Is Sleep Training Evidence-Based? An NDC Perspective on Infant Sleep

If you are exhausted, overwhelmed, and wondering why your baby won’t “just sleep”, you are not alone.

Modern parenting culture often tells us that babies should sleep long stretches, self-soothe, and settle independently within the first few months of life. When this doesn’t happen, parents are frequently advised to “teach” sleep.

As a private midwife and Neuroprotective Developmental Care (NDC) practitioner, I approach infant sleep differently.

Let’s talk about why.

What Is Sleep Training?

Sleep training is an umbrella term used to describe behavioural approaches aimed at reducing night waking or helping babies fall asleep independently.

Common methods include controlled crying, cry-it-out, and graduated extinction — often associated with the work of Richard Ferber.

These approaches are designed to reduce signalling (crying or calling out) at sleep onset or overnight.

For some families, these methods reduce visible distress behaviours within days.

But reduced crying does not automatically equal improved neurological regulation — and this is where context matters.

What Is Normal Infant Sleep?

Within the Neuroprotective Developmental Care (NDC) model — developed by Dr Pamela Douglas — night waking is understood as biologically normal.

Human infants are born neurologically immature. Their sleep architecture is different from adult sleep. They cycle more frequently. They wake more often. They seek proximity.

Waking serves purposes:

• Protection

• Feeding regulation

• Milk supply maintenance

• Neurological development

• Connection and co-regulation

From an evolutionary perspective, proximity-based sleep is protective. Anthropologist James McKenna has extensively described how human infants evolved to sleep in close contact with caregivers.

Waking is not a flaw. It is a feature.

What Does the Research Actually Say?

The research on sleep training is often simplified online.

Here is what we know:

• Behavioural interventions can reduce crying.

• They may increase total sleep duration in some infants.

• Long-term attachment outcomes in low-risk families do not appear significantly different.

• Cortisol research shows mixed findings and remains debated.

What we do not have is strong evidence that night waking in infancy is pathological or harmful when families are supported.

And we do not have evidence that teaching independent sleep improves long-term emotional resilience.

Infant sleep varies enormously. Variation is normal.

The Cultural Context We Don’t Talk About

Expectations around infant sleep are heavily shaped by Western cultural norms:

• Early return to work

• Productivity pressure

• Nuclear families without extended support

• Marketing of sleep products and programs

In many cultures, close proximity and frequent night waking are expected and accommodated.

When parents are unsupported, exhausted, and isolated, sleep training can feel like the only option.

The problem is often not the baby.

It is the system around the family.

The NDC (Possums) Approach to Sleep

Neuroprotective Developmental Care (NDC), often known as the Possums approach, shifts the focus away from controlling infant sleep and toward:

• Optimising circadian biology

• Supporting sensory regulation

• Protecting milk supply

• Reducing parental anxiety

• Increasing flexible, cue-based care

• Reducing unnecessary sleep-related stress

Instead of asking, “How do we make this baby sleep longer?”

We ask:

• Is the baby getting enough daytime sensory input?

• Is feeding functioning well?

• Is there something medical going on?

• Is the baby overstimulated?

• Is the parent depleted?

• Are expectations developmentally realistic?

Often, when we address these foundations, sleep improves organically.

Not because we forced it.

But because we supported regulation.

Safety Always Comes First

Regardless of sleep philosophy, safe sleep practices are non-negotiable.

In Australia, families can refer to guidance from Red Nose Australia for current safe sleep recommendations.

Safety, responsiveness, and informed decision-making can coexist.

If You’re Considering Sleep Training

I do not shame parents.

Exhaustion is real.

Instead, I encourage families to reflect on:

• Is my baby’s sleep within normal developmental range?

• Have feeding or discomfort issues been assessed?

• Do I have enough support?

• Does this approach align with my values?

• Am I responding warmly and consistently during the day?

There is no medal for martyrdom.

And there is no shame in responding to your baby.

Gentle Sleep & Settling Consultations (NDC-Informed)

In my private practice, I offer gentle sleep and settling consultations using a Neuroprotective Developmental Care framework.

This is not about rigid schedules.

It is not about controlled crying.

It is not about ignoring your baby.

It is about:

• Understanding biology

• Reducing distress for both parent and baby

• Protecting breastfeeding where applicable

• Supporting maternal mental health

• Working with your baby’s nervous system, not against it

Every family is different.

Every baby is different.

Care should reflect that.

Final Thoughts

Your baby is not broken.

Biology is not a behavioural problem.

And you are not failing because your baby wakes at night.

If you would like support navigating infant sleep in a way that feels aligned, regulated, and evidence-informed, I’m here.