Bleary-eyed 2 A.M. car rides to wear out irritable newborns. Toddlers forging night-long sibling alliances against unsuspecting mothers. Exhausted parents resting their heads on their computer keyboards at work.
Years of hearing stories about sleepless nights for babies and their parents inspired Helena Harow, a maternal and child health practitioner, to pioneer Israel's newly emerging baby sleep consulting industry. Six years ago, the U.S.-born mother of six left her position as supervisor of the maternal and child unit at the Mayanei Hayeshua Medical Center in Bnei Brak to study baby sleep consulting in England and the United States. Together with her colleague, Israeli-born Shira Krauthammer, Harow became Israel's first certified sleep consultant, earning a qualification as a "gentle sleep coach." She now works at Babylink, a Ra'anana-based company that provides pre- and postnatal services, including sleep consultations.
Sleep consulting involves training children - primarily between the ages of six months and two years - to fall asleep independently with minimal parental intervention, Harow explains. "A child wakes in the middle of the night and doesn't know how to fall asleep on his own without being rocked or placed in a car. Sleep consulting is about re-conditioning the child so that he can self-soothe," says Harow.
The process typically involves one home consultation, a customized sleep plan, and extensive follow-up and support over the phone or via e-mail for the next two months.
To the best of Harow's knowledge, she and Krauthammer are the only certified sleep consultants in Israel. To date, there is no governing body in Israel that regulates the sleep consulting industry. And, as with other alternative health professions, Israel's Education Ministry has yet to address certification for sleep consultants. "Anyone can call themselves a sleep therapist," she explains, cautioning against this phenomenon.
"The fact that Shira and I studied in England and have an extensive background in nursing makes us very strong in the field and gives us credibility," she says. "However, I believe that parents need to check the background and experience of a sleep consultant. Where have they studied? Have they been certified?"
Multiple factors to consider
Canadian-born clinical psychologist Dr. Batya Ludman - who is working in Jerusalem now - says that although she does not believe a sleep consultant must have a doctorate in psychology or be a licensed medical practitioner in order to be effective, he or she must demonstrate extensive knowledge about postnatal medical and psychological issues for mother and baby. "There are certain issues when you look at sleep," she notes: "Is the baby premature? Is the child a sufficient weight? What is going on in the rest of family's life? Was it a normal pregnancy and delivery?"
Ludman, who received her doctorate in psychology from Yeshiva University's Ferkauf Graduate School in New York, and who has extensive experience in the field of sleep, explains that the person teaching a child to sleep must have a real sense of the surrounding factors.
Over the past two years, Harow and Krauthammer have trained 70 new consultants in the field across the country, including at least three Anglo immigrants. Amanda Goldman from Liverpool, England, is a graduate of their training course. At a workshop for new mothers in her Jerusalem home last month, she described some of the primary requirements for establishing healthy sleep habits for babies. These include establishing a bedtime routine, helping babies distinguish between night and day through various cues and introducing a "lovey," or security blanket, to help babies self-soothe.
"I strongly believe that almost every child can be taught how to sleep through the night," Goldman told participants. "Sleep deprivation can affect every area of our lives, including relationships, brain function and even weight. If, as adults, it affects every aspect of our life, imagine what a lack of sleep can do to babies.”
Self-trained sleep consultant Batya Sherizen who is originally from the United States and is currently living in Jerusalem says that despite interest in the industry, parents are often hesitant about the process.
“I get asked a lot if there is a lot of crying associated with what I do. People have a very negative association with crying and are afraid that teaching their children to sleep involves trauma,” Sherizen notes. She says she explains to concerned parents that she does not advocate leaving a child to cry, and that the crying lessens at later stages of the process.
More than a year ago, Rochelle Zelcer, an immigrant from Detroit, Michigan, enlisted Sherizen’s support for her son Shlomo, whose sleeping habits started to regress at around four months old. Sherizen created an eating schedule for Shlomo so that Zelcer would feel confident about not feeding him during the night, outside of assigned feeding times. She also taught Zelcer how to assist her son in falling back asleep without nursing or rocking him. “At 16 months old, Shlomo is sleeping through the night without difficulty,” says Zelcer.
The attitude toward crying is one difference that Harow has noticed between native Israeli and Anglo parents. “Israeli mothers have a very hard time with crying. Anglos are harsher and understand that crying exists to a certain extent,” says Harow.
“When we came back to Israel [after the training], Shira and I had to rethink our sleep consulting approach and make it more comfortable for Israeli parents.” Harow points out, however, that her process is as gentle as possible and involves parents touching and soothing their children while they are in the crib.
“We don’t believe in leaving babies to cry alone, but we do believe that they sometimes have to cry in order understand that they can fall asleep alone as long as the parent is with them.”
According to Harow, the demand for sleep consultants is on the rise in Israel due to an increased awareness about the problems associated with sleep deprivation and an increased willingness by mothers to admit to the difficulties they are facing as new parents.
“I think at one point mothers didn’t want to talk about sleep issues, because they felt that they were failing if they or their babies couldn’t sleep,” Harow says. “However, more mothers are working today and it is harder to work when you are up at night with children.”
Harow is currently training 25 tipat halav [well-baby clinic] nurses about sleep-related issues as part of a course at Tel Aviv’s Ichilov Hospital, which began this month. Sleep-related questions are among the most common concerns that mothers share with health professionals, including tipat halav nurses,” says Harow.
Goldman agrees: “Sleep consulting, even maybe more than breastfeeding, is the subject troubling the majority of new parents today,” says Goldman.