Check out Birthing Instincts podcast #363 on the importance of integrating reflexes (ie skipping crawling and going straight to walking and the negative, long term effects).
Side note: I really wish that these articles talked more about co-sleeping/bedsharing. It would seem to me that sleeping with your baby actually solves all these problems. Sleeping with your baby on your chest also is a major solution. Some women still do this, and they report it’s the only way their baby will sleep. It seems very natural to me. I hope her last article discusses this solution/option. She only very briefly mentioned James McKenna. He needs more time in these articles! :)
So interesting about eliciting the Moro reflex more easily when putting babies down on their backs. Thinking back to my babies 15-21 years ago, I vividly remember that happening easily.
Speaking of infant reflexes, skipping the crawling phase is devastating in terms of lost opportunity for other infant reflexes to be fully integrated and is probably the reason it is associated with some of the other problems mentioned. The biggest problem with not crawling is not about strength or confidence. It is neurological!
I wonder if insisting on back sleeping has long-term effects on sleep later in development. We have something of an epidemic of adult, especially older adult insomnias, and while there are many issues already on the table, e.g. poor circadian habits, light at night, etc., this might be part of the mix.
I cannot thank you enough for looking at this critically. It killed me when they outlawed the rock n play sleeper. Anything that makes babies sleep better is a SIDS risk. How can we keep the babies safe and the parents sane?
And PS - this is yet another reason critical thinking is much needed when we investigate research. Snake oil has been around since well, snake oil. sometimes it’s hard to discern the best research.
I really enjoyed part two as much as I did part one. I’m a 1965 spina bifida baby. So that meant that I slept on my stomach probably until I was 10 or 11 years old! I’m the worst for where, despite having a lot of surgeries; you would never know I had it if I were to walk up to you and say hello! Thank you for an in-depth look at this!!
As a mother 27 years ago when the back to sleep had started, I tried for 6 nights to “back” my child which resulted in sleepless nights for both of us. Then I remembered the research critiques I was an expert during a graduate program where I concluded that most research is garbage. Though I was unable to access research on back sleeping and can’t advise anyone else, from the 7th night on I switched her to her tummy and we both slept happily ever after. After that experience I did wonder if the incidence of child abuse has increased since back-to-sleep. Public health needs to get this right. Thanks for these articles. It’s the first time I’ve ever seen any critique of the back-to-sleep recommendations. I hope they open the doors to a better understanding of the risks and benefits. Parents should have an informed choice.
My newborn (3 days old) rolled from his back to his stomach in his sleep. From then on, I put him to bed on his stomach. He wore those weird sacks, so no blankets needed. Same with my other two,
I looked at the new milestones and couldn't believe that babies aren't expected to be sitting by 6 months!
The history of infant sleeping advise over last 100 years is fascinating (so long as you're not anxious parent or grandparent): front, back, front, back.
It also presents a case study to explore cultural and social iatrogenisis, medicalization, and how science is actually done.
many of the families I have worked with over the years (in hospitals and home visiting programs) overall have such unrealistic expectations of infant sleep, and I am not convinced the arguments here are hitting all the points. The big piece missing here is that normal infant patterns of feeding , are frequent feeds, and if we are responsive feeding that means baby wakes often especially in the first 6 weeks. We do not want to see babies sleeping for long stretches especially since frequent feeding is the driver of prolactin hormone levels and milk supply. The unrealistic expectations of sleep have created an entire industry of "sleep trainers" which likewise pick out 1 piece of the physiological norms of infant patterns. As a side- the work of Bergman and others such as James McKenna do focus on infant breastfeeding patterns as being a driver of sleep patterns. When the droves abandoned physicolocal feeding, we saw an over-correction ( as usual) from public health with the Back to Sleep and now Safe to Sleep campaigns.
Mirine--McKenna's work is fascinating and intuitive, and worth a journalistic deep dive of its own. (I mentioned him only briefly in the first installment of this series.) I agree with you that there is a modern expectation of guiding babies into schedules, both eating and sleeping, beginning with the notion that babies should eat every two to three hours, which seems divorced from both the biology and experience of breastfeeding infants. However, in their defense, most sleep training regimens (whatever we think of them otherwise) aren't usually applied until a baby is three months or twelve pounds.
Thank you for pointing out how ridiculous the sleep on your back campaign has become. I wonder if it could have anything to do with the increase in ADHD? I know that lack of sleep can cause ADHD type symptoms. And beyond the child, let's look at the how it is ruining the parents sleep, which makes it harder to care for young children when you are exhausted all the time.
I have cervical problems and severe stenosis at one level that make it impossible to sleep on my face, the way I really want to sleep. I have to sleep on my back but it helps to have something warm to hug against my stomach. It still isn't nice though. I do feel sorry for the babies.
Great writing. Now loop in the factor of the exponentially increased childhood vaccine schedule since 1986, and consider that SIDS is downstream of neurological damage caused by the adjuvants in the inactivated vaccines. The "back to sleep" campaign is downstream of SIDS. And as you have shown, children are developmentally delayed comparing to 2 generations ago (not to mention the explosion of chronic diseases ).
Time to ask the hard questions about every medical intervention and food products we consume
35 years of Peds practice have noticed the shifts in development of infants and also frazzled parents with babies who cannot sleep on their back. 10 years ago I threw the back to sleep philosophy in the trash and educated parents about avoiding the multiple other risk factors. I quit the AAP when their asinine policy of masking toddlers and saying it didn’t affect speech development was rolled out. And don’t get me started on the total lack of evidence based medicine in policies advocating Covid vaccine for children. Also the tunnel vision in ONLY advocating gender affirmation in dysphoric preteens, ignoring a plethora of other causes for angst and dysphoria in this age group. The list goes on and on.
Tim, I'd be interested to know how many pediatricians have stopped paying their dues to the AAP over time. (I wonder whether membership numbers would be made available if I asked. They continue to tout 67,000 members since 2022.) And I'm curious whether you felt any pressure or shame from quitting them, or whether no one really knows who is a member and who isn't.
Have never heard anything from colleagues or patients. I don’t broad cast it but if anyone were to give me grief, I would simply point out some of the more egregious wrong positions the Academy has taken over the past 30 or so years. In reference to the trans issues I fully support affirmation IF that is what truly is occurring. What I see is a cottage industry of psychologist, endocrinologist and plastic surgeons steam rolling preteens down a path of hormonal and irreversible bodily modifications, never considering how a confused 11-12 year old can get drawn into questioning gender identity as the cause of their dysphoria by social media. Rather than appropriately sorting things out, said child gets affirmed by their social media peers and professional adults. My feeling are many of these CHILDREN, if they develop doubts are afraid to voice them for fear of social media back lash from those who originally affirmed them. More and more 17-19 year olds are coming forward expressing regret about their initial decisions, feeling the system railroaded them into the opposite gender. Affirm trans that are REAL, but find out first if it’s REAL.
I’m a pediatric second year resident and in my first year 100% of the SIDS cases in the ED were from co-sleeping or parents falling asleep with the baby in their arms. For me, it seems like airway compromise and suffocation are the key issues with safe sleep. I wonder if we could get to a place where the back vs front issue sounds a bit more like “if your baby is a very very deep sleeper, place them on their back for the first month of life”
Thanks for this observation, KPL. As we'll see in future installments of this series, the trouble is that suffocation is indistinguishable from SIDS on autopsy.
Absolutely right. The term "public health" is oxymoronic. Health is as individual as it gets. Practically all of the advances in general health and longevity are due to improvements in the standard of living---nutrition, clean water, etc. Improvements in medical care has perhaps contributed something to it, but "public health" has been a detriment.
Check out Birthing Instincts podcast #363 on the importance of integrating reflexes (ie skipping crawling and going straight to walking and the negative, long term effects).
Side note: I really wish that these articles talked more about co-sleeping/bedsharing. It would seem to me that sleeping with your baby actually solves all these problems. Sleeping with your baby on your chest also is a major solution. Some women still do this, and they report it’s the only way their baby will sleep. It seems very natural to me. I hope her last article discusses this solution/option. She only very briefly mentioned James McKenna. He needs more time in these articles! :)
So interesting about eliciting the Moro reflex more easily when putting babies down on their backs. Thinking back to my babies 15-21 years ago, I vividly remember that happening easily.
Speaking of infant reflexes, skipping the crawling phase is devastating in terms of lost opportunity for other infant reflexes to be fully integrated and is probably the reason it is associated with some of the other problems mentioned. The biggest problem with not crawling is not about strength or confidence. It is neurological!
Fascinating. Every change has both upsides and downsides. Thanks for exploring some of the downsides.
I wonder if insisting on back sleeping has long-term effects on sleep later in development. We have something of an epidemic of adult, especially older adult insomnias, and while there are many issues already on the table, e.g. poor circadian habits, light at night, etc., this might be part of the mix.
I cannot thank you enough for looking at this critically. It killed me when they outlawed the rock n play sleeper. Anything that makes babies sleep better is a SIDS risk. How can we keep the babies safe and the parents sane?
And PS - this is yet another reason critical thinking is much needed when we investigate research. Snake oil has been around since well, snake oil. sometimes it’s hard to discern the best research.
I really enjoyed part two as much as I did part one. I’m a 1965 spina bifida baby. So that meant that I slept on my stomach probably until I was 10 or 11 years old! I’m the worst for where, despite having a lot of surgeries; you would never know I had it if I were to walk up to you and say hello! Thank you for an in-depth look at this!!
As a mother 27 years ago when the back to sleep had started, I tried for 6 nights to “back” my child which resulted in sleepless nights for both of us. Then I remembered the research critiques I was an expert during a graduate program where I concluded that most research is garbage. Though I was unable to access research on back sleeping and can’t advise anyone else, from the 7th night on I switched her to her tummy and we both slept happily ever after. After that experience I did wonder if the incidence of child abuse has increased since back-to-sleep. Public health needs to get this right. Thanks for these articles. It’s the first time I’ve ever seen any critique of the back-to-sleep recommendations. I hope they open the doors to a better understanding of the risks and benefits. Parents should have an informed choice.
My newborn (3 days old) rolled from his back to his stomach in his sleep. From then on, I put him to bed on his stomach. He wore those weird sacks, so no blankets needed. Same with my other two,
I looked at the new milestones and couldn't believe that babies aren't expected to be sitting by 6 months!
I learned early on to ignore most of the advice pumped out to mothers of infants. Especially milestones.
I put our boys on their stomachs because it seemed better for sleep. They never complained.
Thank your essay.
The history of infant sleeping advise over last 100 years is fascinating (so long as you're not anxious parent or grandparent): front, back, front, back.
It also presents a case study to explore cultural and social iatrogenisis, medicalization, and how science is actually done.
many of the families I have worked with over the years (in hospitals and home visiting programs) overall have such unrealistic expectations of infant sleep, and I am not convinced the arguments here are hitting all the points. The big piece missing here is that normal infant patterns of feeding , are frequent feeds, and if we are responsive feeding that means baby wakes often especially in the first 6 weeks. We do not want to see babies sleeping for long stretches especially since frequent feeding is the driver of prolactin hormone levels and milk supply. The unrealistic expectations of sleep have created an entire industry of "sleep trainers" which likewise pick out 1 piece of the physiological norms of infant patterns. As a side- the work of Bergman and others such as James McKenna do focus on infant breastfeeding patterns as being a driver of sleep patterns. When the droves abandoned physicolocal feeding, we saw an over-correction ( as usual) from public health with the Back to Sleep and now Safe to Sleep campaigns.
Mirine--McKenna's work is fascinating and intuitive, and worth a journalistic deep dive of its own. (I mentioned him only briefly in the first installment of this series.) I agree with you that there is a modern expectation of guiding babies into schedules, both eating and sleeping, beginning with the notion that babies should eat every two to three hours, which seems divorced from both the biology and experience of breastfeeding infants. However, in their defense, most sleep training regimens (whatever we think of them otherwise) aren't usually applied until a baby is three months or twelve pounds.
YES. James McKenna’s work is so great in this area.
Simply put , sleeping on the stomach is warmer. Infants expend a lot of energy staying warm…even more important to premature babies.
Thank you for pointing out how ridiculous the sleep on your back campaign has become. I wonder if it could have anything to do with the increase in ADHD? I know that lack of sleep can cause ADHD type symptoms. And beyond the child, let's look at the how it is ruining the parents sleep, which makes it harder to care for young children when you are exhausted all the time.
I hate sleeping on my back. Poor infants. Eye opening piece. Thank you
I have cervical problems and severe stenosis at one level that make it impossible to sleep on my face, the way I really want to sleep. I have to sleep on my back but it helps to have something warm to hug against my stomach. It still isn't nice though. I do feel sorry for the babies.
Great writing. Now loop in the factor of the exponentially increased childhood vaccine schedule since 1986, and consider that SIDS is downstream of neurological damage caused by the adjuvants in the inactivated vaccines. The "back to sleep" campaign is downstream of SIDS. And as you have shown, children are developmentally delayed comparing to 2 generations ago (not to mention the explosion of chronic diseases ).
Time to ask the hard questions about every medical intervention and food products we consume
35 years of Peds practice have noticed the shifts in development of infants and also frazzled parents with babies who cannot sleep on their back. 10 years ago I threw the back to sleep philosophy in the trash and educated parents about avoiding the multiple other risk factors. I quit the AAP when their asinine policy of masking toddlers and saying it didn’t affect speech development was rolled out. And don’t get me started on the total lack of evidence based medicine in policies advocating Covid vaccine for children. Also the tunnel vision in ONLY advocating gender affirmation in dysphoric preteens, ignoring a plethora of other causes for angst and dysphoria in this age group. The list goes on and on.
Tim, I'd be interested to know how many pediatricians have stopped paying their dues to the AAP over time. (I wonder whether membership numbers would be made available if I asked. They continue to tout 67,000 members since 2022.) And I'm curious whether you felt any pressure or shame from quitting them, or whether no one really knows who is a member and who isn't.
Have never heard anything from colleagues or patients. I don’t broad cast it but if anyone were to give me grief, I would simply point out some of the more egregious wrong positions the Academy has taken over the past 30 or so years. In reference to the trans issues I fully support affirmation IF that is what truly is occurring. What I see is a cottage industry of psychologist, endocrinologist and plastic surgeons steam rolling preteens down a path of hormonal and irreversible bodily modifications, never considering how a confused 11-12 year old can get drawn into questioning gender identity as the cause of their dysphoria by social media. Rather than appropriately sorting things out, said child gets affirmed by their social media peers and professional adults. My feeling are many of these CHILDREN, if they develop doubts are afraid to voice them for fear of social media back lash from those who originally affirmed them. More and more 17-19 year olds are coming forward expressing regret about their initial decisions, feeling the system railroaded them into the opposite gender. Affirm trans that are REAL, but find out first if it’s REAL.
I’m a pediatric second year resident and in my first year 100% of the SIDS cases in the ED were from co-sleeping or parents falling asleep with the baby in their arms. For me, it seems like airway compromise and suffocation are the key issues with safe sleep. I wonder if we could get to a place where the back vs front issue sounds a bit more like “if your baby is a very very deep sleeper, place them on their back for the first month of life”
One thing I notice again & again is a conflation of SIDS with suffocation. If a baby suffocates it’s not SIDS.
Thanks for this observation, KPL. As we'll see in future installments of this series, the trouble is that suffocation is indistinguishable from SIDS on autopsy.
Public health - "we don't do risk-reduction" we like one size fits all.
Absolutely right. The term "public health" is oxymoronic. Health is as individual as it gets. Practically all of the advances in general health and longevity are due to improvements in the standard of living---nutrition, clean water, etc. Improvements in medical care has perhaps contributed something to it, but "public health" has been a detriment.