Attachment and Sleep: Dr. Sears is Wrong

Sears, W, et. al. “The Baby Sleep Book”. New York: Little, Brown, & Company, 2005, or “Attachment Theory Takes a Holiday”

Attachment Theory: It’s about the Baby, not the Mother

Lots of people talk about “Attachment Parenting” (AP), but not a lot of people know what it is. I’m not sure the Sears family knows either.

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We owe Attachment Theory mostly to John Bowlby and Mary Ainsworth, two psychologists working in the mid-20th century. Put simply, the theory says that infants need to develop a relationship with at least one caregiver in order to learn to regulate their own feelings. On the “Nature vs. Nurture” spectrum, Bowlby and Ainsworth fit solidly on the “Nurture” end. Their type of theory is what we’d call “behavioral”.  Behaviorism stands opposite the “Nature” end, what we’d call “biological determinism”, or “your genes explain everything”.
The truth probably lies somewhere between.

Parents do a more or less good job of helping babies learn to regulate their emotions, according to Attachment Theory.  That’s the whole theory in a nutshell. Nowhere in this theory is there any suggestion that babies should remain physically attached to parents for as long as possible. Nor does the theory say anything about sleep. Or even breastfeeding! The theory is not even about parental behavior; it’s about infantile behavior. That is, it was only about the baby, until the Sears family got a hold of the theory.

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Attachment, Sears Style

I suspect that William Sears (the father of the clan) read “attachment” and took the word literally. Bowlby and Ainsworth only meant the term figuratively. And yet, Sears appreciates that attachment is a subtle and nuanced thing. Here’s how he describes it in his sleep book:

…[A]ttachment parenting (AP) is not a new way of raising children that we and others have dreamed up. It’s what mothers and fathers would do instinctively if they were raising their baby on a desert island

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Attached

Note that Sears is careful not to say that parents have always been this way. He knows enough anthropology to know such a suggestion is wrong. But he does say that attachment behavior is instinctive. Where he gets this idea is a mystery. Perhaps attachment theory predicts the way that modern parents would raise a child on a desert island, far away from parenting books, pediatricians, and pop psychologists. But it is not the way aboriginal parents ever raised children for all but an eye-blink of human history. According to this research it’s doubtful that mothers developed close emotional bonds with their babies, because of the extremely poor chances that the baby would survive infancy! It was not until infant mortality plummeted in the developed world (in the 20th century!) that mothers developed the inclination to bond with their babies. Such a bond is certainly not instinctive, not on the part of the mother anyway.

So what if attachment parenting is a modern invention? So what if it’s a peculiar distortion of Attachment Theory. Is Sears wrong to recommend it?

Yes, He’s Wrong

The sleep book opens its defense of AP with this stunner:

A frequent criticism of attachment parenting is that it puts baby, rather than parents, in control. But can parents actually control their babies anyway? Parenting your baby at night forces you to come to terms with the realistic fact that you can’t control your child’s behavior

You can’t control your child’s behavior? One wishes, in vain, I fear, that Sears doesn’t really mean this. But let’s suppose for the moment that this incredible “realistic fact” were true: how is this going to help us get our baby to sleep? Sadly, Sears never really tells us. In fact, Sears goes on to explain that parents really ought to nudge babies in the right direction. This is what all good so-called “combination schedule” advocates claim. By the way, are “realistic facts” different from other kinds of facts?

When in Doubt, Cry It Out

Sears goes on at length to criticize what he claims to be a virtual army of baby sleep books that allegedly recommend the cry-it-out (CIO) method:

The dictum “let your baby cry it out” has been standard advice in childcare books for more than a century starting with Emmett Holt in 1894

Sears does not provide any examples of this “standard advice”. This is for a very good reason: apart from Holt and experts of his era, there are no such examples. No modern sleep expert recommends CIO. Even Ferber, as I’ve pointed out elsewhere, explicitly rejects CIO. Why Sears constructs this straw man (or should I say “straw pediatrician?) is a mystery.

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Attach THESE, Bill!

A particularly precious argument against the phantom CIO is offered by Sears the Younger (Bob). Dr. Bob tells a story of a mother who lets her 1 month old cry himself to sleep. Years later it turns out the boy has ADHD. Leave aside the the absurdity of letting a one-month old cry himself to sleep: no one who knows anything about infant development would recommend such a thing. How can Dr. Bob draw such a connection? Wait, it gets worse.

Later, Sears suggests that “research” points to a connection between CIO and ADHD. The study in question is about “persistent crying”, not “CIO methods”. There’s an obvious chicken and egg problem here. Are hyperactive 8-10 year olds the way they are because they cried a lot as babies? Or are we looking at a group of children with a biological vulnerability to cry as babies and fidget as school children? The biggest weakness of the study was the finding that these children’s parents but not their teachers saw a difference between the behavior of the supposedly hyperactive group and the control group. Teachers are often much more likely to label a child hyperactive than are parents.

There is much more “neuromythology” dispensed on the subject of crying and ADHD about which I will say only this: just because they’re doctors doesn’t mean they know what they’re talking about. No one has any idea what neurotransmitters have to do with behavior. Don’t believe anyone who claims to know.

Attachment and Co-sleeping

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OOH! These will attach things!

Though Sears claims he believes that babies can sleep anywhere, he clearly prefers that babies sleep in bed with the parents. I wonder if anyone but a board-certified pediatrician could get away with making such a suggestion? Regarding studies demonstrating the dangers of bed-sharing, Sears argues “when there is a conflict between scientific studies, or between science and common sense, suspect that somewhere there’s a fault in the science”.

There is not a word of that sentence that is true. Scientific studies often give variant results. Why should it be otherwise? The bit about common sense is too precious: Common sense suggests that the earth is flat and that the sun revolves around us. When scientific studies demonstrate that the opposite is true, is the “fault in the science?”

The American Academy of Pediatrics has issued several strong warnings about bed-sharing, which is a risk factor for sleep-related infant deaths. Perhaps the Sears book indemnifies itself by going on at length about safety and sleep. But this hardly mitigates the dangerous recommendation. There are an almost infinite variety of sleeping arrangements and devices that parents can use, such as co-sleepers.  Sears comically suggests that, for safety, parents buy the largest king-size bed available. This assumes the reader a) can afford such a bed and b) has the space for one.

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This’ll work too

But Sears isn’t done with the “science”. He suggests that babies are “physiologically safer” when they co-sleep. One has to take his word for it. I will not. It’s a nonsensical suggestion. Sears even claims that babies are protected from SIDS because carbon dioxide is protective and parents exhale carbon dioxide. Nonsense piled upon nonsense. I won’t have any more of this. Neither will epidemiologists. No amount of pseudoscientific piffle will make bed sharing any safer.

The worst part of all of this is that you don’t have to sleep with your baby in your bed in order to develop attachment.

Sex and the Sleeping Baby

Here’s an obvious objection: Dr. Sears, many folks would really rather have sex without another person in the room. Call it bourgeois if you must, but that’s a fact. How does Dr. Sears suggest you accomplish the feat? First suggestion: put the baby in the crib first. Okay, great idea! To which I reply, why not leave her there? Second suggestion: play “musical beds”. In other words, have sex with your husband with the baby in another room. This includes keeping the baby in your room and having sex in the den, or the nursery! Finally, the most puzzling suggestion: morning sex. What, the baby disappears in the morning? I don’t get it. Finally, Sears tips his hand. He’s okay with you having sex in front of your baby. Fine for him and Martha (I really could do without descriptions of Sears’ own sex life). We Philistines value our privacy.

Sears the Lumper

Much as he tries to squeeze baby-led sleep schedules out of his Attachment Parenting system, at the end of the day, Sears can’t do it. He’s a combination-scheduler as much as Ferber, Spock, and Tracy Hogg, the Baby Whisperer. The place where Attachment Parenting falls down is its failure to appreciate the dangers of developing bad sleep associations. I’ll qualify that statement. If mothers and their sleeping partners are okay with a toddler who shares their bed wakes up every three hours to nurse at night, then God bless them!  Who am I to judge? But when they come to me for help them get the child to sleep through the night, I do indeed have an an argument. An argument with Dr. Sears.

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Rob Lindeman

Rob Lindeman is a sleep coach, entrepreneur, and writer living in Massachusetts. Ready to Get Rid of the Pacifier? Sign up for our FREE Video eCourse: The Paci-Free Method http://bit.ly/1U8Tdzx

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