Sleep consulting is the latest must-have for strung-out parents. Photo / Thinkstock
Parents are shelling out for sleep consultants despite warnings of the impact on babies.
Emma Purdue isn't surprised when she answers her phone and finds the woman at the other end of the line is in tears.
The Auckland businesswoman started Baby Sleep Consultants about 2.5 years ago and offers a free initial phone consultation to parents struggling to get their little ones to bed.
Every month, Purdue deals with hundreds of mums at their wits' end, sleep-deprived and unsure where to turn.
"Sleep deprivation is absolute torture," she says. "You're so emotionally involved with your child that some women can't cope."
From that first 15-minute chat most callers become paying customers, shelling out from $99 to $600 to have a sleep consultant work with them. Some will opt for a phone or email service and others will spend more for consultants to come to their homes.
Purdue says most parents could expect to see some improvement immediately, and then things to get better still over time.
Sleep consulting is big business. It's the latest must-have for strung-out parents looking for something more personalised — and expensive — than they can get through the health care system of midwives and Plunket visits.
Dedicated sleep consultancy institutes operate internationally, charging thousands for online courses that churn out people promising parents a full night's sleep, at a price. In New Zealand, mums and dads pay anything from $19 for a detailed response to their emails to $3,000 a year for ongoing support.
Purdue's is the biggest firm in New Zealand. Up to 20 consultants work at any one time between Whangarei and Dunedin.
New sleep consulting businesses are opening all the time but because there is no requirement for them to be licensed or registered, it is hard to get an idea of the exact number.
Purdue, a former teacher, says sleep consultancy is filling a gap in the market.
Modern parents operate in a more isolated way than 100 years ago. Mums feel pressure to know what to do "instinctively" but many haven't had a chance to develop those skills.
Family sizes are smaller and people are having babies later in life so, for many parents, the first baby they have a lot to do with could be their own. Throw in a bit of sleep deprivation, lack of support from family and friends, and some start to feel they're floundering.
When her children, now 8, 5, and 3, were small, Purdue lived on Whenuapai airbase with her husband. She immersed herself in books about baby sleep and became known as the person to turn to when a new parent was having trouble.
When the time came to go back to work, she took the plunge and started her own business. The response was immediate.
"There was a giant void in the market for mums who needed sleep," Purdue says. "Sleep is as important as food. We don't deprive new mothers of food but people think it's fine to deprive them of sleep for 12 months."
After operating on her own for three months, she brought her sister into the business as a second consultant, then set about hiring more staff.
Purdue tried working with an American institution that offers sleep consultation certification but was not impressed by the standard of its course work, so she has now registered as a training provider through the International Institute for Complementary Therapists.
New consultants train online through lectures, homework assignments and by working with volunteer clients. It takes 16 weeks to complete.
Purdue's consultants speak to between 50 and 100 parents a week in group sessions and deal one-on-one with about 80 every week.
Babies are coached to sleep with a range of methods, from "no cry" techniques to "extinction" - leaving the child to cry until it falls asleep. The technique depends on the parents' style and how quickly they need a result.
"Often there are situations where parents are in high pressure jobs and are under the pump at work and need a child to sleep through the night quickly," Purdue says. "Then you'd choose controlled crying or cry-it-out methods."
She says her consultants take a holistic view, considering nutrition, the sleep environment and the family situation. "It's not shutting the door and walking away." The business has expanded to Rotorua, Nelson and Whangarei.
Purdue wants to help parents feel empowered. "The big thing I'm trying to get across is you're not a failure for asking for help."
One of the newest sleep consultants in Auckland is mum-of-two Karen Biddlecombe, who launched Karen's Simply Sleep late last year, after completing a three-month online course and a three-day workshop in Sydney.
"The interest I've had is unbelievable," she says. "People want their nights back, they want to be able to go back to work. "
She has worked with eight babies so far, each for a two-week period. She charges from $300 each time after a free 15-minute consultation.
A sleep consultant's impact can be much wider than just a baby who sleeps better, she says.
"A quarter of Kiwis have chronic sleep problems. Getting them while they're babies and learning healthy foundations of sleep is vital. It benefits the whole family."
But is this just the latest must-have in the arsenal of middle class parenting, the next frontier in the "mummy wars" that have parents spending $1000 on a stroller?
Critics say parents are shelling out money for the cachet of having consultants provide them with cut-and-pasted templates of advice they could find easily and free online.
Others question the lack of clarity around qualifications and registration for consultants as sleep consulting is not regulated.
Parenting experts such as Parents Centre argue some consultants are trying to change "problems" that are just part of babies' natural sleep habits.
Daycare centres have complained about parents asking them to change their methods to match those devised by a consultant.
Professor Barry Taylor, dean of the Dunedin School of Medicine, researches children's sleep disorders. He says about 30 per cent of parents think there is a significant problem with their baby's sleep habits — usually things such as refusing to go to sleep or waking frequently.
There is no argument that there are clear benefits to helping parents get their babies into a good sleep pattern, he says. A Melbourne study showed when parents were helped to put a sleep programme in place, there were decreased levels of postnatal depression in mothers because their own sleep had improved.
Taylor says parents seem to be choosing to pay for something that they could get free from their local Plunket nurse.
"People think if they pay $100 they'll get something better than they would from their Well Child service but treating sleep disorders is not complicated and it should be within the reach of a Plunket nurse."
Elaine Gordon, Plunket clinical adviser, agrees and points out that parents have many free options available. Sleep is one of the top 10 reasons parents call PlunketLine, which offers 24/7 free support.
"They can ring the moment they're having problems, from home, and have a one-on-one conversation with the nurse to explore, assess and provide support and guidance that works for the situation."
Taylor says parents should consider how qualified their sleep consultants are. Major problems could arise if a medical problem is missed.
"If you have a straightforward behavioural issue it can be dealt with by behavioural means.
"But they need enough knowledge to pick up on other things that might be affecting sleep. You wouldn't want just anyone on the street. They should have some clinical training to understand the range of things that can affect sleep."
Advocacy and education group Parents Centre has warned its members about sleep consultants, mainly because its own "responsive" style of parenting does not gel with the routine-based method most sleep consultants espouse.
Head of childbirth education Liz Pearce says many parents aren't prepared for what it will be like to have a baby. "Sleep consultants are there to fix the so-called problem the parents perceive they're having but it's normal behaviour for the baby.
"The parents have the problem because they don't have realistic expectations about how life changes."
She says sleep consultants can sometimes offer a Band-Aid fix. "While babies sometimes do go to sleep when you leave them to cry, what are the long-term effects? They're not going to sleep feeling secure, they're shutting down because no one is responding."
Hawkes Bay mum Fiona Woodham says, whatever the arguments, being able to reach out to a sleep consultant when she was getting desperate was a godsend.
She searched for sleep solutions online but nothing was working because she couldn't decide which to commit to. She would try one way, doubt herself, then try another — all the time making her problem worse.
"Ava was four months old and waking up to eight times a night and I had no clue what I was doing.
"I wasn't coping with no sleep and it was affecting my health.
"After one tearful night, my husband suggested finding someone who could advise us."
Over two weeks, she had a series of phone and email consultations with a consultant from Purdue's firm.
The consultant recommended a capped extinction method because Ava couldn't be soothed by touch or words. She would fall asleep within five minutes left to her own devices.
"We set up blackout curtains, white noise and stuck to our schedule like clockwork.
"Within two days Ava was having three good naps a day, the middle of the day one was 2 hours of bliss.
"She was down to one wake-up a night and, less than a month into it, had moved herself on to sleeping from 6.30pm-7am every night."
She says the $150 cost was worth it. "I'd said to my mum when I was exhausted I would pay $1,000 for one night's sleep and for what we paid for our sleep consultant, it was a bargain."
'A rough journey of obstacles'
Jaynie Ball describes herself as an unsuccessful graduate of sleep consultancy. The Auckland mum got in touch with "baby whisperer" Dorothy Waide when her daughter, Avie, was crying for hours before going to sleep each night.
She didn't want to use a method that involved leaving her baby to cry, so Waide's more gentle style appealed.
Waide asked her to fill out a schedule of what she did over 24 hours and deduced that Avie, now 10 months, was suffering reflux because of what she was eating at dinner. "I felt awful as within a day or two of cutting a list of foods out of her diet she stopped the screaming. I felt so bad that I had not noticed the connection but, as it was only nights, it had not occurred to me."
A Skype call followed and Ball was given tools to help teach Avie to settle to sleep. "After initiating the extremely loving and gentle process, she slept through the night for the first time. Ten to 12 hours a night for a week and a half."
But then Avie started teething and would become hysterical when Ball left the room. Things started to improve after more email and phone communication with Waide but deteriorated when Avie contracted a virus and the family moved house.
"She then got more teeth, another cold, another move and now school holidays, where she is sharing a room, so unfortunately she is still getting up between one and three times a night."
Ball says she'd recommend Waide, even though she wasn't successful herself.
"I loved her gentle, intuitive, holistic approach to supporting Avie and me to develop the skills to sleep better.
"We were obviously in a bad place so we didn't fully succeed. We had a rough journey of obstacles, which is no fault of Dorothy's, and I wouldn't hesitate to use her services again in a heartbeat or to recommend her to another tired mumma."
The child is left to cry for gradually increasing periods before being comforted. Comfort could be just verbal reassurance or being picked up. This is also referred to as spaced soothing or capped extinction.
• Pick up/put down: Parents pick up and comfort their baby until he or she is drowsy. They then put the baby down to sleep. If the baby cries, they pick up and repeat until the child falls asleep in the cot.
• Extinction: Parents put the child to bed and leave the room. Consultants say babies can be left to cry for up to 60 minutes but that most will fall asleep within a few minutes if this method is done properly.
• Parental presence method: This is designed to reduce the panic of the extinction method. Parents set up a bed in the baby's room and pretend to go to sleep. They don't comfort the baby but stay in the room until the child goes to sleep. Another option is to sit in a camp chair next to the cot and slowly move the chair further away each day until it is outside the room.
• Fading: Parents continue to help the child to sleep, such as rocking or patting, but gradually do less of it until they wean completely. This slowly shifts responsibility for falling asleep from the parent to the child.