Thursday, July 19, 2012

Bringing Up Bebe: The Pause





If you frequent baby-related websites, you probably heard about “the pause” even if you haven’t read Paula Druckerman’s Bringing Up Bebe. Because along with all the other feats of magic that French babies and children perform (like eating everything) they also sleep through the night from a very early age.  Druckerman attributes this miraculous French baby sleeping phenomenon to “the pause.”

American parents are given lots of messages about the importance of responding to their infants quickly and consistently (and are frequently advised to never let a small baby cry for long periods of time at such a young age). This behavior is seen as the foundation of a secure infant-parent attachment. So the idea of not responding to an crying infant sounds suspect. But, rather than ignoring the child, the French say they are listening without interrupting. They are trying to distinguish infant cries (is she tired, uncomfortable, just sleeping noisily, etc?) and giving the infant a chance to settle down on her own.

French parents don't believe that "babies should withstand biblical-sized trials. But they also don't think that a bit of frustration will crush kids. To the contrary, they believe it will make children more secure. According to Sleep, Dreams and the Child, 'to always respond to his demands, and never tell him 'no,' is dangerous for the construction of his personality.' Because the child won't have any barriers to push up against, to know what's expected of him." This idea intrigues me. Druckerman insists most French parents are actually turned off by the notion of “cry it out” methods of sleep training {although, according to the author, some of them "pause" for 5-10 minutes, which is pretty much the definition of graduated extinction CIO methods. If that is what parents are doing, then they are just practicing a form of CIO at a very young age. I have no idea if that is the norm in France or what.}

A French pediatrician practicing in downtown NYC explained some of the logic behind this approach to Druckerman, saying that if a baby is just sleeping noisily or barely awakened between sleep cycles, a mother who picks the child up and feeds him is just further disturbing the baby’s sleep and creating a sleep association (the need to be fed or held to fall back asleep) that didn't previously exist. {So parents of poor sleepers aren't just responding to their awakenings, they might be unintentionally causing them.} The thinking is, once you allow and enable a baby to "learn" how to sleep through a sleep cycle transition, like learning to ride a bike, she will be off! Sleeping like a champ in no time.

Maggie sleeping in Mommy's arms when she had an ear infection
Druckerman even provided some research that confirms this. A group of women were given the following advice for caring for their newborns:
  1. Do not hold, rock, or nurse a baby to sleep in the evenings so the baby learns the difference between day and night sleeping.
  2. Once the baby is a week old, do not immediately feed the child between midnight and five A.M. Parents can change the baby, reswaddle the baby, walk/rock/bounce the baby, but only feed him if you've tried all that and he is still crying. (My only concern, I was led to believe that feeding a baby between 12-5am was crucial to maintaining and adequate milk supply, but I'm not doctor or lactation consultant. Also, maybe a baby who sleeps through the night is way more important that your breast milk supply)
  3. Try to distinguish between a baby whimpering in their sleep and a baby who is actually awake. Obviously, never wake up the former.

The remaining women were given no instructions. The results were that at four weeks (FOUR WEEKS) of age, 38% of the treatment group babies were sleeping through the night, while only 7% of the control-group babies were. The French believe that babies have a brief window in which they can learn to either sleep or not sleep. By four months, the fate is set. {at that point, the French pedi in NYC recommends babies who still aren't sleeping through the night experience rapid extinction: put them to bed at 8pm and don't come back until 7am. yeesh.} Conversely, most American pediatricians pronounce those "formative months" a free-for-all, do sleep routines and then whatever you have to (that is safe) to survive those early months. It isn't until 4-6 months that more concrete advice emerges and the parents of babies who didn't figure it out on their own are left to choose between "no cry" (I use quotes because there will be crying) sleep solutions, cry it out techniques, and cosleeping and praying for it to pass.

I found some research that seems to support the French thinking. Depressed and/or anxious moms are more likely to have babies who sleep poorly and much of that was ultimately attributed to the fact that those moms were more frequently picking up a baby who wasn't even or was barely awake! All I can think is, UGH, did I do that? Probably. I wasn't even depressed, just stressed out. I know when Hannah was a baby, I dreaded those times she woke in the middle of the night (all one million of them). It was a special kind of torture because you never seemed to know how long she'd stay awake (would getting her back to sleep be a sprint or a marathon?). I would just pray over and over "just let her fall back to sleep" and then "just let her stay asleep." I found that if I intervened more quickly, it was more likely that she'd fall back to sleep sooner, versus if I waited longer and she got more worked up and took longer to calm down. But maybe it just seemed that way because sometimes when I intervened, she wasn't even awake yet? uuuuugh.

Reading this made me feel sort of annoyed I didn't read about this before my babies were born. I do think American sleep guidance mentions stuff like this, but it is just buried in mounds and mounds of (usually conflicting) sleep advice. I don't think I could (or necessarily should) wait five minutes to respond to a teeny baby, but an actual pause sounds like it isn't such a bad idea. If you're going to have a baby or just had one, I'd definitely recommend reading Bringing Up Bebe for some French perspective on sleeping babies (otherwise, it feels sort of too late). Even if you don't/won't have any tiny babies, there is still lots of interesting non-sleep stuff in this book I'll touch on next.
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