Children and Sleep: UCSF Pediatrician Supports Softening of Ferber "Rule"

In his 1985 bestseller Solve Your Child's Sleep Problems, Richard Ferber, MD, took on one of the most controversial questions that pediatricians are asked to address: whether or not infants should sleep in a crib alone or be allowed to "co-sleep" with their parents. Ferber's answer - that children should learn to sleep alone because it helps them develop self-esteem and a separate identity - became the mantra of parents in the 1980s and 1990s. His prescription that parents train their child to sleep through the night with incremental bouts of crying became known as "Ferberizing." In a new edition of his book, published in May, Ferber has softened his position on whether or not children should be put to bed alone. Jane Anderson, MD, UCSF clinical professor of pediatrics and a general pediatrician at UCSF Children's Hospital, agrees with this more moderate approach. "When pediatricians talk to parents about sleeping arrangements, there are numerous factors that come into play, including how they (parents) were parented, their cultural background, their own sleep requirements, their expectations of how the baby should sleep, the baby's age or developmental level, and the baby's temperament," among other considerations, Anderson said. "What's right for one family may not be right for another family," she said. Anderson said that today, many pediatricians are seeing more co-sleeping among patients in their practices because of the rise in numbers of breastfeeding mothers. "In my practice, 90 percent of the women are breastfeeding their babies," she said. "With breastfeeding, it's much easier to sleep with the baby." Anderson also noted that parents should never co-sleep when using mood-altering substances like alcohol or drugs, or cigarettes. All railings and headboards should be removed from the parents' bed to avoid entrapment, she said. Anderson said that what's most important is that children sleep safely. "If you're going to put them in a crib, it should be done safely, and there are federal safety guidelines for cribs. If you're going to co-sleep, it should be on a firm mattress, without too many blankets." Links: The Little One Said 'Roll Over'