#3 - Does Your Baby Have a Sleep Problem?
“Babies don’t have sleep problems!”, exclaimed one angry lady from the online mother's forum.
"Its normal for babies to wake during the night!", fired another one.
"It's a right of passage!", chipped in another.
Ok. There is a context for these comments directed at me back in 2008, as people don't randomly go attacking others. They react. And these mums - as well as a host of others, had a real crack at me.
But babies don't have sleep problems? I was surprised, even stunned at this comment. I had seen many parents at their wits end because their baby was not sleeping well. Furthermore, I'd read a fair bit of literature on the subject.
And here’s why I learned a baby can have a sleep problem.
In clinical psychology, we’re basically told a problem exists if there is a significant consequence. Below are the types of consequences that can result from a baby not sleeping well - and this is on the assumption that the parent or parents are not sleeping well either.
In respect for those who have suffered greatly, I’m not going to soften this, as their reality has been one we all do not wish to live. So I'm starting with the harshest consequence of all.
Mortality
When teaching cognitive therapy to clients, we not only inform them of the probability of something bad happening, but also how bad is the consequence if it does occur. At this point I’ll quote my Nonna - “My mother use to say anything can be fixed, except death”.
I’ve learned babies have died because they haven’t slept well, and thus this sleeplessness has in turn affected their caregiver(s).
That is, ‘filicide’ was a new word I unfortunately learned. It’s when a parent kills their infant. And there is documented evidence of this happening when a parent hasn’t slept well because their infant has a sleep problem.
But there are also indirect ways this occurs. Many parents in Westernised countries are educated not to bed-share with their infant, but many will in desperation because they're exhausted, they’ve tried so many different techniques, and the only one that provides some relief is co-sleeping with their infant in the parental bed.
Unlike other cultures where it is common practice for parents to sleep with their infant, there are risk factors for the infant being smothered by a parent from a Westernised culture. They include: a higher BMI and softer bedding. Other risk factors include whether the parent drinks alcohol, smokes, or is very sleepy. I need to state the obvious that the latter factor is prevalent.
So unfortunately there are far too many infants who have been accidentally smothered by their parents when co-sleeping in a bed, whether in my home town, or in Milwaukee (see the controversial bus stop posters, below, advocated by Milwaukee's lawyer), and some parents have even been jailed for this (e.g., in the USA ... and not just one, but many). And with more babies dying of sleep-related factors than drowning, chances are more will follow.
For these reasons alone, a baby can have a sleep problem. Although the probability of this occurring is low, the consequence is the pinnacle of all negative consequences.
Thoughts of Harming the Child
It’s been documented that parents with depression may have an increase in thoughts of harming their child. No one really talks about this in the open, but there are many sleep-deprived parents that have voiced to me these fleeting thoughts that dart through their minds, usually in the deep depths of the night, when they’re beyond tired. But humanity quickly takes over, the guilt enters, and the action does not occur. Unfortunately we’ve learned that poor sleep can reduce our ability to inhibit our actions - and as you'll see from the next section, parents who don't sleep well . So even these unobservable thoughts would be considered serious enough to warrant the notion that a baby can have a sleep problem.
Depression
Research has reliably shown that if an infant has a persistent sleep problem that there is a 2-fold increase in the chance that a mum will develop depression. Depression is very hard to treat, in terms of the time it takes and thus the cost - not to mention the toll it has on the individual and their loved ones. If a major cause is an infant sleeping so poorly it affects the mum’s sleep, and meta-analyses show adult sleep problems lead to the later development of depression, it suggests to me that putting up with a baby who wakes often and for longs periods during the night is not ‘a right of passage’. This is a preventable and treatable scenario.
And everything else...
When a baby wakes often and/or for long periods during the night, the parent inevitably is intermittently awake during the night. This means the parent is getting less sleep than they need and the quality of the sleep is poor because it’s fragmented. All the studies over the previous decades have shown if adults don’t get enough sleep then just about every aspect of their functioning suffers. The findings from Prof David Dinges lab experiments are often cited in these cases. Yet his participants did not undergo chronic sleep disruption for weeks and months on end.
It follows that if one is sleep deprived then daytime sleepiness rises. The person carries around a constant ‘fog’ that obscures everything they do - like the dad I saw a couple of years ago whose work place is on top of domestic houses - one of which he fell off.
Need I say more?
Conclusion
Every time I hear someone claim “babies do not have sleep problems”, I think of:
the dad who almost killed himself falling off the roof of a house
the mum crying on the phone because it’s too much having a baby waking so much during the night
the mum who desperately sought sleep from various services but in the end killed her own baby
the coroner’s report describing the deaths of 5 infants who were accidentally smothered by their parent whilst co-sleeping
and aside from these cases, the body of research showing millions of people around the world carry the negative consequences of sleep loss with them on a daily basis.
The morale of the story?
When a ‘textbook’ mum says “I think my baby has a sleep problem" - remember - we’re born with 2 ears and 1 mouth. Whether you’re the other parent, a friend, or a health professional ...
Listen!