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The Myth of Controlled Crying
About the Author: Pinky McKay
An International Board Certified Lactation Consultant (IBCLC) and a Certified Infant Massage Instructor, Pinky McKay is a Melbourne based writer and editor specialising in health, education and family issues.
This is an edited extract from Sleeping Like A Baby by Pinky McKay (Penguin $24.95)
Despite the popularity of controlled crying it is not an evidence-based practice. Professor James McKenna, director of the Mother-Baby Behavioural Sleep Laboratory at the University of Notre Dame, Indiana and acclaimed SIDS expert describes controlled crying as ‘social ideology masquerading as science’. What this means is that despite many opinions on how long to leave a baby to cry, 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 made 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 vital for infant development. Leaving a baby to ‘cry it out’ 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 less food.
Paediatrician William Sears has claimed, “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. “Babies can indeed have an actual diagnosis of clinical depression”. Often caused by trauma due to early hospitalisation and medical treatments it is also easy to understand how rigid regimes can cause depression. You too would withdraw and become sad if the people you loved avoided eye contact and ignored your cries, as some sleep techniques advise.
Leaving a baby to cry evokes physiological responses that increase stress hormones, heart rate and temperature. These reactions can result in overheating and could pose a potential risk of SIDS in vulnerable infants. There may also be longer-term emotional effects. Babies need our help to learn to regulate their emotions, meaning that when we respond to and soothe their cries, we help them understand that when they are upset they can calm down.
There is also compelling evidence that increased levels of stress hormones may cause permanent changes in the stress responses of an infant’s developing brain. These changes can affect memory and emotion and trigger an elevated response to stress throughout life, including a tendency to 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 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 controlled crying is that it ‘works’, but perhaps the definition of success needs to be examined. In the small number of studies undertaken, while most babies will indeed stop waking when they are left to cry, ‘success’ varies from an extra hour’s sleep each night to little difference between babies who underwent sleep training and those who didn’t. Some studies found that up to one-third of babies who underwent controlled crying ‘failed sleep school’. To me this suggests that even if harsher regimes work initially
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