Infant Development and Parenting Practices PSY3048

TOPIC 1. Infant Sleep and Parenting Practices.

Infant sleep disturbance can have significant implications for the health and wellbeing of both the developing child and their parents. Behavioural sleep interventions exist to support these difficulties. However, their use has become increasingly controversial, with some parents and theorists claiming these approaches are harmful to children and parent-infant attachment quality. Is there convincing evidence that behavioural sleep interventions are harmful for children?

In your review:

1) Provide a theoretical explanation for how behavioural sleep interventions are believed to work in relation to the management of infant sleep disturbance.

2) Critically review the research evidence for the impact of behavioural sleep interventions for children and their parents, making sure to address conceptual and methodological issues associated with this body of research.

Topic 1. Infant Sleep and Parenting Practices

Proper sleep is considered to play a vital role for the development of cognitive, motor and social skills in infants. It is also responsible for regulating the homeostatic and circadian processes (Young & McCormack, 2024). However, the infants face different types of disturbances for getting an adequate sleep such as frequent night awakening, separation anxiety, confusion about the day and night cycle, frequent requirement of feeding, medical issues such as gastroesophageal reflux (GERD) which negatively impacts the well-being of both the infants and their parents (Da Silveira et al., 2023). There are several types of behavioral sleep interventions such as unmodified extinction, modified extinction, gradual, sleep training, etc. which are utilized by the parents to induce proper sleep in their infants (Kang & Kim, 2021). However, the negative effect of these interventions on the relationship between the parent and the infant has always been a topic of debate. The current literature focuses on highlighting the positive impact of these strategies but there is less evidence on the negative implications of these strategies on the well-being of the parents and the infants which has been mentioned by some theorists. In addition to this, there is less comparative research on the different behavioral sleep interventions based on their effectiveness and cross-cultural differences. Through this literature review, an attempt will be made to explore the theoretical underpinnings of the different behavioral sleep interventions and critically analyse the research evidence to discuss the associated conceptual and methodological issues.

The different behavioral sleep interventions used for ensuring proper sleep patterns in infants have been based on the theories of operant conditioning, classical conditioning and attachment theory. Operant conditioning introduces a two-way approach which states that a behavior is influenced by the consequence of its actions (Akpan, 2020). This can be observed in the unmodified extinction method where the parents remove their reinforcements by giving no response to the infants crying which ultimately lowers the frequency of crying with time (Whittall et al., 2021). Similarly, the theory of classical conditioning states that a natural reflex reaction is influenced by a neutral stimulus (Akpan, 2020). For instance, the presence of environmental cues such as rocking and feeding can make the infant depend on these parameters for getting proper sleep. Bowlbey was one of the initial attachment theorists who discussed the importance of the bonds formed between the mother and her infant for the prolonged survival of the infant and also states that they have an inner urge to develop psychological connectedness with their parents (Bilgin & Wolke, 2020). Aintworth added to this theory by introducing four new attachment styles namely secure attachment, avoidant attachment, ambivalent-anxious attachment through her strange situation study (Robledo et al., 2022). Thus, the different categories of behavioral sleep interventions promote adequate sleeping patterns in infants by breaking the previous sleeping habits, reducing the reinforcement of wakefulness and making them learn new sleep-inducing habits which completely align with these theories.

There has been a difference in the preference of different behavioral sleep interventions among the parents in different western communities. A study involving 43 infants belonging to the age group of 6 to 16 months from Australia were recruited for conducting a randomized controlled trial on evaluating the efficacy of graduated extinction, bedtime fading and sleep education control on parent infant relationship, parental stress and wakefulness in infants. The findings of the study revealed that Australian parents found it difficult to resist their childs bedtime crying and prefer to use graduated extinction method which significantly improved the sleep pattern of the infant as well as the reduced the level of stress in the parents (Gradisar et al., 2016). However, similar study conducted among the infant and the parents of the United States varied in their preferences. A survey was conducted which involved the responses from 2090 parents of the infants belonging to the age group of 3 to 18 months. 64% of the parents supported using different behavioral sleep intervention strategies such as unmodified and modified extinction for improving the nighttime sleep of their infants (Kahn et al., 2023).

However, these difference in the preference of using behavioural sleep interventions in different western cultures has been associated with increased stress in the infants. A randomised controlled trial in Australia recruited 235 families of infants ranging from 6 to 8 months of age. They were randomly allocated with a specific sleep intervention and maintained a diary data for 6 weeks. One of the findings of the study revealed that unmodified extinction method which involved no parental interference for managing the night waking and crying for their children led to increased stress in the infants. They developed emotional insecurity and attachment issues later in their life (Hall et al., 2015). In addition to this, the implementation of these behavioural sleep strategies is also found to impact the parent-infant bond by increasing the stress levels of the parents, disturbing their sleep schedule and inducing elevated levels of anxiety and depression (Etherton et al., 2016). This has been supported by a systematic review which involved 476 articles suggesting that even though these interventions have been helpful in reducing the sleep disturbances in infants, but it has a significant emotional impact on the relationship between the parents and their infants. Though this systematic review highlighted the negative impact of these interventions on the parent infant relationship, but it presents its own challenges of quality of the included studies, heterogeneity in the data and potential for bias (Reuter et al., 2020).

There has also been an increasing interest of the parents specifically mothers to prefer using breastfeeding for reducing the night awakenings in their infants rather than using the behavioral sleep interventions which involves ignoring the crying of their infant. A Norwegian study shows that infants fed with breast milk wake up less frequently during the night, while an Australian study shows a negative correlation where infants who are breast fed at night have more sleep disturbances to sleep alone (Madar et al., 2023; Galbally et al., 2013). This demonstrates effectiveness and perception of breastfeeding as a sleep intervention is variable.

The detailed literature search conducted for evaluating the outcomes of behavioural sleep interventions on the infants highlighted some methodological issues such as use of subjective and objective measures, differences in the temperament of infants and ethical issues associated with the sleep interventions. A systematic review which included 36 studies for data synthesis points towards the different challenges faced in balancing the subjective reports with objective measurements such as actigraphy and the role of long-term follow up in improving the sleeping patterns in infants (St Laurent et al., 2022). The objective measurements provide reliable data by keeping a regular track on the sleep patterns of the infants but is used in a very limited manner due to its high costs. This develops bias in the data reported which is based on subjective measures such as the perspectives of the parents, diary data, etc. Another cohort study conducted by Morales-Muoz et al. (2020) mentions the interplay of different temperaments in infants with their response to the behavioural sleep interventions. It also mentions the unreliability of the data obtained from subjective measurements and the variability in the temperaments of the infants which impacts their response to the sleep interventions.

Positive sleep interventions based on the principles of behaviour modification drawn from operant & classical conditioning are helpful in dealing with sleep problems of infants. Nevertheless, there are dangerous trends that may result from such relations including emotional insecurity and deterioration of parent-infant relations. The difference in the kind of parents prefer for their childrens sleep between in Australian and U. S. and also the difference in cultural contexts also support the importance of culturally appropriate strategies in the use of sleep interventions. Besides, the limitations of the methods used for data collection, like subjectivity of the data and cost of using objective measures call for more advanced research that incorporates both the objective and self-report data. More research should be carried out to further deal with these methodological problems and more research should also be conducted to study the effects of various sleep intervention programmes in the long term solution on infant and parents (Blunden & Dawson, 2020). Sleep quality is an essential feature of early childhood development and parenting to ensure a balance between sleep regulation and families emotional and social welfare is still challenging.

The literature review highlights the complexities and challenges associated with behavioral sleep interventions for infants. Different procedures like, unmodified and modified extinction, has proven efficient in changing sleep patterns but there is contradicting evidence showing that their practice affects negatively the parent-infant relations and the infants emotional health. The data given in the present work indicate that although these interventions positively affect sleep, they might negatively impact parental stress in the families with infants and make children emotionally insecure. Further, the choice of interventions is also culturally dependent; there are cultural differences of approach like on breastfeeding as an intervention rather than behavioral approaches.

Are you struggling to keep up with the demands of your academic journey? Don't worry, we've got your back!
Exam Question Bankis your trusted partner in achieving academic excellence for all kind of technical and non-technical subjects. Our comprehensive range of academic services is designed to cater to students at every level. Whether you're a high school student, a college undergraduate, or pursuing advanced studies, we have the expertise and resources to support you.

To connect with expert and ask your query click hereExam Question Bank