How Your Doctor Might View Night Waking

It would be natural to turn to your General Practitioner (GP) if you are struggling with your older baby or toddler’s sleep. In Australia, GPs provide primary health care and are partly or fully funded by Medicare.

However, how your GP will counsel you might not be the support you are seeking if you have chosen a gentle parenting approach.

The Royal Australian College of General Practiitioners’ (RACGP) website outlines in Behavioural Intervention: Infant Sleep Problems and Maternal Mood.

One-third to one-half of Australian parents report a problem with their infant’s sleep in the second 6 months of life.

Infants aged 6–12 months with severe sleep problems according to parents. Problems include waking more than 5 nights a week, waking more than 3 times a night, taking more than 30 minutes to fall asleep or requiring parental presence to fall asleep.

Infants with sleep problems are more likely to sleep in the parental bed, be nursed to sleep, take longer to fall asleep, and wake for often and for longer periods.

The presence of an infant sleep problem is a strong predictor of maternal depression.

Infant sleep problems and postnatal depression are both associated with increased marital stress, family breakdown, child abuse, child behaviour problems and maternal anxiety. Postnatal depression can adversely affect a child’s cognitive development.

The solutions suggested are both extinction-based methods of sleep training:

A brief sleep intervention based on teaching parents techniques of ‘controlled crying’ or ‘camping out’.

Controlled crying

With controlled crying, parents respond to infant’s cry at increasing time intervals, allowing the infant to fall asleep alone.

Camping out

Parents sit with infant until infant falls asleep and gradually reduce their presence over a period of 1–3 weeks.

There is no discussion of night waking being typical in the first and second year of life. There is no reference to development impacts of infant sleep. There is no alternate approach offered. The Patient here is the parent and the problem to be fixed is the baby. The priority if the maternal mood and potential Postnatal Depression.

After two weeks, the following reasons are given if the problem has not been solved:

If the sleep problem has not improved, consider possible reasons, such as:

• behavioural technique not being correctly implemented

• parent disagreement about how to manage sleep problem

• maternal or paternal depression.

What to keep in mind:

• Night feeds are an important part of breastfeeding throughout the first two years.

• Babies should share the same room as their mother for the first 12 months

• Evidence shows that cortisol levels rise and remain high after an infant ceases crying with extinction.

• Parents of wakeful babies need support to manage their mental and physical health without risking infant mental health.

You are not obligated to follow your GPs advice and might like to seek evidence-based approaches using the philosophy of Neuroprotective Development Care (NDC) also known as the Possums Program. Search here