History of Sleep Training; Part One.
From Homes to Hospitals
Have you ever thought about where it all began? The pressure to sleep train, and all of the guidance that you receive from your pediatrician to avoid night feedings and other “sleep crutches?” This two-part blog post looks at where it all began and provides some historical context for how and why sleep training became a highly sought-after technique in infant care.
In her article, “Changing Cultures of Night-Time Breastfeeding and Sleep in the US” Cecilia Tomori explores the medical and social history of infant care, specifically related to breastfeeding and sleep. Her work takes a closer look at the transitional period in the early-to-mid 1900’s when pregnancy and childbirth went from happening in the home, to becoming medicalized. This transitional period offers a lot of insight into the foundation of sleep training. During this time, people were not only having their babies in hospitals more frequently, but they were also starting to have consistent requirements around pediatric care. Parents were now expected to seek guidance from medical providers, instead of the neighbors, family, and village.
The Pioneers of Sleep Training
During this time the medical providers who were providing new parents with advice, were driven by science that was heavily influenced by Freudian psychology and religion. While Sigmond Freud introduced the world to a variety of concepts related to the mind and psychoanalysis, clinicians providing care to infants and new parents were specifically interested in the Freudian beliefs related to sex and morality.
Simply put, if mothers were too busy caring for infants all night, surely, they would not have the time or energy for sex with their husbands. While this seems outrageous that an entire approach related to infant care was created on the premise that women needed to be available for sex with their husbands, it is unfortunately the foundation for what we know as sleep training, specifically the cry it out (CIO) method.
One of the earliest advocates of “heavily regulated infant care” was Luther Emmett Holt, a physician who strongly encouraged parents to implement strict routines related to feeding and sleep; many practitioners in the sleep training industry still follow his standards to this day. Holt claimed that “…by the age of 3 months, and at most 5 months, all infants can go without feeding between 10 pm and 6-7 am. Holt identified night feeding as the primary cause of wakefulness and disturbed sleep” (Tomori, et.al, 2018). Holt also advised parents that “in order to be effective, crying it out should last for 3 hours.”
Over time, Holt passed the sleep training baton off to a man in academia named John Watson, who took Holt’s recommendations a step further to ensure that “routines and regulation” were implemented from day one, as to not interfere with a mother’s additional responsibilities, such as maintaining the household, and caring for her husband. Watson and Holt’s approaches are still widely referenced in medical care and are still the basis by which pediatricians educate parents.
