■ Amy Brown, Associate Professor of Child Public Health, Swansea University
BECOMING a new parent certainly ranks up there in the exhaustion and anxiety stakes. Countless parents find themselves questioning at 3am whether their baby is feeding too much, if they should be sleeping through the night by now, and wondering if there is anything else they should be doing differently. Social media posts often boast of sleeping, contented babies while in reality many parents feel unable to put their baby down. Some want a miracle solution — and quickly.
Ever since the publication of Dr Benjamin Spock’s multi-million selling baby and childcare title, the Common Sense Book of Baby and Child Care, countless self-proclaimed experts have offered incredible solutions for infant sleep, feeding and care. Generations of parents have turned to books such as Dr Spock’s for advice over the years, but the thing is — beyond anecdotal evidence — we don’t actually know whether these books work.
The elephant in the room with many of these books is that actually, despite their popularity, they are not based on evidence. Some of them actually go against what we know about promoting positive, healthy infant attachment, well-being and health. In fact our recent research has suggested that some books’ impact on maternal well-being is not good, and that there is a link between their use and an increased likelihood of symptoms of depression and anxiety.
The problem is that there is a potential mismatch between expectations of what the books offer and the reality of being a parent. Our research found that mothers’ experience of following books’ advice played an important part in their well-being. If they found the books useful, the mothers’ well-being was not affected, but if they didn’t find them useful, they were at a higher risk of depression and anxiety. Unfortunately only around a fifth of mothers in the study found them useful – 22 per cent reported feeling more in control – while over 50 per cent found them harmful in some way, and 53 per cent felt more anxious.
Only one in ten of the participants felt that the advice in the books made them less tired, while one in six actually reported feeling like a failure because of them. The promised nights of sleep did not emerge. Given that mothers who are already feeling anxious and miserable might be drawn to these books as a solution, the potential for things to be made worse is concerning.
So why don’t these books seem to work for most parents? Most likely because the suggestion that you can encourage a baby into a parent-led routine goes against a lot of what we know about young babies’ needs. Babies need to feed often because their tummies are small. Breast milk in particular is really easily digested so they need to feed lots, which also helps build a good milk supply.
Waking at night is normal too. After all, lots of adults wake up at night but can attend to their own needs such as pulling a cover back over them or getting a drink. Babies need help doing this. Finally, human infants are really quite vulnerable compared to many other mammals. They can’t even hold their heads up let alone walk and feed themselves shortly after birth. This means that they are programmed to want to keep their caregiver close.
Trying to persuade babies that they want to feed less often, sleep through the night and lie contentedly on their own flies in the face of normal developmental infant needs. Although some parents may be lucky enough to find it works for them, many others will find it instead creates other issues. For example, trying to limit how much a baby feeds can reduce milk supply, making them distressed, and increasing the likelihood of breastfeeding difficulties. Not responding to an infant’s cries at night is stressful for their developing brains too. Meanwhile, sleeping close to their mother at night promotes a steadier temperature, heart rate and breathing.
Saying all of this, you can fully understand why parents are drawn to books that promise that routines will work. Motherhood is exhausting and many new mothers are now isolated from family, which can increase the risk of depression. Many may need to return to work while still dealing with sleepless nights.
It’s normal for parents to worry about whether they are doing it ‘right’. But they should remember that a baby having frequent needs and wanting to be kept close is normal. In fact, responding to babies’ needs helps the newborn to learn that the world is a good place.
Books and ‘expert’ advice may seem like a good idea but the fact of the matter is that little ones respond to biology, and haven’t been reading the same advice as mum or dad.