Good night? Good luck

Parents wage midnight struggles with sleepless babies and daytime battles with an overabundance of advice

November 17, 2005|By KATE SHATZKIN | KATE SHATZKIN,SUN REPORTER

Getting a baby to sleep these days is enough to make his mom and dad cry all night.

Faced with sleep-deprived couples at each other's throats in the wee hours, three major sleep experts and the leading organization of pediatricians are tweaking their prescriptions for infant sleep. But their wide range of advice might confuse parents more than ever.

Should they let the baby cry it out alone? Take him on 2 a.m. car rides? Nurse him no matter what the hour?

"It's already a tense situation because you're exhausted all the time," said Michele Mulligan of Towson, who had to negotiate with her husband, Kevin, on how long they would let their daughter, now 23 months old, cry at night.

"So if you don't decide ahead of time what you're going to do, if you're in the moment and you're trying to figure out what to do, that's really, really stressful."

Dr. Richard Ferber, known as the father of the "controlled crying" method, will de-emphasize that strategy in a future version of his book. Dr. Marc Weissbluth, who has advocated the even harsher "extinction" technique, now focuses more on preventing sleep problems for harried parents whose work schedules keep them from putting babies to bed at the right times.

At the opposite end of the advice spectrum, Dr. William Sears, the guru of "attachment parenting" - a philosophy in which parents stay close to their children, sleeping with them and breastfeeding on demand - offers tips in his new sleep book for mothers who are exhausted from responding to a baby at all hours.

Last month, the American Academy of Pediatrics recommended that parents offer babies pacifiers at bedtime to reduce the risk of sudden infant death syndrome, or SIDS - raising eyebrows from those who worry about giving their babies a "sleep crutch" that will keep them from settling down for the night on their own.

The shifting advice is part science, part reality check: As researchers learn more about the harm of sleep deprivation for people of every age, doctors and a growing number of parent coaches see exhausted mothers and fathers arguing over what to do when the baby wails in the middle of the night.

"Ferber's method ignored what I think parents are going through today, which is separation during the day and wanting closeness at night," said Dr. T. Berry Brazelton, the eminent Harvard Medical School pediatrician.

Add to that the fact that today's generation of parents is already particularly sleep-deprived. This year, the nonprofit National Sleep Foundation released a poll reporting that Americans sleep almost two fewer hours a night than Americans of 40 years ago.

In his book Sleep: The Brazelton Way (Perseus Books Group, 2003, $9.95), Brazelton tells parents to show children as young as 4 months that they can sleep on their own by sitting beside them and softly telling them so.

"I'd go to him and say, `You can do it. I'll sit here until you can do it,'" Brazelton said. "`I'll be here, but I can't take you out [of the crib].' Each time, you gradually, gradually teach them they can manage for themselves."

Dr. Alice Tanner, a Glen Burnie pediatrician who has practiced for 20 years, gives similar guidance.

"My advice on sleep totally changed after I had children," said Tanner, whose children are now 9 and 12. "I used to think you never picked up a baby in the middle of the night. I've become more tolerant of comforting the baby and making sure the baby's needs are met."

All of this leaves parents in something of a daze.

"It is all too much," said Debbie Steinig of Guilford, 33, who tried several ways to get her 2-year-old daughter, Talia, to sleep through the night. "On the night she doesn't sleep well ... it doesn't help that you have read 800 books that all say that if your baby isn't sleeping well, it is your fault."

Ferber's 1985 book, Solve Your Child's Sleep Problems (Fireside, $14), outlines a method in which parents leave infants alone in their cribs, drowsy but awake. If they cry, the parents are to wait progressively longer intervals - in the beginning, just a few minutes - before comforting the child, until he learns to fall asleep himself.

But in the middle of the night, that's easier said than done.

Mulligan's daughter Maya, for example, seemed to get angrier the more her parents came in when she was crying, so they tried letting her go "cold turkey." But Mulligan, 36, said her husband, a software developer who had to work in the morning, wanted to stop the crying by bringing the girl into their bed. They compromised by putting a time limit on Maya's crying. Eventually, she learned to get to sleep.

Kim West, an Annapolis social worker known as "the Sleep Lady" who works with parents on sleep issues, says it's crucial for couples to agree on their approach during the daytime.

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