A baby’s arrival often means sleep deprivation for the parents during their child’s first five years of life. Between a quarter and a third of parents report sleep problems in children under the age of five. It is one of the most frequent reasons parents consult a pediatrician.
Parents are eager to learn how to regulate their child’s sleep and how sleep affects their development. Social pressure encourages parents to look for answers to the problem of “getting a good night’s sleep” as quickly as possible – or face parental guilt!
But what does good quality sleep mean for a baby? What are the winning conditions for making the most of the benefits of sleep in a child’s development? And what are the consequences of not getting enough sleep?
The science of sleep gives us lots to think about and act on, despite ongoing debates within the scientific community and among early childhood professionals. There is a significant gap between what science knows about child development and sleep, and what is conveyed in our society. For example, the myth of sleeping through the night by a certain age creates unrealistic expectations among parents that can shake their confidence.
Catherine Lord, the co-founder and president of Immerscience, and I have created a project on sleep for children aged five and younger, called “Learning to sleep is like learning to walk.” The project aims to help parents who are caught in a whirlwind of information, intermingled with advice, testimonials and expert recommendations.
Three realities about sleep
Sleep is a pillar of health, just like healthy eating and exercise. A number of areas in a child’s development are linked to sleep, including thinking (cognitive health), interacting with others (social skills), growing (physical health), feeling emotions (mental health) and healing (immune health). Sleep and health work in tandem, while the reverse is also true: being healthy promotes good sleep quality.
Sleep development is specific to each child, just like learning to walk. Sleep needs vary with age and aren’t the same for everyone. A baby does not have the same needs for naps and night sleep as an adult.
We grow at the same speed, on average, but we don’t all develop at exactly the same pace. Like walking, sleep develops at a different pace for each child. This period is called the sleep maturation stage. Sleep quality varies greatly until the age of two. Two studies that followed babies over time found that the time it takes to fall asleep decreases during the first six months of life, and that children wake less in the night during the second year of life.
By six months of age, a child may experience variability in sleep. And up to age three, sleep varies from one child to the next. To create the winning conditions to positively influence a child’s sleeping development, the important thing to consider is not their age, but where they are in their development.
Falling asleep alone becomes possible with parental support if this is carried out one step at a time. There are a myriad of ways to raise children to support their development. The same is true for acquiring sleep autonomy, meaning a child’s ability to fall asleep and return to sleep alone with confidence.
This confidence can be acquired in different ways as long as safety is respected: with or without crying, co-sleeping or not, with the breast or the bottle, with water or milk. Sleep is regulated by biology, but also by environmental factors, such as parental practices surrounding sleep.
Two leading experts on child sleep, Avi Sadeh and Thomas Anders, have proposed a theoretical model of children’s sleep. Based on a biopsychosocial approach, their perspective takes many factors into account including those associated with the child (such as temperament), the parents (such as mental health problems) and the parent-child relationship (such as parenting styles). All of these factors influence a child’s sleep.
Sleep is embedded in a social context where parents play a crucial role in fostering sleep autonomy. An epidemiological study of preterm and full-term infants admitted to special baby care units after birth suggested that neurological immaturity is less important in the development of sleeping problems than parental behaviours.
Studies have shown that parental actions, such as staying near a preschooler until they fall asleep, can lead to more sleep problems. A review of the studies on pediatric sleep suggests that some types of interactions between parents and preschoolers at bedtime may predict sleep problems. Parents can support their child in learning to fall asleep and return to sleep on their own, as soon as the parent sees that the child is ready.
Three ways to acquire sleep autonomy
A review of the scientific research literature describes the advantages and disadvantages of different sleep intervention methods. Some are more appropriate than others, depending on the child’s age, development or the context of the child’s sleep difficulties.
Behavioural sleep intervention methods discourage parents from intervening when children wake in the night, so that the child can learn to fall asleep on their own. The three approaches — the standard “sleep extinction method” (“cry it out”), extinction with parental presence and gradual extinction technique (“camping out”) — include a pre-bedtime routine and putting the child to bed while awake. The parent leaves the child’s sleeping area so they can find sleep on their own.
Cognitive-behavioural sleep intervention methods change parents’ expectations, beliefs and perceptions about sleep. As the child gets older, additional components are added, such as relaxation techniques, thought modification related to worry and anxiety, positive imagery training and others.
Attachment-based methods are those that introduce a transitional object such as a blanket. In this category of sleep intervention methods, the key is to target “small steps” or “small goals” that are gentle and caring.
No magic method … but winning conditions
There is no magic method, but parents can develop the winning conditions for sleep autonomy. Parents must make choices based on their child’s needs, which will vary over time, and their family context. Parents must be willing to adapt their methods but also be consistent in their individual interventions. Parents must be consistent so that the child will be confident.
The key message is to have confidence in your child and in yourself. Just like walking or potty training, falling asleep alone with confidence is a step toward autonomy. Helping your child in this learning process is helping them “grow up.”
Having realistic parental expectations about sleep is crucial. As a parent it is important to keep three things in mind: that your child sleeps enough for their stage of development, that your child’s sleep develops at their own pace, which can fluctuate, and that the parent must provide favourable and safe conditions to support their child in gaining sleep autonomy.