|When controlled crying ("graduated extinction") was first
advocated around twenty years ago, it was recommended for infants over six months old, not newborns. While
there are still professionals who feel comfortable with variations of controlled crying for older babies, many
of these people would see any such methods as inappropriate for younger babies. However, popular advice by
various authors and even some baby sleep centers now commonly includes leaving babies as young as a couple of
weeks old to cry in order to teach them to sleep, much like advice offered in the 1850s. Sometimes modern
sleep-training methods are couched in euphemistic labels like "controlled comforting" or even
"controlled soothing" and within each definition there can be different recommendations about how
long to leave babies to cry and how often or how long to "comfort". Others simply advise leaving the
baby to cry until he falls asleep.
|Although many baby sleep trainers claim there is no evidence of harm from practices
such as controlled crying, it is worth noting that there is a vast difference between "no evidence of
harm" and "evidence of no harm". In fact, a growing number of health professionals are now
claiming that training infants to sleep too deeply, too soon, is not in babies' best psychological or
physiological interests. A policy statement on controlled crying issued by the Australian Association of
Infant Mental Health (AAIMHI) advises, "Controlled crying is not consistent with what infants need for
their optimal emotional and psychological health, and may have unintended negative consequences."
According to AAIMHI, "There have been no studies, such as sleep laboratory studies, to our knowledge,
that assess the physiological stress levels of infants who undergo controlled crying, or its emotional or
psychological impact on the developing child."
|Despite the popularity of controlled crying, it is not an evidence-based
practice. Professor James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University
of Notre Dame and acclaimed SIDS expert, described controlled crying as "social ideology masquerading as
science". What this means is that despite a plethora of opinions on how long you should leave your baby
to cry in order to train her to sleep, nobody has studied exactly how long it is safe to leave a baby to cry,
if at all. Babies who are forced to sleep alone (or cry, because many do not sleep) for hours may miss out on
both adequate nutrition and sensory stimulation such as touch, which is as important as food for infant
development. Leaving a baby to "cry it out" in order to enforce a strict routine when the baby may,
in fact, be hungry, is similar to expecting an adult to adopt a strenuous exercise program accompanied by a
reduced food intake. The result of expending energy through crying while being deprived of food is likely to
be weight loss and failure to thrive. Pediatrician William Sears has claimed that "babies who are
'trained' not to express their needs may appear to be docile, compliant or "good" babies. Yet, these
babies could be depressed babies who are shutting down the expression of their needs."
Often the predisposing conditions for depression in infants are beyond our control, such
as trauma due to early hospitalization and medical treatments. However, if we consider the baby's perspective,
it is easy to understand how extremely rigid regimes can also be associated with infant depression and why it
isn't worth risking, especially if your child has already experienced early separation. You too would withdraw
and become sad if the people you loved avoided eye contact, as some sleep training techniques advise, and
repeatedly ignored your cries.
||Leaving a baby to cry evokes physiological responses that increase stress hormones.
Crying infants experience an increase in heart rate, body temperature and blood pressure. These reactions are
likely to result in overheating and, along with vomiting due to extreme distress, could pose a potential risk
of SIDS in vulnerable infants. There may also be longer-term emotional effects. There is compelling evidence
that increased levels of stress hormones may cause permanent changes in the stress responses of the infant's
developing brain. These changes then affect memory, attention, and emotion, and can trigger an elevated
response to stress throughout life, including a predisposition to later anxiety and depressive disorders.
English psychotherapist, Sue Gerhardt, author of Why Love Matters: How
Affection Shapes a Baby's Brain, explains that when a baby is upset, the hypothalamus produces
cortisol. In normal amounts cortisol is fine, but if a baby is exposed for too long or too often to stressful
situations (such as being left to cry) its brain becomes flooded with cortisol and it will then either over-
or under-produce cortisol whenever the child is exposed to stress. Too much cortisol is linked to depression
and fearfulness; too little to emotional detachment and aggression.
|One of the arguments for using controlled crying is that it
"works", but perhaps the definition of success needs to be examined more closely. A recent
Australian baby magazine survey revealed that although 57 per cent of mothers who responded to the survey had
tried controlled crying, 27 per cent reported no success, 27 per cent found it worked for one or two nights,
and only 8 per cent found that controlled crying worked for longer than a week. To me, this suggests that even
if harsher regimes work initially, babies are likely to start waking again as they reach new developmental
stages or conversely, they may become more settled and sleep (without any intervention) as they reach
appropriate developmental levels.
." - Michelle
"I am so glad that I didn't cave and do controlled crying. My baby is now fifteen
months old and even my husband has thanked me for standing my ground on this one. Learning to listen to what
is in my heart when it comes to parenting has been the greatest gift. I know myself better now and I think
it has helped me in every area of my life. Just knowing that my instinctive responses are the right ones
give me so much confidence as a mother
Controlled crying and other similar regimes may indeed work to produce a self-soothing,
solitary sleeping infant. However, the trade-off could be an anxious, clingy or hyper-vigilant child or even
worse, a child whose trust is broken. Unfortunately, we can't measure attributes such as trust and empathy
which are the basic skills for forming all relationships. We can't, for instance, give a child a trust
quotient like we can give him an intelligence quotient. One of the saddest emails I have received was from a
mother who did controlled crying with her one-year-old toddler.
"After a week of controlled crying he slept, but he stopped talking (he was saying
single words). For the past year, he has refused all physical contact from me. If he hurts himself, he goes
to his older brother (a preschooler) for comfort. I feel devastated that I have betrayed my child."
It is the very principle that makes controlled crying "work" that is of
greatest concern: when controlled crying "succeeds" in teaching a baby to fall asleep alone, it is
due to a process that neurobiologist Bruce Perry calls the "defeat response". Normally, when humans
feel threatened, our bodies flood with stress hormones and we go into "fight" or "flight".
However, babies can't fight and they can't flee, so they communicate their distress by crying. When infant
cries are ignored, this trauma elicits a "freeze" or "defeat" response. Babies eventually
abandon their crying as the nervous system shuts down the emotional pain and the striving to reach out.
Whether sleep "success" is due to behavioral principles (that is, a lack of "rewards" when
baby wakes) or whether the baby is overwhelmed by a stress reaction, the saddest risk of all is that as he
tries to communicate in the only way available to him, the baby who is left to cry in order to teach him to
sleep will learn a much crueler lesson - that he cannot make a difference, so what is the point of reaching
out. This is learned helplessness.
|Neuroscientists and clinicians have documented that loving interactions
that are sensitive to a child's needs influence the way the brain grows and can increase the number of
connections between nerve cells. The Australian Association of Infant Mental Health advises: "Infants are
more likely to form secure attachments when their distress is responded to promptly, consistently and
appropriately. Secure attachments in infancy are the foundation for good adult mental health." So, when
you adopt the perspective that your baby's night howls are the expression of a need, and she is not trying to
"manipulate" you, and you respond appropriately (this will vary depending on your baby's age and
needs), you are not only making her smarter, but you will be hardwiring her brain for future mental health.