A response to claims against the Middlemiss research

For that line of thinking to work, logically, any new location has to be stressful for baby. Regardless of caregiver presence or responsiveness. Now even if they (sleep consultants) insist that this only applies to sleep, they are still making the claim that babies will automatically have higher cortisol levels if they are in an unfamillar location. 

Which means that they would have raised cortisol; when you go to vist family, go camping, go to the beach for a weekend, go on vacation, move house, move them rooms, move them from a bassinette to a cot, if they are out and about in their stroller, or carrier, if you start them in daycare, and so on. 

In other words: you are stuck in your house for every sleep for the entire first year at least. ​

Once again I have read a comment stating the Wendy Middlemiss' study on the effect of sleep training on babies coritisol levels is fundementaly flawed and therefore completly discreditable because the study took place in a "hospital"

Ok lets get one thing straight, right now. It was not a hospital. It was a mother and baby sleep clinic. The whole purpose of these buildings, their entire reason for being is to teach parents sleep-training techniques using a residential program, rather than an in-home program. This is the major government funded residental sleep center in Brisbane - The Ellen Barron Family Center yes it is located on the campus of a hospital, as are the private hospital equivalents, but it is not a "hospital" you don't get put in a ward, given a drip line. You are not surrounded by sick people and hurried staff who are trying to deal with multiple emergencies or patents needs at once. They don't come with the "hospital" vibe and related stress. 

So what those claiming that the study is flawed because it didn't take place in the home, is that it didn't take place in the home, and any rasied cortisol can be attributed to the unfamilliar surroundings, not the sleep-training process. Aussmably they belive that if both groups had been in the home, the sleep-training group would have shown very different responses. 

And that's where they loose me.

Let tease out this argument shall we. 
 
For that line of thinking to work, logically, any new location has to be stressful for baby. Regardless of caregiver presence or responsiveness. Now even if they insist that this only applies to sleep, they are still making the claim that babies will automatically have higher cortisol levels if they are in an unfamillar location. 

Which means that they would have raised cortisol; when you go to vist family, go camping, go to the beach for a weekend, go on vacation, move house, move them rooms, move them from a bassinette to a cot, if they are out and about in their stroller, or carrier, if you start them in daycare, and so on. 

In other words: you are stuck in your house for every sleep for the entire first year at least. 

Considering how much pro-sleep trainers like to argue that sleep training prevents post natal depression, I'm confused as to why they would turn around and promote issolation from society. 

​
Now you might aruge that carriers, or car seats or prams become fammiliar locations, and allow the baby to have a space of calm where they feel safe to sleep, despite the greater suroundings. I agree. But Tizzie Hall doesn't. Nither do Gina Ford, Gary Ezzo, Tracy Hogg and all the major sleep-training authors/promoters.  

Their entire system is built around convincing parents that their baby needs to sleep in its own bed. 


From full on Extinction methods, through Cry-it-out, Controlled Crying, Controlled Comforting,  to Responsive Settling, they all insist that the best place (and in fact the only acceptable place) for baby to sleep is in it's bed. They even make up or appropriate terms like "Junk Sleep" and "Catnapping" and use all sorts of research (done on Adults btw)  to make you question the quality of sleep that your baby gets if they fall asleep on you, at the breast, in the pram, in the car, in the swing, anywhere that isn't their bed. But none of their claims that the babies' bed is the only place that baby will get sufficient quality sleep for brain development actually stack up. ​

While western sleep trainers and “baby whisperers” consider the inability to self-settle as a fault needing correction, those who study humans – anthropologists – look beyond the expectations of modern parents and look at what is normal for babies. And they tell a much different story. Throughout history, babies have fallen asleep at the breast, while being held or carried and while lying in bed with their mothers. And this is not only of historical interest – these practices are still considered normal infant care by the majority of human societies, as well as other primate communities.


In Indonesia, Balinese babies sleep with their mothers until they are three, and are carried on their mother’s back as they go about their daily work. Else they are passed to an aunt, grandmother, sibling or cousin to be carried. It’s unusual for these babies to be on the ground.
Italian babies do not have a bedtime, and often fall asleep before their parents put them down in their shared bedroom.
In Turkey, breastfeeding to sleep is common, and babies are swaddled and rocked to sleep in cradles. Babies are rhythmically lulled to sleep in baby slings, hammocks and cradles in most cultures. Lullabies are universal. Nomadic tribes space their babies, to allow for the carrying of children until aged four, when their legs are strong enough to keep up with the tribe Yvette O'Dowd (Belly Belly)

(Just no one tell western parents that or these sleep trainers might be out of a job!)


Oh, well....but, the "unfamilliar surroundings" they caused the the cortisol spikes......


Sorry. You're out of luck there. Yes, your argument might stand up if we are talking about babies who have already been sleep trained. Those who have been taught sleep associations that rely on familiar surroundings to instill calm, rather than sleep accosiations that rely on parental responsiveness to instill calm.

But the babies in the study have not been sleep-trained. So the babies in the study have not been taught that the only place they are allowed to sleep (and therefore the only place they will feel safe to sleep ) is their own bed. The babies in the study are most likley used to falling asleep wherever they are when they are tired, and it is highly likely that for many of them, their preffered sleep space is on their parent's chest. 

What does this mean in terms of the Middlemiss study? Well firstly it means that, the critics are trying to convince us that a learned behaviour is an innate behaviour, and that and after-affect of sleep training can logically be applied to babies who are yet to be sleep trained. 




Now you could argue that parental presence overides the stress of the unfamillar situation. Again, I agree, so does Mary Ainsworth. But then you would have just contradicted your own argumemt that the Middlemiss study is flawed because it was done in a non-familliar setting. So.........that's just confusing. Which do you belive?!


Personaly I fully expect that if they actually tested it the babies in Dr Meckenna and Dr Ball's studies on bedsahring would have no raised cortisol, despite being in a sleep lab (and a lab where you are being watched, filmed and are hooked up to dozens of monitior is much more hospital-like/stress inducing than the mother baby clinic Midllemiss used.) because they still had parental responsivness. 

SImmilarly being in the home, in the babies' fammiliar sleep space doesn't automatically mean lowered cortisol. 

Again, no one has tested it yet. But i'm pretty willing to bet that if Wendy Middlemiss repeated her study with in home sleep-consultants, the results would be the same. The sleep training group would show high levels of both mother and babies cortisol on night 1, and a lowering in the levels of mum's cortisol over the week, but not in the babies level. 

One day, someone will actually test those situations, and we will know the answer, in the meantime, I'm going to stick with the insticnts of  67% of the world and the entire of human history - babies are not ment to sleep alone.


Edit: 2017 - Wendy Middlemiss has recently authored a new study looking at "Responsive Settling" 
I'm not defending that one. 
It's got issues. 

This is Tracey Cassells of Evolutionary Parenting's breakdown