was.

Once asleep, she came out to find me to assure me we would try again next time and I’d be surprised how quickly he’d learn.

And so, a few hours later, we did it all again. It went almost exactly the same way. The only difference was that there wasn’t that momentary calm at the start. My clever little man knew what was going on and was crying before I could even walk to the door.

Door, shushing, floor, shushing, mattress patting, shushing, chest rocking, shushing, calming hysteria, shushing, place back down, shushing, hysteria, me running, nurse rocking.

This second time, one of the nurses came to me to give what she no doubt thought was pep talk and asked me if I was going to be ‘stronger’ than my baby or not? I told her to p#%s off and get away from me.

Again, a few hours later for bedtime.

My mum came to visit the next morning and was upset by what she could see. She told me my baby looked pale and exhausted and asked what was going on. I told her and she told me that I either spoke up to the nurses and told them this wasn’t working and we needed a new tack or we’d be leaving. I was a mess.

The morning settle was the same so after lunch I started packing our bags.

A nurse saw and came to ask me what I had hoped from the stay. I told her I NEEDED help but I didn’t feel like we were getting anywhere and no one seemed to have any better ideas to help my baby as their way still ended with hysteria and rocking in arms which was no better than I was doing at home anyway.

She asked me what I thought might work, and I told her that if I could at least go to him BEFORE he was so upset, I may be able to keep him calm enough to find sleep. She agreed to support me on the next settle and miracle of miracles, it worked.

I was elated.

It continued to work my way for the next few days there but nights continued to be a challenge as they wanted me to try to resettle before offering a night feed but I needed their help with this as the instant he had me, he wanted the boobs and my husband was a 2.5-hour flight away.

The nurse was ‘happy’ to help but just as they showed no faith in what I told them about my baby by day, they showed no interest in hearing my belief that being prompt was essential because if you allowed him to wake right up, the settle could take hours versus the minutes if he was still drowsy.

So, I’d hear him stir and knowing my baby, I knew this only meant one thing- he was waking and would not return to sleep without help, so I’d go to the nurse’s station and alert her to his waking and ask for her to attempt the resettle. She’d deliberately go slow saying I need to not rush to his side as he needs to try to resettle himself first. At 2am in the morning, I’d say, we talked about this during the day and this DOES NOT work for my baby, please come now or we’ll be awake for hours. Feet.Dragging.Teeth.Pulling.Sloth.Slow movements, before starting the horseshit ‘shhing’ at the door routine responses and then rocking a hysterical baby who was now wide awake and HAD to have a breastfeed to find any form of calm. At least an hour later, I’d finally crawl back to bed only for him to wake an hour or so later and rinse and repeat. It. Was. F^&*ed.

The next day, in daylight hours, I would reiterate the need for prompt response and I’d firstly get reminded that the goal was to get my baby self-soothing and that affording him space was essential. I’d then try to explain the HUGE difference in awake time because of this and they assured me that this short-term pain and extra loss of sleep, would have a long-term pay off that was worthwhile.

I agreed to stick with it. He was sleeping a longer block at the start of the night so I felt that maybe they were onto something and I owed the effort to try and make it work.

So, after 5 days, my baby was sleeping in his cot, settling to sleep without much help and having a longer block at the start of the night.

I left feeling like the wheels of positive change were in motion and I felt positive that with continued commitment, we would have him sleeping ‘well’ in no time.

It wasn’t to be.

My husband and I threw ourselves at the technique with a 300% commitment to being consistent and persistent (bordering on lunacy).

Our baby however, held an even greater faith in us and belief in his own needs and he continued to fight and call and demand our presence with an intensity that was even more than before.

Within a week of returning home, despite adhering to every responsive settling ‘rule’, we were up to 2-hour battles for every nap, every bedtime and ever resettle through the night. It was horrific.

We were all exhausted, frustrated and incredibly at odds with each other.

We WERE responding damn it!!!

We responded to every god damn cry, every god damn whimper (well the whimpers that sounded ‘emotional’ anyway). He couldn’t possibly NEED us, he just WANTED us. This was bulls&*t. Why did he need more from us than they said we should give? WHY? Why wasn’t he learning? Why wouldn’t he just let up?

Our poor baby on the other hand was no doubt deeply confused about why these people who he loved and needed so completely seemed to be so hellbent on pretending like they couldn’t respond the way he truly needed them. Why do they keep standing at the door or tapping my mattress when they know I need a cuddle? Why are they taking so long to let me nurse when all I need is a quick minute and we could all be back to the sleep we all need?

Responsive Settling gives the illusion of response.

Being told how to respond, when to respond and when to withdraw that responsiveness is NOT being responsive. It’s the equivalent of when someone is talking to us and we are busy or can’t really hear so we just smile and nod or say something like, ‘that’s nice dear’. It allows the adult to feel they are doing SOMETHING and therefore they are being ‘gentle’ while they train their baby. It is a disturbing mismatch that plays a significant role in the justification and vindication of the widespread use of these techniques in Public and Private facilities and by consultants around the world.

I desperately NEEDED help. There is an overwhelming need for help for new mothers, particularly those with mental health challenges and those with very wakeful babies.

The Possums Clinic in Brisbane offer the service I needed back then and I can only hope that all service providers begin the rapid shift to their approach. The Possums Sleep Film, should be compulsory viewing for Mums and Bubs groups nationwide and their Professional Development courses would surely see a change for the better in the practice of Frontline Care Professionals.

I hold no malice for the people who worked with me during my stay at the Mother/Baby Unit but it would be wrong of me not to speak up and to demand they reflect on their practice, the impact it had on not only me and my baby, but many of the people they see and to ask, maybe there is a better way.

So, here’s to growth.

Here’s to change.

Here’s to ensuring very tired mothers and babies receive the care and support they deserve and need.

EDITED TO ADD (After being torn apart by a prominent Sleep Trainer)-

Sure, write our hideous sleep training experience off as an exception not the norm.

Minimise the shit out of it.

Justify why it misses the point and sways too heavily away without a balanced counter argument.

Say you feel sorry I didn’t use YOUR service because it would have been handled so much better.

Tell me again why my reality is just scaremongering and far from the real ‘reality’ of the majority who sleep train.

I may be the exception but I suspect not the way the sleep trainers think.

I believe what makes my case exceptional is that we ultimately failed because our baby NEVER gave in.

He rejected the techniques so squarely that we were forced to pull back and re-evaluate the whole situation.

It is a sad reality, that normally, the baby gives in.

They succumb.

They submit.

They give the illusion that their trainers and parents ‘succeeded’.

The first part of my tale … the ugly bit that ended in me running and a nurse rocking my hysterical baby and then us doing the whole thing again next settle because ‘he will learn’ … that bit IS NOT EXCEPTIONAL.

That trauma, I can still replay in graphic detail, that was NORMAL.

No one at the Mother-Baby Unit acted as if this was anything other than a normal, expected part of the process.

No one was surprised.

No one was concerned.

It. Was. Normal.

Do not tell me what happened to me is the exception.

I thank goodness my baby was different.

I thank heavens we were forced to pull back and see this process for what it truly is.

We, the sleep training ‘failures’ of the world … WE are the real ‘reality’.

Our babies are the gatekeepers for all of the babies who simply couldn’t keep going.

They are the voice and the evidence the world needs to see that this sleep training culture is not the support very tired mothers and their babies need or deserve.

So minimise, justify and explain me away again.

But, I’ll still be here and my voice will not be silenced.



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