What the Heck is Musical Head Banging?

I thought I knew what musical head banging was.  I was wrong.musical head banging 1

In 1995 I won a musical head banging contest at my niece’s bat mitzvah. As I recall the DJ played “Smells Like Teen Spirit” by Nirvana. I did what any student of 70’s hair band culture would have done. I planted my feet firmly in place, raised my right arm, saying “I Love You” in American Sign Language (cuz rock n’ roll is all about the love, dontcha know?) Then I proceeded to make like I was hammering finishing nails into a two-by-four. With my forehead. Brother Beavis will demonstrate.

I was so naive. That was NOT musical head banging.

Apparently, musical head banging has something to do with your baby’s sleep. It is claimed by some “experts” that if you play music to your baby as she falls asleep in the crib, she may develop musical head banging. And this is bad.

I learned this from illinoishomepage.net in an article entitled “Sleep Problems”

CHAMPAIGN COUNTY, Ill.

You might think letting your baby fall asleep to music is a good thing, but old habits sleep hard. It could actually negative affect their sleep.

It sounds harmless, but letting baby drift off listening to music might have a few consequences. Studies show constantly relying on certain sounds to go to sleep can create a need to listen to music.

So, if they’re away from home and don’t have access to that music, baby might not be able to sleep without listening to it first.

This could lead to musical head-banging. Music could make your child more likely to bang their head against solid objects.

If you think music isn’t the right choice for your child, experts suggest a white noise machine. It will drown out household sounds and provide a quiet environment for them to sleep in.

You can even find some apps for them on your smartphone.

A graphic in the accompanying video suggests that livestrong.com is the source of this information. I followed the lead and found this article from s2015. It states, in part,

[H]eadbanging (sic) is the habit some children have of banging their heads against solid objects. If you have a child who bangs his head, you may notice it’s more prevalent when falling asleep or when listening to music, notes the University of Michigan Health System. That means headbanging could be exacerbated when your little one listens to music to fall asleep.

I was floored. I’ve been a sleep consultant for a long time and I’ve never heard of this phenomenon before. According to her bio, the author of the piece, whom I will not name, “specializes in health, fitness and lifestyle topics. She is a support worker in the neonatal intensive care and antepartum units of her local hospital and recently became a certified group fitness instructor.” I wonder if she’s ever had a baby?

Not finished with my search, I checked the references at the bottom of the article. There was one piece that did indeed come from the University of Michigan Health System web site. The subject of the article was “Bad Habits/Annoying Behavior“. Here is what this piece had to say about head banging:

Body rocking is when (sic) a child rhythmically rocks while either sitting or resting on their knees or elbows. This behavior usually starts around age six months and disappears by age two. Most children rock for 15 minutes or less. Like head banging, it occurs while listening to music or falling asleep.

That’s it. How did we get from here to “Music could make your child more likely to bang their head against solid objects”?

I’m afraid what happened here is the internet version of a game of telephone. The message got so garbled by the last call that this television station in Illinois ended up giving some pretty dumb advice to parents.

What is Musical Head Banging, Really?

It’s one of two things. Babies rock and bang their heads sometimes when they are tired. It is a sort of self-soothing technique. It usually lasts no more than 15 minutes. Other babies bang their heads as a kind of what I call “Stupid Baby Trick”. Bonking her head makes the baby hear this hollow ‘thud’ sound that she didn’t expect. Any unexpected sensation is interesting to a baby. She’ll keep doing it because, well, it’s interesting. The same thing happens when she pulls her own hair (it HURTS!) or gags herself with her own fist.musical head banging 2

Eventually the child gets bored and the behavior stops. But sometimes the baby keeps the behavior going if it gets a big reaction from a caregiver. It is as if the baby says to herself “I’m getting bored with this head banging thing, but look what a reaction I get from mom! I’m gonna keep this going!”

Can music become a negative sleep association?

Something else the Illinois article said caught my attention. It was the suggestion that that music at bedtime might interfere with sleep: “Studies show constantly relying on certain sounds to go to sleep can create a need to listen to music (emphasis added).” What were these studies?

I went to the online National Library of Medicine/National Institutes of Health, affectionately known as “PubMed“. I performed every search I could think of combining “music” and “sleep disturbance” or “sleep associations”. I could find none. There are no such studies. Playing music in the nursery does not interfere with the process of a baby falling asleep or staying asleep. In fact, one of the sources cited at the livestrong article actively recommended music to help a baby fall asleep.

Unless of course you decide to blast “Smells Like Teen Spirit” in the nursery.

Insomnia in Children

There’s something important about insomnia that I did not know before I studied it.

I confess I thought of insomniacs as people who stayed up all night because they did not get tired. I was wrong. People with insomnia are not merely tired. They are exhausted. They want to sleep desperately but cannot. The less they sleep the worse a person suffering with insomnia feels.

Worst of all, perhaps, children suffer from insomnia too. And it’s more common in children than I ever imagined. Some experts believe that as many as 30% of children suffer from insomnia or other significant sleep disturbance.

Insomnia in Children is Different from Adult Insomnia

…in some ways at any rate. It is often the parent, not the child, who first notices that there is a problem. And children have a type of insomnia that develops with the “help” of their parents. I’ll get to that a little later. But many of the causes are very similar to the things that keep adults awake. In fact, many adults report that they’ve had trouble sleeping since childhood.

The simple definition of insomnia is “habitual sleeplessness”. But embedded in that simple definition is the entire field of sleep problems in children. The problem is most often lack of sleep, or absence of enough sleep. The trick is to figure out what makes the absence of sleep “habitual”.

In children, we tend to define insomnia by its effects, not by its duration. If the sleeplessness has a negative effect on the child or her parents, it does not matter how recently it started or how long it lasts.

Long- and Short-term

Having said that, sometimes it’s useful to ask how long the child has had trouble sleeping. Short-term reasons for sleeplessness include illness, or a medication the child is taking. The sleep problem will often go away when the child recovers or stops the medication. But if the child is not sick or taking medication, and yet the sleep problem happens at least three times per week, and/or lasts more than a month, there might be another problem that deserves medical attention.

Need a SLEEP COACH?

I firmly believe that sleep is the natural condition. Children (and adults) sleep naturally unless there is something keeping them from sleeping. So it’s essential to figure out what is keeping the child awake.

Symptoms

In children, you are less likely to have her come up to you and say “Gee, mom, I’d really like to sleep but I can’t!” More likely, you’ll notice something is wrong before she does. Common symptoms in children include:insomnia 5

  • Early Waking: Typically, we’re talking about a child who awakens at 3:45 AM and appears to be up for the day. This may appear first as an annoyance to parents. It’s important to realize the child is not doing this on purpose!
  • Anxiety about going to bed and being able to fall asleep: The child knows they’ll have trouble falling asleep and they’re anxious about it. These anxieties can take the form of fear of the dark, or fear of monsters under the bed. The more anxious they become, the tougher it gets for them to fall asleep!
  • Daytime Sleepiness: Even if you believe the child is sleeping at night, they might not be getting enough restful sleep. They’ll tire out during the day.
  • School or behavior problems: Sometimes the first sign of a sleep problem will be notes coming home from school. Or you may notice the child misbehaving when she never did before. Or she’s misbehaving more often than before.
  • Irritability/mood swings: Irritability simply means sensitivity to changing moods quickly. This is different from simple grumpiness. The parent reports that the child is “easily set off”, or that she “flies into a rage” over seemingly small things. Lack of sleep will do this to a child (or an adult, for that matter!)
  • Depression: Sometimes the sleepless child will not be irritable or badly behaved. She’ll just have a flat, or depressed mood. It’s difficult sometimes to know which caused which, lack of sleep or the depression (more on this below)insomnia 1
  • Hyperactivity: It’s not unusual for children to misdiagnosed with ADHD. To some extent, this is understandable. Lots of things are mistaken for ADHD. Narcolepsy and Restless Legs Syndrome, for example. But neither is this an excuse. Whenever teachers or any other authority suggests to you that your child may have ADHD, it’s necessary to rule out other causes for the behaviors.
  • Decreased attention span: It’s difficult to concentrate when you haven’t slept. Most of the time the child herself will not realize she cannot stay on task. It will be pointed out to her by others.
  • Aggression: This is a product of the irritability mentioned above. A previously docile child may lash out unexpectedly. This is a red flag that should always raise concerns about a sleep disturbance.
  • Memory problems: There is a close association between sleeplessness and memory problems. It is suspected that a normal sleep pattern is necessary for solidifying memories. This is important to remember for students pulling “all-nighters”. Lack of sleep never helps memory.
  • Making errors or having accidents: This is a particularly serious, potentially deadly sign in young drivers. Attentiveness, distractibility, and reaction time are all affected by sleeplessness.

What Causes Insomnia in Children?

  • Stress: We like to think of childhood as carefree and blissful. Sadly this is a myth. It always has been a myth. Childhood is stressful, more or less for many, if not most children. Children have a limited number of ways to communicate that things are not okay in their world, and loss of sleep is one of them (the others are acting out and refusing to eat).
  • Caffeine or other stimulants: Many parents do not realize just how much stimulant their children are consuming in the form of soda and so-called “power drinks”. Leave aside the issue of sugar, and the damage it wreaks! You should always examine the diet of a child who cannot sleep.insomnia 3
  • Medications: The treatment for ADHD is notorious for causing insomnia. The medications are amphetamine-based stimulants. One thing for certain is that no inattentive child is made more attentive by losing sleep! These medications should be very closely monitored to say the least, if not eliminated entirely.
  • Medical causes: Difficulty breathing is a common, often unrecognized cause of sleeplessness. Sometimes sleep disturbance is the first sign of asthma in children. Children with obstructive sleep apnea often have a great deal of difficulty staying asleep. If a child is too itchy from her eczema, or too uncomfortable with her heartburn (reflux), she may have trouble falling asleep and staying asleep. Finally, thyroid problems may cause sleeplessness. All these potential causes should be addressed with a physician.
  • Psychiatric causes: Depressed children often do not sleep well. Their anxiety and irritability may be worse at night when they are not distracted by daytime activities. And then there is the cause no one wants to talk about, physical or sexual abuse. Nevertheless, abuse is a cause of sleeplessness and we should take it seriously.
  • Environment: Places that are too loud, too hot, too cold, or too light are difficult to sleep in. So are places where electronic devices are too close by!

The Special Cause of Childhood Insomnia

There is one cause of sleeplessness in which the parents are very much part of the cause. Many children cannot sleep because their parents did not allow them to learn to fall asleep on their own. These are the parents who, with the best of intentions, allow their children to develop bad sleep associations. The problem may be that the child needs contact with parents to fall asleep. Or perhaps the child needs to have a bottle or pacifier. These dependencies often lead to sleep problems that the parents end up wishing they never got into.insomnia 4

Another cause is parental lack of limits-setting at bedtime. Again, I’m sure this is done with the best of intentions, but the results can be devastating for sleep. For example, the child who asks for glasses of water repeatedly, or who is allowed to wander the house at bedtime.

Treating Insomnia in Children

The treatment is based on fixing the cause or causes. That’s why it is so important to understand all the possible ways that a child can lose sleep. Regardless of cause, there are some basic sleep techniques that are always helpful:

  • Set a consistent bedtime and routine: Everybody, child and adult, sleeps better when their day is regular and bedtime is is the same time every night. The bedtime routine should be the same as well. It should be as calm and as free of stimulation as possible. If the problem is truly that the child is not tired, try moving bedtime later, by 15 minutes at a time, until the child is good and ready for bed!
  • Comfortable sleep environment: Not too hot, not too cold, quiet and dark! It’s a good idea to keep clocks out of the room of a person who has trouble sleeping. This is especially true of clocks that glow in the dark. It goes without saying that devices with screens must be eliminated. They are the enemies of sleep!
  • Relaxation techniques: Most parents do not know how to teach relaxation. But there is an entire industry of relaxation products available that can help teach a child (or an adult for that matter) how to relax at bedtime. An easy way to start is to make the time between dinner and bedtime as boring and non-stimulating as possible.
  • No tossing and turning! If a child will toss and turn instead of sleeping, have her get out of bed and do something relaxing but boring, like reading in low light. Try this for 20 minutes at a time. If this does not work, have the child repeat at least twice.
  • Cognitive Behavioral Therapy: If medical causes have been ruled out, and you cannot help the child using these techniques, it may be useful to seek the help of a therapist. If nothing else, a therapist may help a child manage the anxiety that so often magnifies sleeplessness.insomnia 6
  • The Bell on the Door: For the child who insists on sleeping with you, I recommend calmly but firmly leading the child back to bed. No arguments, no explanations. You can even tie a bell to the child’s door and respond immediately when you hear it ring. If you do this correctly and do not give in, the child will give up trying to sleep with you.

What About Medications?

I and most sleep experts caution strongly against the use of medications to treat insomnia in children. The first and most important job of the physician and the sleep coach is to find the cause and to treat it. Only in the rarest circumstances, and only as a last resort, should you medicate a child for sleeplessness. The downsides outweigh the upsides. As with teaching a child to sleep on her own when she’s a baby, so it is with curing insomnia. If it is a medical problem, it should be identified so you can treat it. If it is a problem of environment or diet, these should be adjusted.

And if the problem is simply that you’ve developed bad sleep associations or poor limits-setting, these should be reversed. In some ways, these are the toughest causes of insomnia to fix. But fix them you must. The entire family’s sleep depends upon it.

Bottle or Binky in Bed: Bad Idea!

Have you done this? This is for you parents who said they’d never do it. Your toddler sleeps with a bottle or binky in her mouth. You said you’d never do it, but there it is! How did it happen?

The Slippery Slope

It’s a real thing, folks. When you step out on to the edge of the slippery slope you end up at the bottom before you know what happened. bottle or binky 2

I’ve been there. Trust me, I know what it’s like to suffer from toddler-induced sleep deprivation. You will do anything (within reason) to get the little one to settle.

Perhaps you’ve even said this to yourself: “I’ll give her the bottle or binky just this once. I don’t want it to become a habit. I just need to get to sleep!”

A week, maybe a month later, you remember what you said to yourself and the feeling of guilt creeps in. Because the binky is still in the toddler’s mouth, or the bottle is still in the crib. I’ve been there as well.

The Problems Bottle or Binky Cause

Things seem ok for now. She’s sleeping after all, isn’t she?

bottle or binky1
Is that juice in that bottle?

Yes. For now she is. But what if the binky falls out and she goes looking for it? If she doesn’t find it and wakes up fully, she’ll be pissed! This is because the object in her mouth has become a sleep association. That is to say, something that she associates with going to sleep. If that thing is no longer present when she arrives at a shallow sleep phase in a couple hours, she may go looking for it and fully rouse herself.

What about her new teeth? Could they grow in crookedly because of the rubber object in her mouth 8 hours straight? Yes, it could happen. She might also increase her risk for ear infections.

Then there’s the speech thing.

Don’t Talk With Your Mouth Full!

I have met dozens of mothers who worry that their toddlers aren’t speaking when they should. One look at the toddler can tell the story. If her mouth is full of binky, or if she has a bottle hanging from her lips at all times, she probably is going to have a tough time speaking! I’ve consulted on toddlers who do manage to learn to speak around their binkies, but I must say this is rare. Suffice to say these kids aren’t easy to understand. A friend who is a speech pathologist has managed more than one case by simply popping the binky out of her patient’s mouth!

More Teeth Problems

Another typical “slippery slope” story is the problem of “milk bottle cavities“. I’ve seen my fair share of kids who’s mouths look like this:

bottle or binky
Sorry for the disturbing photo, folks

It turns out that bacteria love sugar. When you bathe baby teeth in sugar for several hours at a time, bacteria that cause cavities have a feast! I know that these parents never wanted their toddler’s two top teeth to rot! I know they only wanted the little one to get to sleep and this was the “only way” to get it done. Well, of course it wasn’t the only way, but once you step out onto that slippery slope, you end up at the bottom before you know what hit you.

The sugar in breast milk or formula is fine for your baby; you’d have to admit it’s good for her! But it is meant to be sucked down and swallowed. Milk was never meant to pool in a human’s mouth for any length of time. The effect on teeth tells the story.

Need a SLEEP COACH?

What goes for milk goes triple for juice. Juice is not fruit. Juice is flavored sugar dissolved in water. There is no good dietary reasons for your baby to consume sugar. How much more so is there no reason for sugar-water to swirl around in her mouth. It does nothing but provide a tasty meal for those bacteria!

Bottle or Binky Before Bed?

As I’ve said before, I’m a big fan of the binky. It can be the breastfeeding mom’s best friend for the first six months of the baby’s life. Prior to 4-6 months, your baby needs some external source of soothing. Beyond this point, the baby is able to do it herself, so she doesn’t need soothing aids. This is when the binky becomes something much less than a friend. It becomes a habit that you desperately wish you had broken earlier. The longer you wait, the tougher it gets. A “window of opportunity” begins to close at around 9 months. By one year of life it takes a strong parent indeed to pry the window open again!

bottle or binky 4
Now see? She’s addicted to it!

As for the bottle, it has no place in the crib, ever.

If you absolutely must give a bottle to a toddler in a crib, it should be a bottle of water (sugar-free) and you should do this only on one particular situation (discussed in “The Three Temptations“). After the child has had her sip, she doesn’t need it any more and you can take it away.

Spiked Shoes

I once heard an ethicist say he wished he could climb down the slippery slope with spiked shoes. Sorry. You can’t do that. No one can. The best way to fix the problem of a toddler who won’t sleep without a bottle or binky is never to give either in order to make them sleep. For a binky, you have some leeway until 6 months. With the bottle, it should be easier:

Just. Say. No.

Climbing Back Up the Slope

But if you do find yourself at the bottom of that slippery slope, not all hope is lost. If your toddler really needs something with her in bed, you can replace the bottle or binky with another transitional (or comfort) object. Whatever it is, it should be something she can put in her mouth that will be safe for her. A blanket or stuffed animal can be a good substitute.

Another trick that works well for some parents is a “goodbye” ritual, timed to coincide with a big event like a birthday. My sister prepared a goodbye ceremony for her daughter’s binky when the girl turned 3. They went and threw away all the binkies in the dumpster, and then and bought a nice present for the little girl. My niece was very enthusiastic about the entire thing.

Of course, it’s ideal to be able to avoid transitional objects and goodbye rituals in the first place!

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How to Get Your Toddler to Sleep in Her Own Bed

Half the battle is over: You moved the baby from a crib to her own bed.

Well… let’s say that one-quarter of the battle is over. Now you have to figure out a way to get her to sleep in her own bed. Maybe you’re one of the lucky few whose sweet little angel sleeps all night in her brand new bed. Not likely, though. Here’s how to close the deal:

How to Get Your Toddler to Sleep in Her Own Bed

Step One: Lay the Groundwork

If possible, let the toddler know her “big girl/big boy” bed is coming. This may not be possible if you had to buy the bed in a hurry on the day she climbs out of the crib for the first time. But if you do get the chance, let the little one know that a terrific present is coming. If she can stand it, you might even go shopping for the bed with her. Be as positive about the event as possible. If you are genuinely enthusiastic about the toddler bed, she’ll pick up on your enthusiasm.

Some parents score by buying the bed and setting it up in the toddler’s room before she makes the transition. You might even have her try to take a nap in it. This is a similar technique that works in toilet training: you introduce the potty long before the child actually sits on it to poop! In a similar way, the toddler bed becomes an “acquaintance” before it becomes a “friend”.

What if There’s No Time to Lay the Groundwork?

What if one day you hear “the thud” followed by the cry of the frightened toddler who didn’t realize it was that far to the floor when she climbed over the rail? No time to introduce the bed (although there may be time to shop)? In this case, you may need to rush the process of introducing the her own bed… like down to less than a day. Your toddler might not like the idea of such a dramatic change. I understand.

Need a SLEEP CONSULTANT?

But changes happen in her life, often suddenly and she always adjusts. This time will be no different.

Step Two: Be Consistent

One thing doesn’t have to change, and that’s your bedtime routine. For me, the “bedtime routine” begins at dinner. After that time, every single thing that happens is regular and predictable. Dinner should be at the same time. Bath at the same time. Book reading at the same time. Everything. Consistency is the key to troubleshooting any sleep issue and this one is no different.

own bed
They’re not sleeping, but they’re happy!

As long as you are staying consistent, it is best to use the same mattress she slept on in the crib, with the same sheets and bedding. Most toddler beds are designed to accommodate a standard crib-size mattress. Perhaps you had already splurged and purchased a crib that converts to a toddler bed. Even better! The point here is that the surface the toddler lays on will feel exactly the same as the crib. This is important to her keeping good sleep associations. You might even consider placing the toddler bed in the same place where the crib stood.

Step Three: Set Limits

If you have a perfectly normal bedtime routine and your little one drifts off to a blissful sleep, then you’re done. But more likely than not, your toddler is going to want to get out and find you at night. Most likely this will happen sooner rather than later.

If you have not done so already, this is the time to baby-proof your house. Gates should be placed on stairs. Cords and outlets should be safely secured and out of reach. Every item of furniture that could be pulled down, including chests of drawers, should be secured.

If you haven’t gotten into the habit of setting limits with your child, this would be a terrific night to get started. The first limit ought to involve your bed. Just because the little one has her own bed, doesn’t mean she can sleep in any bed, least of all yours. Now, some parents are fine with this and I cannot judge them. However, if any or all occupants of the bed are not okay with this arrangement, then it’s not okay, period! Also ask yourself if you still want the little one in your bed in four months. Or what if there’s a new baby coming? What if the new baby has already arrived? Clearly, a limit should be set.

own bed
Now THAT’S what I’m talkin’ about!

The limit goes something like this: “You’ve got your own bed. [Partner] and I have our own bed. Everybody sleeps in their own bed!” Simple and matter-of-fact. No reasoning and explanation is required. If you do not know already, you should know that your toddler does not care about reasons! All she wants to know is: What are the limits and are you (mom) going to enforce them?

Step Four: Enforce Them

Here’s the toughest part. Once a limit is set, it’s got to be enforced. Among the worst things you can teach a child is that the limits you set are phony and you aren’t really serious about them. Children who grow up without enforced limits are more anxious and less happy. They may not show it, but they need limits! Kids test limits not because they are unhappy or imp-ish, but because they need to know that the limits are there and are being enforced by the “Limits Setter(s)”.

Every time she gets out of bed and comes to yours, you should bring her back to her own bed. The tough part of this act is doing it calmly and without emotion. I cannot stress this enough. Remember: no explanation or reason is going to help. It’s just wasted breath. Your toddler is never going to say to you “Gee, Mom! I never thought of it that way! Thank you for explaining it to me”.

Step Five: She’s Got Her Own Bed, Now She’s Got to…

When you return her to own bed, the routine should be the same. Brief, matter-of-fact, and to the point. This is much easier said than done. Your toddler’s main job in life is to find the chinks in your armor and plunge through them. Maybe she’ll ask for water, or a bottle (don’t get me started on this one!) It will be tough, but you are tougher. Stay firm, stay calm, and stay consistent.

The Easier-Said-Than-Done List

  • Be Consistent: Keep the entire bedtime routine exactly the same as it was when she slept in a crib.
  • Set Limits: Everybody sleeps in their own bed. Children thrive on limits. Without them they are lost.
  • Enforce the Limits: No limit is any good if you don’t enforce it. Remain calm. Take deep breaths. And enforce the limits you set. You’ll be glad you did. So will your toddler.

Baby Wise: Parent-led Schedules

Ezzo, Gary, and Bucknam, R. “On Becoming Baby Wise”. Mount Pleasant, SC: Parent-Wise Solutions, 2012

Gary Ezzo is a lucky man.

“On Becoming Baby Wise”, as of this writing, ranks #1 for sleep disorders in Amazon Books. This fact speaks volumes for the message, especially in light of the fact that the messenger, Mr. Ezzo, has been the recipient of some withering criticism for his parenting advice, but especially for his religious beliefs. Some of that criticism, sadly, comes from Ezzo’s own church, or I should say former church. Despite all this, the Ezzo collection has grown to nine volumes. That’s impressive.

baby wise X

When I read “Baby Wise” for the first time, I detected no hint of any religious world-view whatsoever. I did not know of the controversy surrounding Mr. Ezzo and I’m glad I didn’t. I appreciate that the first edition of the book expressed this world-view explicitly. Not so with subsequent versions.

My ignorance allowed me to judge the “Baby Wise” message without regard to the messenger. This is as it should be. Here’s what I took away from it:

Baby Wise

The lesson I took away was the commonsense observation that a baby who has just finished a good feeding is probably not hungry. If one hour later, the baby starts fussing and crying, many experienced parents understand that what is bothering the baby cannot be hunger. Because the baby just ate! “Baby Wise” suggests that parents first seek to find what’s bothering the baby before reflexively feeding her.

This is what happens in the real world. What mother has not looked into the bassinet at her crying baby (whom she finished nursing 30 minutes ago) and thought, “You can’t be hungry, I just fed you!” Mom then proceeds to see if the baby had gas, or needed a diaper change.

Another Fact of Life

“Baby Wise” recognizes a fact of life about babies: they are not born knowing how to get along in this world. They are equipped with certain biological set-points, but becoming a person requires nurture as well as nature. Most parents understand this implicitly.

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Ezzo suggests that babies need to be nudged, gently, in the direction of sleeping when it’s time to sleep and eating when it’s time to eat. This may involve staying with the baby for a few minutes to stroke her back, to sing to her, or to give her a fingertip to suck on. I believe that even parents dedicated to attachment methods recognize this truth. I believe “attachment parents” do a fair bit of nudging themselves, though they might not care to acknowledge it!

Baby Wise Claims the High Middle Ground

It has become fashionable in the Baby Sleep World to claim that one’s own method is “centrist” or a “combination method“, and that all the others are either “baby-led” or “parent-led” extremists. Everyone clamors for the exalted, er, middle ground. Ezzo is no exception.

[Parent-directed feeding] is the center point between hyper-scheduling and the re-attachment theories. It has enough structure to bring security and order to a baby’s world, yet enough flexibility to give Mom the freedom to respond to any need at any time. It is a proactive style of parenting that helps foster healthy growth and optimal development. For example, a baby cannot maximize learning without experiencing optimal alertness, and he can only experience optimal alertness with optimal sleep. Optimal sleep is tied to good naps and established nighttime sleep. These advanced levels of sleep are the end result of consistent feedings. Consistent feedings come from establishing a healthy routine.

baby wise
Who’s the director?

Ezzo then goes on to mis-characterize the so-called “baby-led schedule” and “attachment theories” and exhumes the body of Luther Emmett Holt’s clock-feeding schedule.

I wish Ezzo and others were lumpers instead of splitters. We are all “combination schedulers” now. This is where the “debate” has led us.

Off the Rails

Where Ezzo over-promises and under-delivers comes with his discussion of sleeping through the night.

In fact, healthy, full-term babies are born with the capacity to achieve 7-8 hours of continuous nighttime sleep between seven and ten weeks of age and 10 to 12 hours of sleep by twelve weeks of age. But these achievements require parental guidance and a basic understanding of how a baby’s routine impacts healthy outcomes.

I’m not sure where Ezzo gets these optimistic numbers from, but they do not square with observed data, as in this study:

Continuous night-time sleep for at least 6 hours was noted in 35% of the infants under 3 months old and the proportion increased to 72% by the age of 9–12 months. The youngest infants were fed on average 6–7 times per day at 2- to 3-hour intervals in the daytime and at 4- to 6-hour intervals at night.

Ezzo also nods with his misunderstanding of circadian rhythm. “Babies do not have the ability to organize their own days and nights into predictable rhythms, but they have the biological need to do so.” In fact, babies do have the ability to organize day and night, if they are permitted allow synchronize their sleep-wake cycle with the cycle of day and night. This requires no effort on the parents’ part at all. Just allow daytime to be light and nighttime to be dark. You don’t need to train the sun.

I’m not sure what Ezzo means by a “biological need” to organize day and night. There’s a need to sleep, and it’s probably the case that we do better when we sleep long periods at night. Is this what Ezzo means? Perhaps.

baby wise
Oops. Ran out of track

Back on Track

The remainder of the book gives solid common-sense advice about the hazards of overstimulation and bad sleep associations (though Ezzo refers to the latter as “props”, confusing cause and effect). The chapters on crying, feeding, baby care and troubleshooting are all pretty standard fare.

In short, the similarities between Baby Wise and other baby sleep books are greater than the differences. The latter are cosmetic, the exceptions having been noted.

Summary

  • Ezzo may be a religious man, but “Baby Wise” is not a religious book
  • Apart from some unrealistic expectation management regarding uninterrupted sleep at night, the advice is solid.