Join me and Dr. Shanna Alvarez, PhD who is a child psychologist and co-owner of Helping Families Thrive, as we delve into the world of healthy attachment and sleep training and address the BIG question: Is infant and toddler sleep training safe? Does it impact healthy attachment?
Shanna takes an evidence-based approach to explain the difference between “attachment parenting” and “healthy attachment”, as well as all the research we have surrounding these terms and practices. She also does a deep-dive explaining why and how we know that sleep training is a perfectly safe and reasonable parenting choice to make for many families.
You can follow Shanna here:
Shanna’s Essentials Parenting course can be found on their website. Get 20% off with the discount code HFTSLEEP.
**Quality research study on attachment and sleep: Gradisar M, Jackson K, Spurrier NJ, et al. Behavioral Interventions or Infant Sleep Problems: A Randomized Controlled Trial. Pediatrics. 2016 ;137(6):e20151486
Findings: Both graduated extinction and bedtime fading provide significant sleep benefitsabove control, yet convey no adverse stress responses or long-term effects on parent-child attachment or child emotions and behavior.
**Link to the study that Eva references- https://pediatrics.aappublications.org/content/130/4/643
Want to get your little one consistently sleeping 11-12 hours at night so you can be a functioning human? Join my FREE training HERE!
Hey there, you’re listening to the, My Sleeping Baby podcast, which is all about baby and child sleep. I’m so excited to teach you how you can get your little ones sleeping so that you can sleep too and enjoy parenthood to its fullest. I’m Eva Klein, your resident’s sleep expert, mom of three, founder of the Sleep Bible online coaching program, and lover of all things sleep and motherhood. If you’re looking for tangible solutions for your little one sleep woes or you simply want to learn more, this podcast is for you. For more information, check out mysleepingbaby.com and you can follow me on Instagram and Facebook @mysleepingbaby. All right, Shanna. Thank you so much for being here today. Hey, on the, my sleep BBB podcast, why don’t you tell everyone a little bit about yourself and what you do?
Sure, absolutely. Um, I’m Shaun Alvarez and I am a child psychologist and, uh, my partner is Jenna Elgen. She’s not here today due to childcare eruptions everywhere, but we actually met in graduate school at the university of Washington. We were both getting our doctoral degrees in psychology and, um, just ended up being the two that would partner up together for most projects. And we both worked as research scientists, um, uh, for years, uh, doing research on long-term outcomes for children with various developmental differences, um, and also looking at the impact of early childhood experiences and long-term outcomes for kids. And so, uh, we were always passionate about research together throughout that career in school. And then when we graduated, we were still really committed to evidence-based practice, meaning, you know, how do we get rigorously studied information that has been found to be effective out to the families that we’re serving?
Uh, and we did that via a lot of programs, but we led, uh, incredible years groups, which is an evidence-based parenting intervention together for years and have just always been really passionate about that work about supporting families, right? Not just a checklist of activities, um, for the kids specifically, but wrapping around entire family and making sure that parents are also okay. Parents have to be okay for kids to be okay. So, you know, that’s what we’ve been doing in, in clinical work. You know, we supervise students from the university of Washington training, doctoral students and loved it. We also became parents at, uh, around the same time through various journeys into parenthood. Um, I’ve been at foster mom, biological mom, adoptive mom. They’ve every type of a journey into becoming a mom. And Jenna also has three children as do I. And as we supported each other through our personal journeys into parenthood, we got to see a lot of misinformation out there.
And that became a frequent, uh, bonding exercise for us was discussing this disturbing gap between what we knew, um, was effective and grounded. Science-based from our training and from all over the years in clinical practice. And then what we were seeing out in social media now that we were actually part of the social media world after Jenna dragged me, kicking, kicking, and screaming and would send me screenshots going, Ooh, what is this? And I was like, oh, that’s, that’s not consistent with what we know. And at the same time, I’m in clinic seeing more and more this trend of really anxious, overwhelmed parents that I didn’t fully appreciate why until I dipped into social media, that myself, um, and, and started to realize, oh my gosh, they are hearing lots of different perspectives that often contradict each other. Um, and there’s a lot of misinformation out there.
So that became kind of a second branch of our work. Was this dedication to getting evidence-based information out to the everyday parent, essentially. Um, I mean, COVID happened and that, that this small thing of a global pandemic and we could happen. An interesting thing happened in practice, um, in my clinical work, which is that all of a sudden, a lot more families who had kind of known maybe they were struggling before and their kid, you know, struggled with their emotions. Well now they were home with their kids full time and that it was unbearable. It was unbearable. And also I kind of became more accessible. Yeah, you don’t have to leave your office. You can open up your laptop and get therapy and get rights, which I actually hadn’t thought about when it first started. So that’s been beautiful, but also weightless have been a real thing.
So, um, we, we wanted to put together, uh, evidence-based information collectively into, uh, online learning platform for parents that just needed evidence-based information during this crazy time. So that’s how we created our course, um, essentially of parenting. And we looked at these top only the top four evidence-based parenting interventions and said, you know, okay, we’re trained in these, what are the common core components of only things that have been rigorously studied so that parents could have in one place, understand what the actual science is and how to use these tools? So that, that was our COVID passion project was making this for families to have access to that information. And I’ll give you a discount code for your family. So if they are wanting that type of information, they can access that. I want that kind of information, as well as a mom.
Who’s also still living in this pandemic. So that sounds like a fantastic offer for all of us, myself included.
It’s, you know, it’s something we all, I revisit it often and every time I’m doing therapy with clients, you know, I will often be like, oh yeah, I need to revisit that. We’re always, always sharpening our skills. Right. Yeah. I’m sure it needs to revisit that information. So I’m S
I’m so curious. So, you know, before we delve in to, um, sleep and attachment specifically, you, you piqued my interest here. Cause you mentioned that when you and Jenna began doing your work and you were seeing what was happening on social media, that you saw certain, um, themes, or, you know, being told to moms that made you go, where in the hell is this coming from? So can you share maybe some of those messages that I guess if you could scream from the rooftops and say, no, that’s not true. You know, what, what would, what would some of them be? Just give us a couple, oh
Lord, all right, here we go. Um, let me start broad, and then I’ll give you some specific ideas about how all of this is happening. What’s happening is that science doesn’t itself and science doesn’t sell because science is nuanced and that’s boring and hard to capture in a certain amount of characters on Instagram. And, um, and because it’s often so nuanced, if it doesn’t elicit a whole lot of fear or shame, which is what ultimately draws people to buy a product. Right. Um, right. So there’s lots of evidence-based tools out there, um, that have been rigorously studied that have, you know, a hundred followers on Instagram because they’re in the universities and they’re working with families that are in crisis and in the clinic. Right? Yeah. So, so as a result of what we see happening a lot is that there might be something that is based in some type of information out there that started in science, but it’s become an oversimplified game of telephone.
Okay. So there might be a, a research finding, let’s say in rats that says like, you know, wow. When I don’t know, I’m giving a random example, this is not an actual study, but to illustrate when you leave rats alone for five minutes, um, their stress hormones go up. Right. So, you know, interesting like, well, let’s think about that. And then what might come out, you know, in social media and popular media, the next day is something like, you know, uh, leaving your child alone, uh, giving them space or sleep training, insert, whatever parenting practice you want to go in, ice here, speak training, timeout. I don’t know, insert anything. There is damaging in his childhood and child. Okay. So it’s this oversimplification that happens a lot. Not because I think people are malicious, but because it’s a lot of nuance to capture in this particular modality.
Right? So the things that we want to correct broadly speaking that we want to stand and shout from the rooftops are, it’s not that simple. Yeah. It is nuanced. There are many paths up this mountain that doesn’t mean anything goes, okay. So there is evidence that we were trying to do that we’re trying to disperse that a lot of people are dedicated to disseminating, not just us, right. Our mentors, um, in the parent research world are trying to disseminate as well. That tells us kind of what the pillars are that say, like we talk about due north that give you your compass, right? Like here’s the parenting mountain. Here’s what we know really has been shown to damage kids. Here’s what we know has been shown to be really helpful for kids and for parents, this has been studied all of these general guidelines. Okay.
And you’re going to end up north. Now the person next to you might take this path. The other person might take this path, you know, formula, feed, breastfeed coast, sleep, sleep, train, timeout time in w right. There’s lots of paths up the mountain. So what are you going to do north right in your head? So you could be going due north right up this mountain and have different specific parenting practices. Okay. Well, what’s important is that we don’t shame each other for that. Right. And we’re going to get into this. I know because very anxious parenting, right. Or parents that become very anxious because of the level of misinformation that they feel paralyzed by impacts mental health and parent mental health is very well-established and that impacts your kids’ outcomes, right? So it’s, it’s irresponsible. It is irresponsible to fearmonger and shame parents. That’s what I wiped out from the rooftops, right.
Shaming parents for not being on this particular path or parenting trend or parenting philosophy, and closing our eyes to the fact that there are cultures throughout the world that do things differently. Then this one particular group that might have the loudspeaker on social media. And they turn out with kids that have secure attachment and healthy outcomes. Yeah. Right. That is irresponsible to suggest that there is a one size fits all. We have to have some containers. Of course evidence-based practice, of course, but there’s more nuance and more wiggle room in there than I think a lot of parents are being led to believe.
I love that. No, I think that that’s so important because you’re right. I, I listen, you know, I’m on social media all the time. And I do see that messaging constantly that, you know, you have to do things this way and if you don’t, you’re going to damage your child and then they’re going to have lifelong trauma and don’t do that. And that’s, that’s a lot of pressure to put on someone to do things exactly the way that you’re telling them to do. And you’re saying, it’s not even, evidence-based like, it’s not even, it’s just their opinion.
So what we’ll see sometimes is people, you know, and I’ve seen a little bit of this perspective, which I think is great people popping in comments and saying like, could you give us the citation? Meaning like, could you provide the research article that supports this claim that you’re making? Um, and what people will do is though link to an article that maybe is an opinion piece, or like I was talking about with that example earlier with rats, right? Like when you actually look at the article that’s being referenced, and we can dive into this today, when we talk about speed research and when we talk about attacks, but what’s being used as this foundation or this, you know, the rationale behind these claims often isn’t even directly related to the claim being made. So there’s different levels of evidence that can be provided, right. So that’s the trickiest part.
And where do I see the most right now? I would say the trend that I’ve seen in the last 10 years is that I see a lot more anxious parents that feel like if they are not purely positive and responsive all the time in every moment, um, that their kids are not going to be okay. And as a result, we see a lot of anxiety paralysis, and either as a result of that, not setting boundaries or as a result of that, trying so hard to be positive and, and perfect, that may explode at their kids. You know, I see a lot of stuff out there about be really positive, be really coaching. You know, don’t do this, it’ll damage, your kid. Don’t do that. And then, you know, the next day I will see a post from similar groups talking about, you know, did you lose your at your kid again? Have you, here’s how to repair, I’m kind kinda going well. Maybe if we balanced a little bit, either swinging of extremes, right. Where you’re kind of trying to constantly be positive and then always in damage control mode, because it’s just not real.
Yes. Right. And it’s not, it’s not necessary to have to be, it’s not necessary. It’s not realistic. And we’re allowed to experience emotions that are not positive and happy and, you know, butterflies all the time, just like our kids are, our kids are allowed. You know, of course we obviously want to be mindful about how we express those emotions, but to feel frustrated, to feel upset, to feel angry, to feel mad is a normal human way to respond to real life. And, and you’re right. And I think that there is this massive emphasis on suppressing that and to just have everything constantly be, you know, butterflies and rainbows, and maybe it is the pendulum swinging to like the opposite end of the spectrum. You know, where many of us may have grown up where, you know, being spanked and being, you know, being sent up to our rooms all the time and in a very authoritarian type of way. And so do you, I mean, that’s what I can’t help, but wonder like maybe that’s just, it’s the response to that, which is swinging the pendulum too far to the other end. Exactly.
Right. That’s exactly what we talk about in our courses. Kind of dissecting where this comes from. And that’s where I want it in my feistiness. I want to make sure that I’m also sharing this compassion right. In that I work with a lot of parents who have been through trauma themselves. Right? So they grew up with a traumatic experience and nothing will bring up your about your childhood more than raising your kid. And sometimes you response to that pain when you were little is to say, I never been into that to make you, which is amazing. You are going to change it, which we can, we can interrupt those cycles of harsh parenting and abuse and all there is to do that. But then what can be, what can happen is you can have, uh, a trauma response to seeing your kid experienced any level of distress. Yeah. And have that send this message. And you have like, oh, I’m damaging my kid. I’m abusing my kid. Oh no, I’m repeating the cycle. Yes. Really. That’s not what it is. Right. That’s not what it is. And so it comes from love and it is hard to find balance in this is really, really hard to do, but there are ways to do it. And fear-mongering, and shame is not the way.
Nope, Nope, Nope. Nope. And I’m sure that sleep is probably also one of those. I just say the word sleep and it makes you just lose it. Right. Because I can only imagine, you know, you, you and Jenna, both being so knowledgeable and so qualified and you know, you’ve, you’ve looked at the research, you’ve studied it, you dissect it. And then you see these like funny, cute, you know, one line means talking about sleep better that doesn’t have like the least amount of evidence to back it up. I mean, it probably makes you want to lose your mind as well. Right.
Well, you know, what’s interesting is it doesn’t make me lose my mind when people have opinions and then other like-minded people share that opinion and it works for them and they’re, and they’re celebrating that. And they’re like, you know, it’s awesome. Like my kid has never needed a time out. This timing works really well for my kid. Or when they say like, oh my gosh, I love co-sleeping like, it’s worked so well. It’s really helped me feel attached to my kid or I love breastfeeding or I love bottle-feeding. That’s great. That makes me happy. Because connection as human beings is so important. Right. But when we divide into camps to villainize each other, that it’s not okay with me because that impacts parent mental health. And then the psychologists are dealing with, you know, the damage control, all these parents that are not okay as a result of that. Yeah. So empowerment is the name of the game here, right? Like how do we get this information to people so that then they can find what works for their family. Yes. You don’t want to sleep train. You don’t want to bottle feed. You don’t want to press feed. Great. Well, here’s some information so that you can make an empowered decision. So your family will be okay. Yes.
So let’s, let’s dive into this more because I tell you, I have so many people who email me, DME call me, you know, reach out for help. And with the following scenario, their baby, their toddler, their preschooler is not sleeping consistently through the night. They’re waking up multiple times. They take forever to fall asleep. They nap for 20 minutes, you know, something it’s whatever, and nobody is sleeping. And, and, you know, mom is, it’s usually the man reaching out to me. The mom is a disaster. She’s not waking up refresh. She feels like she got hit by a truck on a day-to-day basis. She knows that this is not working, but she is afraid that any kind of sleep training is going to rupture her little one’s healthy attachment. So before we, before we, you know, I guess delve into that, like, let’s just kind of address, you know, the, the broader question here first, what exactly is healthy attachments? And what does it look like when you have healthy attachment with a baby or a young child?
Yeah. Okay. So this is similar, right? This is, this is drawing out the need for us to separate what is, you know, kind of popular media media messaging about maybe attachment parenting versus what is Evan’s space, you know, rigorously studied science of attachment science and attachment clients and attachment parenting are not the same thing, which is tricky because they are, um, so similarly named yeah. And attachment parenting, actually didn’t used to be called attachment parenting. It was called creative parenting when it’s silly. Yeah, I do that. And then, um, but it was right around the time that attached, you know, attachment science was really some foundation work was happening there and the name shifted to attachment parenting. So let’s just more clearly delineate those terms to give some back knowledge. Okay. So attachment parenting, um, was kinda coined by this pediatrician, uh, Dr. William Sears and attachment science is Dr.
Ainsworth and Bowlby. Okay. So just to separate the names, they never worked together. Their work is not related at all. Ainsworth and Bowlby were researchers. Um, and Dr. William Sears was a pediatrician, a general pediatrician. Okay. So his, uh, his work in the nineties was really, um, about this claim that we could immunize. And he actually uses that word, immunized children against, um, these social, emotional diseases that plague our society and that we could do that through the prevention of crime predominantly. Okay. So that was a big part, um, prevention of crying and doing that through maximizing parent empathy and responsiveness. Okay. Um, and continuous bodily closeness and touch. Okay. So he came up with these behaviors, um, he and his wife that he believed could support this idea. None of which have been studied as a program forever. Okay. So no studies of attachment effect
Of attachment parenting practices on attachment.
There are studies of individual practices, very limited. Uh, for example, baby wearing right has been associated with reduced crying in case there are no studies saying that people that practice attachment parenting have children that are more securely attached than others. Now that is not to say that there’s anything wrong with attachment parenting. It, it absolutely these seven behaviors that he came up with, feel like a great fit for many families, right there, birth bonding, breastfeeding, baby, wearing bedding, close to baby, the belief in the language value of crying. He wanted them all to start with bees, right. Um, be aware of baby trainers. That’s the six and seven, which is interesting, is balanced. Um, so those, those are the seven bees. Um, and the aim of those seven bees was to prevent crime at all costs, right? There are zero peer reviewed studies on combining these 17 or the 17, these seven practices at all. It’s actually not even an intervention. It is not a program. It’s a philosophy, right? It’s a philosophy that brings a lot of families. Great joy right now, the problem is that sometimes this philosophy that may or may not bring joy, um, is confused with attachment science. Okay. So totally different. And this is about attachment science is all about what does the research say about how to have healthy attachment with your kid? And that has actually been studied. Okay. So now we’re in, I feel, I feel like I’m lecturing one of my classes. Okay.
Yeah, no, no, no. This is, this is fantastic. I miss.
Okay. All right. Yeah. So bullies interests, um, in this topic was really, uh, related to his own history of being separated from his family. He was sent to a boarding school as a young child during war time. Okay. And so, as an adult, you became really interested in the impact in separation between caregivers and children and that impact on kids. Long-term okay. And then Ainsworth did a lot of work in Uganda kind of studying, um, the relationship between mothers and their infants. Okay. So there’s a whole lot of work there. That’s fascinating, but I’ll bring it down. Her work in Uganda, um, was basically this observation that infants would use their moms as what’s termed as a secure base. Right. So that means something they can return back to in periods of distress. Right. And go then go back out and explore. And this is an interesting thing because the notion of secure base, which is part of healthy attachment involves two things, being able to come in and check in, and then the part that gets overlooked, being able to separate and explore.
Yeah. Right. Um, so it involves both which sometimes I think isn’t fully captured in this oversimplified version where, you know, healthy attachment is pictured is always here. Yeah. Okay. Right. All right. So then when they, when they observed these dyads, these mothers and their infants and Uganda, they kind of tried to replicate, how do we study this more, the us, which is very different culture. Um, and they did that through this experiment that ultimately is called the strange situation. And this is a lab experiment in which essentially, you know, a caregiver and a baby coming in play. And there’s an initial observation period. And they’re observing the kid’s behavior to look at what’s called temperament, right. Kids come into the world with their own flavors. Right. We don’t have ultimate control, right. If you’re a parent of multiples, you know this right. You can have one.
My, my youngest points the bed when she’s ready to sleep, she, you know, she’s hungry at the same time. Every day. She’s pretty laid back my other two, not so much, right. They come in with their own flavors and that’s what they would initially observe. Right. Their temperament then a stranger is introduced to the room, kind of sits in the corner there. And we look at, you know, how does, how does the baby respond to the introduction of a stranger? And then the caregiver actually says goodbye and leaves. And so now the stranger is with that baby. Okay. Now a lot of people think like, oh, that separation is what matters. That shows if they have a healthy attachment or not, actually, no, that tends to have more to do with temperament your kids kind of baby personality. Right. But it doesn’t have to do with their relationship with you as their parent or their Casper.
Okay. But then the reunion. So when that caregiver comes back in the room, that’s the juicy part. Yeah. That’s the part where we kind of look at is a baby able to return to their baseline. So whatever changed there might’ve been in their typical, how they were expressing their personality, how they were behaving in, um, when they were left alone with a stranger, are they able to come back down to their baseline, which can be different for every kid, right. Coming back to this observation, Uganda, right. This idea of safe base. Right. So in other
Words, like mom comes back into the room. Are they able to be calmed and soothed by mom coming back in yeah.
Compton suits return to exploring their environment, right? How do they use the adult as a resource dispute and calmed down because it’s an adult, you become your own secure base, right? You’re able to bring yourself down. And as a child, you do that with the adults in their, in their environment. And, you know, basically they observed all this and he found different patterns and that kids could have secure attachments or insecure attachments. And the kids that had the best and healthiest outcomes, um, socially and emotionally, um, were babies with secure attachment, which means that they were able to regulate, go back to exploring their environment, feel soothed once their mom ultimately, or their caregiver rather did return. Now, this is defined by, you know, a variety of behaviors, but the insecure babies, there’s lots of different ways the child might have insecure attachment, but essentially they, they didn’t use that base as a factor. Right. So that wasn’t able to get them to return back to.
So what does that look like? So with the, with the babies would healthy attachment mom comes back in, they may be cry for a few minutes. They calmed down, they go back to playing with mom, right. You know, mom present, you know, in, in some way, shape or form. What is that, what did that look like for the babies that did not have a secure attachment?
So one, one way that can look is what’s, what’s called resistant babies where they might have, um, they would go towards, um, at the reunion, um, but then have this kind of mixed response to it. It sometimes can also be referred to as disorganized attachment where you want to approach, but you also stay away. Right. So it’s like, you’re agitated, you’re resisting soothing. Um, and then, you know, the least common is, is avoidant type where at the unification, this, this tab might not even, um, go to the parent at all. Or, um, you know, just doesn’t seem to respond whatsoever is indifferent to the parent coming back in. Okay. So I want to be careful here because Jenna and I have all this information and we still will go into an anxiety pit once in awhile, I’ll be like, oh my gosh, you know, my baby is insecurely attached, are my babies, you know, and we do this with all topics, right.
Because information can be awesome and it can be awful. Yeah. This is a very precise and nuanced science coding these behaviors. So because of temperament differences, not every baby needs to, has to should crawl right up to their caregiver and be like, mommy, that is not what is necessary for healthy attachment. Right. So some babies might kind of look over and check in and be like, oh, pause there and then keep playing and then look back over and check in. And that is their way of using you as their base. And they’re good. Other kids might go over and get a little clingy and then go out and explore. So there’s some variation there. And again, variation is okay. Yes.
But the over the overarching theme here is that the baby is calmed by the moms returning, you know, whether they’re super excited to see mom or they’re just like, oh, Hey, what’s up mom? Okay. I’m going to go back to playing now. Um, or, you know, simply just acknowledging like, all right, mom’s here. Fantastic. That’s that’s the most, so like not being completely indifferent, that’s, that’s the most important thing. Okay.
And not being caught, not seeing this disorganized response where, you know, um, you know, I’m a foster mom and, um, and sometimes when you go to sooth a child, they might try to hit you when you, but they also want you yeah. They want you, and they don’t want you at the same time. Right. And, and that’s some, some attachment experience that has been really hard for them. Right. Like, am I safe? Do I push this away? Is this going to suit me? Or is this going to hurt me stupid experience. Right. So that kind of disorganization would be, would be what we’re looking there part to point out. When you look at this situation across various cultures across the world, most babies are securely attached really, right? Yes. Most babies are securely attached. So given all the difference in cultures and all of the differences in parenting practices, this is where I do want everybody to exhale just a little bit.
I can not to say, and this depends on the audience we’re talking to, right? Yeah. When I’m working in communities, in which there’s a lot of physical discipline, a lot of physical violence, a lot of aggression, then we have to do some work to say like, Hey, actually attachments is really important. Here’s what these practices are. Here’s what, you know, neglecting your baby in a really impactful way. Right. Neglecting your baby neglect and not responding every moment of the day are two different things. Okay. Um, I’m going to emphasize that, that population, when I’m working with a parent who is responsive most of the time, right. Which when we look at secure attachment, the best it gets is 50 to 70% responsiveness, the most security attached to babies. That’s what their parents do. Yeah. Okay. So nobody’s rocking this because it’s impossible. And the attempt to be perfect is going to, it’s going to really mess with you. Right.
So then where does this, um, how do you respond when you hear people talk about how attachment is established through proximity? I hear that a lot in the attachment parenting world. Is there any sliver of truth behind that or is that just merely an opinion of the attachment parenting role that isn’t actually backed up by any science?
Yeah. So there are, like I said before, there are individuals limited individual studies, um, uh, specific behaviors such as baby wearing. Right. So for example, I know my, um, my youngest had reflux and was a bit colicky. Right. And I were her for everything. Right. Of course I didn’t with my other two. Right. And lots of parents might find that that is helpful for reducing crying. Now, are there great studies of exactly why that reduces crying? Is it related to somebody who’s being colicky or having digestive issues? Is it related to the comfort of the parent? We don’t know. And that’s the, that’s the truth of it is there’s just, we don’t know what, what we can say is there is not one study showing that if you do not use these seven BS of attachment parenting, that your child will have any difference in attachment incomes whatsoever, any difference whatsoever.
Right. Right, right. But you see, I think that there is so much guilt around sleep training when people hear that sort of message. They’re all wondering whether infant sleep training is safe. Because maybe they’re in a scenario where, you know, their baby or their toddler is co-sleeping with them, not out of choice, out of desperation. It was, you know, a reactive parenting choice. It was the, it was the best way that they could get some sleep, but they don’t like it. They want baby in his crib, but then they hear attachment is established through proximity and then it makes the parent go, do I have to sacrifice attachments in the name of being able to get a proper, proper night’s sleep? You know what I mean? So, you know, let’s, let’s dive into this in detail, you know? Cause I’m, I’m, I’m sure in your practice and in your parenting courses, you have parents asking you these sorts of questions.
You know, I want to be able to sleep train, but I heard, I think another, um, message that I hear a lot is that when you, when you are doing any form of sleep training and you know, your baby or your toddler is crying and you’re not giving them what they want at that moment, whether it be, they want you to feed them to sleep, you want them to, they want to be rocked to sleep. They want to come into your bed. Then it must mean that you’re gonna you’re, you’re teaching them that they can’t rely on you. And so when they learn how to sleep properly at night, it’s because they’ve learned that you’re not gonna, you’re not there for them. Right. That’s heavy stuff. I love for you to unpack this because it weighs on a lot of people and it eats at people’s heartstrings when they desperately want to be sleeping, but then they’re hearing this type of messaging.
Yeah. Um, okay. I want to dive into where that pain comes from. Take it away into that specific study. And before, as a jumping off point, I want to note just as a fun addition here, that early, we were talking about the seven BS and Dr. Sears and everything. I encourage you to look at Dr. Sue’s more updated perspectives on suite training, um, because he actually changed his tune over the years. Really? Yeah. He softened quite a bit. He got more nuanced. Imagine that
As you come up with a new version of his book.
Oh, that would be interesting to know. I don’t know.
I wonder where I would love to see his updated.
I’ve I’ve just listened to a couple of interviews that are far more nuanced than, than what the initial work is to believe. So people evolve over time, but let’s dive in, you know, I think the most common study, um, that’s, that’s cited here is a middle mist, the middlemiss study. Do you know this study all about stress moments? Basically. Tell me, yeah. Let’s talk about where this comes from. All right. So this study was, um, on 25 babies. Okay. Um, various attorney names middlemiss um, at the university of north Texas. Okay. In the college of education and this let’s, let’s separate what the study found versus what has been heard in popular media about it. So something you might hear in popular media is, um, well, the researchers found that high levels of hormones, which is cortisol right in mothers and babies. Um, during safe infant sleep training, after several days, once the babies have learned to go to sleep without crying on those quiet nights, the mom’s cortisol, um, had gone down, but the babies were up.
Right. So, um, the babies had learned to be quiet, even though their cortisol levels were still really high on day three of sleep, dream, sleep training. Okay. So the fact that they’re quiet actually means that this is the interpretation. This is not what I’m saying. Okay. The fact that they’re quiet means that these babies have learned to suffer in silence. Okay. That’s the interpretation. All right. So now let’s, let’s look at that. Um, so you look at this design, there were these 25 mom and infant pairs. Okay. They were enrolled in a sleep training program and in this particular sleep training program, it was just complete extinction, which means you just simply do not respond. There’s no coming into checking. There’s nothing. You just let them pure cry it out as it’s often referred to. Okay. Which is neither here nor there. I just want to bring that.
Okay. And this was done at a hospital and not in a home setting. Okay. So this was at a hospital and the babies were four to 10 months old, I think. Um, and when it was time for bedtime, they help the moms help their babies get ready. But then a nurse was the one to put them down to bed while the mom went out into the hallway. So the mom could still hear the babies cry. Okay. Um, but the babies couldn’t see the moms and they just let them cry until they fell asleep without any soothing. Okay. And that repeated for four days. So let’s point out some key things here. Hospital setting nurse puts the baby down four days, pure, cried out. Okay. Got it. All right. So then what they, what do they do? So on the first night and the third night they measured cortisol, which is a stress hormone.
So the, how much stress hormone was in the mom’s body and how much stress hormone was in the baby’s body. Follow me. Got that. Okay. So when, you know, when you don’t collect data at the beginning baseline data, we don’t know what cortisol levels were before this even started. Yeah. Okay. Also, we don’t know if these other variables, we talked about impacted cortisol. I’m in a hospital. There’s somebody I’ve never met before putting me to sleep. Right. There’s, there’s a lot of things happening too. Okay. So there’s no baseline levels. We don’t know where this idea that, you know, when the cortisol levels were described as high in the study, what does high mean
In relative to what?
Relative to what? Right, right, exactly. Right. And this is common to, you know, not just in sleep research, but you know, it’s been villainized and in a lot of ways, right. That cortisol is the enemy and our goal is to always keep it down. And, uh, that’s a whole nother line of research, you know, about, about stress and resilience and such that, that claim just isn’t true. Right. So we have to be careful about interpreting this. Okay. So we, she calls them high. We don’t know relative to what, um, but you know, those levels stayed pretty steady throughout the study. Okay. Now, interestingly, when, when the author was approached about this, um, she said, well, I did collect baseline data, but I didn’t report it. So that’s, that’s also a little bit, you know, as a researcher, it’s a little bit baffling, right. So we’re starting to see like, okay, there’s some interesting stuff that happened.
This is not to say, this is not interesting data. Right. It’s interesting data, but wholly game of telephone. Right. Second, there’s some really big statistical like math problems with the study. Um, she, she looked at the, the average level of cortisol for the whole group. No control set of, instead of looking at what was happening for each kid. Okay. And that, you know, it’s in this statistical analysis world, that’s like, that’s a big, no-no no, that’s a problem. In addition, there’s no control group, a control group means we’re comparing this. So let’s take a group of kids that had sleep training versus a group of kids that were co-sleeping in a hospital room. Yes. Yes.
Cause that’s gonna make a difference. That’s that’s I mean, as a mom, when I hear about a bunch of babies being sleeping in a hospital, I’m going, well, of course their cortisol levels are going to go up. They’re in a hospital. They’re not at home and it’s a nurse putting them to bed, not mom.
Well, and even there, you know, we have to be careful about saying their cortisol levels are going to go up because we don’t know that they went up.
We nurtured them. We there’s so much, we don’t know about this. And I just want to emphasize, I mean, I am not a researcher myself, but in like my previous lifetime, I worked as a lawyer in a research hospital here in Toronto, and I was responsible for negotiating the hospital’s clinical trial agreements. And so I was on the phone with, you know, doctors and researchers daily about all the research going on. I would sit down on like research ethics, board meetings. And so while I’m, I’m not the scientist, I’m not the researcher. I’m very, very familiar with like what a good study looks like, what a blinded study looks like, what a double-blinded study looks like. And this matters, this really, really matters. There is such thing as really good quality research. And then there is junky research that really doesn’t prove enough in the grand scheme of things, to be able to post a big headline of a conclusion.
Well, this is where pride can get the best of all of us. Right. We all need, we all need projects from time to time. Right. There’s a difference between an interesting study, right? Like I don’t even want to say, you know, trashy research, a trip it’s, it’s interesting, right.
Using research, maybe I shouldn’t have said garbage. It’s more like, it’s more like it’s the beginning stages. And what they usually say is more research needs to be done. That’s what they’ll say at the end of the conclusion, more research needs to be done on XYZ, you know, whatever it is. And, and that, of course, is the scientist being humble and acknowledging that there are a huge amount of limitations as to what we’ve looked at, but Hey, you know what? This is the start of some really interesting research on cortisol levels, you know, in babies. But we need to do much more because of all those limitations that you just mentioned,
Right, exactly. You don’t, by the end of the study, I think only 14. It was about half of the, the, the kids, half of the infants, only half of their data. It could be included for various reasons. So it ends up being it’s tiny, tiny study, right. Which again is enough for interesting, you know, researchers cocktail hour and, you know, talking about this interesting small finding cool jumping off point, but for research to be the basis for practice, right? It needs to have had a control group. It needs to be quite large to be considered powerful. Um, it needs to be replicated, meaning that different groups, other than the original research researcher have been able to find the same thing in the same conditions, which has never been done. Okay. It needs to be shown across different cultures and situations also never been done. Right. So there’s a lot of concern here that people have really jumped with this. Now there’s limited research, but there actually is a quality study that has a lot of this components. Um, and I think it was, hang on. I have to look here cause I wanted to have this one, which one? The Australian study, the Gravatar study. I don’t know. I’m not, I’m
Not holding it because I just know it was done in Australia.
I actually don’t know. But in 2016 there was a great study that was it’s called randomized control trial. It’s getting really nerdy for a second, but already that’s like, okay, that means there was a control group. Yes. Right. Yeah. And that means that they were randomly told, like you’re getting sleep training. You’re not you’re right. Yeah. This study was still somewhat small 43 incense. Right. But that study design was far more solid. Right. Are more solid. And they used a what’s called graduated extinction. Here’s the person you probably so different responses in homes. And let’s just come to say that this, this study that had far stronger design, no differences in attachment styles between the sneak train group and then not some train group. Yeah, yeah. No differences at all in the short term or in the long-term. Yeah. Okay. So, you know, um, the, the control group and the one that was getting sleep training, no adverse stress response, meaning cortisol levels were found. This showed that infant sleep training was safe.
So that contradicts what was found before. Okay. No long-term effects on parent child attachment and no long-term effects or short-term neither I say long-term because sometimes people like, yeah. But when they’re 40, they’re going to have abusive relationships because you sleep training. Right. No, no, no. None of that. None of that was found. Right. Right. So, so what do we know? So there’s one study that has some interesting data that had a lot of flaws that made us curious about cortisol. Yeah. That no way would lead us to say that sleep training impacts attachment. Right. So, yeah. And then we have a much stronger study design that shows that there’s not a difference in terms of child outcomes, parent child relationship, or stress levels in parents of a child. So it was that pain sounds like parents have some choices here. Yes. It sounds like parents can be empowered with that information and know that infant sleep training is safe.
Yes. And what we could do with that information is say, well, okay, what does have more research behind it? You know, what have a lot of research depressed and anxious parents tend not to bond with their kids as well. Oh my gosh, that’s huge. That has a ton of research behind it. I could give you a whole bunch of great study designs that, um, you know, what else has a ton of research that sleep, sleep deprivation really is associated with maternal depression and even maternal psychosis, right? The first treatment for maternal psychosis is sleep. It’s not your meds. It’s first prescription that is made. Yeah. So if you’re doing great and sleep training feels weird to you. And you’re like, oh, I can’t imagine being away from my baby like this. Awesome. You could have a secure, secure attachment with your baby. And if that’s not the case for you, awesome. You can have a secure attachment with your baby learning to be responsive, learn to regulate your own emotions. We could have a whole nother podcast on, on what you can do, um, you know, to, to have a healthy relationship with your kid, but you’re not going to mess up your kid by doing what works for you in terms of sleep. Yes.
And I, you heard that there were some other studies that, you know, where the conclusions around attachment and children, where some of those conclusions were taken to substantiate anti sleep training philosophies, namely that if a child experiences long-term childhood stress, that that can impact attachments. And then from there, they was implied that well, sleep training is the equivalent of your child experiencing long-term childhood stress and it’s, and it’s no different, are you? I, I I’ve, as a parent, I heard that messaging a lot. So I’m wondering if, you know, you’re, you’re familiar with that research and those studies and where that all comes from.
Yeah. So this brings us back to the stress. Um, the stress research, um, has some in, in, in, uh, in why can’t I think of the word in English, I’m thinking Spanish in common, um, in common with attachment research. So essentially there’s this idea of toxic stress, which is real. Okay. I am a foster parent. I am a foster care advocate in Washington state. Um, and I also work with kids that have gone through substantial trauma and a lot of attachment research as, as we talked about before war time separation. Um, a lot of that research is based on families in really hard situations. Trauma is real, right? People growing up around gun violence daily, we’re talking about people witnessing domestic violence. We’re talking about people who cannot attend, not that they’re taking space for themselves for a moment to regulate, right? We’re talking about parents that cannot attend to their kids because they have to leave their child alone to go to work, or they have to go, you know, they have to leave to attend to other things and there’s no one to watch their child and they are leaving them unsupervised.
Right. We’re talking about kids separated due to parental death and war time. Okay. Yeah. This is what these initial studies are based on. Yeah. Stress is real toxic cortisol levels. The impact of trauma is huge, but not all stress is the same and not all people respond to stress the same, but there is actually such a thing as positive stress. There’s a great visual out there, but, um, you know, you have toxic stress, which is basically defined as it comes down to high levels of repeated stress over time in the absence of a secure attachment. Okay. A warm, um, reliable relationship with a caregiver. It doesn’t mean
Speaker 4: (49:30)
And then, you know, positive stress, sorry. NATS is a positive stress is going to be when you have moderate levels of stress, um, in the presence and presence doesn’t have to mean touching in presence means that, you know, you have someones, this could be a teacher, right? Someone’s got your back yeah. Of a loving, secure attachment with a, with a person in your life. Okay. Um, and that’s actually an important type of stress to experience. How does that mean that, you know, oh, you know, if you don’t let your baby cry or if you’re an attachment parent, you’re not you’re overprotect. No, we’re not shaming anybody on either side. We’re saying that trauma research, can’t be weaponized to shame parents into thinking that if they have a different approach to responding to their children’s cries, particularly, you know, for sleep or to maintain own mental health, that’s, that’s okay. You’re not going to damage your kid. That is not the same as war time separation exposure to chronic yelling and conflict, domestic violence, poverty, and equating the two frankly, is a pretty privileged stance. Yeah.
Nope. That, that, and I’m, I’m so happy that you, you know, explicitly said that because I have parents that will say to me and okay, Eva, are you sure that this is not going to ruin my kid for life? Um, because I heard and I read, you know, XYZ. Um, and so you’re explicitly saying like, you know, yes, healthy attachment can be ruptured in these specific, various extreme, awful heart wrenching situations. Infant sleep training is safe and does not fall into that pattern.
Say here. Of course my, my response is to be more nuanced. Cause I’m all about the nuance. A hundred
Percent. I’m trying to generalize.
What I would say is that if you engage in sneak safe practices, right. Which means you have to be safe when you go sleep, right. There are, there are things you have to be careful with there and you have to be safe when you sleep train. Right. So, you know, leaving the house for a night and not monitoring your kids so that your child can Sue them. That’s not speed training. Right. But if somebody wants to make that claim, of course that’s not okay. But you know, a safe infant sleep training program, meaning that you were doing it in a planned and thoughtful way and a safe co-sleeping program can both be to healthy attachment. Neither one of those choices is going to make your attachment. So you could co-sleep into all the seven BS and not necessarily have a secure attachment. You can never sleep train and not necessarily have a super attachment. And it’s not going to break your attachment. That’s, that’s what I wanna, what I want to leave people with choice in itself is not what attachment is about at all didn’t research sleep at all. Right. You know? Um, and there are various the practices all around the world with kids that have secure attachments. Yeah. It’s not a one size fits all thing. So you gotta make sure you’re okay.
Going back to what you were saying, like this is, you just got head north, right. And that’s one path that you can take. And there are other paths that you can take, but this path, if you want to take it, we’ll get you north. Yeah. It’s a perfectly acceptable, safe, realistic plan. That path that you can take, if that is what feels right for
You, if you are engaging in evidence-based positive parenting practices. Right. Which is a whole other thing. Right. But you know, meaning that you’re responsive and warm to child. Most of the time, remember 70% is as good as it you’re staying well-regulated most of the time that doesn’t mean happy, sunshine, unicorn, you know, Zen positivity parents 100 day, times every day. That’s okay. Um, if you are doing safe infant or toddler sleep training in that context or do include sleeping in that context, amazing, you can absolutely head do north, right? You find yourself up at night at 11 o’clock scrolling Instagram or whatever. Um, driven by anxiety and fear. That is probably an indication that you need to hit the pause button. And you, that act in itself is going to determine more about your attachment outcomes than to sleep train or not sleep train and paralysis and comparison and ruminating thinking about over and over again. That is what we need to be more concerned about than whether or not you’re going to sleep train. Everybody should just take a big deep breath,
Really like that’s the, that is the conclusion, right? Like take a deep breath. You’re doing good. You’re doing okay. You know, that’s, that’s, it’s, it’s, it’s not that easy to ruin your kid for life. You know, in other words like it’s, it’s not, it’s not as easy as just a couple of days of sleep training and then boom, that’s it, you know, it’s, it’s done. Okay. Shawna, thank you so much for coming on today and delving into this topic in so much more detail, because I know how huge it is for everyone. And I know how groundbreaking, I think so much of this is going to be for so many people listening. It’s it, it gives them that permission to do what they want to do, what they need to do for themselves and for their family so badly. So if people want more of you in their lives, where can they find you?
Yes, you can go to our email@example.com. Um, you can also follow us on Instagram, helping families by, um, I’ll give, uh, links to the research articles we talked about to you, so that can be available for review so that, you know, walking here, we’re staying consistent with the values. Um, and also we’ll give, uh, a code for our course if people are wondering, you know, okay, so I’m, you know, I’m going to do some training. I’m not going to do some training. How do I make sure that I’m engaging positive parenting behaviors that are backed by research? Um, then we’ll, we’ll give that code of HF T sleep. So each T sleep, um, that they can enter for, for discount on our courses.
All right. Amazing. That will all be posted in the show notes. Everybody can access that. Amazing. Shauna. Thank you so so much. Thank you for everyone. Listening. Have a wonderful
Thank you so much for listening. If you enjoyed this episode, please subscribe, leave a review and share this episode with a friend who can benefit from it. I also love hearing from my listeners. So feel free to DM me on Instagram @mysleepingbaby, or send me an email at firstname.lastname@example.org until next time have a wonderful restful nights.
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