As a Certified Breastfeeding Counselor (CBC), you may frequently encounter questions from parents about sleep training. They may wonder whether to use the “cry-it-out” method, or if they should implement a timed breastfeeding schedule.
It’s important to provide guidance that supports optimal breastfeeding practices and nurtures the parent-child bond, while considering the developmental needs of the baby. Understanding the impact of various sleep training approaches on breastfeeding and infant well-being will help you offer evidence-based advice.
It is also important to provide empathetic support, recognizing the challenges of being sleep deprived.
Understanding Infant Sleep: Biologically Normal Patterns
It’s important to remind parents that babies, like all humans, have varied sleep patterns and waking at night is biologically normal. Newborns especially need to wake frequently to feed, not only to support a healthy breastfeeding relationship but also for their own survival and growth.
Night waking is a normal part of infancy and serves an essential purpose in establishing and maintaining the breastfeeding relationship. While it feels exhausting and parents wonder if it is important for nighttime feeds, it is biologically normal for infants to wake and feed throughout the night.
Why Crying is a Baby’s Communication Tool
When babies cry, they are not being manipulative. Rather, crying is a vital communication tool that signals a need—whether it’s for food, comfort, or relief from discomfort. Ignoring or delaying a response to crying can be detrimental to a baby’s emotional development and the breastfeeding relationship.
The Alliance for the Advancement of Infant Mental Health (AAIMH) has clearly stated that responding to an infant’s needs does not create “bad habits,” but instead fosters a secure attachment.
Babies are unable to communicate clearly through words or signs. They may vocalize a bit, but generally, crying is their way of communicating unmet needs or discomforts.
Popular Sleep Training Methods and Their Impact on Breastfeeding
Many parents hear anecdotal success stories about sleep training methods such as “controlled crying” or “cry-it-out.” However, these methods involve varying degrees of not answering a baby’s cries, which can interfere with breastfeeding and emotional regulation:
- Controlled Crying: This approach involves letting the baby cry for progressively longer intervals before offering comfort. While proponents claim it teaches babies to self-soothe, research shows that increased crying can lead to early cessation of breastfeeding and heightened maternal anxiety.
- Cry-It-Out (CIO): In this method, parents are instructed to ignore their baby’s cries completely until the baby eventually falls asleep. Prolonged crying without comfort may lead to emotional distress and learned helplessness, which can affect the baby’s long-term emotional health and attachment.
What Does Research Say?
Studies have shown that sleep training methods, when used on babies under six months of age, are associated with increased crying, premature weaning, and elevated maternal stress. One study found that even when sleep training was initiated at eight months, over half of the babies still had sleep challenges two months later.
By two years of age, no significant differences were observed in sleep patterns between the sleep-trained group and the control group, suggesting that short-term gains may not lead to long-term improvements.
As a CBC, it is important to help parents understand that the primary focus should be on creating a responsive and nurturing environment that supports both the baby’s and the mother’s needs.
Impact of Cry-It-Out on Breastfeeding
Frequent night waking is an important part of maintaining a healthy milk supply, especially during the early months when the baby’s sucking stimulates prolactin levels, the hormone responsible for milk production.
Sleep training methods that involve ignoring a baby’s cries or feeding on a rigid schedule can reduce night feedings, resulting in lower prolactin levels and decreased milk supply. Note that a baby naturally sleeping longer stretches at night is not the same as a baby trained to sleep longer. Each baby is unique, some can meet their nutritional needs with less frequent feeds.
Parents who try to stretch out nighttime sleep, especially suddenly, may risk blocked ducts, mastitis, or a drop in overall milk production. It’s important for parents to understand that breastfeeding at night is not just about feeding—it’s also about sustaining milk production and ensuring their baby receives the necessary calories for growth and development.
Gentle and Breastfeeding Friendly Alternatives to Cry-It-Out
Parents often ask if there are alternatives that don’t involve prolonged crying but still provide more sleep for the whole family. Here are some gentle approaches:
- Responsive Settling: Encouraging parents to stay with their baby until they are calm or to use calming techniques such as singing, rocking, or patting can help reduce stress for both the parent and the baby.
- Co-Sleeping or Room-Sharing: For some families, co-sleeping or sharing a room can significantly improve sleep for both the baby and the parents. Counselors should ensure that parents are aware of safe co-sleeping practices to reduce risks. Co-sleeping is not the same as bed-sharing. Co-sleeping can be defined as baby sleeping within arms’ reach of parent but on their own sleep surface (e.g. a bassinet).
- Breastfeeding to Sleep: It’s perfectly fine for babies to fall asleep at the breast. Breastfeeding is a biologically normal way to soothe a baby to sleep. A mother’s milk contains hormones like melatonin that naturally promote sleep, making it a gentle, effective, and beneficial way to help a baby settle.
Babies Are Not Using Mothers as ‘Human Pacifiers’
One common concern is that the baby is using the breast as a “pacifier.” It’s important to reframe this belief. The breast is not a substitute for a pacifier—the pacifier is a substitute for the breast.
Breastfeeding offers comfort, security, and optimal nourishment. Helping mothers see this perspective can empower them to embrace breastfeeding as a valuable tool, rather than a problem to be fixed.
Supporting Parents: A Balanced Approach
When guiding parents through sleep challenges, it’s important to validate their experiences and offer a balanced perspective. Every family is unique, and there’s no one-size-fits-all solution. By providing evidence-based information and supportive strategies, you can help parents navigate these decisions in a way that respects their parenting goals, supports breastfeeding, and promotes their baby’s well-being.
As a certified breastfeeding counselor, your role is to provide parents with accurate, research-based information that emphasizes the importance of responsiveness and attachment. Educating parents about the impact of sleep training on breastfeeding and child development helps them make informed decision.