On the importance of understanding research in context

An old friend of mine has a mommy blog. She professes to believe in 'guilt-free' parenting, which I think is amazingly healthy, as well as beyond my capabilities and my anxiety disorder :)

Recently she wrote about an article her husband showed her from the Globe and Mail, titled Coddle or let the kid cry? New research awakens the sleep-training debate. My friend's opinion is that the parenting 'experts' should leave parenting to the actual parents, and stop trying to guilt new mommies into feeling they have to be available for their babies every second of the day and night. Her concern is babies who wake up in the middle of the night but won't go to sleep without the breast, even when they aren't hungry.

While I agree with that, I also agree with the 3 'experts' written about in the Globe article. I just think the reporter takes their research and their professional opinions out of context, and presents the research data as a debate, a fight, instead of as scientific evidence carried out in a rigorous manner with the intention of furthering knowledge. The reporter actually talks about sleep deprived parents being "stuck in the middle" between the 'experts' and other equally offensive (to me) statements pitting 'experts' against 'experts' against parents.

I have recently studied research methods in the social sciences; as well, I have designed and conducted research. So I find the reporter's statements offensive because the point of social science research is NOT to be an 'expert' and tell people what to do. The point is to make sure current practices are evidence based, NOT based on ideology, or a particular sub-set of society's values (as in the tyranny of the minority).

Thus, I felt obligated to look at the actual research (I have access to several electronic databases through my university's library) to see what the researchers were actually studying. The article mentions 3 'experts.' The first is Penn State researcher Dr. Teti, the second, the famous Dr. Ferber, and the third is "British parenting guru" Penelope Leach, whose credentials as a child development psychologist the journalist recognizes only later. I have only looked up one source document to compare to the article. This is Dr. Teti and colleagues' Penn State research, titled Maternal emotional availability at bedtime predicts infant sleep quality (Teti, Kim, Mayer & Countermine, 2010). 

My friend read the article and wrote about sleep-training as necessary when baby is waking up all night long, even when not hungry, and wanting the breast to soothe baby back to sleep. My friend feels waking up at 1am and 3am and 5am is bad for mommy. I agree. But I was a co-sleeper, so I didn't have to wake up to give baby the breast. He fussed, I rolled over in my half asleep, half conscious state, baby latched on, I went back to sleep. No problem. (I'm guessing my friend is not a co-sleeper.)

My friend's blog post also talks about the Globe article's mention of the detrimental effect of cortisol, a stress hormone, on baby's developing brain. She hears, "mommy should never leave baby, even if that means mommy gets postpartum depression." The Globe article concludes with parents who tried 'crying it out' but won't talk about it with their friends, for fear of criticism. I personally think all this criticism comes from popular media such as this newspaper reporter, NOT the actual 'experts.'

If you need to let your baby cry it out alone because you fear you're going to shake that baby, then I'm fairly certain the experts would say, "go for it" - this opinion is based on reading hundreds of articles by 'experts' on attachment theory and the neuroscience research that is backing up the theory (initially developed in the 40's). Much of this research shows that it's best for baby to be with mommy (or alternate primary caregivers), unless mommy is too stressed out, whether by poverty, or relationship circumstances, or what have you. Then baby is better off in daycare, or with grandma, or whatever, for part of the day, because mommy needs that time and support to be the best mommy she can be in the circumstances.

In reading the abstract and skimming the research report Dr. Teti and colleagues published, I noticed that they were concerned with chronic sleep disruption as the clinical research problem, which is associated with "daytime externalizing and internalizing behavioral problems, sleepiness and attention problems, and poor academic performance, and plays a critical role in the regulation of neurocognitive and neuroaffective systems in children and adults." So they are interested in sleep problems which are approaching the clinical level, and not just regular sleep. They are also as concerned with the risk to parents as they are to children.

Teti's study looked at previous research, which highlighted the importance of consistent bedtime routines, without actual observations of parenting in the home. The study's authors note that where research does make actual home observations, the focus was again on parenting practices. The current study felt there was a gap in the research, in that no one had looked at the emotional quality of these routines. Teti et al. though this gap is noteworthy, considering the vast literature linking parental sensitivity, etc., with socioemotional and cognitive outcomes in children.

So Teti et al weren't saying sleep training will damage the parent-child relationship (the conclusion my friend believed the 'experts' came to based on the Globe's reporting). What they were saying was the following (straight from the Discussion section of their paper):

Results suggest that what mothers do with their infants at bedtime (e.g., whether they make use of close physical parent–infant contact, quiet bedtime activities) may be less important than the emotional quality that underlies bedtime activities in promoting quality sleep in infants. Specifically, maternal EA was inversely associated with the frequency with which mothers had to return to their infants at bedtime, the frequency of infant night waking, and mothers’ ratings of whether their infants had a sleep difficulty. By contrast, no linkages were obtained between specific bedtime practices and infant sleep disruption.

My conclusion is that I feel it's vital for the average person to have a basic understanding of research methods and the interpretation and dissemination of research findings so that the media isn't able to spin science in such a manner. Context is everything. My friend is an excellent mommy, because, regardless of her parenting practices (what she does, such as sleep-training), she is an emotionally available mommy. And THAT, my friends, is what Dr. Teti and colleagues were writing about.