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4 - 6 months

Crying-it-out: Will this sleep-training method harm your baby?

17 April 2020 | by Glynis Horning

New research suggests this controversial method does no harm – but should you try it?

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Cry-it-out sleep training has divided moms since it was first popularised by paediatrician Richard Ferber, director of the Center for Pediatric Sleep Disorders in Boston, in his 1985 book Solve Your Child's Sleep Problems.

Ferber said you can teach your baby to soothe themself to sleep, usually between the ages of three and five months, by leaving them to cry for gradually longer periods. The theory is that after a few days to a week, most babies learn to fall asleep on their own, realising that crying gets them nothing more than a quick check-in from you (no holding, rocking or feeding). They then sleep better – and so do you.

Why the controversy?

Critics argue that leaving a baby to cry goes against parental instinct, and more than that – it's harmful for the child. Among the most vocal critics has been US specialist developmental psychologist Dr Darcia Narvaez of the University of Notre Dame, USA. She warns in Psychology Today that when babies are stressed, their bodies release cortisol, a toxic hormone that can damage neuron connections and even kill brain cells.

Narvaez cites Harvard and Yale studies showing that damaging babies' brain cells puts them at greater risk for ADHD, poor memory and academic performance, and anti-social tendencies. “It may foster a child who doesn't ask for as much help and attention,” she says. But it's more likely to foster a whiney, unhappy, aggressive or demanding child who has learned to scream to get needs met, and struggles to trust. “A deep sense of insecurity is likely to stay with them,” she concludes.

Narvaez and others also note that studies have shown that raised cortisol levels can damage the vagus nerve that affects the functioning of digestion and other major body systems, increasing the risk of physical disorders such as irritable bowel syndrome (IBS).

What do the studies show?

Now, new research published in the journal Pediatrics is challenging the link between all this and 'cry-it-out' training. Based on an Australian study at Flinders University in Adelaide, it found that babies who were left to 'cry-it-out' slept longer overall after a week, and woke less frequently.

Parent-child attachment appeared not to be affected either way, but the most surprising finding was that levels of cortisol were lower in the babies left to cry. A year later, these babies didn't show signs of being less attached to their parents, or of having more behavioural problems, than the control group, researchers said.

So should you try the cry-out method?

Bottom line? More extensive studies are needed, says Durban educational psychologist Dr Brenda Talbot of Life Entabeni Hospital. And until then, only you know how you feel – an exhausted parent is not a great one, so you need to weigh that against the anxiety of perhaps trying sleep training. 

It's important to remember, however, that not even Ferber advocated totally ignoring a crying baby: he advised looking in on them, even stroking them, just not holding, cuddling or interacting. Crying babies must always be checked on, Dr Talbot says – they could be ill or have hurt themselves, and need to know that you will respond. 

Tips for better sleep

Try these pointers if your little one struggles to sleep through the night:

- Differentiate between day and night: Interact and play with them during the day, and don't try to minimise daytime sounds like phones or music. At night, keep lights and noise low, and don't play or talk when they wake. 

- Establish a sleep routine: “Sleep time should become predictable and be associated with calm and soothing interactions,” Dr Talbot says. Try a soothing warm bath, nappy change, song or story and a kiss.

- Check for disturbances: If baby keeps waking, check that the reason is not hunger, wind, illness, a wet nappy, or being too warm or cold.

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