Well Being

Why Sleep Training Makes Me Want to Cry

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Welcome to September's Carnival of Breastfeeding (see this month's entries below)! As a parent I understand how hard the parenting job is. That is why I have a general philosophy of “I'll do what works for my family and you do what works for yours.” There are just two issues I feel very strongly about: (1) (not) spanking, and (2) whether or not to let a child “cry-it-out” (“CIO”). While there are different methods, names, and sleep trainers out there (Ferber, Ezzo, controlled crying, crying-it-out, just to name a few), CIO is the general practice of leaving a baby to cry in the hopes that he will settle himself to sleep. For this month's carnival on Breastfeeding and Sleep, I offer the opinion that CIO, in any shape or form, is not the answer for a good night's sleep. I do not offer my opinion to bash other parents or to attempt to change someone else's mind (I have no illusions of succeeding at that). This article is for the breastfeeding mother whose family keeps telling her to “let that baby cry!” against all of her mothering instincts, or for the mother who tried letting her baby cry once and now has regrets or mixed feelings.

One other disclaimer: I do not purport to be any sort of expert on sleep (which is why I quote a lot of actual experts in this discussion!) I have struggled with the sleep issue myself and if you are interested you can crawl through all I have written on the sleep category. However, while I may not have the magic solution to a good night's sleep, I do know that CIO is not the solution. Fortunately, lots of experts in child care, psychiatry, and pediatrics feel the same way. Here are my opinions along with some science to back them up.

I do not believe: “Night-waking to nurse is a habit, not a need.”
I believe: For the first several months of a baby's life, night-waking to nurse certainly is a physical need. Babies' tummies are small and breast milk is digested quickly. Forcing an infant to go too long without nursing can lead to failure to thrive (inadequate weight gain, poor physical and mental development). CIO can be downright dangerous!

Advocates of CIO argue that after a certain age, night-nursing is no longer physically necessary and there's no “need” for it. While I question that (who among us hasn't gotten thirsty or hungry in the night, and we're not still growing!), there are also all kinds of needs: physical, emotional, psychological, developmental, and situational. In an article entitled “8 Infant Sleep Facts Every Parent Should Know,” Dr. Sears describes a baby's need to be parented to sleep and parented back to sleep. Also, the Australian Association for Infant Mental Health notes in its position paper:

AAIMHI is concerned that the widely practiced technique of ‘controlled crying' is not consistent with what infants need for their optimal emotional and psychological health and may have unintended negative consequences.

I do not believe: “Babies need to learn to self-soothe.”
I do believe: Why do babies need to learn to self-soothe, exactly? It seems more that the parents need the babies to learn to self-soothe. Babies who night-nurse barely cry, if at all, and often settle back to sleep quickly and peacefully.

Besides, when a baby is made to CIO and the baby falls back asleep, it's not accurate to say the baby “self-soothed.” Dr. Ben Kim's site describes a study of children ages one to two who were separated from their mothers and left to cry it out:

Results showed a predictable sequence of behaviours: The first phase, labeled “protest”, consists of loud crying and extreme restlessness. The second phase, labeled “despair”, consists of monotonous crying, inactivity, and steady withdrawal. The third phase, labeled “detachment”, consists of a renewed interest in surroundings, albeit a remote, distant kind of interest. Thus, it appears that while leaving babies to cry it out can lead to the eventual dissipation of those cries, it also appears that this occurs due to the gradual development of apathy in the child. The child stops crying because she learns that she can no longer hope for the caregiver to provide comfort, not because her distress has been alleviated.

I do not believe: “It's short-term pain for long-term gain.”
I do believe: First of all, I'm not interested in any short-term pain for me or my child. Nor do I believe the pain is short term. Parents who implement CIO often find that they have to do so repeatedly as a child starts to night-wake again during developmental spurts, teething, and illness.

Furthermore, there's plenty of evidence of long-term harm rather than long-term gain. Psychiatrists at Harvard University researched the long-term effects of CIO and found:

[T]he widespread American practice of putting babies in separate beds — even separate rooms — and not responding quickly to their cries may lead to incidents of post-traumatic stress and panic disorders when these children reach adulthood.

The early stress resulting from separation causes changes in infant brains that makes future adults more susceptible to stress in their lives, say Commons and Miller.

“Parents should recognize that having their babies cry unnecessarily harms the baby permanently,” Commons said. “It changes the nervous system so they're overly sensitive to future trauma.”

Some scientific researchers believe that leaving a baby to CIO can cause brain damage (that the extreme distress of CIO blocks full development of certain areas of the brain and causes production of cortisol in other areas of the brain).

Contrast such findings with those cited by Dr. James McKenna on the long-term effects of co-sleeping. Studies show that co-sleeping promotes confidence, self-esteem, and intimacy, while children who do not bed-share are harder to control, less happy, throw more tantrums, are more fearful, and here's the kicker — more dependent on their parents.

Please feel free to share your views on breastfeeding and sleep in the comments. Read on for other views (not necessarily consistent with mine!) on Breastfeeding and Sleep:

~ BreastfeedingMums talks about the sleep advantages of breastfeeding over formula-feeding.
~ Mama's Magic writes about being “So Tired” and considering the end of co-sleeping.
~ The Motherwear Breastfeeding Blog sings the praises of the side-lying position for breastfeeding.
~ Hathor the Cowgoddess shares a comic on the family bed. (Note that while it's safe for a toddler to sleep next to a sibling, an infant should not sleep next to an older child, only next to his parents.)
~ Leche, Baby! writes about the process of night-weaning.
~ Veggie Way writes about co-sleeping and letting her baby sleep where she wants.
~ Crunchy Domestic Goddess needs co-sleeping for sanity.
~ Life with Twins writes about her use of crying-it-out.
~ The Lactivist laments how each child has different needs.
~ Mama Knows Breast tells the truth about the reality of sleep deprivation.