Sleep Training Your Baby: The Great Debate

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Having a baby comes with a whole set of challenges from mastering the fine, origami-like art of swaddling to changing a diaper like a pro. But most parents would agree that the biggest challenge of all is getting their little one to sleep through the night.

Sleep is critical to parents’ sanity and a baby’s development and a lack of sleep is tied to a greater risk of maternal depression. But parents are often faced with a difficult dilemma: Do they let their babies “cry it out” and endure a heart-wrenching few days or weeks of teaching their baby to self-soothe himself to sleep? Or, do they run in bleary-eyed each time the infant wails, inviting months of zombie-like, exhaustion until the baby naturally slumbers ‘til the morning?

It should be noted that true “crying it out,” also known as the ominously-named extinction method, involves putting the infant to bed at a set time and not going in, despite a child’s cries, until the morning unless the child is in danger or ill. But most parents who say they opted for “crying it out” actually did a modified version called “graduated extinction” or “controlled comforting,” in which they gradually increased the amount of time before returning to the nursery to check on and soothe their baby.

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Some parents argue that “crying it out” is cruel and teaches babies that their parents will ignore them; others say it saved their sanity and that it’s crucial for children learn to self-soothe.

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Photo by Corbis

The Research

A 2012 study in the journal Pediatrics looked at the harms and benefits of sleep training on infants with sleep problems at seven months old. Half the babies were placed in a sleep training group, while the other half didn’t use a sleep training method. At the five-year follow-up, researchers found little to no differences between the two groups in regard to the children’s emotional health and behavior or the parents’ depression and anxiety levels. The researchers noted that “behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.”

However, other research is contradictory. A 2011 study of infants ages four to 10 months-old published in the journal Early Human Development found that when babies cried themselves to sleep without the mother coming in to soothe them, stress levels were high in both baby and mom. By the third day of the study, infants no longer showed outward signs of distress as they transitioned to sleep, but — and this will wrench most parents’ hearts — their stress levels were still high. They had simply learned not to show it.

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What the Experts Say

Darcia Narvaez, Ph.D., a psychology professor at the University of Notre Dame writes about the dangers of ignoring an infant’s cries in an effort to sleep train, in Psychology Today: “The baby is absolutely dependent on caregivers for learning how to self-regulate. Responsive care—meeting the baby’s needs before he gets distressed—tunes the body and brain up for calmness. When a baby gets scared and a parent holds and comforts him, the baby builds expectations for soothing, which get integrated into the ability to self-comfort. Babies don’t self-comfort in isolation. If they are left to cry alone, they learn to shut down in face of extensive distress—stop growing, stop feeling, stop trusting.”

And some pediatricians are concerned about the long-term affects of even the modified, “controlled comforting” method. Tarig Ali-Dinar, a pediatric pulmonologist at the University of Miami Miller School of Medicine, tells CNN.com that such methods may disrupt brain development, mother-child bonding, and the child’s mental health.

However, according to the American Academy of Pediatrics (AAP) infant sleep training methods such as “controlled comforting” and “camping out,” in which parents sit with the infant as she learns to independently fall asleep, slowly removing themselves from the baby’s room, improve infant sleep and reduce maternal depression in the short term.

Even Richard Ferber, M.D., of the famous Ferber method, which has become synonymous with “crying it out,” says he was misunderstood and never encouraged parents to let their babies cry it out all night. Instead, he stands behind several strategies, including gradual extinction in which the response time to crying is delayed. “All humans wake up a number of times at night to check that all is well, to reposition themselves and then return to sleep,” Richard Ferber, M.D., tells Parenting. “When babies experience these normal partial arousals, they may whine or fuss and parents think it’s their responsibility to ‘help’ their child go back to sleep. But when you become a part of the process—by rubbing your baby’s back or rocking her—she might not be able to fall back asleep on her own.”

What the Parents Say

“I tried the ‘crying it out’ method with both my kids because it’s so effective. With our first child, we caved when she cried. We knew we should have toughed it out, but she was our first and we couldn’t take it. It was easier to stick to the plan with our second child, and, thus, we all slept better. It was huge for our sleep and sanity.” —Lysa Puma

“We never let either of our daughters cry for hours, but a little fussing didn’t bother us, as long as it didn’t last more than 15 to 20 minutes. Giving them a schedule and not letting them nap a lot during the day exhausted them, so they were ready to sleep at night.” —Rena C.

“We did sleep training with our second and third kids because we learned the hard way with our first. With our first child, we soothed, we went in often, picked him up, let him fall asleep in our arms, and coddled him. It became a vicious cycle and we were getting no sleep with a baby who had us at his beck and call. After 15 months, we did the Ferber method for three nights and it was extremely hard but it worked.” —Jennifer Bickerton

The Bottom Line

It’s up to parents to find a method—even if it’s none at all—that works for them and their child’s temperament. Most pediatricians don’t advocate true “crying it out” and for those who go the modified route, the method is not typically recommended for infants younger than six months of age or when a child is sick. But whichever method parents choose, most pediatricians agree that being consistent is key.

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