Sleep and Attachment

Night waking in babies serves many healthy and protective functions. It allows frequent feeding and the intake of needed nutrition for growth; it creates the opportunity for emotional reconnection and stimulation of optimal brain development; and it is potentially protective against SIDS, allowing babies to avoid long periods of time in deep sleep that can leave them vulnerable.

Babies are unable to make sense of a caregiver who is attentive at certain times of the day but unresponsive at nap and sleep times. Regardless of which sleeping arrangement one chooses, it is vital to understand the importance of responsiveness to a baby’s cues and needs no matter what time of day or night.

Adequate sleep is a basic requirement of good health for all people. However, sleep requirements vary from person to person and change with age, stage and life events.

Babies have sleep needs that are quite distinct from those of adults. They have shorter sleep cycles, spend much more time in REM (also called dreaming sleep), and don’t establish a circadian rhythm (doing the majority of their sleeping at night) until about 3 months of age. Sleep researchers note that the human sleep mechanism is not completely formed until five years of age and night waking is the norm in babies and young children.

Because western culture values independence and self-reliance, we often look to foster these traits in our children. In our society, a baby who sleeps through the night is regarded as achieving the ideal. However, what seems best for the adults in the family may not be best for baby. Night waking in babies serves many healthy and protective functions. It allows frequent feeding and the intake of needed nutrition for growth; it creates the opportunity for emotional reconnection and stimulation of optimal brain development; and it is potentially protective against SIDS, allowing babies to avoid long periods of time in deep sleep that can leave them vulnerable.

Consistent with our cultural preference for early independence, it is very common for parents in our society to have concerns about their infant’s sleep. Most often parents report problems with settling their baby to sleep or with night waking. In most cases, sleep patterns that parents consider problematic are simply part of the normal range of baby sleep behaviour. In rare cases however, unusually disturbed sleep may result from physical discomfort or be associated with stresses in the family. In these cases, the sleep problem can be addressed by identifying and addressing the underlying issue, possibly in consultation with an appropriate health professional.

Every time babies fall asleep they are faced with the job of temporarily being out of contact with the presence and security of their caregiver. For this reason going to sleep is often an experience of separation that can produce stress and anxiety if not handled sensitively.

Sleep Training

The use of sleep training techniques such as controlled crying, where the baby is left to cry for increasing periods of time until he goes to sleep alone, is a common practice in our world today. These methods, which rely upon babies to ‘self-soothe’ in order to fall asleep and stay asleep, are risky and potentially harmful to babies as well as to the bonding process between baby and caregiver.

Babies are not born with an ability to independently regulate their physiological or emotional states. We are all familiar with the need to place a newborn baby on mother’s chest – or some other warm environment – to assist the baby with maintaining her body temperature. This is due to her inability to regulate her body temperature without assistance. Optimally, this assistance comes from her primary caregiver. Other aspects of physiology, such as heart rate and digestion, are also regulated within the caregiving relationship.

Emotional regulation is just the same. Babies need assistance in managing their emotions so they do not become overwhelmed. Whether it is fear, sadness, surprise or excitement, babies can quickly succumb to emotional intensity. Witness the baby who gets startled and needs a cuddle to return to calm. Thus, it is inappropriate and relatively impossible to ask a young baby to self-soothe when upset, even in a sleep situation. Going to sleep evokes a state of heightened arousal and is a big transition. Babies typically need the assistance of a connected caregiver to make that transition a smooth and healthy one.

Babies who are left to cry even for short periods are left vulnerable to the effects of stress. Stress is the emotional and physical impact our bodies experience as we adjust to challenge. The ability to handle stress is formed via our early experiences. Because a baby’s brain is in an early state of development, it is quite vulnerable to stressful events. An infant brain possesses well-established fear circuitry but very immature circuitry for pleasure. What this means is that a baby is easily overwhelmed by distress and needs vigilant assistance to maintain emotional equilibrium and to feel good. Subjection to repeated, frequent, ongoing or intense stressors leaves a baby prone to the negative effects of future stress as well as more unable to recover from the stress of the moment. Crying is often the only way babies have to communicate that they are stressed. Leaving them in this state only increases their stress levels and teaches them they cannot rely on their caregivers to assist them.

Stress is often measured by cortisol, a blood hormone that increases under stress. Research shows a direct connection between the stress of separation and the levels of cortisol in a baby’s blood. Hence, a baby who is left to cry at nighttime without comfort and attention experiences a flood of cortisol in his body. Repeated extreme stress responses can have an adverse effect on brain development. Additionally, neurological studies show us that the pain of emotional separation registers in the same way as physical pain. The pain a baby experiences at being left alone to cry is clearly quite intense.

Sometimes sleep training advocates advise allowing babies to cry for long enough periods of time that they finally go to sleep. However, when sleep is entered into in this fashion, it is not peaceful sleep earned by a process of self-soothing, nor has the baby finally grasped self-settling skills. This is instead the second phase of the stress response. After the crying intensifies and the cortisol levels increase, the crying sometimes ceases and it appears the baby is finally calm. What has happened is that the baby has more than likely entered a stage of dissociation. When our bodies are too flooded with stress they have no choice but to shut down. Instead of hormones like cortisol, the body is now flooded with pain numbing chemicals and hormones in an effort to physiologically and emotionally retreat from pain it cannot withstand. This is a highly toxic state that should be avoided at all costs. In a young baby with a developing brain, it is even more damaging. Stress at this level causes neural cell death and impairs optimal brain development, while simultaneously weakening the attachment and bonding systems.

Babies are unable to make sense of a caregiver who is attentive at certain times of the day but unresponsive at nap and sleep times. Attachment research shows that this sort of inconsistent or unresponsive caregiving is associated with insecure attachment – a significant risk factor in child development. Babies who endure this sort of stress are more vulnerable to chronic loneliness, depression, violence, and a sense of shame about their emotions that will follow them throughout their life.

Added to this, sleep training poses a further threat to the attachment relationship by effectively training caregivers to desensitise themselves to their baby’s cues. It is not only the baby who is at immediate risk then, but the caregiving system as well. In using controlled crying or other sleep training techniques, the adult uses caregiving strategies that are unresponsive and insensitive and, in doing so, needs to tell herself that her baby’s cries do not need a response from her. It is risky to promote these beliefs in caregivers. It is the direct opposite of techniques used in programmes designed to support secure attachment, which aim to maximise caregiver awareness of and responsiveness to babies’ signals.

Babies’ sleep and sleep arrangements should be approached with the utmost care, not subjecting children to separations or times of not being responded to that last for longer than they can manage. Many parents are best able to respond to their children’s nighttime needs by sharing the bed with them or having them sleep in the same room, at arm’s reach. This arrangement can meet the child’s need for comfort and care in the night, as well as the parents’ needs for a more restful night’s sleep. Research has shown that close sleeping arrangements are associated with significant reduction in rates of SIDS and parents who co-sleep report greater satisfaction with sleep than parents who employ more distant sleep solutions.

Regardless of which sleeping arrangement one chooses, it is vital to understand the importance of responsiveness to a baby’s cues and needs no matter what time of day or night. The younger the baby the more important this is. Babies under 12 months of age are still in the high-risk period for SIDS and waking or signalling (that is, crying) should not be ignored. Additionally, they do not have the developmental, psychological, or neurological ability to self-soothe and must rely on an attuned caregiver for assistance.

Many parents try some sort of sleep training when they feel overwhelmed, exhausted or unhappy about their baby’s sleep patterns. If you have experimented with some of these sleep training techniques and would like to pursue a more secure connection with your child, there are things you can do. It is never too late to repair your relationship with your child and you can achieve this by choosing nighttime parenting strategies that are consistently sensitive and attuned. Just as before, your baby learns about the world via experience. With each new experience, new learning occurs and that new information gradually replaces the old. Over time, your baby’s view about your responsiveness will change, and your relationship will be on the path towards a more secure attachment.

It is normal to want a good night’s sleep and there are alternative ways of creating more peaceful nights for families. These include: infant massage and touch, which is proven to help babies settle and achieve sleep; calming evening routines such as a warm bath, soft music and dim lights; and carrying baby either in arms or in a soft baby carrier such as a sling. For parents who feel particularly exhausted, sleep research shows that napping significantly compensates for minor sleep deprivation. Thus napping when your baby naps is an excellent way to overcome the negative impact of night waking. Similarly, it is important to remember to hold realistic expectations. Having a baby is a 24-hour-a-day job. Parents can relax around non-essential aspects of their life (such as housekeeping standards) in order to give priority to meeting their baby’s needs and looking after themselves. Simple measures like going to bed at the same time as your baby allow you to overcome sleep deficits and maintain the ability to meet your child’s needs.

Reference/Used with Permission from Centre For Attachment

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