Read an Excerpt
Sleep, Not Stimulation
A New View
Who doesn't love a sleeping baby? The sight of a baby, swaddled in a soft blanket, cheeks slightly flushed with sleep, touches us deeply. The baby's complete surrender to sleep reminds us of human vulnerability and tenderness. Our innermost desires to nurture and provide are aroused. In the presence of such innocence, we feel both humbled and strengthened by our duty as adult protectors.
As individuals, we appreciate a baby's sleep, but as a culture, we're having trouble getting our babies to sleep well. Sleep difficulties in children are at an all-time high. My experience with new parents strongly suggests widespread, chronic sleep deprivation in babies. Parents who come to my classes describe babies who sleep only twelve or even ten hours a day (far short of the recommended time, which is around sixteen or more hours daily for newborns; see chart below and on page 12. Other parents have babies who spend hours sobbing in their arms before finally nodding off for a short, restless nap. I see babies rubbing their eyes on their mothers' shoulders--even rubbing their eyes on the carpet if they're lying on the floor--while the exhausted parent shakes a brightly colored toy in front of the child and explains, "My baby never seems sleepy!" Many of these parents are unaware that their children are sleep deprived.
In 2005, the National Sleep Foundation (NSF) commissioned a nationwide survey of the sleep habits and behaviors of children younger than four years old. Sleep needs vary across the first year, but according to the NSF's pediatric task force, most babies past the Baby's Sleep Distribution* newborn stage need somewherebetween thirteen and fifteen hours of sleep in a 24hour period. And that's just a minimum. Some babies thrive on sixteen hours per day, or even more. But according to the NSF study, about half of the nation's babies log only twelve hours or fewer daily. That's a serious problem: A sixmonth- old baby who sleeps twelve hours a day will suffer a cumulative sleep loss of hundreds of hours by the end of his first year of life! The study also showed that days mos mos mos yrs although parents wish their kids could Newborn Infants get more sleep, these parents don't realize *For more information, see the chart on page 12. their kids actually need to sleep more.
A Sleep-Deprived Generation
Why are our babies missing out on so much sleep? Do parents want to deprive their children of a basic biological need? Of course not. Like the generations of parents before us, we want to give our babies everything they need and then some. As expectant parents, we may try even harder than our own parents did to prepare for our new job: We take classes or read books about breastfeeding, child- proofing, infant cardiopulmonary resuscitation (CPR), and making baby food at home. Yet there are few opportunities to educate ourselves about an infant's sleep. As a society, we tend to assume sleep will take care of itself--or, at least, that there's little we can do to encourage good sleep in our babies or to prevent sleep problems from starting. There's also a widespread belief that the only way to help a baby sleep is to wait until she is six months old and then let her "cry it out" until she learns to sleep on her own and through the night. Many parents are uncomfortable with this approa that the six-month milestone can seem awfully distant when your ten-week-old is taking only a few catnaps a day and wakes every hour at night. In fact, there are several steps--most of them very gentle--you can take to promote good sleep habits. It's great if you can start from birth, but you can also implement these steps anytime in the first year to improve your baby's sleep. That's what this book is all about.
But all the sleep science in the world won't make a difference in your baby's sleep habits unless you are committed to helping your baby get the best sleep possible. My program isn't hard to follow, but if you want good results, you'll have to make your child's sleep a priority. For starters, you may need to change your own attitudes toward sleep. Unfortunately, mild sleep deprivation is a way of life for many of us; according to a 2002 NSF study, American adults sleep an average of just 6.9 hours nightly. That's down from nine hours at the beginning at the twentieth century. We are cavalier about our own sleep needs, and some of us may even brag about how little sleep we get at night. In this way, we are poor role models for our children.
Even if you have always tried to get sufficient sleep yourself, you probably experience plenty of social pressure to keep your baby awake. In a culture that downplays the importance of sleep for adults, the attitude toward babies' sleep is affected as well. One mother I know recalls excusing herself and her nine-month-old from a playgroup so the baby could take a morning nap. "My baby gave up her morning nap months ago," crowed another parent in the group. "She's too bright and curious to lie down and go to sleep in the middle of the day. The mother of the napping baby told me, "It made me feel like my child was less intelligent because she needed to sleep." Another mother talks about how the parents in her neighborhood laugh when she puts her baby down for sleep at 7 o'clock in the evening: "When I was growing up, all the kids, not just the babies, went to bed early. Now people think you're a rigid control freak if you don't let your baby stay up late and go out with you to restaurants and friends' houses." On popular television shows, babies don't change the lives of the adult characters; instead, they are simply integrated into their parents' social schedules as cute companions. The message is clear: Sleep is for the slow, the unhip, and the old-fashioned.
In general, we've fallen for the belief that activity is more important than sleep, no matter what a person's age. Activity--and only activity-- is supposedly what makes us smart, productive, and fully engaged with life. In the last decade or so, many parents have been taught that babies in particular need constant stimulation if their growing brains are to be properly developed. New mothers and fathers feel compelled to add several items to their to-do lists: Engage the baby with toys that blink, whir, and whistle; take the baby to "Mommy and Me" music, yoga, or other classes; watch so-called educational television shows or DVDs with the baby; and so much more.
Taking care of an infant is a joy. It is also one of the most physically and mentally demanding jobs a person can undertake. Parents nevertheless push themselves to achieve all the items on their list because they believe that the more stimulation they provide, the more effectively they promote their baby's brain development.
Let's look at the evidence for stimulation and the ability to improve cognitive development. Much of this evidence comes from studies on laboratory rats. Up until the 1960s, it was standard practice for lab rats to be placed three to a cage, with no toys or objects to explore. Then it was discovered that when researchers added two or three additional rat "friends," along with five or six toys, such as wheels or ladders, the rats developed brains with nerve cells that had a more complex pattern of connections. This finding was a huge breakthrough for neuroscience because it showed for the first time that brains can change in response to their environment.
Although all of us--babies and children and parents and grandparents-- need challenges and changes to keep our brains growing, it's important not to exaggerate these findings. Many people--including the folks at companies that manufacture infant toys--have interpreted these and other studies to mean that developing brains need a continual bombardment of colors, music, and extravagant playthings. Let's remember that the rats were given a few friends and a couple of sturdy toys to share. We're not talking about a rat Disneyland here. It's vital to have some colorful, safe toys for your baby and to provide stimulation by holding her, playing with her, and talking and singing to her. But we have no proof that structured activities, specialized toys, DVDs, or flashcards lead to improved cognition or better school performance down the road. In fact, too much stimulation can have the opposite effect because it can cut into crucial sleep time for your baby.
Sleeping Brain, Active Brain misperception that sleep is a sign of laziness or weakness is understandable. Sleep looks and feels an awful lot like a state we enter when we're too tired to continue our productive work and need to shut down. When we sleep, we are relatively still, and our faces tend to adopt a slack, unthinking expression. Our ability to perceive the world-- to hear, feel, and see--is compromised. But in this quiet phase, the body and brain aren't taking a vacation, not at all. Although at present no one can say exactly why we sleep, it's clear that several vital functions are regulated during the sleep state. We know this because of the grave consequences of missing out on sleep. A 2006 Institute of Medicine report stated that sleep deprivation in adults is linked to an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. Scientists at the University of Chicago have shown that after just eleven days of sleep restriction, healthy young men develop prediabetic symptoms and produce lower levels of human growth hormone. Other scientists are investigating a connection between sleep loss and poor immune function.
And it's during sleep that the brain has an opportunity for some of its most efficient work. The brain processes information during sleep. It uses sleep time to encode and consolidate what we learned during the day, which may be why our minds feel so sharp and uncluttered after a good night's rest. It's as if all the information from the day has been filed away in its proper place, where it can be retrieved and used to its best purpose. Without sleep, the brain is more like a messy desk full of teetering stacks of papers--it's harder to remember where the most important information is, much less apply that information at the right time.
In a 2002 study of sleep and learning by Harvard researchers Robert Stickgold and Matthew Walker, right-handed students were taught to use their left hands to tap out a complex series of numbers on a keyboard. After a training session, the students increased their speed at the task by about 60 percent. But were they able to improve their performance any further? When the group was tested later that day, the students did not show any improvement. But after going home for a good night's sleep and returning the next morning, the students' speed increased by another 20 percent--even though they had not practiced at all. These and several other findings suggest it's not just stimulation that's important for learning, it's the sleep we get after stimulation. These studies also offer a reason why babies sleep so many hours out of each day. According to Dr. Walker, "Their intensity of learning may drive the brain's hunger for large amounts of sleep."
Sleep may also help babies develop abstract thinking, one of the highest levels of thought. In a study at the University of Arizona, researchers played a recording of short phrases from an artificial language to a group of fifteen-month-olds. The language was built on word relationships that are similar to those in English. They played the phrases repeatedly until the babies grew familiar with the sounds. Afterward, some of the babies took naps at their regular times; the others were not scheduled for naps and stayed awake. Four hours later, the researchers played the recordings again. They also played new recordings, using the same artificial language but with ne relationships between the first and last words in each phrase. Using a well-established technique for studying infants, the scientists tracked the babies' ability to recognize the sounds by carefully examining their gaze. Both groups of babies were able to recognize the familiar recording--but the babies who had taken naps were better able to take their knowledge of the first recording and use it to help them recognize new patterns in the second.
One of the most compelling arguments for sleep and its connection to learning is a very simple one: It's harder to pay attention or even to care about new information when we're tired. Neuroimaging studies show that the brain has to recruit additional resources and is less efficient when it's sleepy. Tired people are less vigilant, less flexible in their thinking, and less able to solve complex problems, probably because they suffer from apathy toward the task at hand. You've probably had the experience of losing items when you're tired--a classic sign of attention loss--or feeling that you need to summon up reserves of energy just to get simple tasks done. And under those circumstances, who learns well or enjoys life? Although no one has studied the consequences of sleep loss on a baby's attention span directly, I've seen far too many sleep-deprived babies who are unable to focus their attention and take an interest in their world. Sleep helps your baby take more pleasure in her time awake and engage with her environment.
Your baby's first year is a critical period when learning occurs at a faster rate than at any other time of life. New babies must learn how to control their limbs, decipher sounds and sights, identify signifi people, take in nourishment, and eventually communicate with others and manipulate their surroundings. This is a time when, yes, you want to provide your baby with a loving and reasonably stimulating environment--and when you should let her get all the sleep she can, so her developing brain can sort through new information and file away memories of what she's recently learned.
More Sleep Means Less Fussing
There are other reasons to encourage a baby's sleep. One of them is that sleep reduces the mysterious fussing and wailing that send new parents into a panic. Why do babies cry when they're sleepy? Think of it this way. Most of us adults know what it feels like to be sleep deprived. We become irritable, short tempered, impatient, and jumpy. Our tempers are quick to flare and our tears to flow. As the sleepiness accumulates, we may experience the paradox of being so tired we cannot sleep, and it becomes increasingly difficult to calm ourselves.
In this respect, babies are a lot like us. When tired, babies are tearful, edgy, and harder to engage. I've seen many chronically tired babies mislabeled as temperamentally "fussy," "high need," "clingy," or "difficult." Without a well-rested baby for comparison, parents don't realize their babies would be sweeter, more playful, and more fun if they simply had some sleep. Parents may come to expect and tolerate their child's problematic behavior, not realizing they are perpetuating a situation that can be easily reversed with proper sleep management. I once worked with a couple whose eleven-month-old child was difficult to deal with on a frequent, daily basis. They had long ago come to regard her as cranky by nature. Once they my instructions, the child began sleeping solidly and for longer periods of time. When awake, she was calmer and more flexible. The difference was so dramatic that the child's father jokingly asked his wife, "Do we have a different daughter?" No, just one who was finally getting the sleep she needed.
Furthermore, it's hard on everyone when a baby is chronically irritable. A baby's seemingly endless fussiness can stress the bond between parents and child. A Canadian study of nearly five hundred mothers showed that moms score lower on vitality tests when their babies rarely seem content and have no regular sleep or feeding times. When mothers are able to predict when their babies will become sleepy, they are less stressed and have more energy to enjoy their babies.
As well-rested babies grow into kids who understand how to sleep well, they have a better chance of developing the emotional control that is linked to sufficient sleep. Kids who get enough sleep are more likely to control their impulses, develop empathy, learn the consequences of their actions, and comfort themselves. It's much harder to set limits with sleep-deprived babies who grow into sleep-deprived big kids. These kids aren't bad kids by nature; instead, they are too tired to control their emotions or focus their attention.
Good Sleep Now Leads to Good Sleep Later
Think back to a more carefree time in your life when you could stay up late on weeknights and then crash for a deliciously long nap on Saturday afternoon. You were taking advantage of your freedom, as well as your body's ability to recover from sleep deprivation. When adults deprive themselves of rest, they can usually compensate with sleep, in which the slow-wave restorative sleep stages are especially deep.
Babies can't do this. Their brains just aren't capable of recovery sleep yet. Just as visual systems, language, and emotional skills are still being formed in the first year of life, a baby's system of sleep need regulation is also under construction. In other words, their brains have to learn how to sleep. Babies aren't born knowing what it means to feel sleepy, how to fall asleep, or how and when to wake up. When babies are allowed all the sleep they need, eventually they learn what good sleep feels like--and they're more likely to sleep well as older children and adults.
If sleep loss goes on for long periods of time, babies start to act like nursing home or intensive care patients, who suffer from alertness that feels more like sleep and sleep that's less satisfying. The line between sleeping and waking becomes fuzzy. These babies have poor-quality shallow sleep and are easily awakened. They are also more likely to fight and cry at bedtime because they can't tell when they're sleepy--and because they don't get a positive bounce in the morning from having slept well. Sadly, these babies are at risk for growing into sleep-deprived children and adolescents. You might hear that your baby will simply "grow out of" her sleep problem, but several studies have shown that unresolved sleep problems tend to last well into childhood and perhaps beyond.
That's a scenario you really want to avoid, because there are strong links between sleep loss and serious childhood problems such as attention-deficit/hyperactivity disorder, weight gain, frequent injury and illness, and even growth problems. Sleep strongly connected with a child's ability to do well in school. A 2005 study in the journal Sleep shows that when children are sleep deprived, their teachers are much more likely to describe them as forgetful, inattentive, and slower to understand new information. As kids get older, the stakes get higher: Preadolescents with sleep problems are more likely to be held back at the end of the school year. Well-rested children, however, are at an advantage. Study after study shows that kids who sleep well get higher grades and score higher on cognitive tests. In fact, being well rested is a primary predictor of good school performance. No matter what your educational background, family situation, income, or social status, good sleep is an academic edge you can give your child.
Take a Stand for Sleep
Whenever you feel the pressure to skip your baby's naps in favor of supposedly educational experiences, remember this: The whole world is new to your baby, and she gets plenty of education just by looking at her hands, hearing your voice, playing with safe and simple toys or household objects, or smelling dinner as it cooks. What your baby's brain needs is Sleep helps a sleep, and as much sleep as possible, baby understand to process this information, remem what new experiences mean to her and ber it, and integrate it with what she then convert this already knows. Sleep helps a baby understanding into understand what these new experi permanent learning. ences mean to her and then convert this understanding into permanent learning. She doesn't need more stimulation in the form of gimmicks or classes, especially if these experiences deprive her of slumber or if they distract you fr perceiving signs that she is sleepy.
Now you've got plenty of reasons to stand strong against the cultural pressures that downplay sleep and its importance. Next, let's look at a baby's sleep rhythms and how you can use them to improve your child's sleep.
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