Scientists Heather & Julie Talk Sleep
Full interview with psychotherapists about how sleep is natural & how to get a baby to sleep easily.
The full interview with Julie and Heather, authors of The Happy Sleeper, a book which guides parents through sleep supported with evidence from science. As psychotherapists, both want parents to understand that sleep is a very natural function, that comes easily to babies with a gentle helping hand.
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Julie you’re a psychotherapist specialising in babies, children and their parents. Could you explain a little bit more about what this entails and what drove you to take this path?
Julie: During my training I did an internship at a place here called Cedars-Sinai Early Childhood Centre and I was able to learn about the 0-3 year age that you don’t usually learn about when you’re studying clinical psychology. I have always loved children and had an interest in babies, so I had a unique opportunity to learn about how the brain develops, and how relationships and attachments matter during those years.Psychology is such a broad field, so being able to enter a niche in which not that many people had that level of training was exciting as it was both something I loved and was passionate about. I immersed myself in that world of early years childhood. What I learned inspired my Mommy and Me programme here in Los Angeles that implements not only sleep but also the attuned and mindful parenting approach that we love so much. Heather and I are actually working on a new book about that.
Does sleep parenting focus on mindfulness quite a lot?
J: It’s a lot to explain but there are a lot of good books about it. What our book is going to be designed to do is to give parents practical applications. A lot of times we feel like it’s those moments where parents just need some ideas, examples or some suggestions, so a real example is often really helpful.
Heather you write the Science of Kids column for Babble and you also write for the National Sleep Foundation. Science is truly the key to everything, but how does it help with general parenting? And why did you decide to take this direction?
Heather: I also studied psychotherapy like Julie, but when I had my son who’s 8 now, I just started doing lots of research and I’ve always been fascinated by the brain. I come from a family of scientists, and Julie and I have always been science minded. Learning about brain development and how relationships affect children and how their first relationships are the most important and formative was really what inspired me. So I kept on researching and writing and have been for the last eight years. With regards to sleep, it’s been such a lovely combination for Julie and me, that science really backs up what we know to be true about sleep and comes to some really wonderful conclusions. Like how sleep is really natural and actually comes very easily, it’s a basic biological function. Science can be very complicated, but in this case the essence of it comes down to it actually being quite simple, which is a beautiful thing for parents to know. I like how Science can be so high level and complex, but at the same time can give such simple and relieving truths as well.
Before writing The Happy Sleeper, did you know each other beforehand? What was the reason you decided to write a book solely dedicated to helping parents get their baby to sleep?
H: We did know each other beforehand as we had worked at the same parenting centre together. I had been writing about sleep, exploring the science of sleep and had been working with thousands of families, so we started meeting just to talk about our ideas on sleep and attachment. It took us having coffee maybe twice before we knew we’d write a book.
J: We just couldn’t stop talking! We’re kind of nerdy, so we got very in depth about science, and we just realised that we were very excited merely talking about these ideas, let alone implementing them.
H: We both really felt like there was a giant misunderstanding around sleep and attachment, which is very polarised, and we felt like there was another way to look at it, which we were really passionate about. So we started writing.
You both have a lot of experience in the field of not only parenting, but in particular sleep and how to make sure babies sleep well at night. Your book focuses on providing a nurturing but also structured approach to guiding a baby to sleep. Also known as the fading technique, what is the main philosophy behind it?
J: The main way of thinking is that we start from the point that babies are built to sleep and that sleep is very natural. It’s actually very primitive and our sleep centres are in the stem of our brain so they’re very strong and very natural. The main idea of chapter 3 in our book (for babies 0-4 months) has to do with helping parents know during those early months that babies do need help soothing. We also give them strategies in this chapter about how to step back just a little bit so that babies can show them their emerging self soothing capacities. Once a baby is at least 5 months, and some babies are ready earlier, we really want to hand over the role of self soothing to them, because developmentally and scientifically we know that they’re ready.
The main philosophy that we want to face head on is that healthy attachment & healthy sleep are natural partners, they’re not antithetical to each other at all. Being an attuned parent, means being attuned to when your baby needs you but also being attuned to when your baby doesn’t need you, and that way of thinking applies to all moments of parenting. Sleep is an especially delicate and fragile time. Parents often get caught up over-helping babies to sleep, during a period where a child should be developing otherwise it masks their capabilities and you end up with a 5-6 month who’s being rocked, bounced or fed all the way to sleep, every single time. It means that a baby never has the chance to practice his or her abilities, and we find that once we take over during sleep consults, baby will be falling asleep on his or her own within a few nights.
The other thing about our technique, which seems like a small difference, but we feel strongly that it’s not just a small difference, is that our approach is not exactly a fading technique. When we have a baby that’s crying we have parents check on them every five minutes and that amount of time never changes. We call the technique the ‘sleep wave’ and the reason is that it’s really designed to give the baby a feeling of a wave – it’s very rhythmic, predictable, almost hypnotic. We want to set a pattern that the baby absolutely knows, recognises and comes to trust. We never want them to wonder where the parent is as they begin to get worried. That difference is difficult for parents to grasp as they often say: “If I go in every five minutes, my baby gets madder and it doesn’t work.” So we’ve learned to say yes that’s exactly what they do in the beginning, but once you’ve laid down a really predictable pattern, eventually the baby starts to realise.
Do parents find it overwhelmingly difficult to accept that babies need to sooth themselves? Or do the waves comfort them in that regard?
H: When we do sleep consultations in the house, we demonstrate what it looks like – or if we’re on Skype we talk them through and we use a certain voice and a certain predictability. We want parents to have a very confident tone, we want them to send their baby the message that they believe in them. We’re demonstrating to them that we always want the baby to know that mum or dad are there and have a really predictable and reliable response. We don’t want to confuse the baby or interrupt their self soothing process.
J: It’s hard as the biggest problem for parents is they feel guilty and they’re not sure it’s the right thing to do, so coaching them and really explaining to them that doing it in a really clear way to baby is actually easier for them. If you blur the lines, the baby is confused and they don’t know if they should reach out or do their own thing, so we’ve learned over the years about what makes it work very efficiently and very intelligently.
I guess it’s a bit of both – what baby needs and what the parents need as well. What makes this way of helping babies sleep different from other techniques such as ‘crying it out’ and ‘no tears’?
J: The sad news is that closing the door and not going in works. That’s really the main reason why we wrote the book, because in our Mommy and Me classes we would encourage soothing, responding and helping, but many parents found that their baby’s sleep was getting worse instead of better. They would have reached a point of desperation, gone to their paediatrician and been told to close the door and not go in. We wouldn’t want to shame this mum, but they would tell the class how well it worked and we didn’t want to come across as if we condoned this type of parenting. So we decided we needed to solve this dilemma in an intelligent, scientific and appropriate way that satisfies both secure attachment and baby’s sleep, which is what we feel differentiates our book. In our experience the no-cry technique is very similar to our 0-4month chapter and those kinds of techniques work very well for young babies. For a baby 5months or older, those same techniques don’t work very well.
At what stage in a baby’s life do most parents come to you for sleep help?
H: Most people come to us when they’re desperate and past the point of using the 0-4month strategies. The brain and personality of a 0-4month baby compared to a baby in the last 6 months of the year is so different that varying techniques need to be used. An older baby is far too smart, reliant and aware of knowing who’s doing what for earlier strategies to work and it tends to make them angrier and more confused. Most people come to us for help with a baby that’s 5months or older, and we go straight to using techniques suitable for that age.
I think the other thing is that when parents and babies are sleeping well it really supports the attachment relationship & the way they enjoy each other, which is so important.
J: The most common outcome is how surprised the parents are. Even if you have a 5 or 6 month who’s in the parents bed or still being swaddled, we’re going to change everything. We’re going to move them to the crib and we’re going to do this within 2-4 nights. Even difficult babies are able to do it – it’s shocking how ready they are to sleep and how much they’re able to shift very quickly.
It’s amazing how adaptable they are and it must be so relieving for parents to realise that there is a solution to the problem, and it’s not going to last forever. We know that a lot of parents are just tired of feeling tired, so it’s nice to have that reassurance.
J: Parents have never been as tired as they seem to be now. Since the back to sleep campaign, where babies have to be put to sleep on their backs, sleeping has become more of a challenge. We tell parents that it’s not just about getting good sleep (which is obviously important for the baby & the parent) but it’s also about children having access to the developmental abilities that they’re capable of. Whether it’s walking or putting a puzzle piece in place, we want them to sleep as it’s something they can do and we want them to do.
Sleep is an important aspect to everyone’s daily lives, but especially babies as it’s essential to development, as you mentioned. How exactly does sleeping through the night undisturbed benefit them and help them with their development?
H: There’s so many functions that sleep has; it’s how you consolidate information and memories that you have from the day, and that’s why babies sleep so much, because they’re learning so much. They need 11 hours of night time sleep and regular naps to transfer information from short term to long term memory and consolidate their learning. It’s important for emotional regulation, so babies that don’t sleep enough are more emotionally fragile and fussy. It helps with the immune system – if you don’t have a certain amount of sleep then the immune system doesn’t function how it should, meaning people who don’t sleep enough are more prone to getting sick. The other thing is that when parents and babies are sleeping well it supports the attachment relationship and the way they enjoy each other, which is so important.
If they’re not tired all the time then they both have more time to bond with one another and in a happy way. Do you feel like when they are both sleeping well the bond between, whether it’s mum or dad, will become stronger with the child?
H: I think their outlook will become more positive. They have a lighter feeling about enjoying their days, and more humour and just more enjoyment of the moment to moment.
J: Parents that are sleep deprived, all they think about is sleep and they have so much dread and anxiety, and their days are just these groundhog days thinking about how they’re going to get their baby to sleep. Sleep deprivation is not to be taken lightly, it’s terrible. It’s one thing to have it go on for 3 or 4 months but if it goes on beyond that, then it’s really a problem and absolutely affects a parents ability to be present, attuned and loving during the day.
It often affects the relationships between parents as well. When we do consults in the home, we try to get both parents there and sometimes we use our therapy skills to help them support each other and give them a third party way to take the arguing and second guessing out of the equation, which is huge.
Many parents seem to struggle with maintaining a sleep routine and implementing ways to help their newborn to sleep through the night. What tips would you give to new parents to help their child get to sleep?
J: It’s very age dependent. For 0-4month you definitely want to attend to them, and we want you to help them to sleep well. Depending on how much help baby needs with rocking, bouncing and moving, you also need to think about starting to give baby a little bit more space. We want you to be helpful, but not over-help so in addition to creating the right environment and timing, you also need to understand your baby’s sounds. Little newborn babies make a lot more noise than parents were expecting so it’s really common for parents to go running in at the first sound of fuss. You need to just wait because babies didn’t get the memo that when you’re in bed you’re supposed to be quiet, so they’re usually just resettling or trying to figure things out, and we don’t want to interrupt that. So really listen’ are they crying or is it something else?
If you wait, they may resettle and even if they don’t you’re giving them space to do it in future. It might be the next day, week or even two weeks, but by giving them a cushion of space from not rushing in and just listening to their sounds, you’re allowing them to resettle themselves. However, we don’t want to let a young baby from 0-5months cry for more than a minute, but you can wait 30-45 seconds if they start crying. Some babies cry just to release stress and as soon as they’ve had that little moment that will go to sleep. So having a bit of a curious stance is really, really helpful.
H: We also like parents to practice putting baby down awake, in other words, knowing that’s it’s time for sleeping. Babies can be awake for an hour to an hour and a half during the day, so knowing that they’re getting to the point of needing sleep & them down in their regular sleeping spot awake is a really good habit to get into. Eventually they will fall asleep on their own, but you don’t know until you try. Another thing is some parents often keep their babies awake too late at night. By 2months babies are programmed to sleep with the sunset, so quite early. Putting them down following these guidelines will help them to sleep.
J: 7pm seems to be the magical hour, but a lot of parents are keeping their babies up until 9-10pm at night. If we look at a baby who goes to sleep at this time, we see that they’re chronically sleep deprived. So if they’re sleeping a full night, they’re going to be more regulated and organised, and they’re going to be much better at going in and out of sleep on their own without help.
What would you advise parents to avoid?
H: Letting them just cry it out – we never want parent to feel like that’s the only option left and that they’re just going to have to leave their baby and not respond. Avoid weaning feedings and cutting out feedings completely. There’s some techniques that suggest taking away feedings at night, but we always advise parents to wait a certain amount of time, usually until baby is 5months, before even thinking about messing with night time feedings. Even when you’re going to wean them, it needs to be really, really gradually and our book has a very specific and gradual weaning guidelines. Also avoid repeating the same habits over and over again without giving baby any space to practice.
Finally, if you were going to give one piece of advice to parents-to-be and new parents that are becoming anxious with getting a baby to sleep, what would it be?
J: Really believe that your baby is built to sleep and that sleep is a natural function. Give them credit for what they’re capable of doing. It really helps to understand that this isn’t a high-level prefrontal cortex function, it’s almost like breathing and swallowing. Heather and I stay away from the word ‘sleep training’, because it doesn’t fit in with this way of thinking that sleep is a natural function. I can’t train you to swallow, breathe or fall asleep because at that moment when you’re trying to fall asleep, are you doing anything? No, you’re not. You’re trying to let go and relax and you have to let your body do what it does. it’s fascinating to think about. Helpful sleep association means you can help your baby with the environment, with timing and making sure they have everything they need. Unhelpful sleep association, which is where you’re rocking, nursing or bouncing them all the way to sleep when they’re capable of self soothing, is the biggest reason that sleep doesn’t go well.
TIP: What to wear to bed?
H: Many parents overdress their babies for sleep, so we usually encourage them to back off a little on the layers and turn down the heat as well. I think there’s a misconception that more heat is good for sleep but science tells us that cooler temperatures help with sleep. Also for safety reasons, you shouldn’t overdress them. When they’re learning to self soothe, it’s important that they have space like in your Clever Sleeping Bag there’s plenty of space for them to have one leg over here and have their legs up or be able to roll to their backs. If they’re stuck in something too confining, they can’t roll and get comfortable. So being able to move & get cool are the main to things to remember when dressing for bed.
J: Swaddling is definitely a plus for most tiny babies, as they like to secure and stay on their back, so we do believe in swaddling, but once a baby can roll and move – that’s when we really like them to have freedom to move.