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, June 23, 2007

Controlled Crying - some facts and information

Controlled Crying - Some Facts & Information

By Jayne Garrod

What is Controlled Crying?

In recent years, there has been a concerted effort among many health professionals, in particular baby health nurses, to promote the Infant Sleep Training method known as Controlled Crying (sometimes referred to as “Controlled Comforting”) as the preferred ( and indeed in some cases the only) desirable method of settling a baby to sleep. The idea behind Controlled Crying is to teach babies to “self settle” or put themselves to sleep, and to stop them from crying out during the night. It involves leaving the baby alone to cry for increasingly longer periods of time before providing comfort. Originally Controlled Crying was not suggested for babies less than 6 months of age, but increasingly it’s being suggested for use with younger and younger babies, right down in some cases to newborns. In fact one of the originators of the Controlled Crying or “Cry It Out” form of sleep training, Dr Richard Ferber, originally intended it to be used in babies 18 months and older.

So why is Controlled Crying undesirable?

There are several reasons why many health professionals and mothers alike have deemed Controlled Crying to be an unsuitable technique. Here are some of those reasons:

Controlled Crying can be harmful to the breastfeeding relationship.

Newborns need to be fed around the clock, so that the mother establishes her milk supply in the early stages.

Babies have very small stomachs, which are biologically designed to empty quickly, and to be immediately re nourished.. It is unrealistic to expect little babies to go for long periods without milk, and not to become distressed. This also applies to formula fed babies - babies simply cannot be expected to go long amounts of time, without sustenance1

Furthermore, breast milk contains a hormone designed to induce sleepiness in both mothers and babies. This hormone is called Cholecystokinin (CKK) and is released in the mother when the baby starts suckling, and travels through into the breast milk. So it’s natural for babies to go to sleep on the breast-nature designed it this way. Yet proponents of Controlled Crying insist that babies should not be allowed to develop the “bad habit” of falling asleep on the breast. However, feeding a baby to sleep is not “spoiling them” or making “a rod for your back” as these advocates would claim. Rather, attending quickly to a crying baby teaches a child they are loved and are worthy of attention. A baby left alone to cry, may develop what psychologists call Learned Helplessness - in other words, they discover their needs are not worthy of being met, so they give up in despair.

Controlled Crying compromises the development of Secure Attachment, and healthy parent-child relationships.

Infants are far more likely to develop secure attachments when their cries are responded to promptly. Secure attachment in infancy is the basis for good adult mental health. According to child psychologists,babies left alone to cry, are more likely to suffer from poor self esteem as older children, teenagers and adults. The research conducted by Ainsworth and Bell at John Hopkins university showed that when parents responded to a child’s cry quickly, the result was a secure, happy child, who was far more likely to initiate independence at an earlier age ii

Babies suffer separation anxiety when left alone for long periods.

It is normal for babies to go through a period of separation anxiety, when separated from their caregivers. This usually occurs from around 6 months through till 12 months, peaking at around 9 months. In some children it may even last up to 18 months, in correlation with the child’s personality and how well the child is supported during this sensitive period. This also coincides, and is related to children learning about “Object Permanence” In other words, learning that when an object (or person) is removed from sight, it actually does still exist. Babies younger than 8-9 months do not understand that when a parent leaves them, they will come back, in fact the child can’t see the parent, so they may conclude the parent is gone for good. The concept of Object Permanence is not fully developed in children until around the age of four.

Crying and Baby Stress
According to a study conducted by Dr Michael Commons of the Harvard Medical School, researchers found a link between babies crying for extended periods of time, and a higher level of the stress hormone cortisol in babies’ brains.Commons suggested that constant stimulation by cortisol in infancy caused physical changes in the brain.
Dr Commons stated "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." iii

Babies sleep better when close to their caregivers

This is a basic biological fact. There is no developmental reason for babies to sleep apart, and in fact in the case of our ancestors, it would have been perilous to do so. Imagine if our Stone Age ancestors had decided to separate bubs in a different cave or hut, so they could learn to “self settle” They would have been attacked by marauding wild animals! Babies have this biological instinct to respond to perceived danger, in the form of crying. It is the only way they know how to communicate their needs. The fight or flight instinct is still a vital part of our biological makeup. Parents also possess the instinct to pick up and soothe a crying baby-to tell parents this is “wrong”, is to deny them one of the most vital and enjoyable aspects of parenting

Experts speak out against
Controlled Crying…

In 2003 the Australian Association for Infant Mental Health released a paper stating their opposition to the Controlled Crying technique, based on research they had conducted:

“AAMHI 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” iv

They further stated that other strategies should always be discussed with parents, as preferable options.

Other prominent medical professionals have also spoken out against this practice. The following is a quote from well known US paediatrician
Dr William Sears:

“With most of these baby-training regimens you run the risk of becoming desensitised 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 learns anything good from this…

He goes on to say:

“Clicking into the cry-it-out method also keeps you from continuing to search for medical or physical causes of night waking, such as GER and food allergies. Night feedings is normal; frequent night waking is not. v

In other words-there is a reason your baby is crying-and if it isn’t simply because they need to be held and to feel secure, then it is most likely there is another underlying medical reason, which should be investigated.

So what’s the alternative?

Many sleep deprived parents turn to CC because it seems to solve their sleep problems quickly. In some cases it works (at what cost is another story) However, many parents also find this method does not work, and simply causes the whole family incredible distress. So, what else can parents do?

Alternatives to Controlled Crying
Co sleeping. This is the normal way to sleep, for many of the world’s population. Dr Sears says: “Over the years of noting all the good things that happen to babies when they share sleep with their parents, one medical benefit that these babies thrive. The health benefits of sharing sleep have been recognized for many years” vi

If co sleeping does not appeal however, there are many other options. Baby massage, warm baths, soft soothing music, aromatherapy, a recognisable bedtime routine-these things can all help. There are many helpful websites out there, offering gentle solutions to sleepless nights with bubs, and books such as Elizabeth Pantley’s No Cry Sleep Solution, and Pinky McKays “100 Ways to Calm The Crying” and “Parenting By Heart” are excellent resources for parents wishing to discover the many alternatives to leaving a baby to cry itself to sleep.

This fantastic article can be read here;

Tuesday, June 19, 2007

Reasons not to use "Controlled Crying"

Reasons not to use Controlled Crying or other similar methods;

There must be many reasons not to use this method, but here are just a few;

* There are no studies verifying that these methods are safe for a babies developing brain. Safety can not be assured.

* Neurology, Neuropsychology and other fields of Science are revealing more and more about how these methods could damage your child’s emotional, psychological and behavioural development, due to the effect it has on the infants brain

* It is an emotionally difficult experience for both children and parents, and this alone may alter your attachment or future relationship

* There is also the suggestion by some doctors and health professionals that using these methods could adversely affect the child’s sleep in the future. For example they may develop a fear of bedtime, bedwetting, or other behaviours such as head banging and so on.

* There are many examples of heartache experienced by mothers who have used controlled crying methods in the past.(Most of these examples listed have been told to me via emails from the mothers or friends of these mothers) Some examples are;

Death of child (the child died when left to cry. It would have been avoided if controlled crying was not used).
Burst blood vessels in the infants eyes
Vomiting / choking
Rejecting the mother afterwards, or severe and obvious effects on the attachment relationship. (See also Pinky McKays book "Sleeping Like a Baby")

* One of the best reasons not to try these methods is efficacy. The best available estimate on the effectiveness of this method is that it works in 70-80% of cases (Dr Harriet Hiscock), and other reports are as low as 20 - 40%. This means that, at best, 20-30% of babies go through this experience with the potential harmful consequences and it still doesn’t work. At worst 80% of babies and children go through this experience and it doesn’t improve their sleeping. Why take the risk?

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