I am a social worker and parent in Australia concerned about the western practice of a method called 'controlled crying' that is used on infants to get them to sleep. This blog talks about the use of this method and other parenting methods. Search all the information on this site to be better informed about the practice of controlled crying. For any comments or questions, my email is

Friday, June 30, 2006

The Benefits of Co-Sleeping

Lower your baby's risk of stress
disorders, SID and more

by Jennifer Cobrun courtesy of The Compleat Mother

Note: This is a media article on the research of Harvard psychologists.
It can be found at this link (at the very bottom) after an article on Commons and Miller's
research presented to the AAAS.
(Co-sleeping isn't for everyone, and it can take some getting used to, but it is wonderful for some families, who really enjoy sharing cuddles together all night long!)

Harvard psychologist Michael Commons and
his colleagues recently presented the
American Association for the Advancement
of Science with research that suggests that
babies who sleep alone are more susceptible
to stress disorders.
Notre Dame anthropology professor and
leading sleep researcher, James McKenna, has
long held that babies who sleep with their
mothers enjoy greater immunilogical benefits
from breastfeeding because they nurse twice
as frequently as their counterparts who sleep alone.
In his book on Sudden Infant Death
Syndrome, pediatrician William Sears cites
co-sleeping as a proactive measure parents
can take to reduce the risk of this tragedy.
McKenna’’s research shows that babies who
sleep with parents spend less time in Level III
sleep, a state of deep sleep when the risk of
apneas are increased. Further, co-sleeping
babies learn to imitate healthy breathing
patterns from their bunkmates.
Every scientific study of infant sleep confirms
that babies benefits from co-sleeping. Not one
shred of evidence exists to support the widely
held notion that co-sleep is detrimental to the
psychological or physical health of infants.
If science consistently provides evidence that
the American social norm of isolating babies
for sleep can have deleterious effects, why do
we continue the 150-year crib culture in the
United States? Why do parents flock to Toys
R’’ Us to purchase dolls that have heart beats,
sing lullabies and snore when they can do the
same for free?
McKenna suggests that there are several
factors that maintain this cultural norm.
Foremost is the American value of selfsufficiency.
Independence is an important
characteristic for a successful person in our
society. We take great pride in watching our
babies pick themselves up by their own bootie
straps. But the assumption that co-sleeping
inhibits independence is pure cultural
mythology. In fact, the opposite it true.
Children who share sleep with their parents
are actually more independent than their
peers. They perform better in school, have
higher self esteem, and fewer health
problems. After all, who is more likely to be
well-adjusted, the child who learns that his
needs will be met, or the one who is left alone
for long periods of time? McKenna suggests
that it is confusing for a baby to receive
cuddles during the day while also being
taught that the same behavior is inappropriate
at night.
The Commons report states that when babies
are left alone to cry themselves to sleep,
levels of cortisol, a stress hormone, are
elevated. Commons suggests that the constant
stimulation by cortisol in infancy causes
physical changes in the brain. "It makes you
more prone to the effects of stress, more
prone to illness, including mental illness, and
makes it harder to recover from illness," he concludes.
The best-selling book on infant sleep is
frighteningly misdirected and offers
absolutely no scientific grounds for its thesis.
Richard Ferber suggest that the best way to
solve your child’’s "sleep problems" is to
isolate them in another room, shut the door,
and let them cry for ten minutes without
interruption. Then parents may enter the room
and verbally soothe the baby, but are warned
against making physical contact with their
baby. Shortly after, they are advised to leave
the infant to cry for another timed interval a la
"Mad About You."
Most sleep disorders are not biologically
based, but rather, created by well-intended
parents. Making oneself available by intercom
is simply not meeting the nighttime needs of
an infant.
Many parents argue that they tried
"Ferberizing" their baby and enjoyed great
success with the technique. Indeed, the infant
may stop crying and learn to go to sleep on
his own, but this is a short-term pay off for
parents. The baby has not suddenly
discovered quiet content. He simply is
exhausted from his futile efforts to be
Fifteen years later, the same parents
shrug their shoulders and wonder why their
kids are shutting them out.
Though co-sleeping is common in most parts
of the world, many American parents would
not consider it because they fear it will cause
them sleep deprivation. Every scientific study
concludes that parents who bring their babies
to bed sleep longer and better.
A few parents do experience difficulty
sleeping with a baby in their bed. For them, a
"sidecar" or bedside sleeper is an ideal way to
meet their needs for rest and their baby’’s
need for co-sleep. Keeping a crib or bassinet
in the parents’’ room is another option. A
"family bed" is not for everyone, but creative
solutions for co-sleep are abundant in our
consumer-friendly culture.
The most common question co-sleepers are
asked is about maintaining a sexual
relationship with one’s partner. The answer
is simple. Go someplace where the baby is
not. Enough said.
For those who consider unlimited access to
their sexual partner more important than
meeting the needs of their baby, cat
ownership is a wonderful alternative to
parenthood. You can just toss a bowl of Nine
Lives on the floor and frolic around the house
whenever the mood hits you.
Co-sleeping is not right for everyone. Heavy
drinkers and drug addicts should avoid
sleeping with their babies. Of course, these
folks should probably avoid parenthood altogether.
If scientific research consistently
demonstrates that co-sleeping offers
tremendous benefits for babies and has no
deleterious effects, it’s time Americans join
the rest of the world and parent our babies 24
hours a day.
Jennifer Coburn
San Diego, California

For information on safe Co-sleeping see these articles

API Position review

CPSC Data on Co-Sleeping

Co-Sleeping Research

UK Research

NZ Discussion paper; SIDS and Maori Co-Sleeping/Smoking

Invoking sudden infant death syndrome in cosleeping may be misleading; Letter;

Tuesday, June 27, 2006

Infant Stress

Really good article on Infant Stress! (references are attached at the bottom of the article).

Biological psychology researcher Megan Gunnar and her colleagues did infant studies that confirmed animal research findings. In their work, infants three months of age who received consistent responsive care produced less cortisol. Also, eighteen-month-olds classified as insecurely attached (who had received lower levels of responsiveness) revealed elevated levels of stress hormone.7 These same children at age two continued to show elevated levels of cortisol and appeared more fearful and inhibited. Again, these children were those who had been classified as having lower levels of maternal responsiveness.8 Other investigations have confirmed these findings.9 Dr. Gunnar reports that the level of stress experienced in infancy permanently shapes the stress responses in the brain, which then affect memory, attention, and emotion.10

You CAN’T 'spoil' your baby with too many kisses and cuddles!!!

See this article…

According to Alan Schore, assistant clinical professor in the department of psychiatry and biobehavioral sciences at UCLA School of Medicine, a major conclusion of the last decade of developmental neuroscience research is that the infant brain is designed to be molded by the environment it encounters.1 In other words, babies are born with a certain set of genetics, but they must be activated by early experience and interaction. Schore believes the most crucial component of these earliest interactions is the primary caregiver - the mother. "The child's first relationship, the one with the mother, acts as a template, as it permanently molds the individual's capacities to enter into all later emotional relationships." Others agree. The first months of an infant's life constitute what is known as a critical period - a time when events are imprinted in the nervous system.
"Hugs and kisses during these critical periods make those neurons grow and connect properly with other neurons." Says Dr. Arthur Janov, in his book Biology of Love. "You can kiss that brain into maturity."

Gentle Parenting Books

Really great parenting books can be bought on line from

I love Pinky McKay’s books and Dr Sears books!

I have found that these books, along with Elizabeth Pantleys “The No Cry Sleep Solution” are available at my local library, so it’s worth checking if they’re at your library too!

Also your local ABA (Australian Breastfeeding Association) group should have a heap of books that they loan out. To contact your local group, follow this link

Other books

These books have come recommended to me by a parenting expert as being excellent information about the dangers of controlled crying;

Margot Sunderland's new book 'The Science of Parenting'
She discusses over 800 studies and looks at prolonged uncomforted distres in a baby, which can permanently alter the pathways in a babies brain relating to their ability to cope with stress (now and in the future).

Robert Karen's book 'Becoming Attached' Discusses the huge body of research on Attachment theory, started by Bowlby and Ainsworth (Good link for info on Bowlby's work here;

And also 'Why love matters' by Sue Gerhardt has some good references and arguments against controlled crying.

Monday, June 26, 2006

More Research....

Long term cognitive development in children with prolonged crying.

Rao MR, Brenner RA, Schisterman EF, Vik T, Mills JL.

Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.

BACKGROUND: Long term studies of cognitive development and colic have not differentiated between typical colic and prolonged crying.
OBJECTIVE: To evaluate whether colic and excessive crying that persists beyond 3 months is associated with adverse cognitive development.
DESIGN: Prospective cohort study. A sample of 561 women was enrolled in the second trimester of pregnancy. Colic and prolonged crying were based on crying behaviour assessed at 6 and 13 weeks. Children's intelligence, motor abilities, and behaviour were measured at 5 years (n = 327). Known risk factors for cognitive impairment were ascertained prenatally, after birth, at 6 and 13 weeks, at 6, 9, and 13 months, and at 5 years of age.
RESULTS: Children with prolonged crying (but not those with colic only) had an adjusted mean IQ that was 9 points lower than the control group. Their performance and verbal IQ scores were 9.2 and 6.7 points lower than the control group, respectively. The prolonged crying group also had significantly poorer fine motor abilities compared with the control group. Colic had no effect on cognitive development.

CONCLUSIONS: Excessive, uncontrolled crying that persists beyond 3 months of age in infants without other signs of neurological damage may be a marker for cognitive deficits during childhood. Such infants need to be examined and followed up more intensively.

This study is not about controlled crying, but does examine the effects of non-colic crying, which I feel can be related to cc. It can be found on this great Attachment parenting blog....

Sunday, June 25, 2006

Information for all parents....

I wanted to start this blog so that all parents, professionals, and other interested people could read some research and resources on Controlled Crying. I don't support the method, and I would like to see more research into CC. I am hoping to get Government and Child Health care organisations to examine their views on CC and hopefully change their policies.

I am not out to attack parents over their parenting choices. This is NOT what this blog is about. But if you are a parent who has used CC please take the time to read the research and be informed about the practice. Most parents try their best for their children, and many of us have been raised with CC and really don't know about other options or other parenting methods. Many of us have had Child Health Nurses, or other professionals or 'experts' tell us to leave our baby to cry and for many of us this just doesn't feel right to do this.

Please don't think I am attacking or judging other parents, I'm not. I simply want to get the message out there about the research, and the organisations against the practice of CC. I also hope that I can provide options for parents out there who would like to use other parenting methods.

Saturday, June 24, 2006

Gentle Options

There are many other ways to settle a baby. A lot of people choose to parent in a more 'natural' style, called Attachment parenting (AP). But this is not the only way to parent your child gently.

Some good online resources are;

Martha Sears and Dr William Sears and family

Pinky McKay - Melbourne based author and parenting expert (this website links to MANY great resources world wide!)

Elizabeth Pantley - author of "The No Cry Sleep Solution"

Children, Youth and Women's Health Service - South Australia

Dr James McKenna - Director at the Centre for the Study of Maternal-Infant Sleep

The Continuum Concept Website - Articles by Jean Liedloff

The Natural Child Project

Byron Child

Mothering Magazine


I will add more, as I could literally type all day on parenting methods, but I need to parent my baby too!!

Friday, June 23, 2006

Government Website

This is from a new Government Website...

What if my baby vomits?
Up to 20% of babies may vomit during controlled comforting. These are often the more feisty babies. If this happens, quietly and calmly clean up any vomit from the bed and put a clean nappy wrap under the baby’s head. Avoid making a big fuss, turning on lights, or completely changing the baby unless absolutely necessary. Otherwise, some babies learn to vomit each time they are put into the cot.

I would be interested to read the Centre for Community Child Health's research that says leaving a child to cry until they vomit is ok. I would also be interested to find information on SIDS that states nothing should be added to the cot other than a fitted sheet and blankets tucked in tight over a baby sleeping on their back.

I think it is also interesting to look at this quote from another angle.....

Would we be comfortable if the quote said to do this to teenagers who didn't sleep properly? or if a woman (friend, wife, sister, mother or partner) was crying alone in a room would we let her vomit or not comfort her? If an elderly or disabled man was treated this way would this be acceptable?

Questions to ponder.....

I am hoping to find research or child care and protection policies that may provide answers to these questions

What are infant sleeping problems? Can the health disciplines agree on this? There are many different definitions, and different disciplines within Western culture have different theories. Different cultures also have different theories on ‘sleeping problems’.

What is normal child development? Do infants need to learn skills such as teething, crawling or sleeping or do they simply achieve these things when their bodies are ready?

How much sleep is needed by an infant?

How can studies be conducted without these above questions being defined accurately first?

What stress levels if any are experienced by the infant undergoing the behaviour modification of controlled crying? (these can be measured by cortisol levels in saliva, blood pressure, and so on or perhaps be determined by the chemical makeup of tears)

What amount of time is acceptable to leave a crying baby?

What amount of time of leaving an infant to cry is considered abuse / neglect? How long are parents legally allowed to leave their child to cry?

Where is the line drawn? (eg. One mother I have heard of locks her babies in their rooms for two hours at ‘nap time’ and will not return until the end of that two hours. If they cry the whole time she does not attend to them. She believes this is controlled crying).

Studies clearly indicate this method works most of the time. Why does this method work? Is this simply an infant survival / protection mechanism?

What age of an infant is this method suitable for? Why?

When does Object permanence develop? (I've read it develops at 18months, 2 years, 6 months and 8 months, and need to find more information)

What affect does this method have on maternal attitude and responsiveness to their baby?

Why do parents need to distract themselves from going in to their baby? Do they feel an inate need to pick them up? or is this socially conditioned (a learnt social behaviour)?

More research

I found this today....

Infant Stress and Parent Responsiveness: Regulation of Physiology and Behavior During Still-Face and Reunion David W. Haley1 and Kathy Stansbury1,2

This study examined infant response and recovery from a social challenge and parent responses. Behavioral and physiological responses were measured from forty-three 5- and 6-month-olds infants during a modified still-face procedure that used an additional still-face reunion sequence. Results confirm the hypothesis that infants of more responsive parents show more regulation than infants of less responsive parents. Infants of more responsive parents showed greater regulation of heart rate and negative affect during the final episode of the procedure than infants of less responsive parents. In addition, this procedure elicited a cortisol response (from .22 μg/dl to .31 μg/dl). Findings suggest important links between parent behavior and infant stress reactivity and regulation.

Haley, David W. & Stansbury, Kathy (2003)Infant Stress and Parent Responsiveness: Regulation of Physiology and Behavior During Still-Face and Reunion.Child Development 74 (5), 1534-1546.doi: 10.1111/1467-8624.00621

Other Terms for Controlled Crying

Controlled Crying (referred to on this blog as cc) is also called many other things. These other names sometimes mean the same, and are sometimes variations of the original controlled crying method (by Dr Richard Ferber). Many believe any method that involves leaving a baby to cry can be harmful to babies.

Controlled crying (CC)
Controlled comforting
Cry it Out (CIO)
Lay down approach
Sleep training
The Ferber Method
Systematic ignoring
Systematic comforting
Progressive desensitisation
Progressive Waiting
Progressive Settling
Deep end approach
Pick up / Put down
Camping out
Sleep separation technique
Comfort Settling
Hands on Settling
Gradual Withdrawal
Crying down
Minimal Reassurance
Timed crying
Freedom to Cry

Straight extinction (also called Extended crying)
Parents ignore their child's crying until it stops

Graduated extinction
Controlled crying, where parents ignore their children's crying for increasing lengths of time

Modified extinction
This is where parental presence is maintained in the room with the child, however they do not interact or talk to the child. Therefore, parents do not leave their child alone in the bedroom.

'Feed-sleep-play' or other terms for routines can also be used to refer to (or involve) CC.

There are probably other names for this method. I will add them as I read of others.

Quotes from various Doctors, Paediatricians, Nurses, Midwives, Scientists, Researchers, Academics and Child Health Organisations:

(Note: these are excerpts from larger documents, follow the web link to find the full article)

The Australian Association for Infant Mental Health (AAIMHI) says;
Babies have to adapt to a totally new world and even small changes can be stressful for them. Leaving babies to cry without comfort, even for short periods of time, can be very distressing for them. Crying is a signal of distress or discomfort from an infant or young child. Although controlled crying can stop children from crying, it may teach children not to seek or expect support when distressed.
Infants are more likely to develop secure attachments when their distress is responded to promptly, consistently and appropriately. Secure attachments in infancy are the foundation for good adult mental health.
Any methods used to assist parents to get a good nights sleep should not compromise the infants developmental and emotional needs.

Children, Youth and Women’s Health Service, SA Health Department says:
Secure attachments in infancy are the base for good mental health. A major need for secure attachment is for a parent to respond to infant needs and cues. It is important not to leave your baby to cry. Under the topic Attachment they list points for good attachment with your baby. These include; Make eye contact. Babies like to look into your eyes. Notice when your baby is trying to get your attention with looks, smiles or cries. Crying always signals a need. Provide comfort when your baby is upset. Try to relax and concentrate on the baby's world, what he is looking at, trying to do, feeling etc.

The Australian Breastfeeding Association (ABA, formerly Nursing Mothers Association NMAA) quotes these experts;
Sue Cox RN, RM, IBCLC says (for ABA);

I believe the semantics of whether it is controlled crying or comforting means nothing and the overriding impact is of dominance and restraint - a dominant attitude by the parent of 'you will do what I say' and a restraint from nurturing - an 'I mustn't let you get too close to me because I will no longer be in control' attitude. Any relationship built on dominance and restraint will not flourish and fulfil the parent's goal.
We need to ensure that the biological, physiological and psychological requirements of human babies are met as they are by other parents in the animal kingdom.
McKenna; 'At birth the human infant is the least neurologically mature primate of all, and the most reliant on physiological regulation by the caregiver for the longest period.'
Seventy five percent of human brain development, more than any other mammal, occurs after birth. As a consequence of its immaturity, the human infant is forced to rely on external regulation and support, especially in the first year of life.
..the negative effects of short-term mother-infant separation, from primate studies, are that the offspring is less able to fight infections with a depressed antibody count, has increased stress hormones, irregular heat rate, abnormal pauses in breathing rate, lower body temperature, disrupted sleep patterns, behavioural abnormalities with excessive self-stimulation, hyperactivity and depression.
“20th Century Gurus of Parenting pt 3. Controlled Crying... oops sorry controlled comforting”. Sue Cox RN, RM, IBCLC, ABA breastfeeding counsellor. From 'Essence' magazine, Volume 36, Number 6.
Lesley McBurney, Australian Breastfeeding Association Counsellor says;
…many in the association are concerned about the increasing popularity of 'controlled crying' techniques, sometimes called 'controlled comforting'. …Taylor says that typical behaviour of young mammals and birds is to signal distress and wait for a response. If there is no response, the juvenile understands that it has been abandoned, and will die unless it conserves energy. Crying expends energy so crying must be stopped to ensure survival. This leads to 'learned helplessness' where the baby whose needs are not met detaches from reality, and numbs itself into sleep.
….just being alone can make babies insecure and they will cry unless they are 'scooped up in parental arms'. Before about eight months of age, babies have no idea of 'object permanence'. This means that if they can't see something it doesn't exist. A baby does not know the parent will be back in five, ten or fifteen minutes. All it feels is abandonment.
Controlling or Spoiling, Lesley McBurney, Australian Breastfeeding Association Counsellor, Reproduced from 'Essence' magazine, Volume 37, Number 6.

Dr William Sears says:
Beware of using someone else's training method to get your baby to sleep or get your baby on a predictable schedule. Most of these methods are variations of the tired old theme of letting baby cry it out.
With most of these baby-training regimens you run the risk of becoming desensitized to the cues of your infant, especially when it comes to letting baby cry it out. Instead of helping you to figure out what baby's signals mean, these training methods tell you to ignore them. Neither you nor your baby learn anything good from this.
Clicking into the cry-it-out method also keeps you from continuing to search for medical or physical causes of nightwaking, such as GER and food allergies.
Sleep Training - Not for breastfeeding mothers. William Sears, Ph.D.

Dr Commons and Dr Miller, Harvard Medical School say;
Finally, it is apparent that U.S. infants must learn to cope early with being alone and specifically with being separated from their mothers. Tennes (1982) has shown that in human infants there is a positive linear relationship between amount of separation protest and the amount of cortisol secreted. The information we have about sleep patterns in American infants and children also suggests that these produce stress in them. Although we are not aware of studies that have measured cortisol levels in infants sleeping apart from their parents and those sleeping with their parents, there is some evidence that these sleeping practices are stressful for American infants. For example, bedtime rituals seem to occur in U.S. settings, where infants and children are put to bed at set times and in separate areas, but rarely in other settings (e.g. Morelli et al., 1992). These rituals may last up to an hour in some cases and seem to be a response to the difficulty the infant or child has with going to bed on their own. A majority of U.S. infants in the Morelli et al. study also required transitional objects such as pacifiers, "blankies" or stuffed animals. It is well known from studies of adults (as summarized by Fackelmann, 1998) that cortisol is produced during all types of stressful events, and that high levels of cortisol seem to be associated with a number of effects, including low immune system functioning.
As will also become clear, although there is considerable work on early emotional learning (during the first 6-8 months), there is little work explicitly and directly relating this early learning to later behavior. This paper will conclude with some suggestions for doing so. In particular, it is suggested that early stressful experiences may result in a differential ability to handle stressful experiences later in life. The mechanisms by which this is accomplished are: a) that early child care practices that produce stress in infants, may result in higher levels of cortisol on a long term basis, and b) that certain emotional behaviors may be learned sub cortically during the first few months of life, and that these behaviors will persist.
“Emotional Learning in Infants: A Cross-Cultural Examination” Michael Lamport Commons, Ph.D. (Harvard Medical School) Patrice Marie Miller, Ph.D.(Harvard Medical School and Salem State College)

Dr Commons and Dr Miller quoted by Alvin Powell;
America's "let them cry" attitude toward children may lead to more fears and tears among adults, according to two Harvard Medical School researchers.
Instead of letting infants cry, American parents should keep their babies close, console them when they cry, ..according to Michael Commons and Patrice Miller, researchers at the Medical School's Department of Psychiatry. The pair examined child-rearing practices here and in other cultures and say the widespread American practice of putting babies in separate beds - even separate rooms - and not responding to their cries may lead to more incidents of post-traumatic stress and panic disorders among American adults. The early stress due to 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 sensitive to future trauma."
Harvard Researchers Say Children Need Touching and Attention, by Alvin Powell,Contributing Writer, Harvard Gazette.

Dr Commons quoted by John Hoffman;
"I'm not saying babies can avoid all stress," Commons says. "The point is, let's not leave them alone to deal with it. Put most simply, let's respond to and comfort crying babies, so they will learn that when they're stressed, people will help them cope with it.
“Tales from the Crib” By John Hoffman, Today’s Parent.

Dr Commons quoted by Maggie Fox;
Babies who are made to sleep alone or are not picked up and comforted enough may grow up susceptible to post-traumatic stress disorder (PTSD) and personality problems, said Dr. Michael Commons of the Harvard Medical School, and colleagues.
The idea that babies need physical contact is not new --that is why they are no longer swaddled in tight blankets and left to cry for hours. But researchers speaking at the annual meeting of the American Association for the Advancement of Science said they were starting to find evidence of physical changes in the brain caused by stress in infancy.
Scientists have also found levels of the stress hormone cortisol to be much higher in crying babies. Commons suggested that constant stimulation by cortisol in infancy caused physical changes in the brain.
"It makes you more prone to the effects of stress, more prone to illness including mental illness and makes it harder to recover from illness," Commons said. "These are real changes and they don't go away." In the West, children are encouraged to be self-sufficient and face danger alone. "They don't have the emotional resources to seek comfort and consoling and the experience becomes unspeakable," Commons said.
“Stressed Babies May be Prone to Trouble Later”, By Maggie Fox, Health and Science Correspondent. Quoted on the Alliance for Transforming the Lives of Children Website.

Paper presented by Robin Balbernie for SEBDA - Social Emotional and Behavioural Difficulties Association - for children and young people;
From the baby’s point of view the most vital part of the surrounding world is the emotional connection with her caregiver, it is this that she is genetically pre-programmed to seek out, register and respond to. “The ecological niche the baby has evolved the ability to adapt to is the relationship with the mother. Research suggests that emotion operates as a central organising process within the brain. In this way, an individual’s abilities to organise emotions – a product in part of earlier attachment relationships – directly shapes the ability of the mind to integrate experience and to adapt to future stressors." (Seigal, 1999, p.4.)
Nurture then becomes nature. “In the face of persisting threat and, depending upon the age of the child and the nature of the threat, the child will move along the hyper arousal continuum (the child's version of “fight or flight") or into the dissociative continuum.” (Perry, et al., 1995, p.279.) It has been observed that the over-development of the brainstem and midbrain in response to an early hostile environment is associated with hyperactivity, impulsive behaviour, anxiety and poor emotional control. Neglect alone can similarly alter functions in the brain, as: “any deprivation of optimal developmental experiences (which leads to underdevelopment of cortical, subcortical, and limbic areas) will necessarily result in persistence of primitive, immature behavioural reactivity. And, thereby, predispose to violent behaviour.” (Perry, 1997, p.129.)
Cortisol is produced in response to threat, this can occur outside of conscious awareness of danger, and it increases activity in the region of the brain that controls vigilance and arousal (the locus ceruleus, the junction box through which the sympathetic nervous system rouses up the rest of the brain). Those neurochemical reactions that went with the initial period of abuse or neglect are immediately reactivated whenever there is a reminder of that trauma, with the same end result whether or not the threat is real. It is an example of the natural process of state-dependant storage and recall. These surges of cortisol also cause cell loss in the hippocampus, destroying explicit memory recall, as well as corroding those regions in the cortex and limbic system responsible for emotions and attachment. Early traumatic experiences that affect the formation of the limbic and subcortical areas of the brain result in extreme anxiety, depression and a lack of ability to form healthy attachments. If the adverse conditions persist, then cognitive ability may become impaired, and the information-processing and problem-solving style that results is such that the inevitable situations of failure and frustration that life throws up generate aggression rather than consideration (in both senses).
The Structure of the Brain and Early Experience. Paper presented by Robin Balbernie at the AWCEBD (now the SEBDA - Social Emotional and Behavioural Difficulties Association - for children and young people) 50th National Study Course Royal Agricultural College, Cirencester, UK, 22nd March 2002.
Full text; Balbernie, R. (2001) Circuits and circumstances: the neurobiological consequences of early relationship experiences and how they shape later behaviour.
Journal of Child Psychotherapy. 27 (3) 237-255 (or email me for the full article)

Lauren Lindsey Porter clinical social worker says on the science of attachment;
What has emerged is mounting evidence that stress and trauma impair optimal brain development while healthy attachment promotes it. In psychobiological terms, babies are unable to regulate themselves. Despite being born with the capacity for feeling deep emotions, babies are unable to keep themselves in a state of equilibrium, lacking the skills to regulate either the intensity or the duration of those emotions.19 Without the assistance and monitoring of a caregiver, babies become overwhelmed by their emotional states, including those of fear, excitement, and sadness.20 In order to maintain emotional equilibrium, babies require a consistent and committed relationship with one caring person.
Attunement, in the simplest terms, means following baby's cues.
When the mother-baby dyad is in attunement, both will experience positive emotions. If out of sync, the baby will show signs of stress, such as crying, that indicate the need for re-attunement.25
To a baby, stress is anything that pulls it out of attunement and into a negative emotional state. Events that cause such painful emotions as fear, anxiety, and sadness create stress. This includes everything from short, unwanted separations from the mother to the extreme of abuse.
For example, if a mother sets her baby down to answer the phone and the baby begins to cry, the baby requires the mother's return and re-attunement in order to avoid becoming overwhelmed by sadness. Without this assistance, the crying intensifies and leads to a chain of internal reactions that put the baby in a survival mode. In a survival mode, the baby operates at the most primary level, forced to dedicate all resources to the basic functions necessary for existence, thus forfeiting opportunity for potential growth.
This chain of events is a cycle of hyper arousal and dissociation that begins when the baby becomes distressed.
The second, later-forming reaction to stress is dissociation. At this point, the child disengages from the external world's stimuli and retreats to an internal world. This reaction involves numbing, avoidance, compliance, and lack of reaction.32 This second stage occurs in the face of a stressful situation in which the baby feels hopeless and helpless.33 The infant tries to repair the disequilibrium and misattunement but cannot, and so disengages, becomes inhibited, and strives to avoid attention, to become "unseen."34 This metabolic shutting-down is a passive state in response to an unbearable situation, and is the opposite of hyper arousal. In biological and evolutionary terms, it is the same process that allows us to retreat from overwhelming situations to heal wounds and fill depleted resources. However, as a response to dyadic misattunement, it is devastating, and the effects of even short periods of dissociation are profound.35 In this state, pain-numbing endogenous opiates and behavior-inhibiting stress hormones such as cortisol are elevated. Blood pressure decreases, as does the heart rate, despite the still-circulating adrenaline.36 This ultimate survival strategy allows the baby to maintain basic homeostasis.37
Perhaps most important, behavior-based techniques of child raising, such as sleep training, must be shunned. Given the new body of sophisticated, cross-discipline research on attachment and brain development outlined in this article, it is clear that a baby's willingness to accept sleep training after reportedly brief periods of protest is no less than a cycle of hyper arousal and dissociation responses that is damaging to its development. To think that since the infant has passively accepted the new sleep system, the sleep training is thus "successful," is to misunderstand the workings of the infant brain. No longer can we accept the conventional wisdom that babies are merely "exercising their lungs" when they cry; nor can we tolerate interpretations of babies' cries as "manipulation." Babies cry to signal distress and in effort to engage caregivers to help meet their needs and foster their healthy development. It is an attempt at communication, not manipulation. Their goals are survival and optimal development. This is achieved through secure attachment.
The Science of Attachment: The Biological Roots of Love, Lauren Lindsey Porter, Issue 119, July/August 2003, Mothering magazine

Professor Megan Gunnar says;
Scientists believe our ability to manage stress as adults is formed in childhood through a combination of genes and experiences. For two decades, Megan Gunnar, child development professor and director of the Human Developmental Psychobiology Lab, has pioneered the field of measuring stress in young children as a way to unravel the mysteries of healthy development.Gunnar’s research finds that social relationships control cortisol levels in infants and young children. Children with secure attachments to their caregivers—even when emotionally upset—show stable cortisol levels, while even minor challenges raised cortisol levels among those in insecure relationships. She has shown the key ingredient to buffering stress is sensitive, responsive, individualized care, the type of care that leads to secure attachment relationships.
“How young children manage stress; Looking for links between temperament and experience” by Professor Megan Gunnar, child development professor at Research works, College of Education and Human Development, University of Minnesota.

Author Linda Folden says;
According to attachment researchers, the consequences of this parenting style are fewer behavior problems and mental disorders, less social misconduct, a greater ability to form lasting adult relationships, and improved overall health.
In contrast, when nursing is withheld from a baby and there is maternal separation during much of the day and night, high levels of the stress hormone cortisol are produced.7 This leads to permanently altered brain function, hormonal imbalance and reduced immune functioning, as well as increased mental and behavior problems and a decreased ability to deal with stress throughout life.8,9,10
Coming of Age in America (Much Too Soon), Linda Folden Palmer, DC (Author of Baby Matters) Reprinted from Dynamic Chiropractic, May, 1999

Researchers Palmer and Heller quoted in Friendly Village;
When babies are held close by a loving parent or caregiver, they feel calm and contented. There are far less stress hormones (high levels of cortisol) which interfere with normal bodily functions, including digestion and brain development. (Heller, S.) It is theorized that excessive amounts of cortisol over time could magnify their future responses to stress. (Palmer, L.) Research has demonstrated that even while a young child is crying during a stressful event (a doctor visit, for example), if she is comforted (held) during that stressful even, there is a much lower stress response. She still may be crying loudly, but there are much lower levels of cortisol measured. Human touch does make a difference.

Parenting expert, author and lactation consultant Ann Calandro says:
Mothers are sometimes berated by family members and visitors for following their normal and natural instincts of responding to their own babies' needs. It is a sad world when we worry about training a newborn to be happy alone. Of course he needs to be picked up! He is not mature yet, certainly not capable of thinking, "I believe I will make her get up out of bed just for fun and pick me up." I worry about mothers who do not respond to their babies. When babies are left in their cribs to cry or left in the nursery with nurses for hours on end, I wonder what is wrong.
Crying is not normal either. Despite the sage advice of some grandmothers, crying isn't good for Baby's lungs. When you hear your baby cry, your heart will tell you so. Crying causes your baby's cortisol levels to go up, his blood pressure to go up and his whole life to become unbalanced so that he doesn't feed or relax well. When your baby cries, your instinct is to do everything in your power to solve his problem so that the crying will stop. Newborn wailing is meant to be very grating and to spur you into action. Most times with breastfeeding babies, your touch or your breast is the instant solution whether baby is thirsty, hungry, cold or afraid.
Straight Talk About Real Babies - Defining New-mom Expectations, Ann Calandro BSN, RNC, IBCLC

North West Regional Educational Laboratory says;
A responsive, nurturing environment that allows the infant and young child to develop strong attachments to a limited number of caregivers enables the child to build neural pathways that encourage emotional stability. Sroufe and his colleagues found that both that quality of care and security of attachment affect children's later capacity for empathy, emotional regulation, cognitive development, and behavioral control (Kestenbaum, Farber, & Sroufe, 1989).
Gunner's research (1996) on cortisol--a hormone that is easily measured because it is present in saliva - helps to explain how a secure attachment helps children withstand stress, even later in life. In stressful situations, children who have experienced a secure attachment to a caregiver are more adaptive and produce less cortisol. This research also shows that adverse or traumatic events elevate the level of cortisol in the brain. Excessively and chronically high levels of cortisol alter the brain by making it vulnerable to processes that destroy brain cells responsible for thought and memory. Just as importantly, cortisol reduces the number of connections in certain parts of the brain - causing memory lapses, anxiety, and an inability to control emotional outbursts.
Emotional signals, such as crying and smiling, serve as the language of the baby. Babies whose mothers are responsive to crying during the early months tend to cry less in the last months of the first year. Instead, they rely more on facial expressions, gestures, and vocalization to communicate their intentions and wishes to mother (Bell & Ainsworth, 1972).
The Importance of Attachment: The First Relationship. North West Education Collaboration; Beyond Family Involvement (2002).

Dr Aletha Solter says:
A baby’s crying can invoke powerful feelings in caretakers. When asked to describe their feelings when they were unable to quiet their crying babies, new mothers confessed a range of emotions, including exasperation, lack of confidence, fear, anxiety, confusion, anger, and resentment. Some even reported feeling extremely hostile towards their infants (Jones, 1983). Not surprisingly, infant crying has been linked to child abuse (Frodi, 1985; Murray, 1979). In a survey of battered infants, eighty percent of the parents reported that excessive crying by their baby triggered the abuse (Weston, 1968).
Tears for Trauma: Birth Trauma, Crying, and Child Abuse. Aletha Solter, Ph.D.

Dr Aletha Solter also says;
But there is no doubt that repeated lack of responsiveness to a baby’s cries—even for only five minutes at a time—is potentially damaging to the baby’s mental health. Babies who are left to cry it out alone may fail to develop a basic sense of trust or an understanding of themselves as a causal agent, possibly leading to feelings of powerlessness, low self-esteem, and chronic anxiety later in life. The cry-it-out approach undermines the very basis of secure attachment, which requires prompt responsiveness and sensitive attunement during the first year after birth.1
Crying for Comfort: Distressed Babies Need to Be Held, by Dr Aletha Solter, Issue 122 January/February 2004, Mothering magazine.

The Sunday Times quotes Margot Sunderland;
One of Britain’s leading experts on children’s mental health… Margot Sunderland, director of education at the Centre for Child Mental Health in London. She is so sure of the findings in the new book, based on 800 scientific studies, that she is calling for health visitors to be issued with fact sheets to educate parents...Her findings are based on advances in scientific understanding over the past 20 years of how children’s brains develop, and on studies using scans to analyse how they react in particular circumstances.
For example, a neurological study three years ago showed that a child separated from a parent experienced similar brain activity to one in physical pain. Sunderland also believes current practice is based on social attitudes that should be abandoned.
The Sunday Times Britain, Children 'should sleep with parents until they're five', by Sian Griffiths, May 14, 2006,,2087-2179265,00.html

Tuesday, June 20, 2006


tr.v. con·trolled, con·trol·ling, con·trols
1. To exercise authoritative or dominating influence over; direct.
2. To adjust to a requirement; regulate: controlled trading on the stock market; controls the flow of water.
3. To hold in restraint; check: struggled to control my temper.

1. Demanding or requiring action or attention: a crying need.
2. Abominable; reprehensible: a crying shame.
Noun 1.
Crying - the process of shedding tears (usually accompanied by sobs or other inarticulate sounds); "I hate to hear the crying of a child"; "she was in tears"

1. To use wrongly or improperly; misuse: abuse alcohol; abuse a privilege.
2. To hurt or injure by maltreatment; ill-use.
1. Improper use or handling; misuse: abuse of authority; drug abuse.
2. Physical maltreatment
a·buser n.
Synonyms: abuse, misuse, mistreat, ill-treat, maltreatMistreat, ill-treat, and maltreat all share the sense of inflicting injury, often intentionally: "I had seen many more patients die from being mistreated for consumption than from consumption itself" Earl of Lytton.

1. To pay little or no attention to; fail to heed; disregard: neglected their warnings.
2. To fail to care for or attend to properly: neglects her appearance.
3. To fail to do or carry out, as through carelessness or oversight: neglected to return the call.
Noun 1.
neglect - lack of attention and due care

1. A serious injury or shock to the body, as from violence or an accident.
2. An emotional wound or shock that creates substantial, lasting damage to the psychological development of a person, often leading to neurosis.
3. An event or situation that causes great distress and disruption.

All these definitions are from;

Evidence Based Practice
The conscientious, explicit, and judicious use of current best evidence in decision making. It customizes worker experience with the various forms of evidence to the specific problem/situation under investigation. (Sackett, et al, 1997).

Sunday, June 18, 2006

Controlled Crying

This is part of a complaint letter I have been writing to the local 'sleep clinic' in our area.

There is much research to support that methods that involve leaving a baby to cry are potentially very harmful to babies, particularly young babies. The mere suggestion that a method could be harmful should be enough to warrant a warning to be given to clients, or even a decision to ban the practice altogether.
The Queen Elizabeth Centre in Melbourne has recently stopped using controlled crying methods due to the recommendations of the Victorian Parenting Centre. The QEC now uses settling methods based on the book “The No Cry Sleep Solution” by Elizabeth Pantley. Scientists demonstrate that just being alone has been shown to increase cortisol (the stress hormone) in a baby, and leaving a baby to cry for any amount of time has been discouraged by researchers, scientists, medical professionals, child health organisations, and parenting experts the world over for many, many years. According to the body of research on attachment, not comforting or responding to your baby, for any reason, would have significant effects on the mother and baby attachment relationship.
There is no physical or psychological need (in babies or parents) for this practice, and certainly no need that would warrant potential harm imposed on an infant child. In addition to the potential neurological and psychological harm of this practice, infant crying has been linked to child abuse. In a survey of battered infants, eighty percent of the parents reported that excessive crying by their child triggered the abuse. Furthermore, teaching parents that it is acceptable to leave their baby to cry and not respond to them for varied and often unspecified amounts of time concerns me deeply, as it may give parents social ‘permission’ to abuse and neglect their child.
We have not needed this practice to survive as a human race in the past, and it is not necessary to our survival now. Currently, very few cultures practice this method, and this also demonstrates its lack of necessity. The Australian Association for Infant Mental Health (AAIMHI) recommends avoiding the use of this method, as it is potentially harmful to infants. If it is to be used then they recommend it to only be used from the age of 3 years. Certainly not suitable for an infant who is only 20 days old. Even one of the original pioneers of this method Dr Ferber has revised his book and states that his method can be used for children between 12 months and 6 years. The AAIMHI also has other important guidelines that they recommend detailing best practice and duty of care, if using this method is seen as absolutely necessary by parents.

Wednesday, June 14, 2006

Why use controlled crying?

This method is very popular, but only in a few countries of the world.
Obviously it is used to get a child to sleep, but it is considered harmful by many. Do people know this? Why do people use this method if they know it can be harmful? Why do child health organisations continue to use this method and others protest against it? There are so many questions, and hopefully I will find some answers......

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