SILVER SPRING MD, September 13, 2012 – For decades there has been disagreement on how to get baby to sleep through the night. Proponents of attachment parenting believe that letting a baby cry-it-out and thus not responding to the baby’s need for his mother, leads to a weaker attachment and potentially to lower self-esteem.
Proponents of the cry-it-out method say that it leads to babies who sleep through the night sooner. Regardless of where you come down on the issue, you have probably had nights where you were so bleary-eyed from fatigue that you found yourself wondering how you were ever going to get sleep again.
On September 10, 2012, Pediatrics published the results of a five-year study that looked at the pros and cons of “behavioral infant sleep intervention,” or sleep training. The study looked at the long term effects on the child’s mental health, the child-parent relationship, and maternal mental health and parenting styles in 326 families.
The researchers found that at all points, including when the children were 6 and they did their final follow-up, there was no difference in children’s emotional, behavioral, sleep health and habits, stress levels, or psychosocial functioning between the groups. They also found no significant difference in child-parent closeness and conflict, relationship, or attachment, and no difference in parent depression, stress, anxiety, or authoritative parenting skills.
It is important to note there are several methods of sleep training. This study only shows that two of the methods, camping out and controlled-comforting, or “Ferberizing,” are safe and have no negative effects, while it discouraged the “cry-it-out” method. Camping out is when a parent remains in the room with the crying infant. They start with sitting in a chair next to the crib and gradually move it farther away until they are out of the room. This is usually done over the course of several weeks.
The other method, Ferberizing, is named after Dr. Richard Ferber who is attributed with the development of the technique. It is also called controlled-comforting because this technique involves comforting the crying baby by patting or rubbing after letting the baby cry for a short period of time and then increasing that time gradually until the baby falls asleep on his own.
On December 26, 2011 Pediatrics published a report entitled “The Lifelong Effects of Early Childhood Adversity and Toxic Stress” and the American Academy of Pediatrics issued a new policy statement at the same time regarding their position that toxic stress can cause long-term damage to infants and young children’s neurological function. This article and policy statement was based on years of research and multiple studies all showing the negative effects of toxic stress. This report and policy statement coupled with an article published in Psychology Today on December 11, 2011 that uses some of the same research to back the claim that letting baby cry-it-out can cause neurological damage and developmental delays due to the release of cortisol, provided a boost to advocates of attachment parenting who believe that all sleep-training methods are bad.
However, the September 2012 study did take the early stress research into account. Given the concern about toxic stress impacts on childhood brains, the researchers tested for raised cortisol in the study participants. The results showed no significant difference in cortisol levels between the control group and the sleep-trained group.
Another factor when considering the study information when considering sleep-training for your child, all children were 7 months old before being included in the study, and babies were 8-10 months before sleep-training techniques were used. Extremely young infants should always be attended to when they cry because they have more immediate needs. While some people advocate sleep-training as early as 4 months, many health professionals advise waiting until 6 months and only after assessing other factors that may be impacting a child’s ability to sleep, such as schedule and feeding issues.
So, what’s a sleep-deprived parent supposed to do? The answer is ultimately up to you, but looking at the data there is one additional point to consider. When the latest Pediatrics study says there is no harm in sleep-training, they did specify two particular methods while at the same time saying that the “cry-it-out” method, where babies are left alone to cry themselves to sleep, is not advisable. Even Dr. Ferber, the developer of the controlled-comfort method of sleep-training in a 2009 interview with Babytalk, said, “People want one easy solution, but there’s no such thing. I never encouraged parents to let their babies cry it out…” He even published a revision to his book, Solve Your Child’s Sleep Problems, in 2006 to try to clear up the perception that babies should be left to cry. He goes on to say that when parents tell him they tried his “method,” he knows they have not read the entire book because he addresses the fact that there are many reasons a baby might not be sleeping through the night that should be investigated.
The bottom line to the latest research seems to be that while leaving a baby to “cry-it-out” is discouraged due to theories on toxic stress, there appears to be no negative consequences to other sleep-training methods or attachment parenting soothing techniques. So, if you are one of the multitudes of sleep-deprived parents who struggle in getting out of bed in the middle of the night, one of the two suggested methods might offer you some restful nights after a few weeks. On the other hand, if you prefer the intimacy and the closeness of soothing your baby when he wakes, there is no evidence that you are making your child more depend on you in the long term.
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