Is "crying it out" the only way to get a baby to sleep better?

We have a mom/baby group that has been getting together since our babies were born  (they’re 8-9 months old now)  We talk about sleep all the time—the babies’ and ours.  Some of us have been trying to “be there” all the time for our babies and we’re getting pretty worn out. Now we are hearing that a new study shows that  “crying it out” doesn’t damage babies, but many of us don’t want to do that.  What’s even more confusing is that some of the babies in our group who used to sleep well are waking up more.  What should we be doing to get more rest for ourselves and our babies?

If there is anything that can get parents confused, upset, worried and exhausted it’s sleep.  The only thing that comes close is a discussion about the range of opinions out there about what parents should do about sleep!  The latest “study” published in the journal of the American Academy of Pediatrics doesn’t really help new parents because it wasn’t designed to help parents individualize an approach to sleep for their families.  The study only looked at the measurable (by a questionnaire) emotional heath of young children five years after their parents were given advice about how to manage baby’s sleep using a variation of the extinction method--which is what some parents may call “cry it out”, although that method is more extreme than most parents ever try.

Guess what?  It turns out that if you take two groups of five year olds whose parents were given different advice about sleep when they were babies, there isn’t a big difference between the groups.  Of course, the same study could have compared the groups by looking at whether the parents were given advice about feeding, choosing age appropriate toys, or whether the next sibling should be conceived within a year.  Showing that there is any connection between advice given to parents of babies and how their children behave 5 years later assumes that we have far more control over outcomes than we do.  Emotional well being of children is affected by many, many factors, and the one that sleep deprived parents should consider the most is how their own emotional well being fares if they are not well rested.

Some moms and dads can weather the ups and downs of a sleepless night with little effect on the next day.  Almost all parents can make it through a week or two of comforting a restless or sick baby during the night.  But some of us (I was this way when my children were little, and still am!) are grumpy and distracted when we don’t get enough sleep.  Our moods affect our response to our babies, and mothers and fathers who are anxious or depressed because they are exhausted or probably not creating as nurturing an environment for their babies as they would like.

An eight month old baby should be able to sleep for 11-12 hours every night.  Some babies, especially if they are breastfeeding, may need a nighttime feeding but after feeding should be able to return to sleep.  If your babies are taking hours to fall asleep, or waking repeatedly during the night to be fed or comforted, the chances are you are doing more to assist sleep than is really necessary.

Babies who take a long time to fall asleep at bedtime are often depending on a parent to soothe them into a state of deep relaxation before they can drift into a deeper sleep.  If a parent is rocking, walking, holding or feeding a baby while she falls asleep and the baby seems tired but can’t fall asleep, it’s reasonable to conclude that what the parnt is doing isn’t working well for that particular baby.  Even if bedtime falling asleep goes quickly, if the baby wakes up frequently during the night needing a parents’ comfort to fall back asleep, whatever the pattern is may not be best for that baby.  (If a baby takes a little while to soothe at bedtime but is able to sleep well for the rest of the night, that’s normal baby sleep!)

The strategy for babies with falling asleep and staying asleep difficulties is to create an environment that halps a baby to soothe herself which includes routines, a non-stimulating environment, a day/night feeding schedule, and lots of predictability.  It might also include a variation of the “extinction method” which involves gradually decreasing the amount of help a parent gives the baby when she’s falling asleep.

If some of the babies in your group are waking up more than they used to, it may be that they have entered into a new stage of development where being awake is a lot more interesting and exciting than staying asleep!  Parents of eight month olds sometimes say that their babies seem to want to interact and play during the night!  In can take a lot of fortitude to resist a baby who is smiling and interactive at 2 a.m., but unless your idea of a good night is fragmented sleep, the only solution is to keep lights out, refuse to respond to your baby’s charm or protests, and try go back to sleep youself!

Another cause of nighttime waking in eight month olds is hunger.

Babies go through growth spurts and need to nurse or eat more during the day or night to get enough calories for their extra growth.  A baby who is primarily nursing may need to have a middle of the night meal until she begins to take more solid foods during the day.  The foods have to be as high in caloric density as milk--fruits and vegetables aren’t enough.  

Meals during the day, whether milk or solids, can be challenging at this age because a baby who is busy playing all day may be too distracted to eat well. So instead of eating during the day, a baby feeds at night--and then isn’t as hungry the next day! 

There are other reasons for babies to wake up at night at this age:

A baby who is away from her mom during the day may need to nurse more during the night to fill up. A mom who misses her baby during the day may find it harder to resist feeding or playing with her baby at night.

Travel, visitors, or changes in a baby's daily routine may cause her to be a bit upset or stressed and her night waking may be a result.

A baby may wake up if she is teething or is getting sick or is at the end of an illness and has nasal or ear congestion.

A baby may react to being over stimulated during the day if you take her out  a lot during the day.

A baby will sometimes sleep less well right before going through a developmental spurt such as learning to crawl or stand.

A baby who is starting child care or who is experiencing a change in child care may have trouble sleeping at night.

If your child is experiencing any of these changes, you will have to weigh her need for comfort with her need for sleep. You may need to modify her daytime experiences before she will return to sleeping well during the night.

So before you decide what to do about “fixing” your baby’s sleep, you have to analyze why her sleep isn’t what you’d like it to be.  Is it habit? Hunger? Environment? Development?  Addressing the patterns and finding an appropriate solution will result in much better results than just assuming that your baby needs to “cry it out”.