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

Saturday, September 02, 2006

Dr Sears on crying

1. An infant's cry – the perfect signal. Scientists have long appreciated that the sound of an infant's cry has all three features of a perfect signal.
First, a perfect signal is automatic. A newborn cries by reflex. The infant senses a need, which triggers a sudden inspiration of air followed by a forceful expelling of that air through vocal cords, which vibrate to produce the sound we call a cry. In the early months, the tiny infant does not think, "What kind of cry will get me fed?" He just automatically cries. Also, the cry is easily generated. Once his lungs are full of air, the infant can initiate crying with very little effort.
Second, the cry is appropriately disturbing: ear-piercing enough to get the caregiver's attention and make him or her try to stop the cry, but not so disturbing as to make the listener want to avoid the sound altogether.
Third, the cry can be modified as both the sender and the listener learn ways to make the signal more precise. Each baby's signal is unique. A baby's cry is a baby's language, and each baby cries differently. Voice researchers call these unique sounds cry prints, which are as unique for babies as their fingerprints are.
2. Responding to baby's cries is biologically correct. A mother is biologically programmed to give a nurturant response to her newborn's cries and not to restrain herself. Fascinating biological changes take place in a mother's body in response to her infant's cry. Upon hearing her baby cry, the blood flow to a mother's breasts increases, accompanied by a biological urge to "pick up and nurse." The act of breastfeeding itself causes a surge in prolactin , a hormone that we feel forms the biological basis of the term "mother's intuition." Oxytocin, the hormone that causes a mother's milk to letdown, brings feelings of relaxation and pleasure; a pleasant release from the tension built up by the baby's cry. These feelings help you love your baby. Mothers, listen to the biological cues of your body when your baby cries rather than to advisors who tell you to turn a deaf ear. These biological happenings explain why it's easy for those advisors to say such a thing. They are not biologically connected to your baby. Nothing happens to their hormones when your baby cries.
3. Ignore or respond to the cry signal? Once you appreciate the special signal value of your baby's cry, the important thing is what you do about it. You have two basic options, ignore or respond. Ignoring your baby's cry is usually a lose-lose situation. A more compliant baby gives up and stops signaling, becomes withdrawn, eventually realizes that crying is not worthwhile, and concludes that he is not worthwhile. The baby loses the motivation to communicate with his parents, and the parents miss out on opportunities to get to know their baby. Everyone loses. A baby with a more persistent personality— most high-need babies—does not give up so easily. Instead, he cries louder and keeps escalating his signal, making it more and more disturbing. You could ignore this persistent signal in several ways. You could wait it out until he stops crying and then pick him up, so that he won't think it was his crying that got your attention. This is actually a type of power struggle; you teach the baby that you're in control, but you also teach him that he has no power to communicate. This shuts down parent-child communication, and in the long run everybody loses.
You could desensitize yourself completely so that you're not "bothered" at all by the cry; this way you can teach baby he only gets responded to when it's "time." This is another lose-lose situation; baby doesn't get what he needs and parents remain stuck in a mindset where they can't enjoy their baby's unique personality. Or, you could pick baby up to calm him but then put him right back down because "it's not time to feed him yet." He has to learn, after all, to be happy "on his own." Lose-lose again; he will start to cry again and you will feel angry. He will learn that his communication cues, though heard, are not responded to, which can lead him to distrust his own perceptions: "Maybe they're right. Maybe I'm not hungry."
4. Be nurturing. Your other option is to give a prompt and nurturant response. This is the win-win way for baby and mother to work out a communication system that helps them both. The mother responds promptly and sensitively so that baby will feel less frantic the next time he needs something. The baby learns to "cry better" , in a less disturbing way since he knows mother will come. Mother structures baby's environment so that there is less need for him to cry; she keeps him close to her if she knows he's tired and ready to sleep. Mother also heightens her sensitivity to the cry so that she gives just the right response. A quick response when baby is young and falls apart easily or when the cry makes it clear there is real danger; a slower response when the baby is older and begins to learn how to settle disturbances on his own.
Responding appropriately to your baby's cry is the first and one of the most difficult, communication challenges you will face as a mother. You will master the system only after rehearsing thousands of cue-responses in the early months. If you initially regard your baby's cry as a signal to be responded to and evaluated rather than as an unfortunate habit to be broken, you will open yourself up to becoming an expert in your baby's signals, which will carry over into becoming an expert on everything about your baby. Each mother-baby signal system is unique. That's why it is so shortsighted for "cry trainers" to prescribe canned cry-response formulas, such as "leave her to cry for five minutes the first night, ten minutes the second," and so on.
6. What cry research tells us. Researchers Sylvia Bell and Mary Ainsworth performed studies in the 1970's that should have put the spoiling theory on the shelf to spoil forever. (It is interesting that up to that time and even to this day, the infant development writers that preached the cry-it-out advice were nearly always male. It took female researchers to begin to set things straight.) These researchers studied two groups of mother-infant pairs. Group 1 mothers gave a prompt and nurturant response to their infant's cries. Group 2 mothers were more restrained in their response. They found that children in Group 1 whose mothers had given an early and more nurturant response were less likely to use crying as a means of communication at one year of age. These children seemed more securely attached to their mothers and had developed better communicative skills, becoming less whiny and manipulative.
Up until that time parents had been led to believe that if they picked up their baby every time she cried she would never learn to settle herself and would become more demanding. Bell and Ainsworth's research showed the opposite. Babies who developed a secure attachment and had their cues responded to in a prompt and nurturing way became less clingy and demanding. More studies were done to shoot down the spoiling theory, showing that babies whose cries were not promptly responded to begin to cry more, longer, and in a more disturbing way. In one study comparing two groups of crying babies, one group of infants received an immediate, nurturant response to their cries, while the other group was left to cry-it-out. The babies whose cries were sensitively attended to cried seventy percent less. The babies in the cry-it-out group, on the other hand, did not decrease their crying. In essence, crying research has shown that babies whose cries were listened and responded to learned to "cry better"; the infants who were the product of a more restrained style of parenting learned to "cry harder." It is interesting that the studies revealed differences not only in how the babies communicated with the parents based on the response they got to their cries, but there were also differences in the mothers, too. Studies showed that mothers who gave a more restrained and less nurturant response gradually became more insensitive to their baby's cries, and this insensitivity carried over to other aspects of their parent-child relationship. Research showed that leaving baby to cry-it- out spoils the whole family.
7. Crying isn't "good for baby's lungs." One of the most ridiculous pieces of medical folklore is the dictum: "Let baby cry, it's good for his lungs." In the late 1970's, research showed that babies who were left to cry had heart rates that reached worrisome levels, and lowered oxygen levels in their blood. When these infants' cries were soothed, their cardiovascular system rapidly returned to normal, showing how quickly babies recognize the status of well being on a physiologic level. When a baby's cries are not soothed, he remains in physiologic as well as psychological distress.
The erroneous belief about the healthfulness of crying survives even today in one of the scales of the Apgar score, a sort of test that physicians use to rapidly assess a newborn's condition in the first few minutes after birth. Babies get an extra two points for "crying lustily." I remember pondering this concept back in the mid 1970's when I was the director of a newborn nursery in a university hospital, even before fathering a high-need baby had turned me into an opponent of crying it out. It seemed to me that awarding points for crying made no sense physiologically. The newborn who was in the state of quiet alertness, breathing normally, and actually pinker than the crying infant lost points on the Apgar score. It still amazes me that the most intriguing of all human sounds—the infant's cry—is still so misunderstood.

If only my baby could talk instead of cry I would know what she wants," said Janet, a new mother of a fussy baby. "Your baby can talk," we advised. "The key is for you to learn how to listen. When you learn the special language of your baby's cry, you will be able to respond sensitively. Here are some listening tips that will help you discover what your baby is trying to say when he cries.
The cry is not just a sound; it's a signal – designed for the survival of the baby and development of the parents. By not responding to the cry, babies and parents lose. Here's why. In the early months of life, babies cannot verbalize their needs. To fill in the gap until the child is able to "speak our language," babies have a unique language called "crying." Baby senses a need, such as hunger for food or the need to be comforted when upset, and this need triggers a sound we call a cry. Baby does not ponder in his little mind, "It's 3:00 a.m. and I think I'll wake up mommy for a little snack." No! That faulty reasoning is placing an adult interpretation on a tiny infant. Also, babies do not have the mental acuity to figure out why a parent would respond to their cries at three in the afternoon, but not at three in the morning. The newborn who cries is saying: "I need something; something is not right here. Please make it right."
At the top of the list of unhelpful advice – one that every new parent is bound to hear – is "Let your baby cry-it-out." To see how unwise and unhelpful is this advice, let's analyze each word in this mother-baby connection- interfering phrase.
"Let your baby." Some third-party advisor who has no biological connection to your baby, no knowledge or investment in your baby, and isn't even there at 3:00 a.m. when your baby cries, has the nerve to pontificate to you how to respond to your baby's cries.
The cry is a marvelous design. Consider what might happen if the infant didn't cry. He's hungry, but doesn't awaken ("He sleeps through the night," brags the parent of a sleep-trained baby). He hurts, but doesn't let anyone know. The result of this lack of communication is known, ultimately, as "failure to thrive." "Thriving" means not only getting bigger, but growing to your full potential emotionally, physically, and intellectually.
"Cry…" Not only is the cry a wonderful design for babies; it is a useful divine design for parents, especially the mother. When a mother hears her baby cry, the blood flow to her breasts increases, accompanied by the biological urge to "pick up and nurse" her baby. ("Nurse" means comforting, not just breastfeeding.) As an added biological perk, the maternal hormones released when baby nurses relax the mother, so she gives a less tense and more nurturing response to her infant's needs. These biological changes – part of the design of the mother-baby communication network – explain why it's easy for someone else to advise you to let your baby cry, but difficult for you to do. That counterproductive advice is not biologically correct.
"It…" Consider what exactly is the "it" in "cry-it-out": an annoying habit? Unlikely, since babies don't enjoy crying. And, contrary to popular thought, crying is not "good for baby's lungs." That belief is not physiologically correct. The "it" is an emotional or physical need. Something is not right and the only way baby has of telling us this is to cry, pleading with us to make it right. Early on, consider baby's cry as signaling a need – communication rather than manipulation.
Parent tip: Babies cry to communicate – not manipulate
"Out" What actually goes "out" of a baby, parents, and the relationship when a baby is left to cry-it-out? Since the cry is a baby's language, a communication tool, a baby has two choices if no one listens. Either he can cry louder, harder, and produce a more disturbing signal or he can clam up and become a "good baby" (meaning "quiet"). If no one listens, he will become a very discouraged baby. He'll learn the one thing you don't want him to: that he can't communicate.
Baby loses trust in the signal value of his cry – and perhaps baby also loses trust in the responsiveness of his caregivers. Not only does something vital go "out" of baby, an important ingredient in the parent- child relationship goes "out" of parents: sensitivity. When you respond intuitively to your infant's needs, as you practice this cue- response listening skill hundreds of times in the early months, baby learns to cue better (the cries take on a less disturbing and more communicative quality as baby learns to "talk better"). On the flip side of the mother-infant communication, you learn to read your infant's cries and respond appropriately (meaning when to say "yes" and when to say "no," and how fast). In time you learn the ultimate in crying sensitivity: to read baby's body language and respond to her pre-cry signals so baby doesn't always have to cry to communicate her needs.
What happens if you "harden your heart," view the cry as a control rather than a communication tool and turn a deaf ear to baby's cries? When you go against your basic biology, you desensitize yourself to your baby's signals and your instinctive responses. Eventually, the cry doesn't bother you. You lose trust in your baby's signals, and you lose trust in your ability to understand baby's primitive language. A distance develops between you and your baby and you run the risk of becoming what pediatricians refer to as a doctor-tell-me-what-to-do. You listen to a book instead of your baby. So, not listening and responding sensitively to baby's cries is a lose-lose situation: Baby loses trust in caregivers and caregivers lose trust in their own sensitivity.
Mother loses trust in herself. To illustrate how a mother can weaken her God- given sensitivity when she lets herself be less discerning about parenting advice; a sensitive veteran mother recently shared this story with us:
"I went to visit my friend who just had a baby. While we were talking, her three-week-old started crying in another room. The baby kept crying, harder and louder. I was getting increasingly driven to go comfort the baby. Her baby's cries didn't bother her, but they bothered me. My breasts almost started to leak milk! Yet, my friend seemed oblivious to her baby's signals. Finally, I couldn't stand it anymore and I said, 'It's okay, go attend to your baby. We can talk later.' Matter-of-factly she replied, 'No, it's not time yet for his feeding.' Incredulous, I asked, 'Mary, where on earth did you get that harmful advice?' 'From a baby-training class at church,' she proudly insisted. 'I want my baby to learn I'm in control, not him.'"
This novice mother, wanting to do the best for her baby and believing she was being a good mother, had allowed herself to succumb to uncredentialed prophets of bad parenting advice and was losing her God-given sensitivity to her baby. She was starting her parenting career with a distance developing between her and her baby. The pair was becoming disconnected.

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