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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.

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My thanks to Attachment Parenting

Attachment Parenting can get a pretty bad rap.  

This is hardly surprising in a society that places little to no value on the natural, biological development of our infants and toddlers in favour of behaviourist interventions that force babies to conform to an ideal that allows adults to get back on with the more ‘important’ business of life with as little disruption to their productivity as possible.

Interestingly though, it also gets a negative review from many a mother who while initially drawn to the basic attachment parenting tenants, then found/ decided they were unable to follow them in their setting.

Plenty of mothers explain that while all of it sounded great in theory, they simply could not or would not be able to make it work for them or they felt they ‘outgrew’ this style of parenting or felt stifled and restricted by it.

A couple of weeks ago, I was reading another account of how a mother felt ‘let down’ by Attachment Parenting as her children grew older and when a subsequent child didn’t respond well to the techniques recommended.

This got me thinking about my own experience with Attachment Parenting and how it has shaped me as the mother I am and the mother I continue to strive to be.

I can say that I am eternally grateful to the Attachment Parenting movement for all of the ideas, guidance, confidence boosts and belief it has provided me with in the early phase of this mothering gig. I am grateful for all of this being done without ever feeling like I had been told what I HAD to do to mother my unique children.

I am grateful because they spoke of a norm I would otherwise not have known existed.

They offered me an explanation and coping strategies and mothering techniques that no one else told me were okay let alone what might be exactly what my baby and I needed.

They helped me see why my baby only slept calmly in my arms or on my chest and offered up babywearing and co-napping as normal and natural ways for me to meet my baby at his point of need.

They encouraged me to feel confident that my baby who breastfed SO frequently did so because this was not only his source of nutrition but also his preferred method for comfort, soothing and reconnection. They also didn’t place arbitrary limits on when my baby should stop needing me so and instead encouraged me to trust that I could follow his lead with no notion of it being ‘bad’ or that I may be stifling his development.

The work done by Attachment Parenting advocates to normalise and educate about safe bedsharing is perhaps their greatest gift to me and my family. It is, to date the single best thing I have done as a parent. It saved me, my husband and my baby. It is no exaggeration to say, my life did a complete 360 turn when I finally felt like I could make this arrangement work. I finally had a way to survive my High Need baby’s non stop extreme frequent waking. I had tried EVERYTHING to ‘fix’ him. Nothing worked. But, Attachment Parenting didn’t disown me the way mainstream advocates did. They threw me a lifeline. I could still be a ‘good’ mother even if my baby woke 59 billion times a night and on top of this, my husband and I could get the best quality sleep we could get while still meeting our baby’s needs at night.

Our night time parenting schedule remained gruelling. There was no miracle that occurred or peaceful, perfect family bed image to paint here but we could live again. We could survive and most important of all, we finally felt we could accept our baby for who he was and that included being extremely wakeful.

For me, I didn’t ever feel like I HAD to do XYZ to ‘be’ an Attachment Parent. But then again, I wasn’t striving to ‘be’ anything in particular other than the best mum I could be to my babies.

I didn’t feel constrained or judged if I needed to do things in another way as I followed my baby’s lead and my own heart.

With my second baby, my parenting repertoire was a source of great comfort to me. I had no idea who this little person would be, but I felt comfortable knowing the norms of human infant behaviour and I felt confident knowing that I had the range of skills and techniques to help me meet him at his point of need wherever that may be.

I didn’t feel bound to bedshare but I knew I would keep him close to make night time parenting manageable for me. If he needed my closeness, then into our bed he’d come. If he relished his space, I happily prepared a safe sleep space next to me in case.

I experimented continually as he grew to work out how he felt most comfortable finding and maintaining sleep by and day and night and I rolled with it. Sometimes we babywore, sometimes he slept in the pram. Other times we co-napped with a boob in his mouth or he snoozed alone on our floor bed.

I didn’t HAVE to do anything other than respond to my baby in the way that worked best for us.

As my babies grow, I thank Attachment Parenting for ensuring I continue to actively question commonly accepted mainstream practices. I have found gentle parenting, respectful parenting and peaceful parenting as well and I continue to read, grow and learn with my babies.

The single best thing Attachment Parenting has gifted me is to ensure that while I pick and choose and grow and evolve, at the heart of my parenting decisions is my heart. Decisions are made with ALL of the humans in our family considered as valuable people worthy of respect. My children’s childish nature is not held against them, just as their babyish behaviour wasn’t while they were infants.

As a family, we work as a team, to meet each other right where we are at and see value in each other for who we are.

I will be forever grateful for the healthy questioning that Attachment Parenting stirred in me. To feel confident in questioning accepted parenting practices, to look more deeply at why they are popular, what outcomes they may have and what their impact may be, intentionally or unintentionally, is so important to me.

So thank you Attachment Parenting for opening my eyes to possibilities.  
Thank you for having my back when I couldn’t fit with the mainstream.  
Thanks for having my baby’s back when my faith in him was at its lowest.  
Your work in this world is so needed.  

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Accepting the Reality of Infant and Toddler Sleep

Imagine if we, as a society accepted normal infant and toddler sleep. 

I mean really accepted it, in all its glory. 

Every part of society, from every generation, every family, every profession, every community, every culture, every religion.

What if we knew and accepted it as expected and respected elements of a child’s development? 
What if everybody knew well before having their own children that their child would need night time parenting for the first few years of life? 
If everybody knew that waking frequently to nurse was the biologically normal way for an infant/ toddler human to sleep? 
If everybody knew that we are in fact ‘carry mammals’ and that our young require near constant contact with a caregiver for the first few months to continue their growth and development outside of the womb? 
If everybody knew that a baby’s and toddler’s sleep can fluctuate a lot  over the first couple of years as they grow and develop at a phenomenal rate? 
If everybody recognised that a baby’s and toddler’s need for comfort, closeness and nurturing at night is just as valid and important as their need for these things during the day? 
What if nobody doubted the value of night time parenting and wouldn’t even for a moment consider that they could trade it off so they could be a ‘better’ parent by day? 

We, as a society, would come at infant and toddler sleep from a whole other place than we do right now.

There’d be no sleep training and therefore no sleep training industry.

There would be less focus on the baby and their behaviour and more focus on the dyad as a dynamic pair and nurturing the nurturer.

There would be focus on all levels from family right through to the political sphere on the kinds of support families need to navigate this time in their lives.

Antenatal classes and Mums and Bubs groups would be all about helping mothers to build their support network and discovering options that will allow them to meet their baby’s needs while also meeting their own.

For mothers who are struggling with intense high needs babies, the support would recognise the extra level of challenge these mother face as they run the Ultra Marathon of her life and help put the supports in place that mother needs and deserves.

Mothers with mental health concerns would be nurtured and treated in ways that respect her child’s legitimate needs day and night.

Families making decisions about paid employment would do so with the full knowledge that their baby will still require night time parenting.

Wouldn’t the world look so different to the way it does right now.?


The stress, strain, struggle and sacrifices made all because so few people know and recognise what has always been and always will be the way our tiniest most vulnerable humans find sleep normally.

I was told that new and expecting mothers don’t want to know that babies continue waking for a couple of years. I was told I was scaring them unnecessarily and that it was the equivalent of telling horror birth stories to a pregnant mama as she prepared to birth.

I strongly disagree.

Knowing and accepting what IS likely to happen as your baby grows and develops is not a horror story. No one knows how your baby will find sleep in this world but one thing is for sure, they will need you and that is not something you need to fear. Instead of fear, it gives room to mentally, physically and practically prepare. It takes away the element of surprise. It removes the angst of ‘shouldn’t they be sleeping better yet?’, ‘why does my baby still wake?’

A birthing mother doesn’t need to hear every horrific tale of every horrific thing that may or may not happen to her. That does nothing to help her towards her own journey. But it equally does not help to tell her that it will be easy, straight forward and you practically just sneeze and the baby falls out without pain/ discomfort.

A pregnant or new mother does not need to hear every detail of every form of sleep torture she may or may not face in the years ahead with her child. But she equally doesn’t need to sprint to some arbitrary finish line that someone has told her and think that her child’s night-time needs will magically cease and her sleep will return to that of pre-baby.

Let’s be real. Let’s be honest and let’s give new parents the very best chance to set themselves up with realistic expectations for the early time in their child’s life where they will be needed just as much at night as they are by day.

I know this may seem like a pipe dream right now, but all it takes is for voices to rise. Mothers and babies of the future deserve better than what is offered up in mainstream society today.

When we know better, we can do better and so, for all of those in the know, it’s our turn to share our voice, speak our knowledge and share with all we can the truths of normal infant and toddler sleep.

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Ten little known facts about your baby’s sleep

1. It is biologically normal for a baby to wake and nurse frequently throughout the first year and beyond. It is not a sleep problem. Some babies do have underlying issues that may be exacerbating their normal wakeful behaviour and addressing these is crucial but the idea that a baby of X age is ‘too old’ to be waking is based on fallacy not fact.  

2. Feeding to sleep is the biologically normal way for a baby to find and maintain sleep. It is not a sleep problem.

3. The vast majority of cultures do not sleep separately from their babies or young children. A baby not wanting to sleep in their cot is not a sign of something being wrong with the baby and their ability to sleep but a sign of society having a problem with how babies prefer to sleep.

4. Keeping your baby close, limits the disruption of normal wakeful behaviour to both the breastfeeding mother and her baby’s sleep. Not having to physically fully wake to go to another room, then try to stay awake to settle or then need to wind back down  to sleep, all helps the mother. Nighttime breastmilk is also packed full of sleepy goodness that help both mother and baby return to sleep more easily. This one also links to number 1, 2, and 3. In our society that is obsessed with making babies ‘sleep through the night’ by cutting nighttime parenting out of the parenting role as quickly as you can and places high value on solitary sleep, we see many mothers keeping their babies at great distance. This is exhausting and extremely difficult to maintain and can result in both mother and child losing far more sleep than if they were close together.

* There are many safe cosleeping arrangements that can be considered to suit the family, from bedsharing to side car cots. If you haven’t already, read up on safe sleeping practices to help guide your family.


5. Your baby’s sleep will cycle through patches of relative ease and then through intense times with more frequent waking right up to the age of 2. It is rare that a baby proceeds in a straight line of gradually dropping feeds and sleeping longer without ever going through times of needing more. Just because they could find and maintain sleep one way last week, does not mean they necessarily can right now. This isn’t your baby ‘forgetting’ how to sleep, this is their body and mind going through the rapid development, growth and painful experiences (like teething) that they need to in the first couple of years of life. Them needing you to help them find the comfort, peace and support to be able to fall asleep and then maintain it, is normal.

6. Babies and young toddlers lack the brain development required to self regulate enough to ‘self soothe’ themselves from a place of distress. It is normal for babies and young children to need help to find and maintain sleep.

7. No two children are the same when it comes to their sleep needs, just as no two adults are the same. No one has a ‘formula’ that tells you when and how much your child needs to sleep. The only guide is your unique child.

8. ‘Catnapping’ or sleeping for only one 1-2 sleep cycles (20-40 mins) during the day is normal. Sometimes a baby may resettle for longer but it is okay if they do not. So much time and energy is wasted trying to resettle babies who are simply ready to get up.

9. Babies who are separated from the caregiver by day may ‘reverse cycle’ by night to meet their nursing and connection needs. Closeness and contact can help achieve their needs.

10. Many ‘experts’ like to name an age when night feeds are no longer necessary. What this fails to recognise is that night nursing is so much more than feeding. They may only ‘need’ say 2 feeds but they equally needed those 2-3 other quick nurses as well. Nursing for comfort, pain relief, immune boosting, connection and to help them relax when their busy growing body and mind cannot seem to find calm are all valid reasons to need nursing aside from nutrition.

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Dehumanising babies while treating their mother’s Mental Illness

Dehumanising babies while treating their mother’s Mental Illness

It is of major concern to me that peak bodies entrusted with the treatment, education and support of mothers with mental illnesses are following what they call a ‘simple and effective’ intervention to rid ‘problematic’ waking by their baby to facilitate the mother’s recovery. The intervention is Controlled Crying or Controlled Comforting.  

The basis for this is that an ‘infant sleep problem’ is a strong indicator for maternal depression and ‘Infant sleep problems and postnatal depression are both associated with increased marital stress, family breakdown, child abuse, child behaviour problems and maternal anxiety. Postnatal depression can adversely affect a child’s cognitive development.’ (Royal Australian College of General Practitioners, 2014 )

These are seriously heavy consequences and certainly not something that can nor should be ignored, BUT the fact remains that by and large, very few babies genuinely suffer from true sleep problems and therefore it must be asked, if the baby itself is not behaving in a biologically unhealthy manner, should it be their normal, functioning behaviour that professionals look to intervene on, or should the interventions be focused directly on the person who is exhibiting the unhealthy, non functioning behaviour?

It is understandably a blurred line as the mother- baby dyad is unique and shouldn’t be treated in isolation but the current recommendations by the Royal Australian College of General Practitioners (RACGP) and the Raising Children Network as an arm of the Australian Government’s Department of Social Services to employ the Controlled Crying technique, in no way honour this dyad.

Yes, a mother’s mental health is essential to her ability to successfully and healthily mother her children but let’s not dive straight for the measure that provides a ‘simple and effective’ fix to her problem that has been in fact oversimplified and effectively silences a baby’s cry and therefore their ability to communicate their night time needs.

This problem is complex and delicate. What will be effective for both mother and child in one setting may not be for any other but I do believe there are processes that could be put in place in order to take a deeper more holistic approach to this very serious and critical issue.

The place to start should be the research into human infant’s biological sleep patterns and behaviours. No, not research into sleep problems and sleep training or interventions but a solid grounding in what is truly normal from a biological, physiological, psychological and anthropological stand point.

Starting with this baseline, scientific understanding will naturally lead those seeking information to learn more about the intricate link between infant sleep, breastfeeding, maternal sleep and sleep environments and situations.

From here, it is no stretch to see why the disconnect and misalignment of modern societal views and expectations of infant sleep has created incredibly difficult barriers and challenges for mothers to face while trying to mother her infant who understands and knows nothing of modern society and its expectations and being able to fit in to what is seen to be a ‘successful’ mother, wife, partner, friend, daughter, sister, employee, volunteer and community member.

The RACGP state, ‘ Infants with sleep problems are more likely to sleep in the parental bed, be nursed to sleep, take longer to fall asleep, and wake for often and for longer periods.’ I’d like this to be viewed in light of what normal infant sleep actually looks like in the 6-12 month age group of infancy. These are NOT sleep problems for the infant but DO pose sleep problems for their parents and in particular their mother particularly for parents who are unable, unwilling or unaware of what changes they need to make to their own sleep habits, lifestyle, environment and support network to enable them to meet these biologically normal sleep behaviours of their baby or toddler that are seen in every culture and society in the world but are only identified as problematic and linked so closely with the incidence of maternal depression in our Western societies.

The other side of this statement from RACGP is it is another nail in the coffin to very tired mothers everywhere to see once again, their child’s sleep behaviour being blamed on natural nurturing parenting behaviours.
It is normal and natural for an infant to sleep in a family bed. This is how the majority of culture’s in the world manage normal night waking of breastfed infant and toddlers. It is not and has never been the cause of a ‘sleep problem’ for a baby or child. It can and is done safely by most (not all) families.
It is normal for a human infant or toddler to be nursed to sleep. It is not a sleep problem. Our night time breastmilk is packed full of sleep inducing components that act to assist both mother and child to sleep more easily and remain more relaxed. Mother Nature is no idiot and this is by perfect design not error.
It is biologically normal for a human infant to wake and nurse frequently at night for the first year and beyond. It is not a sleep problem.

IF a baby is waking in an extreme fashion or staying awake for long periods on many occasions, then I urge all General Practitioners and other professionals on the front line who work with these vulnerable mothers to not ignore this key factor. Absolutely DO NOT take steps to extinguish this child’s cries and calls for help. There is highly likely an underlying issue exacerbating this child’s normal wakeful behaviour and they deserve to have this fully investigated. Reflux, allergies, food intolerances, tongue and lip ties, birth trauma and the residual discomfort from it are all possible issues that need to be looked into and ruled in or ruled out.
After all of the investigations have taken place, if nothing else is at play, please consider this child as a whole person. It is highly likely that a child waking in this extreme fashion is highly sensitive, extremely intense and requires a huge amount of parental nurturing to be able to regulate their body and mind throughout the day and also by night. It has been shown that some children are far more sensitive to parenting choices and techniques than others and I would argue that a baby exhibiting such high level needs could be safely considered a strong candidate to be one of the children who will be heavily effected by the way they are parented and as such, their parents and those acting to care for those parents, need to be mindful of what interventions are suitable not only for the mother but also her unique child.

This brings me to my next point, with so little focus on the well being of the baby in this advice, I would like to bring into question the Hippocratic Oath, ‘first, do no harm’. I have read the studies cited by RACGP and the Raising Children Network and there is a heavy bias toward Proof of Harm and in particular Proof of Harm in the short and medium term but I question whether this is enough. Proof of Harm is vastly different to Proof of No Harm and there is most certainly not any Proof of no harm. It also seems that RACGP has focused only on studies that support the method they wish to employ with no recognition of studies that indicate otherwise.

As the babies in these situations are not in fact the patients but are intricately linked to the problem and the solution, it is not enough to find that the improvement in maternal depression warrants the widespread use of these techniques that cannot be proven to be doing no harm to their babies. A solution that only considers the mother’s needs and sacrifices her baby’s need for night time parenting is frankly no solution at all.

I am no stranger to this situation. I have lived and survived an extremely wakeful baby, I have been referred to a Mother-Baby unit for sleep training by my GP, I have been diagnosed and recovered from Post Natal Depression, I have tried and failed to implement a modified Controlled Crying technique and my extraordinarily intense baby resisted all attempts to extinguish his cries. I have had to recover from Post Natal Depression while STILL mothering my extremely wakeful baby and therefore while still sleep deprived.

I take this topic extremely seriously. I do not doubt or question that many mothers who are given this advice and have implemented it to varying degrees of ‘success’ will largely attest that they NEEDED this intervention. I don’t question that they needed help but I do question that THIS intervention is what was needed.

I sincerely hope to see a shift in practice in the management of severe sleep deprivation, Post Natal Depression and the handling of infant sleep by the professionals mothers turn to for support and assistance at his extremely vulnerable time in her life.

I ask that RACGP, review their current guidelines and practice by seeking access to research and techniques that will give a fuller more human view of this issue for all people involved.

I am not an expert, so my thoughts may be largely dismissed but the true experts in this field are resources that RACGP should acknowledge. Here are a few to get the ball rolling:

  • The Australian Association for Infant Mental Health has a position paper regarding Controlled Crying which can be accessed here.
  • Dr Pamela Douglas who runs the Possums Clinic for mothers and babies in Brisbane, Australia is a wealth of knowledge on normal infant sleep and working with mothers during this weary season in their lives. The Possums Clinic also offers Professional Development opportunities for those working with vulnerable mothers.
  • Tracy Cassells PHD of Evolutionary Parenting is a wealth of knowledge and can assist with identifying research from across this topic around the world.
  • Professor James McKenna of Notre Dame University can offer an Anthropological understanding of infant and mother sleep particularly for breastfeeding mothers.
  • Professor Helen Ball runs the UK Infant Sleep Information Source and is a wealth of information and will be in Australia in 2017 for professional development opportunities.
  • Pinky McKay and Meg Nagle are both International Board Certified Lactation Consultants who offer alternative views on managing infant sleep with a particular focus on breastfeeding mothers.

If we as a society truly wish to see a change in the occurrence of Post Natal Depression and Anxiety in mothers, let’s work to create the environment and support they need to be able to mother their babies the way they need to be mothered while also being able to be mentally well and the best way to do this is to ensure all parties work together to find a solution that fits with all of the humans involved. Controlled Crying is hopefully soon to live in the deep, dark recesses of history. Our mothers and babies deserve better.

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