BawlingBabies

2008-10-11T11:37:00.002+11:00

SA study to settle battle of cry babies debate
THE long-term health impact of controlled crying on babies will finally be determined by a world-first study in South Australia.
http://www.news.com.au/adelaidenow/story/0,22606,24305993-5006301,00.html

The wording of this article seems to indicate a bias on the part of the researchers, which - if true - would then indicate that the researchers need to seriously consider and document that they are indeed already biased, if they are to conduct any decent credible research.

http://socsci.flinders.edu.au/psyc/students/KateJackson/index.php

But if there is any possible risk to the babies, then how is the research being permitted through the ethics committee?

Many professionals and mothers have asked this question and the resulting petition can be signed at this link;

http://www.gopetition.com.au/online/21782.html

We the undersigned strongly object to the conditions of the study on Infant Sleep Disturbance, which is being conducted by Kate Jackson at Flinders University.

We are concerned that the children involved in the study will be subjected to ‘sleep training’, otherwise known as controlled crying, cry it out or controlled comforting. This aspect of the study is inconsistent with Flinders University Ethics policy [1], which requires researchers to protect the rights of their experimental subjects.

The Australian Association for Infant Mental Health [2] does not support the practice of controlled crying stating that the technique “is not consistent with what infants need for their optimal emotional and psychological health, and may have unintended negative consequences”. If there is ANY concern that controlled crying could be harmful to infants, then the rights of the child are not being protected and the study should cease immediately.

We are also concerned with comments that Kate Jackson has made to the media which display bias unfit for someone conducting a scientific study, “Conflicting advice about controlled crying meant some parents were being scared off the technique” [3] .

As informed individuals we question the theoretical foundations of this study, in particular, the definition of 'sleep problems' [4]. There is evidence to support that it is completely natural for infants to wake often during the night throughout their first year and beyond [5,6]. This is NOT a 'sleep problem'.

Controlled crying and other similar regimes may indeed work (although one Australian baby magazine survey found that only 8% of mothers who used controlled crying said that it worked for more than a week [7]) to produce a self-soothing, solitary sleeping infant. However, the trade-off could be an anxious, clingy or hyper-vigilant child or even worse, a child whose trust is broken. Unfortunately, we can't measure attributes such as trust and empathy which are the basic skills for forming all relationships[7].

We suggest that a study into the true causes of parent fatigue would benefit families much more than this proposed study.

References:

1. Flinders University, Ethics and Biosafety.
http://www.flinders.edu.au/research/info-for-researchers/ethics/

2. The Australian Association for Infant Mental Health,
http://www.aaimhi.org/documents/position%20papers/controlled_crying.pdf

3. The Sunday Mail, Adelaide Now.
http://www.news.com.au/adelaidenow/story/0,22606,24305993-5006301,00.html

4. http://www.ssn.flinders.edu.au/psyc/students/KateJackson/
http://www.ssn.flinders.edu.au/psyc/students/KateJackson/ISDwebflyer.pdf

5. Pub Med, http://www.ncbi.nlm.nih.gov/pubmed/8680184?dopt=Abstract

6. Goodlin J, Beth L, Burnham M M, Gaylor E E, Anders T F, 2001, Night Waking, Sleep-Wake Organization, and Self-Soothing in the First Year of Life, Journal of Developmental and Behavioral Pediatrics, Volume 24, Issue 4. View abstract at http://www.ncbi.nlm.nih.gov/pubmed/11530895?dopt=Abstract

7. http://www.pinky-mychild.com/index.php?option=com_content&view=article&id=22:the -con-of-controlled-crying&catid=11:sleep&Itemid=36

Being "Fully Informed"

2008-10-11T11:34:00.001+11:00

Read all the reputable articles on this Blog to be fully informed about the practice of controlled crying. Once you have read this information and sought further information in support of controlled crying, then you should be comfortable in knowing you are making a fully informed decision.

In Australia all material risks must be disclosed (as in the case of Rodgers vs Whitaker) in any proposed treatment. So you are within your rights to discuss any issues or questions you have with your health professional (and you should expect them to be able to discuss it with you) before using this method on any child.

“Informed consent is a legal condition whereby a person can be said to have given consent based upon an appreciation and understanding of the facts and implications of an action. The individual needs to be in possession of relevant facts and also of his or her reasoning faculties” (Wikipedia)

“In the United States, Australia, and Canada, a more patient-centered approach is taken and this approach is usually what is meant by the phrase "informed consent." Informed consent in these jurisdictions requires that significant risks be disclosed, as well as risks which would be of particular importance to that patient” (Wikipedia)

Trust in Yourself!

2007-08-21T07:54:00.000+10:00

The best advice I can give to anyone reading this blog, is to simply trust in yourself. If you truly feel happy when your baby drifts off to sleep in your arms then there is nothing to worry about. If you truly feel happy and elated while you listen to your baby cry to sleep, then obviously you have made the right choice for you. However, I would be suprised if you truly felt joyous when you heard your baby cry. No-one I know of feels deeply happy to hear their baby crying and upset, and I would worry about them if they did. This is obviously a simplistic way of viewing things, but it is the best way to judge your experience of life. If it feels good, then do it, but if it doesn't make you feel good, you need to seriously and deeply consider WHY, and change your actions.

You are the one who knows your baby best, you are the one who knows what feels right to do for them. After those first few weeks of getting to know their cries and expressions and ways of communicating, you know deep down how to respond to your baby. Trust in yourself and have confidence that what you feel in your gut as the best thing to do, is what you need to do. If you truly feel good helping your baby to sleep by rocking or feeding or in any other creative and gentle way, then this is the only choice to make.

If you are still not sure how you feel about how to settle your baby, read this blog and try to gauge how you feel after reading the articles. Go online and read articles that support controlled crying. Use your head but also tune into your feelings. Imagine yourself in your babies shoes. Imagine the experience of leaving your baby to cry. How do you feel? This will hopefully help you decide how to make your decision. In the words of the famous poet SriChinmoy;

Be happy, be happy!
Unless you are happy,
Your outer life will not succeed
And your inner life will not proceed.

Be happy, love your baby, live with confidence and trust in yourself. Know that you are doing all you can to be the best parent you can.

Controlled Crying - some facts and information

2007-06-23T10:45:00.000+10:00

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;
http://www.joyousbirth.info/articles/controlledfacts.html

Reasons not to use "Controlled Crying"

2007-06-19T08:32:00.000+10:00

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?

The Play

2007-05-08T19:05:00.000+10:00

Controlled Crying, a play written by Ron Ellisha, is mentioned here in a post 'Controlled Crying in the Meida'.
( http://bawlingbabies.blogspot.com/2006/08/controlled-crying-in-media.html )

It's on again! Read more here;

http://www.smh.com.au/news/arts-reviews/controlled-crying/2007/04/30/1177788010658.html

Mums told to ditch controlled crying

2007-05-08T18:23:00.000+10:00

Here is a media article about Anni Gethin and Beth Macgregor's new book, "Helping your baby to sleep". As I have mentioned this is a great book (and my experience is listed in the book too!) and is very well researched.

http://www.smh.com.au/news/national/despairing-mums-told-to-ditch-controlled-crying/2007/03/10/1173478729137.html

There is abundant research that clearly indicates that leaving a baby to cry for any amount of time is harmful, however, people continue to assume that it isn't harmful. Just because something is a common practice, doesn't mean it's not harmful!

In the few research articles supposedly 'supporting' controlled crying or 'graduated extinction' (I can only find three), the only method used to measure the infants emotional state is maternal observation and a completed survey. Basically the mother watches the infant to see if they appear 'normal' or not. How can this be a credible measure of an infants emotional health? And even if the mother could tell if her infant was somehow different from before controlled crying, (which is most likely impossible!), then would she write it down in a survey for others to read? I doubt it. This is only one of the problems with this research.

The media article above mentions Dr Harriet Hiscock. It is her research that is quoted as support for controlled crying and is the only Australian* piece of research stating that controlled crying is important for mothers who suffer from PND. I fail to see how using a harmful behavioural technique on an infant can improve a depressive state in another person. How is this a valid scientific argument? Isn't there clear problems with the methodology? Is a normal infants behaviour a direct cause or even a symptom of PND?

At the moment the Victorian Government is training 200 maternal and child health nurses to use controlled crying on babies. They cliam this is evidence based practice. However, 'evidence based practice' is defined as using a large body of evidence to support a method. The Victorian Government uses just one study, and the validity of the methodology of this study is widely questioned.

Robin Barker is an author and mother who is also quoted in the article. She states that there is no concrete evidence that it harms babies, but fails to note that there is no concrete evidence that it doesn't. And I wonder why she mentions nine months old as an appropriate age? When is the right age to leave a baby to cry on their own? I was told 20 days was fine for my baby by a qualified Registered Nurse and Lactation consultant. I have been told by Harriet Hiscock that only from 6 months of age is controlled crying suitable. And Robin Barker states from nine months of age. I'm confused! Perhaps there is no real 'safe' age for this practice? Since no one can prove that it is NOT harmful, I tend to agree with Professor James McKenna, acclaimed SIDS expert, who describes controlled crying as social ideology masquerading as science.

*I am aware of another study conducted in New Zealand, with a similar invalid methodology and similar conclusions.

The Nazis were beaten and left to cry as children

2007-05-05T19:35:00.000+10:00

"Parenting for a Peaceful World" by Robin Grille is a book I am currently reading. So far it has changed my world and I am not even half way through! It could alternatively be called "A Psychohistorical Account of Child Rearing", and it provides clear evidence of how parenting children in a gentle and peaceful way, leads to a peaceful society. I would urge every parent, and indeed every member of society to read this book. If I had the money I would buy a copy for every politician and policy maker! Buy, borrow, beg or steal (perhaps not steal!) this book!! It is deeply moving and incredibly well researched.

http://www.our-emotional-health.com/index.html

Sleeping with the baby

2007-04-28T16:41:00.000+10:00

"Annals of Parenthood; Sleeping with the Baby, Which Side of the Bed Are You On?
The Author and His Wife Defied the Experts."
by John Seabrook

This is a great article found at this link;

http://www.supportgroupformothers.com/thoughts1.htm

Here's a preview, but it is definately worth reading the whole article!!

I am a co-sleeper. That is, my wife and I sleep with our ten-month-old son, and we've been sleeping with him since he was born. This puts us on the wrong side of the federal government's recent edict about co-sleeping, which is that parents should never sleep with children younger than age two. "Don't sleep with your baby or put your baby down to sleep in an adult bed," stated Ann Brown, chairwoman of the United States Consumer Product Safety Commission, announcing the results of an eight-year study sponsored by her agency, published in October in the Archives of Pediatrics and Adolescent Medicine. As a co-sleeper, I wondered, on reading her remarks in the newspaper, after another night in the sack with the boy, what does sleep have to do with consuming product? Sleep is one of the secret channels by which parents communicate with their kids-under the radar, one hopes, of commercial influence and government control. The Consumer Product Safety Commission is the federal agency built at the intersection of those interests. .....

And here he talks about a meeting he had with Dr Ferber, who is often quoted as the inventor of controlled crying;

"But it says here in your book..." I read him two sentences I had read to my wife during one of our 2 A.M. showdowns: "Although taking your child into bed with you for a night or two may be reasonable if he is ill or very upset about something, for the most part this is not a good idea." And, "Sleeping alone is an important part of his learning to be able to separate from you without anxiety and to see himself as an independent individual."

"I wish I hadn't written those sentences," Ferber replied. "That came out of some of the existing literature. It is a blanket statement that is just not right. There's plenty of examples of co-sleeping where it works out just fine. My feeling now is that children can sleep with or without their parents. What's really important is that the parents work out what they want to do."

Helping your baby to sleep - A fantastic new book!

2007-04-16T08:29:00.000+10:00

This book is a MUST read for all parents!!!!!!! (I mean it!!)

Helping Your Baby to Sleep -
Why gentle techniques work best
by Anni Gethin & Beth Macgregor

In this groundbreaking book, authors Anni Gethin and Beth Macgregor argue against the practice of ‘controlled crying’, in which parents are encouraged to ‘train’ their children to sleep by ignoring their crying and distress.
Instead they present important research into babies’ emotional and brain development, and offer gentle techniques for parents to use, which take into account a baby’s natural sleep habits.

‘This excellent book, and the resources it directs parents to, offers ways of working with babies’ sleep patterns and of creating the conditions for better sleep without endangering a baby’s mental health or
damaging its experience of being loved and safe.’
From the foreword by Steve Biddulph, author of Raising Boys

Beth Macgregor is a psychologist who trains health and welfare workers in infant mental health, and an active
member of the Australian Association for Infant Mental Health. Anni Gethin is a health social scientist with
special interests in early childhood development, and a lecturer in public health and social science.

Here's some more information here;
http://www.femail.com.au/helping-your-baby-to-sleep.htm

And an interview on ABC radio;
www.abc.net.au/rn/lifematters/stories/2007/1874757.htm

A Baby Speaks

2007-02-27T17:56:00.000+11:00

Jan Hunt is an amazing author and psychologist, and has written some fantastic books and articles. Here's one from the Natural Child Project;

The Critical Importance of a Child's First Years: a Baby Speaks

By Jan Hunt, M.Sc.

Statistics tell us that something has gone wrong in our world. A steadily rising rate of social ills, and the proliferation of self-help books and therapy techniques for "reparenting the inner child" attest to the sad fact that we have lost our way in raising our children.

It is up to us as parents - despite our personal limitations - to give our children the right start in life: to help them become fulfilled, emotionally healthy adults, capable of loving and trusting others. Philosopher Blaise Pascal wrote that "the entire ocean is affected by a pebble." Our children should be like pebbles bringing forth waves of joy, not more sorrow and suffering.

Current thinking about our failure to fulfill our children's needs points to the importance of the earliest years of childhood, making it clear that the first three years are especially critical. What should we be doing during those years to ensure that our children have the best chance of becoming healthy and happy - as they deserve to be? Consider what a member of that age group might recommend to us - if only they could speak:

I am eleven months old. I can't talk yet, so when I am hungry, tired, wet, lonely, ill, or in pain, I cry. It is the only means I have to let my parents know that something is wrong.

If my crying is ignored, all that happens is that my needs become greater - I get even more miserable. On top of that, I have to face the fact that apparently no one cares about me. I'm sure Mommy would feel the same way if she were crying and Daddy ignored her. Believing that no one cares about you is a very devastating thought.

When my tears are ignored, I begin to believe that no matter how hard I cry, and no matter what is wrong, no one will ever come. If no one ever comes, I worry that I will die, because I cannot meet my own needs yet. You see, I have no concept of time, and two minutes is forever to me.

Sometimes I stop crying - but I am not learning patience - I am learning despair. When I stop crying, it means that I have lost all hope of ever being loved again, and all I feel is helplessness and despondency. I worry that I will never learn to communicate with words if I am not allowed to communicate with cries. And I worry that if I feel this frustration too many times, I will withdraw and stop feeling anything.

It sure can be frightening to think that no one cares enough about me to meet my needs. In fact, when my cries are ignored, I begin to think the world is a really bad place, and I worry that this will give me a negative and selfish outlook on life. But when my needs are met, I feel loved and secure enough to return that love to others, and eventually to my own children. I do so want to become a loving, caring person, but how will I learn to be like that if I don't see examples of it?

I get very lonely if I am separated from my parents. For nine months, my mother and I were inseparable, and I felt so much love inside her. She was all I knew when I arrived on this strange planet. It will require a certain amount of time - perhaps three years or longer - before my sense of trust is established and I am ready to spend extensive time with other caregivers. The more secure I can feel now, the sooner that time will come. if I am forced to face this separation before I am ready, it will take a lot longer; in fact, I may never reach the level of maturity that I hope to reach by the time I am an adult.

At night, I like to sleep next to my parents. Being able to touch them and hear them during the dark hours of the night are my only means of knowing that they have not disappeared. There are other reasons for wanting them near: their presence helps to regulate my heart rate, blood pressure, body temperature and sleeping cycles, and their breathing regulates my own breathing.

I love to breastfeed. Breast milk is the best food for me; it contains important substances, not found in formula, which will help to keep me healthy for many years. When Mommy breastfeeds, she produces a hormone which keeps her happy too. Best of all, breastfeeding keeps Mommy and me close.

I have no desire to take unfair advantage of my parents. I love them very deeply. I am simply asking for the same care that was given to babies for thousands of years until recent history. If my needs are met, I will be free to demonstrate all the love and trust I was born with. All I want is a chance to express that love fully.

Here's the link; Check it out for references and more articles by Jan Hunt
http://www.naturalchild.org/jan_hunt/babyspeaks.html

Kindred Magazine

2007-01-30T19:06:00.000+11:00

There is a fantastic article in the new Byron Child Magazine, now called Kindred, on Controlled Crying. In fact, the whole magazine is an amazing read, and it's not just about parenting. I would reccomend this magazine to anyone!!

Their website is;
http://www.kindredmedia.com.au/

You can buy Kindred direct from the website or here;

http://www.natureschild.com.au/products/kindred_magazine/366/1

Infant Mental Health - Update

2006-12-27T08:57:00.000+11:00

The Australian Association of Infant Mental Health have put out another paper on responding to babies cries. In addition to their first here;
http://www.aaimhi.org/documents/position%20papers/controlled_crying.pdf

The new paper can be read here;
http://www.aaimhi.org/documents/position%20papers/Position%20Paper%202.pdf

It's an important read if you're concerned about infant mental health.

Medical news today - study

2006-11-12T16:37:00.000+11:00

Pick Up Your Baby For Crying Out Loud
Main Category: Pediatrics News
Article Date: 01 Nov 2006 - 2:00am (PST)

Parents should listen to their instincts and pick up their newborn babies when they cry, Queensland University of Technology researcher Professor Karen Thorpe said.

A joint study with QUT and the Riverton Early Parenting Centre has found many parents of infants up to 12 weeks, were uncertain about how best to settle their crying baby and whether or not it was "right" to pick them up.

"A lot of parents are unsure if they should pick up their baby when their baby cries," Professor Thorpe from QUT's Faculty of Education said.

"The answer is: you should. Babies in the first 12 weeks of their life need highly responsive parents. They want and need a parent that is responsive to their cries."

Professor Thorpe said the study was initiated by concerns by clinical nurses from the Riverton centre that parents were choosing to ignore their crying newborn for fear it would "spoil" their baby to pick them up.

Riverton clinical nurse and co-researcher Claire Halle said parents felt picking up their crying baby would create "bad habits" which would impact negatively on their child's behaviour in the future.

"Parent's felt torn between what they thought and what they felt was the right thing to do, and this uncertainty seemed to heighten their stress levels," Ms Halle said.

The study found about 20 per cent of first time parents and 30 per cent of experienced parents admitted they were uncertain about picking up their crying baby. It also revealed that almost 25 per cent of first time parents and just over 10 per cent of experienced parents believed picking up a crying baby would spoil them.

"One parent said 'I feel guilty for not picking him up when he cries'," Ms Halle said. "Another said 'frequent and sudden changes in baby's behaviour make it hard to judge; too much attention may spoil them'."

But Professor Thorpe said in the first three month's of a baby's life, having responsive parents was very important to the child's emotional and neurological development.

She said the study highlighted there was a problem because parents were getting mixed messages about how best to settle their newborn baby.

"We need to ensure nurses, educators and health professionals are providing parents with consistent and appropriate guidelines for caring for their baby," Professor Thorpe said.

"It is also important for parents to have the confidence to trust their instincts when it comes to caring for their baby."

###

The study, funded by the Royal Children's Hospital Foundation, is a joint collaboration between Dr Toni Dowd from QUT's School of Nursing, Professor Karen Thorpe and the Settling Team at the Riverton Early Parenting Centre.

The study was a unique experience for clinical nurses to work as co-researchers and demonstrated the value of engaging clinical staff, academics and parents in research.

Contact: Sandra Hutchinson
Queensland University of Technology

http://www.medicalnewstoday.com/medicalnews.php?newsid=55344
http://www.sciencedaily.com/releases/2006/10/061027184248.htm

Disembodied from the beginning

2006-11-11T20:41:00.000+11:00

This is a fantastic essay! It is by a nursing student; Kathryn. Email me if you would like the references.

Disembodied from the beginning: the practice of controlled crying

In recent decades, nursing has moved away from biomedical theories in favour of theories that value individual experience (Madjar 1997, p. 55; Koernig Blais et al. 2006). Nurses are now expected to listen to patients and respect their experiences as embodied people (Erickson, Tomlin & Swain 1983, p. 46; Lawler 1991, p. 29), not separate the physical, emotional, social and spiritual aspects of self and treat people as just a body with a problem to be fixed. But what of those who have a voice that is misunderstood, or worse, ignored, whose attempts to communicate their most basic needs go unheeded? In western societies, babies, perhaps our most vulnerable and powerless members of society, are disembodied, and this is not simply condoned by the medical and nursing professions, but actively promoted by many.
This paper explains how controlled crying disembodies babies. It briefly reviews embodiment research specific to infants, explores the history and theories behind controlled crying and examines the societal factors that lead parents, particularly mothers, to adopt the practice. The implications of controlled crying for the infant are discussed, and the idea that it is as harmless as many doctors and nurses who promote it believe is challenged. The paper explains how embodiment theories specific to pain and illness apply to healthy infants, and concludes with implications for nursing practice. Not included is a detailed discussion of the effectiveness of controlled crying programmes. Knowledge of this is important in understanding why controlled crying is promoted by many and is in such wide use. The benefits for families when controlled crying is effective, particularly for mothers with post natal depression, is well researched, from Dr Ferber (1985) who pioneered the method, through to more recent studies (Pearce & Bidder 1999; Hiscock & Wake 2002; Hawkins-Walsh 2003; Skuladottir & Thome 2003; Hall et al. 2006), but is outside of the scope of this paper. Also omitted is a discussion of alternative settling methods and sleeping practices (McKay 2001; Pantley, 2002; Buckley 2005; Buckley 2006).

Early modern embodiment theorists include Sartre (c1960 cited in Lawler 1991, p. 57) who wrote about the body as being socially constructed, Merleau-Ponty (1962 cited in Madjar 1997, p. 55; Lawler 1991, p. 58; Marriner-Tomey & Alligood 2006, p. 172) who argued that the body is central in developing ones identity, and Heidegger (1962 cited in Madjar 1997, p. 55; Marriner-Tomey & Alligood 2006, p. 172) who wrote about existentialism and caring. These theories formed a basis for later embodiment and holistic nursing theorists such as Neumann (1989) Lawler (1991) and Madjar (1997), but most of these theories are concerned with illness and health in adults. There has been little written about infants and embodiment, perhaps because their communication skills are limited and it’s difficult to understand an infants’ lived experience. What little embodiment research specific to infants has been reported includes studies of the birth experience (Goldberg 2002), the mother/baby dyad (Bartlett 2000; Dykes 2005) and cultural embodiment and early experience (Rydstrom 2001), which are not very relevant in a discussion about controlled crying in western societies. This paper therefore focuses on how general embodiment theories illustrate the disembodiment of infants in the practice of controlled crying.

Over the past 150 years scientific approaches and ‘experts’ have taken over from maternal instincts and started telling parents how to raise children (Buckley 2005, p. 258; Kitzinger 2006). In the 1870’s parents were told that babies cry for exercise, that it is beneficial and should be ignored (Smiles 1871 cited in Kissinger 2006, p. 77). In the 1940’s the ‘rules’ dictated that every baby should sleep for 19 hours a day, be placed alone in its cot after the six o’clock feed and left to cry it out (Medley 1943 cited in Kissinger 2006, p. 77). Even quite recently parents have been told to ignore babies who vomit in ‘temper’ (Pearce & Bidder 1999, p. 45), or to manipulate parents (Ferber 1985, p. 70). These practices disembodied babies by treating them as a malfunctioning body, which was in accordance with the view of nursing and medicine at the time (Madjar 1997). This medicalisation or ‘scientising’ of nursing has been criticized as objectification, and care and comfort do not fit well with objectification (Lawler 1991, p. 30). In this context, controlled crying, where a baby is left for increasing periods of time to cry but returned to at specified intervals, was seen as a kinder option (Ferber 1985, p. 15). Controlled crying is based on behaviourism, which is a school of psychology that only observes measurable responses, with no regards for emotions or ideas, and has been criticized by many (Block 2001). Behaviourism is in direct opposition to theories of embodiment, which view the person as a whole- ideas and emotions experienced seen as integral to the development of ones personal identity (Madjar 1997, p. 55; Lawler 1991, p. 29). Prompt response to the cries of a baby also recognizes that the body is a means of expression (Lawler 1991, p. 29). Communicating with the infant and treating it as an individual with unique needs, rather than adhering to a controlled crying program designed to be applied to all infants, respects that there is a ‘uniqueness in how people experience their own bodies for themselves…’ (Madjar 1997, p. 55).

A central theme in embodiment is understanding ones lived experience, that a person is not just a physical body but exists in a social and cultural context (Madjar 1997, p. 55). In a similar way to how culture is a major determinant of health (McMurray 2003, p. 23), the way babies are raised and how we view the role of parents and children is highly influenced by the culture that one lives in. When mothers follow their natural instincts, treat their babies as embodied people, and attend to their basic needs, children are likely to grow up with strong attachment and be secure, independent adults (Buckley 2005, p. 242). In western societies however, many mothers have never even held a baby before they hold their own, and most feel insecure about their ability to parent (Spencer 2003; Buckley 2005, p. 241). We have a history of being bombarded by advice by ‘experts’, whose books for parents are so prescriptive that parents feel guilty if the are not following the ‘rules’ (Kitzinger 2006), and the media portrays a good baby as one who is controlled and disciplined from birth to sleep a lot and rarely cry (Kitzinger 2006). Parents are under so much pressure to have a ‘good’ baby- a baby who does not sleep through the night is labeled a ‘bad’ baby, and the implication is that the parents, usually the mother, is responsible (Ferber 1985, p. 20; Kirschner 2006). In western societies there is a high value placed on self control and independence (Wilson 1993; Buckley 2005, p. 242) and controlled crying is seen as a way to enable babies to improve their self control and foster independence by developing self settling abilities. Ironically the reverse is true- babies who are taught to self settle through controlled crying are more likely to exhibit ‘clingy’ behaviour later in childhood, and be less secure and independent adults (Houlahan 2006; Buckley 2006).

Other adverse effects of controlled crying on the infant are also significant and lifelong. Psychoneuroimmunologists have found that under stress the adrenal cortex releases cortisol, which causes an inhibition in the formation of antibodies (Rapee 2001, p. 51), and, in chronic stress situations such as controlled crying, results in long term immunological impairment (Buckley 2006). Early adverse experiences can interfere with establishment of social bonds and the regulation of emotional behavior later in life (Wismer Fries 2005). Experiments on infant rats have even found that early maternal inattention adversely effects the development of the limbic system, the vermis and the hippocampus, which, for humans, has lifelong effects on sexual arousal and the ability to love, and results in an increased risk of developing borderline personality disorder (Teicher et. al. 2001, p. 157). These negative effects show that viewing and treating a person from a purely scientific perspective and completely disregarding the holistic, embodied nature of an infant, can have lifelong effects on the formation of a positive personal identity.
Madjar writes that in health, embodiment is taken for granted, that it is only when the body is malfunctioning that we become aware of our bodies (Madjar 1997, p. 55). This, however, is different for infants- even in health they are disembodied by practices that ignore their needs. Although there is no way of knowing for sure, it has been suggested that when left alone to cry, babies feel threatened and abandoned (Buckley 2005, p. 265; Buckley 2006) and experience feelings of terror and hopelessness (Leidloff 1977 cited in Pantley 2005, p. 10). This could be seen to be a type of mental pain, a term that has also been used to describe the pain felt by people with a mental illness (Baker 1996, p. 25). Madjar (1997, p. 62) writes ‘Pain has the capacity to enter the very fabric of one’s body and destroy the familiar, taken-for-granted being in the world.’

There is also a ‘trend towards an increasing pathologization of…personality and behavioural ‘difference’’ in children (Kirschner 2006). In this way, the child is seen as an object, and disembodied. The behaviour, in this case crying, is viewed as an illness- a problem to be fixed. For centuries, philosophers and theorists have maintained that the mind and body are interconnected (Lawler 1991; Madjar 1997; Erikson, Tomlin & Swain 2002). Lawler (1991, p. 55) has even suggested that Descartes’ work, which has long been attributed to the so called ‘Cartesian dualism’, or mind-body split (Montgomery et al. 1988, p. 64; Madjar 1997, p. 56; Tomey & Alligood 2006, p. 172, Benner 2000) has been misunderstood, and that he too, recognized the interdependence of the mind and the body. If the infant is respected as an embodied individual, and if the mind-body interconnectedness holds true, then the cause of the crying when left alone is simple to understand. It follows that what the inner self experiences will be expressed bodily- in this case expressing feelings of abandonment, hopelessness and terror (Leidloff, 1977 cited in Pantley 2005, p. 10; Buckley 2005, p. 265; Buckley 2006) through one of the few ways infants have of communicating- crying. With the controlled crying method, however, crying is seen as a symptom of disease- and the symptom is treated without examining the underlying cause. Although embodiment theorists have claimed that during illness the mind and body are ‘emotionally, intellectually and practically inseparable’ (Lawler, 1991, p. 155), it is very common for people to feel as if their symptoms are being treated at the expense of their emotional self (Fassett & Gallagher 1998). Many parallels can be drawn from the illness experience, and that of a baby- the main difference is that although the baby is treated as ill, by crying when left alone and having disturbed sleep patterns it is displaying what proponents both for and against controlled crying agree are actually very common behaviours (Ferber 1985, p. 20; Skuladottir & Thome 2003, p. 376; Pantly 2005, p. 32).

To empower parents to make informed choices with which they feel comfortable, the medical and nursing professions must present parents with a balanced view of the advantages and implications of controlled crying, and make gentler options more acceptable. While the government provides information on a variety of gentle settling methods, and acknowledge that babies and children can be adversely affected by controlled crying (Parenting SA 2003), many doctors and nurses still promote controlled crying (Buckley 2005, p. 264, Houlahan 2006), and some sleep schools still use controlled crying (Cooke, 2003, p. 159; Houlahan 2006). Infants with severe sleep problems are at an increased risk of child abuse (Skuladottir & Thome 2003, p. 378), and controlled crying is certainly preferable to shaking or hitting a baby out of frustration (Buckley, 2005, p. 266). Nurses should, however, weigh this and other advantages of controlled crying against its potential long term effects before they suggest it to parents, and it should only be used as a method for improving infants sleep patterns when gentler approaches have failed. The experiences that each of us has, from birth to death, contribute to the uniqueness of our personalities (Madjar 1997, p. 55; Lawler 2001, p. 29). By choosing to communicate with and promptly respond to our babies we show a respect for their fundamental needs of human affection, touch, warmth and love. A shift away from treating them as objects of control is a positive move towards treating them as embodied humans.

Independence Learnt?

2006-11-11T18:31:00.000+11:00

This article is from Natural Parenting Magazine, and highlights the concerns people have about controlled crying.

Independence Learnt? Issue 3 Winter 2003, Natural Parenting Magazine, Editorials (Free Access) by Susan Stark

A Baby Needs to Have Needs
It is a natural, appropriate and desirable part of development for a baby to be dependent. A baby needs to have needs. A baby who is forced into independence (to become a self soother) before his time misses the needs stage. A baby needs first to learn to bond to people before things. If a baby can’t have needs, who can? If the parents can’t fill those needs, who will? Later in life you may be very distressed to see who or what will be used to fill needs that went unmet in infancy.
Sears, W and Sears, M (1993) The Baby Book; Little Brown and Company; New York; p.314.
A common point of discussion in parenting groups all over the country is sleep. From day one baby’s ability to sleep well is often a measure used by many to indicate a parent’s competency and how ‘good’ or ‘difficult’ the baby is. Parents may feel distressed at their baby’s wakefulness and often feel pressure to have baby sleeping independently through the night at a very early age. Exhausted parents seek advice and support from those around them and may be encouraged to try methods such as controlled crying.
Controlled crying, a well known method of issuing limited comfort to a child in an attempt to get a child to sleep independent of their parents, is frequently explained to parents as a solution to all their night time worries. The appeal of getting quick results and the pressure to ‘perform’ as a parent means thousands of babies across the country are subjected to this method of invoking sleep.
What parents aren’t told however is that controlled crying while it may engender a short term solution comes at a price.
Methods such as controlled crying are devised on the notion that babies can be taught to be independent and that the sooner this training begins the more mature and competent sleeper the baby will be. Independence however is not a skill to be learnt by a child but rather a natural progression that will occur at developmentally appropriate times throughout a child’s life. Independence is best nurtured in the loving arms of an attentive parent.
William and Martha Sears in the Baby Book (1993) warn parents to “watch out for short cuts, especially in nighttime parenting.” They state that methods such as “leaving babies alone or setting them up to devise their own methods – rather than allowing babies to rely on their mother or father, ignores a basic principle of infant development: a need that is filled in early infancy goes away; a need that is not filled never completely goes away but recurs later in “diseases of detachment” such as aggression, anger, distancing, withdrawal and discipline problems” (1993:314).
Methods such as controlled crying assumes that a baby is waking because they are being manipulative and picking them up or allowing them to sleep in the family bed, will only spoil them. How many new parents are told they are making a ‘rod for their own back’ by merely following their natural desire to comfort their child? Nature intended babies to be highly dependent on their parents and gave them the ability to cry in order to communicate their needs. It is the only mechanism at their disposal. To ignore these cries for help goes against the natural instincts of a parent to comfort and console their child. The bond of trust is broken when our baby’s cries for help go unheard. Babies learn that they are helpless to change their situation. Parents learn detachment and distance from their child.
So where does this leave an exhausted and frustrated parent needing a much desired good nights sleep? My son Harrison has shared our family bed since the night he was born. He snuggles happily on our king size mattress on the floor and often asks to go to bed. He does not fear sleep time nor does he cry on waking. We have never paced the floor at night with a crying baby nor have we ever left our bed to meet Harrison’s night time needs. But rather we have enjoyed a very precious closeness with our child and treasure the special memories of waking up beside him. That is not to say however, that there is never a stray kick to the ribs or struggle over the blankets.
While co-sleeping works well for our family, it is not the solution for everyone. Every family is made up of a unique set of individuals with varying needs and expectations. Parents feeling challenged by night time parenting need our encouragement and support. Sometimes all that is needed is an understanding of a baby’s natural sleep cycle and a reassurance that this time is so short and will pass. What is perceived as a problem may be a natural developmental progression that is necessary for a child to reach a final stage of maturity in regards to their sleep. Variations on co-sleeping such as having a baby in their own bed in your room, or baby starting out in her cot and then joining the family bed later, will be workable solutions for some families.
Parents often fear creating a situation whereby their child will continue to be highly dependent upon them to achieve sleep. We can be reassured that in most traditional cultures the custom of sharing sleep is a natural unquestioned part of parenting that has been practiced for thousands of years. Westernised ‘experts’ have labeled the practice as harmful and encourage people to distrust their natural desire to stay close to and comfort their child. It is important to remember the bigger picture and know that the investments made in a baby’s early years will pay off three fold in years to come.
Babies are not a commodity that will fit conveniently into our existing lifestyle. They require constant nurturing and attention. New parents need to be supported in this challenging and at times difficult role so that the vital bond of trust with their baby is honoured and preserved. One of the most precious gifts you can give your baby is a sense of security and belonging and a belief in his ability to meet his own needs. These intimate memories are greater than anything money can buy and will serve your child a life time.
Useful Books:
Sears, W and Sears, M (1993) The Baby Book; Little Brown and Company; New York.
McKay P. (2002) 100 Ways to Calm the Crying; Lothian Books; Melbourne.
Issue 3 Winter 2003, Editorials, Free Access.
http://naturalparenting.com.au/index.php?id=128&tx_ttnews[pointer]=3&tx_ttnews[tt_news]=30&tx_ttnews[backPid]=229&cHash=280d2744a6

Parent Responsiveness - A Study

2006-10-29T16:46:00.000+11:00

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

Elizabeth Pantley's views

2006-10-29T16:14:00.000+11:00

Here's an article from Elizabeth Pantley, who is the author of "The No Cry Sleep Solution" books.

Q. Should I Let My Baby Cry it Out?
From Elizabeth Pantley
A. Does it takes forever for your baby to fall asleep? Does he or she only fall asleep if you breastfeed, give a bottle or pacifier, rock, carry, swing, take a ride in the car, or perform other elaborate rituals? Does your baby wake up frequently throughout the night? Are your sleep issues further complicated because your baby won’t nap easily, or takes very short naps?
Do you ever feel like Leesa, mother of 9-month-old Kyra who said, "I am truly distressed, as the lack of sleep is starting to affect all aspects of my life. I feel as though I can't carry on an intelligent conversation. I am extremely unorganized and don't have the energy to even attempt reorganization. I love this child more than anything in the world, and I don’t want to make her cry, but I'm near tears myself thinking about going to bed every night.
Sometimes I think, ‘What’s the point? I'll just be up in an hour anyway.’"
As your sleep issues cast lengthening shadows over your life, you may begin to live purely for the moment. Your sleep-deprived, foggy brain may focus so intently on sleep that you can’t think beyond the next few hours of rest. You may have one – or many – people telling you that you should just let your baby cry to sleep. You are probably frustrated and confused. What you lack is perspective. To gain that perspective, ask yourself these questions:
Where will I be five years from now?
How will I look back on this time?
Will I be proud of how I handled my baby’s sleep routines, or will I regret my actions?
How will the things I do with my baby today affect the person he will become in the future?
Once you have some perspective about your baby’s current sleep issues, it is important to be realistic in determining your goals and to be honest in assessing the situation's effect on your life. Some people can handle two night wakings easily, while others find that the effect of even one night waking is just too much to handle. The key is to evaluate whether your baby’s sleep schedule is a problem in your eyes, or just in those of the people around you.
Begin today by contemplating these questions:
Am I content with the way things are, or am I becoming resentful, angry, or frustrated?
Is my baby’s nighttime routine negatively affecting my marriage, my job, or my relationships with my other children?
Is my baby happy, healthy, and seemingly well rested?
Am I happy, healthy, and well rested?
What is a reasonable expectation for my baby at his/her age?
What naptime and bedtime situation would I consider “acceptable”?
What naptime and bedtime situation would I consider “pure bliss”?
Why do I want to change my baby’s sleep patterns? Is it truly what’s best for me and my baby, or am I doing this to meet someone else’s expectations?
Am I willing to be patient and make a gradual, gentle change for my baby if that means no crying?
Once you answer these questions, you will have a better understanding of not only what is happening with regard to your baby’s sleep, but what approach you will feel most comfortable using to help your baby sleep better.
In addition to my two-year-old son Coleton, I have three older children, and they have afforded me the perspective I lacked the first time around. My children have taught me how very quickly babyhood passes. I struggle now to remember the difficulties of those first couple years, so fleeting are they. And I am proud that I didn’t cave in to the pressures of others around us to do what they felt was right; instead I followed my heart as I gently nurtured all of my babies. That time is long gone for us, but those memories remain. And now, all four of them sleep through the night. And so do I.
By Elizabeth Pantley, Author of The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night

http://babyparenting.about.com/cs/sleeping/f/cryitout.htm

Sleep deprivation

2006-10-21T15:22:00.000+10:00

Parent sleep deprivation is the reason some practitioners give for the use of controlled crying on infants. Some claim that by reducing sleep deprivation in mothers, supposedly via controlled crying getting the infant to seemingly 'sleep better' (and this can certainly be debated), that this enables the parents to cope better with Post Natal Depression (PND). I believe there are many flaws in this argument. Firstly, it is almost impossible to separate sleep deprivation from early parenthood, and secondly that there are many influences in an individuals environment that would effect PND, not just sleep. In addition to this, different people have different reactions and symptoms of PND, and some do not suffer difficulties sleeping. In addition, the effectiveness of controlled crying on getting an infant to sleep longer is not always successful. I also find the below information on sleep deprivation very interesting, as it adds another dimension;

This is from Wikipedia online;

Sleep deprivation is an overall lack of the necessary amount of sleep. A person can be deprived of sleep by their own body and mind, as a consequence of some sleep disorders, or actively deprived by another individual. Sleep deprivation is sometimes used as an instrument of torture, but it has also been shown to be an effective treatment of depression.

As a treatment for depression
Recent studies show sleep deprivation has some potential in the treatment of depression. About 60% of patients, when sleep-deprived, show immediate recovery, with most relapsing the following night. The incidence of relapse can be decreased by combining sleep deprivation with medication [2]. Incidentally, many tricyclic antidepressants happen to suppress REM sleep, providing additional evidence for a link between mood and sleep [3].
http://en.wikipedia.org/wiki/Sleep_deprivation

What is attachment parenting?

2006-10-21T15:07:00.000+10:00

What is attachment parenting?
http://www.apparenting.com/what_is_attachment_parenting.html
http://www.beba.info/home.php
http://www.naturalparenting.com.au
http://www.attachmentparenting.org/ideals.shtml

Attachment Parenting: The Eight Ideals
Attachment Parenting is a philosophy based in the practice of nurturing parenting methods that create strong emotional bonds, also known as secure attachment, between the infant and parent(s) This style of parenting encourages responsiveness to the infant or child's emotional needs, and develops trust that their emotional needs will be met. As a result, this strong attachment helps the child develop secure, empathic, peaceful and enduring relationships.
In conjunction with the work of Dr. William and Martha Sears, and informed by current research, API promotes The Eight Ideals of Attachment Parenting. Recognizing that every family is unique, these ideals are guidelines to help parents understand their baby's needs to develop a secure attachment.

Preparation for Childbirth
Emotional Responsiveness
Breastfeed your Baby
Baby Wearing
Nighttime Parenting and Safe Sleeping Guidelines
Avoid frequent and prolonged separations from your baby
Positive Discipline
Maintain balance in your family life

How should we respond to cries?

2006-09-27T19:42:00.000+10:00

Here's an article by Ingrid Bauer

Loving Responses to Baby's Cries

By Ingrid Bauer

Not knowing why your baby is crying or how to respond can be one of the most difficult times any new parent faces. No matter what you've been told about spoiling or not responding to every cry, your whole body and instincts tell you to help. Now! That intense feeling is perfectly natural. It is part of an optimal nurturing system to help assure that babies have their needs met.
Here's how it works: if the vital needs of a baby aren't responded to promptly and adequately, the baby may attempt to communicate with a few more sounds or body signals. If these still do not relieve the problem, an alarm system kicks in. Everyone within earshot hears about it. Those cries are meant to get attention and response. Quickly!
Rarely, however, are they the first indication that something needs to be addressed. Except in cases of sudden fright or physical pain, crying is often a last resort. It indicates that earlier communication hasn't been understood or responded to in a satisfying way. That's why it feels so heartrending when you don't understand what your baby is trying to communicate.
Parents who practice a natural attached style of infant-care have a distinct advantage in responding to a baby's needs fully. Babies who are breastfed, are carried in-arms and have frequent or constant contact with their mother's bodies feel satisfied, secure, and content. In turn, this strengthens the parent's confidence, pleasure, and responsiveness. Studies have shown that these infants are more likely to have their subtle signals heeded, and cry less. Even when these babies cry, they do so in the loving arms of a parent who is doing their utmost to understand and help.
It's clear that babies are not the passive beings they were once believed to be. They are absorbing and processing new stimuli and sensory information moment by moment. They are also signalling in both subtle and not so subtle ways throughout the day, trying to communicate to their caregivers exactly what they need, when. When babies cries and signals are not answered At first, it's difficult to understand all the nuances of a baby's language. Yet when we listen closely, the signals become loud and clear. We soon learn that this snuffle means "I'm hungry", that look means "There's too much noise", and that squirm means "I need to poop".
What's hard then, is to overcome our cultural conditioning, which often denies these infantile needs, and to respond promptly. When parents are not responsive to their babies, this is usually because they themselves were not adequately responded to in infancy. As we learn compassion for our children, we simultaneously give ourselves the gift of compassion and gentleness on our journey.
Fortunately (or perhaps unfortunately), nature also has an emergency back-up plan when a baby's signals and urgent cries are consistently ignored. Biological design protects the baby from experiencing an extended, acute state of stress that taxes the adrenals and immune system. The body opts instead for a state of withdrawal and self-preservation.
The needs do not go away. They just become secondary to basic physical and emotional survival. In her fascinating and well-researched book Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent (Anchor, 1998), anthropology professor Meredith Small writes, "When signals are missed, babies stop signalling; they withdraw; they suck their thumbs; they turn away; they try to right the system themselves by not sending out any more signals." The baby protects herself by shutting down, and "accepts" the situation because she has learned that a response is not forthcoming.
We've been led to believe that this is more "convenient" and easier in the short term from the adult's point of view. After all, it seems to "work": the baby eventually stops crying. That partially explains the popularity and usually well-intentioned use of such nighttime techniques as "Ferberizing" or "crying it out". But for the baby (and in the long run for all concerned) the results can be potentially life-long and detrimental. When mothers are generally unresponsive or lack empathy, Small writes, babies "are more likely to exhibit negative responses and the attachment process does not go well. It is reasonable to predict that babies developing in such a system will not fare well in other interpersonal interactions."
As well, mothers who don't nurture this strong attachment with their infants are missing out on one of the greatest pleasures in life. As we nourish our babies at our breasts, we are given the gifts of increased intimacy, lasting convenience, enjoyment, and confidence that our babies' needs are being optimally met. We carry them next to our hearts throughout the day. Through the night we sleep with them next to our skin, their warm milky breath caressing our cheek. We're well aware that we do all this for our babies. May we remember that in the process we are also giving abundantly to ourselves.
http://www.natural-wisdom.com/lovingresponse.htm

Dr Sarah Buckley's views

2006-09-17T19:16:00.000+10:00

Getting a Good Night’s Sleep: Another Perspective

© Dr Sarah J Buckley 2005 www.sarahjbuckley.com

This paper was first published in Playtimes, the magazine of the Playgroup Association of Queensland, May 2002, also published in Natural Parenting no 2, autumn 2003 .
An expanded version (twice as long) with more about controlled crying, and gentle approaches to sleep, is published in Sarah’s upcoming book, Gentle Birth, Gentle Mothering: The wisdom and science of gentle choices in pregnancy, birth, and parenting.

As a GP [family physician], writer and current full-time mother of four, I have many concerns about the standard advice that mothers are being given about young children and sleep in such sources as Queensland Health’s article “How Does Your Child Sleep?”(Playtimes, Oct 2001 and Richard Ferber’s book Solve Your Child’s Sleep Problems.
Part of Ferber’s controversial methods, sometimes called “Ferberizing,” include leaving children alone to cry for increasing periods (so-called “controlled crying”). Such sources suggest shutting crying children in their bedrooms for prolonged periods so that they learn to go to sleep alone.
Advising parents to ignore the cries of a distressed child, for however long, does not produce a loving and trustful parent-child relationship. I wonder how many of us would want our partners or friends to treat us this way, if we were alone at night and feeling upset and frightened.
But it is not only the hard-heartedness of these suggestions that concerns me. All of the scientific and anthropological research that I have read supports my instincts and experience. Our babies need constant care and attention because of their extreme immaturity. Unlike other mammals, they cannot keep themselves warm, move about or feed themselves until relatively late in life, which makes the mother-infant relationship crucial to our offspring’s survival (McKenna 1996). Therefore, our children have developed behaviours and expectations to ensure that they get the special care they need in babyhood and beyond.
For example, for a baby, the safest place is in the mother’s arms—and this is still true today, with SIDS being the leading cause of death in young babies. This applies equally at night, when sleeping with the mother, also called co-sleeping, gives the baby protection, temperature regulation, emotional reassurance and breast milk. It’s a perfect system, and what babies are born to expect.
The mother also receives rewards—nature always supplies rewards to encourage us. Co-sleeping gives us less disturbed sleep because we both get into the same cycles, and our babies will wake to feed when we are both in light sleep. We can do more breastfeeding for less effort and therefore maximise the contraceptive effect.
We will also benefit from the extra doses of two breastfeeding hormones. Oxytocin—the hormone of love—is stimulated by both breastfeeding and skin-to-skin contact, and keeps mother and baby soft and loving with each other. Endorphins are the hormones of pleasure, making mother and baby relaxed and sleepy—just right for night feeding. No wonder co-sleeping mothers and babies wake up with a smile. Worldwide research confirms the safety of co-sleeping, as long as parents are not smokers, very over weight, or under the influence of drugs or alcohol, and attention is given to avoiding the suffocation hazards that go with our soft Western bedding.
Another major concern I have about these standard approaches to sleep is that they follow our society’s belief that children will not become independent unless we force them. In fact, research shows that the exact opposite is true. According to Paul Klein, “Research… confirms that indulgence of early dependency needs leads to independence” and “A mother’s reliability and receptivity promote trust and emotional stability in her child” (1995). In other words, when we treat our children with love and respect for their needs, we plant the seeds for a lifetime of happiness—and relaxed sleep.
For me, the benefits of co-sleeping do not end with babyhood. My older children are equally sweet and cuddly at night, and sharing sleep into the pre-school years has its own rewards. For example, sleep becomes a time to share intimacy and loving feelings, especially when the day has been grueling or conflict has arisen. There is nothing so sweet as lying next to my child as he or she drops into dreams (and often we do this at the same time). We have never had the bedtime battles or night terrors that are considered normal in our culture—and remember that our culture is totally abnormal, in global terms, in not sharing sleep between family members.
Every co-sleeping family that I have met has their own unique arrangement. Right now in our household, our middle children sleep together in a double bed, and our eldest Emma, 10, has graduated, in her own time, to her own bed. We continue to lie down to settle Zoe, 8, although she says she can put herself to sleep now. Jacob, 5, often joins us in the wee hours. We have a king-sized bed that we have turned around to make it 6’6” wide and 6’ long—a real family bed.
These three children, who are very confident and sociable, have no problems with different routines when they sleep over with their friends. Why would they, when sleep has always been easy and pleasurable for them?
My youngest, Maia, who is 15 months, continues to fall asleep most nights with Mother Nature’s best toddy—breast milk.
Since my first baby, I have gained more confidence and experience with co-sleeping, and honestly, some of the things that are said to discourage it strike me as crazy. For example, I have read in many places, including in the earlier mentioned article, that if we cuddle or nurse our baby to sleep, they may awaken later and “…may not be able to go back to sleep because their environment has changed.” As an adult waking up, I don’t remember how I got to sleep. It seems to me that our babies simply want to be held and nursed to sleep because it is pleasurable, biologically adaptive and it works.
A family bed might not suit everyone, but I feel that it is important to consider that co-sleeping is what we as humans have evolved to do with our young, and it is what our babies and small children expect. When we ask our children to sleep alone all night, we are stretching their biological capabilities and there is a good chance they will protest.If this happens, we can choose not to lock them up, but to take their feedback seriously and work to find loving, gentle and co-operative solutions.
There are many different possibilities.
For example, some families have invited an older child back into their bedroom and found that a “dose” of co-sleeping, or even sleeping on the floor (in what Emma calls a “nest”) is all that is needed.
In many families, as in ours, one parent lies down with a child or children until they fall asleep, giving reassurance at the time when it is most needed. Sitting quietly or meditating also work well at this time, and I am less likely to fall asleep myself.
When one of our children wake in the dark hours, we have often gone into the child’s bed—double beds work best for obvious reasons—and fallen asleep until morning. Currently, this is my partner Nicholas’s specialty: We have a casual division of nighttime labour with Maia being my responsibility, and the others his.
When a child is sick or needs extra care, having him or her in our bed, only an arm’s length away, feels good. Needing an extra dose of Mummy or Daddy is a good enough reason most of the time, and I notice that sleeping together promotes harmony in a subtle and beautiful way.
As parents, we are in it for the long haul. “Ferberizing,” “controlled crying” and the like are short-term solutions that I see as detrimental in the long-term.
Our children will outgrow their dependency needs—including the need for company at sleep time—in their own time, and our job is to provide the love, reassurance and guidance that maximises growth and happiness in the short and long terms.
As one !Kung mother from the African desert responded upon hearing that Dr. Spock advocated ignoring our children’s cries,
Doesn’t he understand that he’s only a baby and that’s why he cries? You pick him up and comfort him. When he’s older, he will have sense and he won’t cry any more.”
I hope that we as a culture can come to our senses and treat our children lovingly day and night.

http://www.sarahjbuckley.com/articles/good-nights-sleep.htm

Do you have any information?

2006-09-16T17:40:00.000+10:00

If anyone has information on controlled crying, I would love it if you could email me at the address listed above. There is a huge amount of evidence that states that controlled crying is very likely to be harmful to infants.

Many are reluctant to study controlled crying, and there are many reasons for this. If you have an interest in research methods and study design, I would also be interested in your comments.

Don't forget to read all the information listed here, to be better informed about controlled crying and other methods involving leaving a baby to cry.

Kellymom's thoughts on CIO

2006-09-16T17:39:00.000+10:00

From the Kellymom website;

What about letting baby ‘cry it out’?

There are two schools of thought about getting babies to sleep. One is a rather rigid method of "sleep training" where a baby is put down awake in a crib and left to cry himself to sleep so that he learns to "self-soothe" and doesn't develop sleep associations that require someone else to put him to sleep. This method has been around since the 1890's and was dreamed up by male university sleep laboratory researchers. Many of the popular "sleep training" methods of today are modified versions of this (allowing baby to cry for progressively longer periods without comforting him, instead of just leaving him to cry until he gives up and stops).
I can't, with good conscience, recommend the cry-it-out method for getting baby to sleep. Anyone who advises you to let your baby cry until he gives up and falls asleep is focusing on the baby's behavior (going to sleep by himself) and not on how the baby feels in the process. In my opinion, this "sleep training" often creates an unhealthy attitude about sleep: after going through this training, baby tends to view sleep as a fearful state to enter into and to remain in. Parents often need to "retrain" baby if there is any break in the usual routine. In addition, it can condition parents to ignore baby's cries, and break down the relationship of trust between parent and child.
Younger babies, in particular, do not have that sense of "object permanence" and if mom leaves them to cry, they are developmentally *unable* to realize that she is just in the next room. All baby knows is that he has been abandoned and that mom is not there. A young baby can only express his needs through crying. A baby who is left to cry alone will eventually stop crying because he has abandoned all hope that help will come: as far as he can tell, no one cares enough to listen, or come and provide comfort. In the book Our Babies, Ourselves: How Biology and Culture Shape the Way We Parent, anthropology professor Meredith Small writes, "When signals are missed, babies stop signalling; they withdraw; they suck their thumbs; they turn away; they try to right the system themselves by not sending out any more signals." The baby protects himself by shutting down, and "accepts" the situation because he has learned that a response is not forthcoming. Crying is also hard, physically, on baby: it can lead to hoarseness that can last for days; the digestive system is upset; heart rates can climb to levels over 200 beats per minute; and oxygen levels in the blood are diminished.
Another school of thought, which I subscribe to, discourages viewing sleep as a state you can *force* a baby into. Instead, it's best to create a sleep-inducing environment that allows sleep to overtake the baby. The process of breastfeeding itself regulates baby's temperature and heart rate and lowers his blood pressure, and puts him to sleep. This helps your baby develop a healthy attitude about sleep, where baby views sleep as a safe, comforting, natural state.

http://www.kellymom.com/parenting/sleep/comfortnursing.html

Dr Sears on crying

2006-09-02T14:51:00.000+10:00

7 THINGS PARENTS SHOULD KNOW ABOUT BABY'S CRIES
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.

LETTING BABY "CRY-IT-OUT" YES, NO!
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.
http://www.askdrsears.com/html/5/T051200.asp#T051205

Controlled Crying in the Media

2006-08-27T09:01:00.000+10:00

A Current Affair
Author Pinky McKay was recently on A Current Affair in a segment called Sweet Dreams for you and your baby. In it she describes that Controlled Crying can be harmful.
http://aca.ninemsn.com.au/article.aspx?id=120727

Meet the Fockers
In this movie, the tough CIA agent Dad, Jack Burns (played by Robert DeNiro) says to his soon to be son in law, Greg Focker (played by Ben Stiller), that he is "Ferberizing" the boy (little Jack), so by no means are they to go into him when he cries.
"Now, remember, Greg,we're Ferberizing him. So unless it's an emergency, under no circumstances should you pick him up or cuddle him in any way when he cries". "He's learning to self-soothe, that means no television, no unapproved toys, and most of all, no monkey businessof any kind. Is that clear?"
Greg Focker is unable to sit and listen to the boys cries, and goes in to comfort him.

Controlled Crying
A play written by Ron Ellisha, playing in October. See the below link for more info;
http://www.theatrealive.com.au/whatson/303/
Controlled Crying dissects the anxieties and trials of Oscar (Paul English) and Libby (Margot Knight) as they raise their daughter Millie. The opening scene gives the play its title, as Oscar and Libby lie awake at night desperately following the technique called "controlled crying", which stipulates that parents must obey a strict protocol of not comforting their baby unless it cries for more than 10 minutes at a time.
According to crude behavioural theory, this should ensure the child learns a sense of independence - but it plays hell with the parents' instinctive desire to comfort their baby.
Read the rest of the review for this play here;
http://www.theage.com.au/news/arts-reviews/controlled-crying/2006/10/10/1160246108111.html

Mad About You
Did a show involving the Ferber method, and attempted an uninterrupted half hour of leaving their baby crying. Jamie & Paul sat outside the bedroom door, with their baby crying on the other side, clutching Dr Ferbers book and agonizing for a while, then he said something like, "What do you really want to do?" and she said, "Go to her!" and so they rescued the baby and apologized and hugged and cried.

Can you think of other examples in the media? Email me and I will post them here

2006-08-23T18:05:00.000+10:00

Here are some more articles I have recently found.

Don't let baby "cry it out"

Crying is a baby's only way to "talk" to his caregivers. Some people will tell mom that baby has to be on a schedule and he will have to cry it out until it's feeding time again. Our mothers and grandmothers were given this advice based on formula feeding and mistaken beliefs that babies need to be scheduled. Today experts believe that we should view the breast as an external placenta providing nourishment whenever it is needed. Newborns aren't on the same time clock that adults are. In fact, most newborns seem to have their days and nights mixed up (see The first 4 weeks: baby ). A newborn responds to his natural internal clock.
Letting a baby "cry it out" is bad if not dangerous advice. Prolonged crying is physiologically detrimental to the infant. The effects of crying are like the Valsalva Maneuver in the adult. [The Valsalva Maneuver is where you try to push air out of your lungs without opening your throat, it can also occur when an adult strains to have a bowel movement or during the pushing stage of labor.] The Valsalva Maneuver affects the way the body functions: large changes in blood flow occur, oxygen levels in the blood decrease, blood pressure rises, the heart rate slows, intracranial pressure (inside the head) rises, pressure on the ear drums increases, and blood flow from the inferior vena cava (a large vein in the abdomen and chest) to the heart decreases, which keeps the heart from pumping as much blood as it should. (Marasco and Barger)
This article can be found here;
http://hometown.aol.com/davisrnclc/myhomepage/cuefeed.htm

A Baby's Cries
by, Jeri

"'As a mother comforts her child, so will I comfort you...'" ~Isaiah 66:13a (English-NIV)
"Crying is as good for the lungs as bleeding is for the veins." ~ Dr. William Sears, The Fussy Baby, page 63
". . . crying has been found to be physiologically detrimental to the new infant. Large fluctuations in blood flow occur during extended crying periods, decreasing cerebral oxygenation and causing an increase in cerebral blood volume. As a result, rising blood pressure increases intracranial pressure, putting baby at risk for an intracranial hemorrhage. Meanwhile, oxygen-depleted blood flows back into the systemic circulation rather than into the lungs (Anderson, GC)." ~ excerpted from Examining the Evidence for Cue feeding of Breastfed Infants by Lisa Marasco, BA, IBCLC and Jan Barger, MA, RN, IBCLC

"A mother is ridiculed for wanting to pick up her crying baby. Yet, this response to a call, the concern for her offspring, is an action that comes from the very depth of her motherhood." ~ excerpted from An Oversight of Our Culture By Tine Thevenin

My Thoughts
Have you ever heard the old sayings that "babies need to cry to exercise their lungs" or "your're going to spoil him by picking him up every time he cries--he's just trying to manipulate you"? They are myths, and contrary to what these statements try to make us believe, babies cry to communicate their needs. If they hurt, they cry. If they miss the closeness they were so used to for nine months (and why shouldn't they miss it??), they will cry. Babies need closeness and warmth, love and nurturing.
If a mom holds herself back from comforting her child because she fears she might spoil him, his crying will most likely escalate. His blood pressure will rise. He may become hysterical... and very hard to comfort. This type of crying causes extreme frustration in those who hear it, not to mention being frightening, exhausting, and potentially dangerous to a baby.
Whereas if a mom follows her heart and immediately tries to comfort her crying baby and meet his needs, her baby will be more responsive to her care. Responding quickly to a baby's cries has been shown to reduce the amount of crying a baby does. A quick response helps your baby learn to trust you, and teaches you to be sensitive to your baby's needs.
If you respond quickly to your baby's cries, and he still cries a lot, you may start to worry that you are spoiling your baby or that there is something wrong with you or your baby. If you know that your baby does not have a medical problem that makes him cry a lot, then worry no more. . . . You probably have been blessed with a high-need baby. Striving to meet his needs will forge a strong attachment between you and your baby and will help him feel as contented as possible. This will encourage your baby to meet his full potential.
Since a crying baby is trying to communicate his needs to you, perhaps your goal should not be to stop the crying, but to meet your baby's needs. Sometimes that need is a shoulder to cry on. Be there for your baby!! Maybe some of my hints for Calming a Fussy Baby will help you!
Unanswered Cries Can Lead to Hopelessness
In Suzanne Arms' book Immaculate Deception II, she explains how in the 1970s Dr. T. Berry Brazelton studied newborns to see whether they could feel hopeless or depressed. In the following quote from page 186, Arms tells of a study that Dr. Brazelton did in which he videotaped babies crying in order to get the attention of their moms, and, eventually, when this failed, their descent into hopelessness:
In a heartrending series of videotaped sessions, each baby can be seen crying to elicit a response from its mother and, failing to do so, working even harder. After a number a minutes of making all kinds of faces and trying to make eye contact, each baby finally reaches its level of tolerance and begins to look away from the mother, finding it too difficult to continue making an effort with no response. The baby eventually turns it sic face away from its mother's face. Then it turns toward the mother again and tries to rouse a response. Each time it turns away for longer and longer periods. Finally, each baby slumps down, drops its head, and shows all the signs hopelessness.
This article can be found here;
http://www.mothersnature.com/babies/info/criesJ.html

Perinatal Neuroscience

2006-08-14T20:03:00.000+10:00

This is an excerpt out of a talk delivered by Dr Neil Bergman (his website is www.kangaroomothercare.com) and shared with me by a Lactation consultant.

Skin-to-Skin Contact and Perinatal Neuroscience
Bergman N. J. MB ChB, MPH, MD, Capers Breastfeeding Seminar 2006.

Breastfeeding: A Lifelong Investment

Basic mechanisms for brain growth
Schore presents a new slant with the same message in two recent in depth reviews from developmental psychology, infant psychiatry and developmental neuroscience(3;4;4). The development, growth and function of the human brain has been studied extensively in the last decade, and in the following section some 40 pages are summarised in a few quotes (verbatim):
“Maturation of … adaptive right brain regulatory capacities is experience dependent, and this experience is embedded in the attachment relationship between infant and primary caregiver, …“ … the environment affects the structure and function of the brain.
“ …an early postnatal period represents a “critical period” of limbic –autonomic circuit development, during which time experience or environmental events might participate in shaping ongoing synapse formation.” (Bowlby)
The capacity to cope with change and stress is a right brain function, which is built up over time. After birth, the critical neural pathway that develops is the amygdala-orbitofrontal tract, and the salient stimulation or experience required is tactile:
State organisation refers to the organism’s level of alertness, and ranges from deep sleep through several stages to awake and at the extreme “hard crying”. Critical for the well-being of a newborn is the requirement of “cycling” appropriately between levels of sleep that is not too deep, and being awake for feeding, and avoiding crying and stress. Optimal synaptogenesis and wiring is related to normal sleep cycling. Electroencephalographic recordings have shown that the normal sleep cycling of a newborn is 60 to 90 minutes, and disruption of this cycling leads to stress and pathology. This kind of optimal state cycling is only observed in infants that are together with their mothers, and optimally so where there is maximal skin-to-skin contact.(14;15;15-17)
The pattern of breastfeeding that results when an infant is never separated from the mother is very different from that we believe to be “normal” in our western culture. Firstly – the pattern is entirely determined by the infant and not the mother, and each infant is unique. An infant allowed to decide its own feeding pattern from initiation will settle in to “maintenance” feeding, and will feed every hour or two at most, will ingest the full ejection load of a single let down reflex, which just happens to be the comfortable maximum capacity of its stomach, and which happens to contain enough food and calories for one or two hours at most, and it will cycle its state organisation effectively. This is the pattern observed from almost all non-western cultures.(18)
Consequences of adverse environment on brain growth
Removed from the correct habitat, all mammals exhibit an identical pre-programmed response, referred to in biology as the "protest - despair response"(6). This is the defence programme, and has its own set of hormones, autonomic controls and somatic expressions. The “protest” response is one of intense activity seeking reuniting with the habitat/mother, the “despair” response is a withdrawal and survival response of decreased temperature and heart rate, mediated by a massive rise in stress hormones. Reunited with the correct habitat (mother), there is a rapid rise in heart rate and temperature.
The "protest-despair response" was first described in humans, in orphans after WWII(3;4) , it was subsequently studied in monkeys and then in many other mammals. Separation has been shown to cause maladaptive changes in brain structure and subsequent behaviour, and changes in the fundamental efficiency of all the body systems(8). Early separation produces major shifts in susceptibility to stress-induced pathology(2). The origins of many human behavioural deviations are unknown, it has been suggested that most of these can be traced back to “violations of an innate agenda?"(10) The primary violation, the worst case scenario, to any newborn is separation from its habitat/mother.
In current neurobehaviour studies in human beings, protest-despair is referred to as “hyperarousal and dissociation”. This work is summarised in the long but illuminating psychoneurobiological review by Allan Schore(4).
“…the human infant’s psychobiological response to trauma is composed of two separate response patterns – hyperarousal and dissociation. (Perry et al)
“…(In hyperarousal) the sympathetic autonomic nervous system is suddenly and significantly activated, increasing heart rate, blood pressure, tone and vigilance, distress is expressed in crying then screaming…this state of “frantic distress”, or what Perry terms fear-terror, is known as ergotropic arousal…with excessive levels of major stress hormone releasing factor…resulting in a hypermetabolic state in the brain.
“(Dissociation) is a second later-forming reaction in response to terror, and involves numbing and avoidance…a state of conservation-withdrawal, a parasympathetic regulatory strategy that occurs in helpless and hopeless situations … a hypometabolic process used throughout the lifespan, in which the individual passively disengages “to conserve energies” … to foster survival by the risky posture of feigning death.
“In this passive state of profound detachment, pain numbing and blunting endogenous opiates are elevated, instantly triggering analgesia and immobility and inhibition of cries for help … vagal tone increases dramatically, decreasing blood pressure and heart rate … in this state both the sympathetic energy-expending and parasympathetic energy-conserving components of the infant’s developing brain are hyperactivated … (creating) chaotic biochemical alterations, a toxic neurochemistry in the developing brain
“ … the psychotoxic contexts of early relational trauma … intense relational stress alters calcium metabolism, a critical mechanism of cell death … result in permanent alterations in receptors … (causing ) high risk for developing severe psychopathologies at later stages of life.”
Neurobehavioural evidence of environmental deprivation
Prematures and newborns have a nervous system which lacks the ability to dampen down sensory signals. Over-stimulation of any of the senses will be experienced as PAIN by the newborn. Stress hormones increases the perception of pain. When the entire environment provides noxious stimuli to the developing brain, the effects or early abuse and neglect have catastrophic impact(4).
“Severe levels of stress associated with infant abuse and neglect are pathogenic to all immature human brains, and neglect may be even more detrimental than abuse.
“Caregiver induced trauma is qualitatively and quantitatively more potentially psychopathogenic than any other stressor …
“In human infancy, relational trauma, like exposure to inadequate nutrition during brain growth spurt, biological pathogens or chemical agents, and to physical trauma to the baby’s brain interferes with the experience dependent maturation of the brain’s coping systems, and have a long-enduring negative impact on the trajectory of developmental processes.
Birth complications … affect personality, relationships, self esteem … and behaviour patterns later on in life”(13). "The origins of many behavioural deviations are unknown ... can some be traced back to violations of an innate agenda?" Maternal rejection and lack of bonding combined gives a strong correlation to violent criminal behaviour. Advent of hospital nurseries and early separations correlates with attachment disorders, maternal abandonment of baby, increased addictive behaviours (unmet oral needs).
In short, separation of mother from infant is psychotoxic for the infant’s brain.

Please email me if you would like the references for this article

Sleeping through the Night

2006-08-08T17:50:00.000+10:00

by Katherine A. Dettwyler, Ph.D. Department of Anthropology, Texas A & M University
(from her website)

[This essay was originally directed to one person. It has been edited slightly to make it less specific.]

I am an Adjunct (semi-retired) Associate Professor of Anthropology and Nutrition at Texas A&M University, and I do research on infant/child feeding beliefs/practices both cross-culturally and from an evolutionary perspective, as well as research on children's health and growth. I know from first-hand experience that being a new parent is a difficult time of adjustment, especially when expectations don't match reality, especially when our culture has taught us that children should have certain needs/wants/behaviors and then our children don't seem to fit that mold. This problem of a mismatch between expectations and reality can be very difficult for new parents to accept and adjust to. Sometimes, some children can be encouraged/convinced/forced to fit the mold of cultural expectations, and they do fine. Othertimes, though they do eventually fit the mold, it is at the expense of their sense of who they are, their self-confidence, their view of the world as a safe and trusting place, sometimes, even, at the expense of their health or life. Probably nowhere do cultural expectations and the reality of children's needs conflict more than in the two areas of breastfeeding frequency and sleeping behaviors.
Human children are designed (whether you believe by millions of years of evolution, or by God, it doesn't matter) -- to nurse *very* frequently, based on the composition of the milk of the species, the fact that all higher primates (Primates are the zoological Order to which humans belong, higher primates include monkeys and apes) keep their offspring in the mother's arms or on her back for several years, the size of the young child's stomach, the rapidity with which breast milk is digested, the need for an almost constant source of nutrients to grow that huge brain (in humans, especially), and so on. By very frequently, I mean 3-4 times per hour, for a few minutes each time. The way in which some young infants are fed in our culture -- trying to get them to shift to a 3-4 hour schedule, with feedings of 15-20 minutes at a time, goes against our basic physiology. But humans are very adaptable, and some mothers will be able to make sufficient milk with this very infrequent stimulation and draining of the breasts, and some children will be able to adapt to large meals spaced far apart. Unfortunately, some mothers don't make enough milk with this little nursing, and some babies can't adjust, and so are fussy, cry a lot, seem to want to nurse "before it is time" and fail to grow and thrive. Of course, usually the mother's body is blamed -- "You can't make enough milk" -- rather than the culturally-imposed expectation that feeding every 3-4 hours should be sufficient, and the mother begins supplementing with formula, which leads to a steady spiral downward to complete weaning from the breast. Human children are also designed to have breast milk be a part of their diet for a minimum of 2.5 years, with many indicators pointing to 6-7 years as the true physiological duration of breastfeeding -- regardless of what your cultural beliefs may be. I can provide you with references to my research on this topic if you wish to read more.
The same is true of sleeping. Human children are designed to be sleeping with their parents. The sense of touch is the most important sense to primates, along with sight. Young primates are carried on their mother's body and sleep with her for years after birth, often until well after weaning. The expected pattern is for mother and child to sleep together, and for child to be able to nurse whenever they want during the night. Normal, healthy, breastfed and co-sleeping children do not sleep "through the night" (say 7-9 hours at a stretch) until they are 3-4 years old, and no longer need night nursing. I repeat -- this is NORMAL and HEALTHY. Dr. James McKenna's research on co-sleeping clearly shows the dangers of solitary sleeping in young infants, who slip into abnormal patterns of very deep sleep from which it is very difficult for them to rouse themselves when they experience an episode of apnea (stop breathing). When co-sleeping, the mother is monitoring the baby's sleep and breathing patterns, even though she herself is asleep. When the baby has an episode of apnea, she rouses the baby by her movements and touch. This is thought to be the primary mechanism by which co-sleeping protects children from Sudden Infant Death Syndrome. In other words, many cases of SIDS in solitary sleeping children are thought to be due to them having learned to sleep for long stretches at a time at a very early age, so they find themselves in these deep troughs of sleep, then they may experience an episode of apnea, and no one is there to notice or rouse them from it, so they just never start breathing again. Co-sleeping also allows a mother to monitor the baby's temperature during the night, to be there if they spit up and start to choke, and just to provide the normal, safe environment that the baby/child has been designed to expect.
Is this convenient for parents? No!

Is this difficult for some new parents to adjust to? Yes!
No doubt about it, the gap between what our culture teaches us to expect of the sleep patterns of a young child (read them a story, tuck them in, turn out the light, and not see them again for 8 hours) and the reality of how children actually sleep if healthy and normal, yawns widely.
But the first steps to dealing with the fact that your young child doesn't sleep through the night, or doesn't want to sleep without you is to realize that:
(1) Not sleeping through the night until they are 3 or 4 years of age is normal and healthy behavior for human infants.
(2) Your children are not being difficult or manipulative, they are being normal and healthy, and behaving in ways that are appropriate for our species.
Once you understand these simple truths, it becomes much easier to deal with parenting your child at night. Once you give up the idea that you must have 8 hours of uninterrupted sleep at night, and view these nighttime interactions with your child as precious and fleeting, you get used to them very quickly.
I highly recommend Dr. Sears' book on Nighttime Parenting [available from the La Leche League International Catalogue]. Our children's early years represent the most important and influential time of their lives. It passes all too quickly. But meeting your child's needs during these first few years will pay off in many ways in the years to come.
Prepared August 25, 1997.

Guilt

2006-07-26T12:50:00.000+10:00

Guilt is often said to be synonymous with parenting. But should we feel guilt if we are happy and comfortable with all the choices we have made? If we are not comfortable with the choices we’ve made, then do we feel guilt? or is it more like regret? or perhaps even grief?
I think that when we make informed choices we don't feel guilty. I have received some negative comments about my parenting style but I don't feel guilty because of this, that’s because I'm happy with my decisions. Really, we can’t feel guilty for accepting the bad advice that our society offers us. Most Maternal and Child Health Nurses in Australia are told to encourage self-settling and this often involves advocating controlled crying. These professionals are meant to present all options for evidence based care, in a balanced and unbiased way, but sadly they often do not. Sometimes we are unaware there are other options other than controlled crying, and often we are raised by parents who have used it on us.

Guilt has been referred to as the ‘useless emotion’ (Hay, 1999) because there is nothing we can do about the past, we can only go forward. Here is a great quote from Pinky McKay;

“When we pussyfoot around about making women feel guilty, we are patronising them - how can anyone make an informed choice if information is deliberately withheld? In any other circumstances, if we deliberately withheld information, we would be considered dishonest or even negligent. When we are prescribed any medication or medical treatment, if we are sensible - we will ask, "what are the risks?" / "are there any side effects?" We expect to make informed choices, and give informed consent about health care.
Guilt is only legitimate if we have let another person down - if we haven't honestly done all that we could have or should have. And nobody can make us feel guilty without our permission. Feelings of guilt may be triggered by external factors -like a health professional telling us about the hazards of artificial feeding, as we are reaching for the bottle - but these are OUR feelings. This is our own internal value system at work. We each need to decide whether this guilt is legitimate or not - or whether it is in fact, guilt , or some other feeling - and how we will act on this feeling.
For the sake of the mother child relationship, we do need to help mothers differentiate between feelings of guilt, and unrealistic expectations of perfection. We can encourage mothers to examine their feelings - to ask them selves -

 "Where is this feeling coming from?"
 "Is this the best I can do for now? Or am I really letting my child down?"
 "What are my responsibilities?"
 "What can I change?"
 "Where can I find support?"

The positive thing about guilt is that we can act on it: If we feel guilty about the choices we are making, we can use these feelings to motivate us to make better choices. There is a vast difference between guilt and regret. We can act on guilt. The sad thing about regret is that it is too late. We don’t get another chance to go back and do it all differently with each baby”.

It is important to release feelings of guilt, regret and grief, in whatever way we can. But it is also important to see that we can’t go back, but we can make changes NOW. Some researchers believe that with more ‘natural parenting’ methods (holding baby as often as we can, co-sleeping and so on), we can even somewhat reverse the effect of controlled crying on our babies maturing brains.

We all have the right to be informed about our options and choices so we can make the best decisions that suit our family. The majority of parents wouldn’t know that there are possible risks in choosing CC as a method to settle their baby. This is why I have put together this blog, so that parents can have access to all the information about controlled crying. They can read this and then form their own opinion on the information, but it is not intended to make parents feel guilty.

As Jodie Miller says, “Parenting is not about being perfect. It's about gradually moving in a forward direction and doing the best [we] can with each new day. I know what I’ll definitely do different next time. Trial and error. Is there any other way?”

"Sleeping Like a Baby"

2006-07-26T08:33:00.000+10:00

An excerpt from Pinky McKay's New Book!

Chapter one
The con of controlled crying

After a week of controlled crying he slept, but he stopped
talking (he was saying single words). For the past year, he
has refused all physical contact from me. If he hurts himself,
he goes to his older brother (a preschooler) for comfort.
I feel devastated that I have betrayed my child.
Sonia

The ‘science’ of sleep training
Although many baby sleep trainers claim there is no
evidence of harm from practices such as controlled crying,
it is worth noting that there is a vast difference between
‘no evidence of harm’ and ‘evidence of no harm’. In fact, a
growing number of health professionals are now claiming
that training infants to sleep too deeply, too soon, is not
in babies’ best psychological or physiological interests.
Despite the popularity of controlled crying, it is not
an evidence-based practice. What this means is that despite a plethora
of opinions on how long you should leave your baby to cry in order to
train her to sleep, nobody has studied exactly how long it
is safe to leave a baby to cry, if at all.

Babies who are forced to sleep alone (or cry, because
many do not sleep) for hours may miss out on both adequate
nutrition and sensory stimulation such as touch,
which is as important as food for infant development.
Leaving a baby to ‘cry it out’ in order to enforce a strict
routine when the baby may, in fact, be hungry, is similar to
expecting an adult to adopt a strenuous exercise program
accompanied by a reduced food intake. The result of
expending energy through crying while being deprived
of food is likely to be weight loss and failure to thrive.
Paediatrician William Sears has claimed that ‘babies
who are “trained” not to express their needs may appear to
be docile, compliant or “good” babies. Yet, these babies
could be depressed babies who are shutting down the
expression of their needs.’

Leaving a baby to cry evokes physiological responses
that increase stress hormones. Crying infants experience
an increase in heart rate, body temperature and blood
pressure. These reactions are likely to result in overheating
and, along with vomiting due to extreme distress, could
pose a potential risk of SIDS in vulnerable infants.
There may also be longer-term emotional effects.
Babies need our help to learn how to regulate their emotions,
meaning that when we respond to and soothe their
cries, we help them understand that when they are upset,
they can calm down. On the other hand, when infants are
left alone to cry it out, they fail to develop the understanding
that they can regulate their own emotions. There is
also compelling evidence that increased levels of stress
hormones may cause permanent changes in the stress responses
of the infant’s developing brain. These changes
then affect memory, attention, and emotion, and can trigger
an elevated response to stress throughout life, including
a predisposition to later anxiety and depressive disorders.

One of the arguments for using controlled crying is
that it ‘works’, but perhaps the definition of success needs
to be examined more closely. In the small number of studies
undertaken, while most babies will indeed stop waking
when they are left to cry, ‘success’ varies from an extra
hour’s sleep each night to little difference between babies
who underwent sleep training and those who didn’t, eight
weeks later. Some studies found that up to one-third of
the babies who underwent controlled crying ‘failed sleep
school’. A recent Australian baby magazine survey revealed
that although 57 per cent of mothers who responded to the
survey had tried controlled crying, 27 per cent reported no
success, 27 per cent found it worked for one or two nights,
and only 8 per cent found that controlled crying worked
for longer than a week. To me, this suggests that even if
harsher regimes work initially, babies are likely to start
waking again as they reach new developmental stages
or conversely, they may become more settled and sleep
(without any intervention) as they reach appropriate developmental
levels.

Want to read more?

Pinky's fab new book is available from your local book store or via her website
http://www.pinky-mychild.com/

Attachment Workshop Sydney, Australia

2006-07-17T18:59:00.000+10:00

Two day workshop "Attachment and pathways to psychopathology: Growing up unprotected and uncomforted" to be presented by Dr Patricia Crittenden. Dr Patricia Crittenden is a well known attachment and developmental theorist. She studied under Mary D. Ainsworth and developed the Dynamic-maturation model of attachment. Her work focuses on foster children, children with mental health problems, and children at risk of abuse and neglect.The two day workshop will explore a developmental approach to risk for psychopathology tied to attachment relationships. Age appropriate assessments will be described and empirical evidence will be surveyed.The workshop will be held at Lorimer Dods Lecture Theatre - The Children's Hospital Westmead, Sydney, on February 26th and 27th 2007.

For further details on the workshop please contact:Andrea Caputo (02) 9845 2005

Early bird registrations to be received by 30th November 2006.

"He won't remember it anyway!"

2006-07-13T14:48:00.000+10:00

Maybe not......This is from my copy of Natural Parenting magazine,

New discoveries about early memory - and how it affects us
Issue 12 Spring 2005, by Robin Grille (AAIMHI)

Most of us have been told at one time or another that children don’t remember anything that happens to them before the age of two. Emotionally painful experiences during infancy will therefore have no lasting impact. These words might have been reassuring, if they didn’t also imply that our infants don’t remember the love we have given them, and so our love at this time has no lasting impact either. As science continues to throw open the mysteries of the brain and the nature of memory, this kind of advice will gradually vanish. Every emotionally meaningful experience - whether joyous or painful - is stored in memory and has a lasting impact on a baby’s developing nervous system. The way our world feels to us as babies profoundly influences our unfolding personality, emotionality and relating styles.

There are different kinds of “memory” beyond the stories we can recount. We actually “remember” a lot more than we realise.Within the limbic system of the brain - an area concerned with processing emotions - are the amygdala and hippocampus. The amygdala processes highly charged emotional memories, such as terror and horror. The hippocampus processes narrative, chronological memory. The amygdala is mature at birth, so babies are able to feel a range of intense emotion, even though they cannot understand the content of the emotion and its relation to what is going on around them. The hippocampus on the other hand, does not mature until sometime between the second and fourth years. Until then, babies are relatively unable to organise memory meaningfully in terms of sequences of events. Rarely does anybody consciously recall the events of infancy. However, the storage of the emotional content of memory is facilitated by the amygdala. We therefore remember every emotion and physical sensation from our earliest days, and even if we have no clarity about the events that took place, these memories imbue the way we relate to each other as adults.Just as memory can be divided up into the dual categories of short term and long term, there are also two qualities of memory: explicit and implicit. The capacity for explicit memory reaches full maturity at around three years of age. This is the kind of memory that is conscious and enables us to tell a story that makes sense of what happened. Implicit memory is available from birth or earlier, it is unconscious, and is encoded in emotional, sensory and visceral recall. In other words, what we don’t remember with our minds, we remember with our bodies, with our hearts and our “‘guts”. This has lasting implications for our thinking, feeling, and behaviour.The process of forgetting is more superficial than we once thought: it only rubs out conscious recall. Even as adults we are mercifully capable of deleting any record of traumatic events. If we are unlucky enough to face a situation of panic or terror which we feel helpless to escape, the brain secretes endogenous opioids in order to numb us to overwhelming emotional or physical pain. These brain chemicals also interfere with the storage of explicit memory, though implicit memory of the trauma remains available. Experiences that are emotionally too overwhelming to deal with are stored somatically, as a body memory. Thereafter they are expressed as an unconscious response to stress. When we over react to mildly stressful or even innocuous situations without knowing why, this might be the result of implicit, traumatic memories dating back to childhood or infancy.

The memory centres that govern narrative recall, emotional memory and body memory can operate independently of each other. Despite being in a coma, one man went into physiological anxiety states when exposed to a smell that was associated with a personal trauma. It is possible to have strong emotional reactions without conscious recall, even without consciousness! Another man whose damaged brain had lost all capacity for short term memory, still reacted aversively to specific doctors who had conducted unpleasant tests on him, without any recollection of having met them. A brain damaged woman who had also totally lost her short term memory refused to shake the hand of a doctor who had earlier hidden a sharp pin in his hand. She was bewildered by her own refusal, since as far as she was aware, each time she met him was the first. So, much of what we think, feel and do is induced by implicit memories “written” into muscle, sinew, fascia and viscera. Not one of our experiences is lost to us. Each experience, particularly those that are charged with emotion, adds to the complex mosaic of our personality.Our brain has an amazing capacity to make associations. Something or someone that “reminds” our brains of a traumatic situation - a smell, a song, a person that looks like someone from our past – triggers our automatic, self-protective “fight, flight or freeze” responses. This reflexive reaction occurs too quickly; before the information reaches the cortex where it can be evaluated rationally. That is why we sometimes over react to things, people or situations reminiscent of a traumatic event, without any conscious recollection of the event in question.There are occasions when implicit memory can be made explicit. Since implicit memory is “stored” in the body, repeating certain movements, gestures, breathing patterns, or assuming certain postures associated with highly charged emotional memories can bounce these memories into explicit, conscious awareness. It is as if the body releases its secrets to the mind. Many individuals have been able to retrieve traumatic memories, both from adult and infant experiences, when induced by strong emotions associated with the original experience. In certain states of consciousness, in psychotherapy or meditation, people have spontaneously recalled things that happened to them as babies. Many have remembered how it felt to be a baby, howling for a mother who would not come. In reconstructing a particular body posture, or talking about a similar emotionally charged event, the contextual memories of unbearable longing, rage or terror come back into focus. It is equally possible for sweet, joyous memories of a parents’ loving face to resurface. This phenomenon is called “state dependent memory retrieval”, and while it is not essential, it can bring healing under certain conditions.But even if not consciously remembered, early memories show themselves indirectly through behaviour. It is intrinsically human to reenact defensive reactions to forgotten traumas, though our reactions are no longer relevant. Often early memories become evident through persistent feelings that don’t seem to relate to a present situation, or through bodily sensations that don’t seem to make any sense. More commonly, these early memories of emotional pain or hurt are indirectly evident through persistent difficulties in relationships, particularly in intimate relations.Implicit memory, or body memory, explains why for instance, a woman who was molested as a child remains fearful of intimacy - at least with men that “remind” her of the perpetrator. A man fears being alone because it triggers an emotional memory of terror as he cried in the cot, and no-one came to comfort him. He has no recollection of the event, and all those around him find him likeable and congenial. He has no understanding about his compulsive avoidance of solitude. Though successful and functional, many people can be avoidant, clingy, or perhaps insensitive in relationships. These are just some of the problems of relationship that have their roots in hurts we felt at the advent of life. To some extent, most of us suffer from some behavioural manifestations of painful implicit memories.Unbeknownst to our “rational” minds, we sometimes respond mistakenly to current challenges as if they were the hurts we suffered originally. This dynamic holds true in our relationships with our children. There are many reasons why, for instance, we might find our children’s expressions of need aversive and overwhelming. Here is a common scenario: when a baby screams, our bodies react the same way as when our parents screamed at us as children, we are neurologically conditioned to escape or push away, rather than to respond with spontaneous compassion. Alternatively, our baby’s cry might trigger in our bodies an implicit memory of a time when our own cries, as infants, were not met with a loving response. Either way, our baby’s cries evoke our own painful memory, and so we seek refuge. We are all biologically capable of a wellspring of spontaneously loving responses toward our children and toward each other. Sometimes this love is blocked by automatic defensive reactions to unresolved, implicitly remembered hurts. We are not insensitive nor neglectful; we are wounded.When a child is reprimanded, an image of the scolder’s looks of disapproval gets stored in the lateral tegmental limbic area of the brain. The growing child and adult judge their own behaviour through the lens of these stored inner representations, which are imprinted as images charged with feelings of shame. These inner visual and auditory records of the shamer usually – but not always - operate beneath conscious awareness. The experience of parents setting healthy boundaries literally grows the child’s orbitofrontal brain, whose purpose it is to contain and regulate raw emotion. When the parent imposes limits, for some time following the symbiotic time of infancy, the toddler feels a degree of hurt and betrayal. This developmentally necessary change in the parent child relationship is emotionally stressful. It is important that the parent soothe the toddler after imposing restrictions on him, to help him cope with his “shame stress”. Reassurance of the parent’s love repairs the child’s wounded “self” and restores his self-confidence. If parents diligently assist with their child’s shame repair, he soon learns to take over, and based on his parents’ role modelling, repair his own shame when needed. Inner representations - stored as emotional and narrative memory in the brain - of a soothing and reassuring parent are used later in life as a template for shame repair. This internal portrait of a reassuring adult is essential so that as an adult the individual won’t be disabled or overly inhibited by experiences of shame. Though this process is usually unconscious, it secures our ability to self soothe, and to recover from shame when needed.Psychological and social problems arise when a child grows up with too many images of a disapproving face stored in the brain centres that store implicit memory, without the subsequent images of a soothing and reassuring adult. A child that lacks these positive images, stored in his emotional memory centres, is at risk of slipping into depression, becoming overly inhibited, or defensively hostile.From the earliest moments of life, parental nurturance shapes the child’s emotional make up, literally altering the course of brain growth. One of the key elements of secure parent child attachment is affectionate eye contact. A parent’s sustained, loving gaze and smile suffuses infants with indescribable joy. What ensues is a cascade of dopamine, endogenous opioids, enkephalins and endorphins in the baby’s brain - all feel good chemicals associated with loving relations. This joy precipitated surge of brain chemicals promotes the maturation of precise regions of the cortex, which are concerned with healthy regulation of emotion later in life. Every baby requires this kind of nourishing experience regularly and frequently, for healthy brain development.By the end of the first year, the infant has stored an internal representation of her mother’s loving face in the area connecting the anterior temporal and the orbitofrontal cortices. These images, though rarely consciously remembered, form the basis for an internal working model of relationships. It is as if the child has filed a video clip of her mother in her brain’s “hard disk”. Henceforth, these inner representations will animate her core emotional responses, forming the basis of her fundamental relationship style. When she feels her emotional needs are consistently attended to, this engenders in the child an enduring expectation of a supportive world. This attitude is pervasive and unconscious, and it inclines the child toward friendly and considerate behaviour.Just as we might not remember learning to walk, yet our legs and feet seem to play their parts perfectly, some of our most pivotal lessons in human relations were learnt at a time that our bodies, but not our minds, can remember. The greatest gift in these discoveries is the knowledge that every loving moment we share with our children, from the very beginning, will stay with them for life.

A full list of references for this article are available by contacting Robin Grille.
Issue 12 Spring 2005, Emotional Wellbeing, Attachment Parenting

You can read the article here at Natural Parenting and can subscribe for a small fee; http://naturalparenting.com.au/index.php?id=179&tx_ttnews[tt_news]=82&tx_ttnews[backPid]=155&cHash=a2b86cb64b

I know people who can remember things from when they were babies, things their parents never told them. I also know new research has revealed babies remember music tunes played to them in the womb, so it seems that babies may well remember early experiences.

A Baby Cries: How Should Parents Respond?

2006-07-13T14:37:00.000+10:00

by Jan Hunt, M.Sc.

Imagine for a moment that you have been abducted by space ship to a distant planet, and you are surrounded by giant strangers whose language you do not speak. Two of those strangers take you under their care. You are entirely dependent on them for the satisfaction of all your needs - hunger, thirst, comfort, and - especially - reassurance that you are safe in this strange place. Then imagine that something is very wrong - you are in pain, or terribly thirsty, or in need of emotional support. But your two attendants ignore your cries of distress, and you are unable to get them to help you or to understand your needs. Now you have another problem, more serious than the first: you feel completely helpless and alone in an alien world.
In all innocence, a baby assumes that we, as his parents, are correct - that whatever we do is what we ought to be doing. If we do nothing, the baby can only conclude that he is unloved because he is unlovable. It is not within his capabilities to conclude that we are only busy, distracted, worried, misled by "experts", or simply inexperienced as parents. No matter how deeply we love our baby, it is mostly the outward manifestations of that love that the baby can understand.
No one likes to have his communication ignored. and if it is, this brings on feelings of helplessness and anger that inevitably damage the relationship. Such a response seems to be one that is universally experienced by adults, and there is no reason to conclude that it is any different for babies and children. Few people would ignore an adult while he repeatedly said, "Can you help me? I'm not feeling right." Ignoring such a request would be considered most unkind. But a baby cannot make such a statement; he can only cry and cry until someone responds - or until he gives up in despair.
Immediate response to a baby's cry went unquestioned for thousands of years until recent times. In our culture, we assume that crying is normal and unavoidable for babies. Yet in natural societies where babies are carried close to the care-giver much of the day and night for the first several months, such crying is rare. In contrast to what many in our society would expect, babies cared for in this way show self-sufficiency sooner than do babies not receiving such care.
In fact, research on early childhood experiences consistently shows that children who have enjoyed the most loving care in infancy become the most secure and loving adults, while those babies who have been forced into submissive behavior build up feelings of resentment and anger that may well be expressed later in harmful ways.
In spite of this research, most arguments for ignoring crying are based on fears of "spoiling" the baby. A typical baby-care brochure advises the parent to "let the baby handle it for a while". Though infancy can be a challenging time for the parents, a baby is simply too young and inexperienced to "handle" the cause of the crying, whatever it may be. He cannot feed himself, change himself, or comfort himself in the way that nature intended. Clearly, it is the parents' responsibility to meet their baby's needs for nurturing, security, and love, not the baby's responsibility to meet his parents' need for peace and solitude.
The pamphlet implies that if the parents give their baby an opportunity to become self-reliant, they are helping him to mature. But an infant is simply not capable of such maturity. True maturity reflects a strong foundation of emotional security that can only come about from the love and support of those closest to him during the earliest years.
An immature person can only respond to stress in an immature way. A baby denied his birthright of comforting from his parents may respond by turning to ineffective self-stimulation (head-banging, rhythmic rocking, thumb-sucking, etc.) and emotional withdrawal from others. If his needs are routinely ignored, he may decide that loneliness and despair are preferable to risking further disappointment and rejection. Unfortunately, this decision, once made, can become a permanent outlook on life, leading to an emotionally impoverished life.
Many child-care professionals feel that parental encouragement of self-satisfiers and over-substitution of material objects - teddy bears substituting for parents, strollers for arms, cribs for shared sleep, pacifiers for nursing, toys for parents' attention, music boxes for voices, formula for breast-milk, wind-up swings for laps - have led to an age of materialistic acquisition, personal loneliness and lack of emotional fulfillment.
Ignoring a baby's crying is like using earplugs to stop the distressing noise of a smoke detector. The sound of a smoke detector is meant to alert us to a serious matter that requires a response - and so is the cry of a baby. As Jean Liedloff wrote in The Continuum Concept, "a baby's cry is precisely as serious as it sounds."
Stressful though it may be, infant crying should be seen not as a power struggle between parent and child, but as a gift of nature to ensure that all babies can grow to adulthood with a generous capacity for love and trust.
The Natural Child Project
http://www.naturalchild.org/jan_hunt/babycries.html

Ten Reasons to Respond to a Crying Child
By Jan Hunt, M.Sc.

1. A baby's first attempts to communicate cannot be in words, but can only be nonverbal. She cannot put happy feelings into words, but she can smile. She cannot put sad or angry feelings into words, but she can cry. If her smiles receive a response, but crying is ignored, she can receive the harmful message that she is loved and cared for only when she is happy. Children who continue to get this message through the years cannot feel truly loved and accepted.
2. If a child's attempts to communicate sadness or anger are routinely ignored, he cannot learn how to express those feelings in words. Crying must receive an appropriate and positive response so that the child sees that all of his feelings are accepted. If his feelings are not accepted, and crying is ignored or punished, he receives the message that sadness and anger are unacceptable, no matter how they are expressed. It is impossible for a child to understand that expression of sadness or anger might be accepted in appropriate words once he is older and able to use those words. A child can only communicate in ways available to him at a given time; a child can only accomplish what he has had a chance to learn. Every child is doing his best, according to his age, experience, and present circumstances. It is surely unfair to punish a child for not doing more than he can do.
3. A child who has been given the message that her parents will only respond to her when she is "good" will begin to hide "bad" behavior and "bad" feelings from others, and even from herself. She may become an adult who submerges "bad" emotions and is unable to communicate the full range of human feelings. Indeed, there are many adults who find it difficult to express anger, sadness, or other "bad" feelings in an appropriate way.
4. Anger that cannot be expressed in early childhood does not simply disappear. It becomes repressed and builds up over the years, until the child is unable to contain it any longer, and is old enough to have lost his fear of physical punishment. When this container of anger is finally thrown open, the parents can be shocked and perplexed. They have forgotten the hundreds or thousands of moments of frustration which have been filling this container over the years. The psychological principle that "frustration leads to aggression" is never more clearly seen than in the final rebellion of a teenager. Parents should be helped to understand how frustrating it can be for a child to feel "invisible" when crying is ignored, or to feel helpless and discouraged when his attempts to express his needs and feelings are ignored or punished.
5. We are all born knowing that each and every feeling we have is legitimate. We gradually lose that belief if only our "good" side brings a positive response. This is a tragedy, because it is only when we fully accept ourselves and others, regardless of mistakes, that we can have truly loving relationships. If we are not fully loved and accepted in childhood, we may never learn how that feels or how to communicate that acceptance to others, no matter how much therapy or reading or thinking we may do. How much easier our lives would be if we had simply received unconditional love throughout our early years!
6. Parents wondering whether to respond to crying might give some thought to their own responses in similar situations. Parents may consider it appropriate to ignore a child's cries, yet feel intensely angry if their partner ignores attempts to have a conversation. Many in our society seem to believe that a person must be a certain age before he has the right to be heard. Yet what age would that be? Infants and children are not any less a person just because they are small and helpless. If anything, the more helpless someone is, the more they deserve to have our compassion. attention, and assistance.
7. If children are taught by example that helpless persons deserve to be ignored, they can lose the compassion for others that all humans are born with. If, as helpless infants, their cries are ignored, they begin to believe that this is the appropriate response to those who are weaker than themselves, and that "might makes right". Without compassion, the stage is set for later violence. Those who wonder why a violent criminal had no compassion for his victims need to consider where he lost that compassion. Compassion does not disappear overnight. It is stolen, through unresponsive or punitive parenting, drop by drop, until it is gone. Loss of compassion is the greatest tragedy that can befall a child.
8. When a child learns by her parents' example that it is appropriate to ignore a child's cries, she will naturally treat her own child the same way, unless there is some intervention from others. Inadequate parenting continues through the generations until fortunate circumstances come about to change this pattern. How much easier it is for a parent to have learned in childhood how to treat his or her own child! Perhaps the cycle of inadequate parenting can begin to change when bystanders no longer walk past an anguished child without stopping to help. This may be the first time the child has been given the message that her feelings are legitimate and important, and this critical message may be remembered later when she herself has a child.
9. Crying is a signal provided by nature that is meant to disturb the parents so that the child's needs will be met. Ignoring a child's cries is like ignoring the warning signal of a smoke detector because we find it disturbing. This signal is meant to disturb us so that we can attend to an important matter. Only a deaf person would ignore a smoke detector, yet many parents turn a deaf ear to a child's cries. Crying, like the detector signal, is meant to capture our attention so that we can attend to the important needs of the child. It just makes no sense to think that nature would have provided all children with a routinely used signal that serves no good purpose.
10. Parents who respond only to "good" behavior may believe they are training the child to behave "better". Yet they themselves feel most like cooperating with those who treat them with kindness. It is as though children are seen as a different species, operating on different principles of behavior. This makes no sense, because it would be impossible to identify a moment when the child suddenly changes to "adult" operating principles. The truth is much simpler: children are human beings who behave on the same principles as all other human beings. Like the rest of us, they respond best to kindness, patience and understanding. Parents wondering why a child is "misbehaving" might stop and ask themselves this question: "Do I feel like cooperating when someone treats me well, or when someone treats me the way I have just treated my child?"

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Jan has some interesting views.
Someone in my family was 'controlled cried' and had terrible headbanging at night later in his life. He was pushed into a room and left to cry for 15 minutes as a newborn, when he woke for a feed at night. I'm not saying this is definately why he had other sleep problems later, but it's just interesting that this happened in my family.

More Research....

2006-07-12T18:06:00.000+10:00

These are some studies on infant care, take from these what you will..

Initial Lessons in Socialization

"When the infant is in a state of helpless fear and panic the amygdala
kicks in and sends messages to the brain to prepare the body for "flight or
fight." An infant can neither fight nor flee. If the panic isn't subdued by
intervention from a nurturing adult, the flood of chemicals and hormones may
rage through the brain, specifically targeting the amygdala and hippocamus, for
an unhealthy length of time.
Crying infants who are unattended have been
known to cry desperately for an hour or more until the amygdala eventually shuts
down. The infant in turn, learns after repeated episodes that it can not expect
comfort and response to its cries, and it may decide its needs are unworthy of
attention and nurturing--a decision which may ultimately affect the infant's
development self-worth.
Even though the brain may eventually determine it is
not in any danger on its own, vital opportunities to develop and reinforce
social lessons in trust, security and empathy may be missed if no attempt is
made by a nurturing caregiver to calm that state of emotional turmoil".

Read the whole article here;
http://web.archive.org/web/20010305082321/babyparenting.about.com/parenting/babyparenting/library/weekly/aa040100b.htm

Also this, a media article in USA Today;

Study: Maternal care affects adult stress
USA Today

"BRIGHTON, England (AP) — The way a mother cares for her baby can determine
how stressed out the child will be as an adult because her nurturing can
permanently change the way the infant's genes operate, new studies on rats
suggest.
"This is a very important study," said Peter Gluckman, a professor of
pediatric and perinatal biology at the University of Auckland in New Zealand,
who was not involved in the research. "It shows us that the expression of genes
in mammals can be permanently changed by how mothers and infants interact and
how that can have long-term effects on behavior and psychiatric health." "

Read the whole article here;
http://www.usatoday.com/news/health/2003-06-08-maternal-stress_x.htm

Controlled Crying and Routines

2006-07-08T13:50:00.000+10:00

The following Authors are advocates of the Routine. They believe it is very important for a baby to have routine, but many believe this is possibly detrimental to a babies mental and physical health. Their methods often include scheduled feeding (as opposed to demand breastfeeding) and controlled crying methods for sleep 'management'. However this perspective is widely criticised, including by the American Academy of Pediatrics, as it can effect bonding and breastfeeding, and can be associated with a failure to thrive.

'Routine' advocates include;

Gary Ezzo

Gary Ezzo, the co-author of 'On Becoming Babywise' (also by Robert Bucknam M.D), is a pastor with no medical background. According to the website below, "he possesses no expertise in the care of infants ranging from newborn to six months, the approximate age-range covered in his book". His religious based book is criticised by the American Academy of Pediatrics and there is a website that collates the risks of using his method here; http://www.ezzo.info/

He has two adult daughters who are presently estranged from him.(information from the above website)

(His co-author, Dr. Robert Bucknam, is a pediatrician. Fresh out of residency, he added the foreword to the original self-published Babywise (c. 1993). His foreword recounts how, prior to his pediatric training, he and his wife found guidance for parenting their young children in the Ezzos' earlier, religious version of Babywise).

Tizzie Hall

No qualifications are listed on her website.

Tizzie has a book called 'Save our Sleep'.Tizzie has no children http://www.saveoursleep.com.au/about.asp

Gina Ford

Author of the book 'The Contented Baby'. Her website says that after studying Hotels and Catering in Edinburgh, she became a maternity nurse, but no training for this position is listed.

According to Wikipedia http://en.wikipedia.org/wiki/Gina_Ford she doesn't have any children. (I was told by a GP in the UK that Gina Ford has just had a baby, but I can find nothing to back this up). http://www.contentedbaby.com/Gina-Ford-bio.htm

Tracey Hogg

RNMH (registered nurse mental handicap) after a three-year course at the Doncaster School of Nursing, England.In 2001 Tracy, with co-author, journalist Melinda Blau, published 'Secrets of the Baby Whisperer: How To Calm, Connect, and Communicate With Your Baby'.

Tracey had two children (this information was not obtained from her website)http://www.babywhisperer.com/babywhisperer.php?load=tracy

Dr Brian Symon

Brian is the author of 'Silent Nights' and is a GP and a lecturer in General Practice at the University of Adelaide, Australia.He has Four children.As a father, he is not able to feel what a mother feels when her child cries. He recommends a method called minimal reassurance, or 'crying down' from birth. He admits on his website that his teachings are not all based in research, but in his experience. "This is not a scientific book, but hopefully a collection of useful hints".Heres a quote from his website; 'During daylight hours I set an upper limit of 45 minutes of crying. The reason for this is that it is too harsh on the parent who is listening to tchild'slds cries. Some children will cry for a couple of hours particularly if they have become overtired. If I ask a mother or father to listen to this crying for hours it becomes distressing and can lead to a loss of confidence. Because of this I allow the baby to be lifted after 45 minutes'.And another; 'Your child's protest is logical, understandable and loud. It tugs at your heart. It needs to be ignored in a way that helps to develop sleep skills".http://www.silentnights.org/

The following is a media article expressing concern for the Routine followers;

When to let a baby cry: Let the little one be your guide

By Barbara F. Meltz, Globe Staff June 3, 2004. The Boston Globe

Babies cry. That's a fact of life. How much we let them cry, that's a fact of parenting, and it's easily one of the most confusing, emotional, and even divisive issues new parents face. One parent may insist it's a no-brainer: If baby is crying, you do what you can to comfort and console. Another may argue that if you are always at baby's beck and call, life will never get back to "normal."For decades, the advice from respected child development specialists and pediatricians such as best-selling authors William Sears ("The Baby Book") and Penelope Leach ("Your Baby and Child"), as well as a host of organizations such as the American Academy of Pediatrics, Zero to Three National Center for Infants, Toddlers and Families, the Brazelton Touchpoint Institute at Children's Hospital, and Brigham and Women's Hospital, is to respond to a crying baby as quickly as possible, especially a baby under 3 months old but including up to 6 months."Here's what I tell parents," says Sears, a pediatrician in San Clemente, Calif., who is known as the father of attachment parenting, a practice based on a high degree of responsiveness. "When in doubt, put yourself behind the eyes of your baby and ask yourself, `If I were my baby, what would I want my mother or father to do?' "Most of the time, that means parents will -- and in his mind, should -- pick up a crying baby.While this is widely accepted pediatric practice, it is not universal. In some places, it's even controversial.Today in England there's a growing brouhaha over what has come to be known as "controlled crying" -- allowing a baby to cry as a way to manipulate him onto a schedule: If he cries because he's hungry and the clock doesn't say it's time to feed him, let him cry.Leach, a British developmental child psychologist, is so alarmed at the growing popularity of this practice that she has written a position paper this month in the journal for the World Association of Infant Mental Health urging professionals to take a stand against it. The fuel for the movement, she says, is "The New Contented Little Baby Book," by Gina Ford, a maternity nurse, published in 2001. Ford's book is not unlike "On Becoming Babywise," by Gary Ezzo, executive director of Growing Families International, which drew some attention when it was published in 1998.Sears says it would be presumptuous to tell a parent at what moment, exactly, to pick up a crying infant. Pediatrician Constance Keefer of the Brazelton Touchpoints Center at Children's Hospital says that .. "If this [kind of crying] is the way it is for baby day after day, it takes a toll on the body. It creates a state of stress, raising blood pressure and pulse rate. Eventually it compromises oxygen level," she says. The parent of any baby knows that 10 minutes of crying is an eternity. The advice of Indianapolis neonatologist William Engle, a spokesman for the American Academy of Pediatrics, is not to go by the clock but by what the cry sounds like. Sometimes you know within 20 seconds that a baby has lost it; other times, if you leave her for a minute, she'll go back to sleep.How long we let a baby cry may also have consequences that reach into the future."The more we know about brain development, the more we know that when a mother is not responsive, it's linked to [poor] cognitive development and social behavior," says Leach. "The hazard is of a child with too little conviction that he is really loved, as in unconditional love. If you don't respond to him when he cries, he comes to distrust the validity of his own feelings and your willingness to respond to them."Parents who are likely to let a baby cry it out typically do so because they are afraid of spoiling a baby, something Sears calls "nonsense," or as a way to get on a schedule, thinking that if the baby "learns" that this is not feeding time, for instance, eventually he'll stop crying."That's management, not mothering," says Leach in a telephone interview from London.Indeed, Ezzo throughout his book refers to "training" a baby.Ford's book offers feeding and sleeping schedules for newborns that are down to the minute. For instance, for a breast-feeding baby at 6 to 8 weeks, she writes: "Baby should be awake . . . and feeding no later than 7 a.m. . . . Do not feed after 7:45 a.m., as it will put him off his next feed. . . 9 a.m., Settle baby to sleep for no longer than 45 minutes. . ." Efforts to reach her through her British publisher were unsuccessful.Sure, eventually, all parents want children to eat and sleep on a routine, "but it's a matter of self-regulation, not of training or obedience," Leach says. "When it happens will differ from baby to baby. It depends on the maturation of the central nervous system as well as the self-confidence that is gained from warm, sensitive, responsive parenting."Anecdotal evidence suggests that neither Ezzo's nor Ford's book is selling strongly in New England. "Secrets of the Baby Whisperer" by Tracy Hogg is somewhat more popular. Registered nurse and certified lactation consultant Nancy Holtzman, director of postpartum programs at Isis Maternity in Brookline, says Hogg's book is not as rigid as the others, but it worries her nonetheless for its one-size-fits-all approach, especially to nursing. In an interview, Hogg describes her philosophy as "structured routine," but says she would never leave a baby to cry.As someone who comes into daily contact with new mothers, Holtzman says she can understand the appeal of "Baby Whisperer." "Women who are used to being organized and in control want a schedule. Anything less feels uncomfortable to them," she says. "The problem is that young babies are not very predictable. With a 3-week-old, I tell parents to expect every day to be different, but by 3 months, routines develop, predictability happens." A new "normal" emerges.Ideally, those routines happen because parents follow a baby's cues. "Every baby is an individual," says child development specialist Claire Lerner of Zero to Three who also objects to cookie-cutter approaches."What calms one baby upsets another. What bores one overwhelms another. Maybe you've got a baby who is easily frightened by loud noises, so you learn to insulate him when you want him to sleep. Maybe you have a baby who is social. She fusses when you insulate her. So you learn to put her to sleep in a baby carrier in a room full of people."Molly Trudell, who comes to Isis every Wednesday with 7 month-old Annike for a new mom's group, says that in the beginning, she woke her baby every two hours to feed her. "It took a long time to wake her, a long time to feed her, and a longer time to get her back to sleep. It was stupid. I did it for three days."Alanna Harrington, in the same Isis group, says it was her mother-in-law who got her on the right track with baby Julia, now 7 months old. "She kept saying, `Stop waking a sleeping baby.' Finally I did. Looking back now, I realize how ridiculous we were.""Babies are funny that way," says Molly Ducker, whose son Logan is 5 months. "They can figure out their own schedule if you just let them."Contact Barbara F. Meltz at mailto:meltz@globe.comhttp://www.boston.com/yourlife/home/articles/2004/06/03/when_to_let_a_baby_cry_let_the_little_one_be_your_guide/http://www.boston.com/yourlife/home/articles/2004/06/03/when_to_let_a_baby_cry_let_the_little_one_be_your_guide/

Another article;

Guilty secret that helps mums sleep at night

TOM CURTIS HEALTH CORRESPONDENT Scotland on Sunday - Scotsman.com

There is no doubt that Ford's methods polarise the baby care world. Many midwives hate her theories. Many are also quick to point out that Ford has no children of her own.Last night, one infant-feeding expert even warned that Fords books could lead to a reduction in breast-feeding, now seen almost universally as superior to the bottle.Allison Ewing, an independent midwife based in Glasgow, said: "Ive had some distressing calls from women that it hasnt worked for, possibly because they felt inadequate that they couldnt do what the book said."I dont think Ms Ford has had any children herself and I dont know how shed feel about leaving her own child, born from her own body, to cry. Its a lot easier to leave another baby to cry than yours. Id never recommend anyone to do that. They dont feel comfortable with it, and I would say you shouldnt do controlled crying in a child younger than six months."Another Scottish midwife, who did not want to be named, said: "Babies are not designed to be treated like this. They are not machines and I worry about the consequences."Professor Beth Alder, an expert on infant-feeding based at Napier University in Edinburgh, said the effect of Fords methods on a childs emotional development were unknown because no studies had been done."It would be fascinating to know, but we dont know," she said. "Breast-feeding is most successful if babies are fed on demand. This doesnt fit into a routine very easily, and my concern is that if mothers attempt to feed by routine they may find breast-feeding is difficult. The production of milk comes from suckling on the nipple, and a baby may not suckle frequently enough if it is in a routine."She said overall she would not recommend Ford "in its entirety" but that it contained "elements of good advice".However, Dr Jack Boyle, a chartered psychologist specialising in children, warned that Fords methods could be tantamount to abuse. He said: "Children are different in terms of temperament and intelligence, and hence a child-rearing pattern that suits one will not suit another. Thus the one-size-fits-all school of child-rearing is rejected entirely by mainstream psychologists."In my opinion its a form of abuse to impose a rigid child-rearing practice, because it doesnt take into account a childs own needs."Boyle, who is based in Glasgow, also warned: "[Fords] rules have not been verified. Theyre just made up by her. No one has followed up the babies subjected to those rules to see how they turn out."Ford was not available for comment.This article: http://news.scotsman.com/uk.cfm?id=1370932003

An important statement from the American Academy of Pediatrics;

Babywise advice linked to dehydration, failure to thrive

by Matthew Aney, M.D.

Expectant parents often fear the changes a new baby will bring, especially sleepless nights. What new parent wouldn't want a how-to book that promises their baby will be sleeping through the night by three to eight weeks?One such book, On Becoming Babywise, has raised concern among pediatricians because it outlines an infant feeding program that has been associated with failure to thrive (FTT), poor weight gain, dehydration, breast milk supply failure, and involuntary early weaning. A Forsyth Medical Hospital Review Committee, in Winston-Salem N.C., has listed 11 areas in which the program is inadequately supported by conventional medical practice.The Child Abuse Prevention Council of Orange County, Calif., stated its concern after physicians called them with reports of dehydration, slow growth and development, and FTT associated with the program. And on Feb. 8, AAP District IV passed a resolution asking the Academy to investigate "Babywise," determine the extent of its effects on infant health and alert its members, other organizations and parents of its findings.I have reviewed numerous accounts of low weight gain and FTT associated with "Babywise" and discussed them with several pediatricians and lactation consultants involved.The book's feeding schedule, called Parent Directed Feeding (PDF), consists of feeding newborns at intervals of three to three and one-half hours (described as two and one-half to three hours from the end of the last 30-minute feeding) beginning at birth. Nighttime feedings are eliminated at eight weeks.This advice is in direct opposition to the latest AAP recommendations on newborn feeding (AAP Policy Statement, "Breastfeeding and the Use of Human Milk," Pediatrics, Dec. 1997): "Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting. Crying is a late indicator of hunger. Newborns should be nursed approximately eight to 12 times every 24 hours until satiety."Although demand feeding is endorsed by the Academy, WHO, and La Leche League among others, "Babywise" claims that demand feeding may be harmful and outlines a feeding schedule in contrast to it. The book makes numerous medical statements without references or research, despite that many are the antitheses of well-known medical research findings. In 190 pages, only two pediatric journals are referenced with citations dated 1982 and 1986.Many parents are unaware of problems because the book is marketed as medically supported. It is co-authored by pediatrician Robert Bucknam, M.D., who not only states in the book that the "Babywise" principles are "medically sound," but also writes, "'Babywise' has brought a needed reformation to pediatric counsel given to new parents."The book's other author is Gary Ezzo, a pastor with no medical background. Ezzo's company, Growing Families International (GFI), markets the book as "ideally written" for "obstetricians, pediatricians, or health-care providers to distribute to their patients." (GFI promotes the same program under the title "Preparation for Parenting," a virtual duplicate with added religious material).Though "Babywise" does say, "With PDF, a mother feeds her baby when the baby is hungry," it also instructs parents to do otherwise. In a question-and-answer section, parents of a 2-week-old baby, who did not get a full feeding at the last scheduled time and wants to eat again, are instructed that babies learn quickly from the laws of natural consequences. "If your daughter doesn't eat at one feeding, then make her wait until the next one."Unfortunately, the schedule in "Babywise" does not take into account differences among breastfeeding women and babies. According to one report, differences of up to 300 percent in the maximum milk storage capacity of women's breasts mean that, although women have the capability of producing the same amount of milk over a 24-hour period for their infants, some will have to breastfeed far more frequently than others to maintain that supply. Babies must feed when they need to, with intervals and duration determined according to a variety of factors in temperament, environment, and physiological make-up. Averages may fit into a bell-shaped curve, but some babies will require shorter intervals. (Daly S., Hartmann P. "Infant demand and milk supply, Part 2. The short-term control of milk synthesis in lactating women." Journal of Human Lactation; 11; (1):27-37).My review of the low weight gain and FTT accounts associated with "Babywise" revealed several disturbing trends...Pediatricians need to know about "Babywise" and recognize its potential dangers. History taking should include questions to determine if parents are using a feeding schedule, especially before advising formula supplement to breastfeeding mothers or when faced with a low-gaining or possible failure to thrive baby. Lactation consultants also should be instructed to probe this area.Efforts should be made to inform parents of the AAP recommended policies for breastfeeding and the potentially harmful consequences of not following them.Dr. Aney is an American Academy of Pediatrics (AAP) candidate fellow based in Lancaster, Calif.

This article can be read here; http://www.ezzo.info/Aney/aneyaap.htm

American Academy of Pediatrics Review of Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate with Your Baby by Tracy Hogg and Melinda Blau

Author Tracy Hogg, a British-trained nurse, lactation educator and newborn consultant, works with parents individually as well as organizes and teaches group classes in Los Angeles. Her Secrets of the Baby Whisperer: How to Calm, Connect, and Communicate with Your Baby has been described as a common-sense approach to parenting newborns. In it, she recommends various techniques to help parents understand and soothe their babies. Pediatricians who are familiar with the methods described in this book will be able to help parents distinguishwhat information is pertinent to their own families.Hogg advocates putting babies on a cycle she labels E.A.S.Y., or Eat, Activity, Sleep and Your Time, a schedule fairlyreminiscent of that described in Babywise. Parents are left without a suggested schedule once these naps have been eliminated. Hogg also suggests some feeding techniques that are counter to the AAPs and other specialists recommendations. For example, she advises scheduled rather than demand feeding in the newborn period, earlysupplementation with formula, and only nursing from one breast at each feeding. Such informationmay be confusing and possibly even harmful for patients.The author also classifies babies into five different types to help parents understand and therefore respond totheir infants personality. These categories are: Angel, Textbook, Touchy, Spirited, and Grumpy. For mosttrained practitioners, not to mention many parents, this classification is an oversimplification. Such stereotypesmay even be offensive to parents whose babies who do not fit in one of the 'nicer' groups.That said, her tendency to be authoritative and create oversimplified categories may be welcomed by someparents but, as discussed above, may be potentially misleading or even harmful for others. As with many parenting 'solutions' books, her categories are too narrow to represent the true variation in infant personalities and behaviors.

Jennifer Shu, MD, ChairAAPhttp://www.aap.org/sections/youngphys/wintnews02.pdf

Note; I am told that Tracey Hogg has written other books, with so called 'softer' approaches to controlled crying.

What is Controlled Crying?

2006-07-03T12:50:00.000+10:00

My understanding of controlled crying is anything that involves leaving a baby to cry. Basically it means that a baby is put in a cot and a parent or carer leaves the room, re-entering at increasing intervals of time to ‘comfort’ or ‘reassure’ the baby while they cry, usually by putting one hand on the baby, but NOT looking at or picking up the baby. This usually results in the baby ‘learning’ to go to sleep. Some believe it involves the carer leaving the baby to cry without going in to the baby at all. This has to be repeated night after night until the baby ‘learns’ to sleep on its own, or gives up looking for comfort, care and attention.

A modified technique could be the carer staying in the room, limiting comfort for the child while in the cot (patting or shhing), or picking baby up when they are getting too upset to settle (vomiting or other physical effects of controlled crying) and then replacing in the cot when calm. To me, both ‘softer’ methods still involve leaving a baby to cry and are thus still controlled crying, although probably called something else, but still most likely producing the same result in the babies brain and emotions.

Search this blog in the June 2006 archives to find information and BE INFORMED about the reasons WHY controlled crying seems to work.

UK Infant Mental Health

2006-07-03T12:47:00.000+10:00

This is from the UK Association for Infant Mental Health:

Newborn babies have a built-in drive to develop and practise every aspect of being human, yet each aspect of their growing up depends on their partnership with adults. If a parent holds herself aloof from her baby as a person, and from revelling in the physical pleasure in each other’s bodies, and in nursing at the breast or bottle, that underpins their adjustment to each other, seeing him instead as a programme and a project, she will not do all she can to keep him happy and busy and communicating with her. And of course the less busy and happy the baby is and the less he ‘talk’ to her, the less of a pleasure he will be.
The instruction manual approach gives parents a sense of adult control and separateness and supports their use of authority over the baby when what they most need is personal support while they risk submerging themselves in a relationship with him. It is misleading to parents to suggest that by rationing and routinising their attention to the baby they can conserve their adult autonomy because, however much they may resent the fact, their happiness and the baby’s are inextricably entangled. A mother may resent her baby’s crying; resent, even reject, the fact that he needs her - again. But ignoring (“controlling”) the crying does not only condemn the baby to cry unanswered but also condemns the mother to listen to him crying. So being sensitive to a baby’s needs, tuning in to him, treating him as he seems to ask to be treated, is not only better for the baby but also better for the mother and for their relationship. Being responsive to a baby soon grows into mutual responsiveness between child and parent.
Infants are not out to “get at” parents. Watching and listening to babies and responding positively to them whenever possible does not turn babies into bullies or parents into victims. On the contrary, it leads, naturally and without prior planning or particular rules, to negotiation between adults and infants and thence to the reciprocity on which all intimate relationships eventually depend. It is by negotiation (rather than by rules) that a parent arrives at the appropriate period of grace between this particular baby waking up and an adult arriving at the cot side. It is by negotiation that a mother can gradually stretch the time between feeds, or persuade her baby to accept her face and voice for reassurance when something startles him, instead of instant breast. It is through months of these reiterated mini-negotiations that a baby learns that mother is not him but someone separate. Someone who thinks about his needs and can be trusted, but who also has needs of her own. These lessons are the foundations of mutual regard. Laid in the first six months, they will support the mother-child relationship not only through infancy and as an alternative to rigidly programmed parental control, but through the toddler’s confused and confusing developmental drive for autonomy and the child’s increasing passion for peers, and into adolescence. And by then mutual regard is the only hope because power-tactics no longer work at all.

For the full article see:
http://www.aimh.org.uk/position_statement_nov2004.htm

How Babies Sleep

2006-07-01T16:28:00.000+10:00

Many child psychologists and psychiatrists disagree on how babies sleep. A lot of professionals believe an infant has a 'sleep problem' at even a few weeks of age. Some even expect a baby to be 'sleeping through' the night by age 12 weeks and others believe they should be able to 'sleep through' by 6 months. According to some, it is more realistic to expect your baby to sleep through when they are ready developmentally, which is more likely to be around 2 - 4 years of age.

Infant Sleep Facts Every Parent Should Know
by Dr Sears

Babies don't sleep as deeply as you do. Not only do babies take longer to go to sleep and have more frequent vulnerable periods for nightwaking; they have twice as much active, or lighter, sleep as adults. At first glance, this hardly seems fair to parents tired from daylong baby care. Yet, if you consider the developmental principle that babies sleep the way they do -- or don't -- for a vital reason, it may be easier for you to understand your baby's nighttime needs and develop a nighttime parenting style that helps rather than harms your baby's natural sleep rhythms. Here's where I'm at odds with modern sleep trainers who advise a variety of gadgets and techniques designed to help baby sleep more deeply through the night -- for a price, and perhaps at a risk.
Nightwaking has survival benefits. In the first few months, babies' needs are the highest, but their ability to communicate their needs is the lowest. Suppose a baby slept deeply most of the night. Some basic needs would go unfulfilled. Tiny babies have tiny tummies, and mother's milk is digested very rapidly. If a baby's stimulus for hunger could not easily arouse her, this would not be good for baby's survival. If baby's nose was stuffed and she could not breathe, or was cold and needed warmth, and her sleep state was so deep that she could not communicate her needs, her survival would be jeopardized.

For more go to this link… it’s a fantastic article:
http://www.askdrsears.com/html/7/T070200.asp

Comfort babies rather than let them cry

2006-07-01T16:19:00.000+10:00

June 1, 2006 - 8:29AM
The Sydney Morning Herald

Comforting babies is better than letting them cry and ultimately results in fewer tears, at least during the first few weeks of life.
British researchers who compared the benefits of soothing bawling babies or letting them settle themselves found that holding and comforting them minimised the crying.
"The hands-off approach appeared to backfire: babies fussed and cried 50 per cent more at two and five weeks," New Scientist magazine said.
"And they were still crying more after 12 weeks," it added.
Ian St James-Roberts, of the University of London's Institute of Education, examined the benefits of different approaches used by British, Danish and American parents who kept a diary of their baby's behaviour and their own responses.
Some parents held their babies for up to 16 hours a day and quickly answered their cries while others had them in their arms much less and left them crying for awhile.
St James-Roberts said comforting the baby on demand, rather than a very high level of comfort and care, minimised the tears.
"But it makes no difference to the unsoothable bouts of crying that are the core of colic," he told the magazine.

http://www.smh.com.au/news/World/Comfort-babies-rather-than-let-them-cry/2006/06/01/1148956448469.html

Here's the reserach they're talking about:

Infant Crying and Sleeping in London, Copenhagen and When Parents Adopt a "Proximal" Form of Care
Ian St James-Roberts, PhDa, Marissa Alvarez, PhDb, Emese Csipke, PhDa, Tanya Abramsky, MSca, Jennifer Goodwin, BAa and Esther Sorgenfrei, MScb
a Thomas Coram Research Unit, Institute of Education, University of London, London, United Kingdomb Department of Psychology, University of Copenhagen, Copenhagen, Denmark
PEDIATRICS Vol. 117 No. 6 June 2006, pp. e1146-e1155 (doi:10.1542/peds.2005-2387)

OBJECTIVE. Western parents are given conflicting advice about whether to introduce a "scheduled" approach to infant care or to follow their infants' demands. Attempts to address this issue using randomized, controlled trials have been unsuccessful. This comparative study collected evidence about methods of parenting and associated infant crying and sleeping in 2 communities with substantially different approaches to infant care (London, United Kingdom, and Copenhagen, Denmark) and in a "proximal care" group, where parents planned to hold their infants 80% of the time between 8 AM and 8 PM, breastfeed frequently, and respond rapidly to infant cries.
METHODS. Validated behavior diaries were used to measure parental behavior and infant crying and night waking longitudinally at 8 to 14 days, 5 to 6 weeks, and 10 to 14 weeks of age. Feeding and sleeping practices were measured by questionnaire. RESULTS. Proximal care parents held infants for 15 to 16 hours per 24 hours and coslept with them through the night more often than other groups. London parents had 50% less physical contact with their infants than proximal care parents, including less contact when the infants were crying and when awake and settled. London parents also abandoned breastfeeding earlier than other groups. Copenhagen parents fell in between the other groups in measures of contact and care. These differences in caregiving were associated with substantial differences in several aspects of infant crying and settled behavior at night. London infants cried 50% more overall than infants in both other groups at 2 and 5 weeks of age. However, bouts of unsoothable crying occurred in all 3 of the groups, and the groups did not differ in unsoothable bouts or in colicky crying at 5 weeks of age. Proximal care infants woke and cried at night most often at 12 weeks. Compared with proximal care infants, Copenhagen infants cried as little per 24 hours, but woke and cried at night less often at 12 weeks of age.

CONCLUSIONS. "Infant-demand" care and conventional Western care, as practiced by London parents, are associated
with different benefits and costs. As used by proximal care and Copenhagen parents, infant demand parenting is associated with less overall crying per 24 hours. However, the proximal form of infant-demand parenting is associated with more frequent night waking and crying at 12 weeks of age. Copenhagen infants cry as little per 24 hours as proximal care infants but are settled at night like London infants at 12 weeks of age. Colicky crying bouts at 5 weeks of age are unaffected by care. The findings have implications for public health care policy. First, they add to evidence that bouts of unsoothable crying, which are common in early infancy, are not much affected by variations in parenting, providing reassurance that this aspect of infant crying is not parents' fault. Second, the findings provide information that professionals can give to parents to help them to make choices about infant care. Third, the findings support some experts' concerns that many English parents are adopting methods of care that lead to increased crying in their infants. There is a need for informed debate among professionals, policy makers, and parents about the social and cultural bases for the marked differences between London and Copenhagen parents' approach to care.

http://pediatrics.aappublications.org/cgi/content/full/117/6/e1146

The Benefits of Co-Sleeping

2006-06-30T18:36:00.000+10:00

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!)
http://www.tiac.net/~commons/AAAS%20Interviews.pdf

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
nurtured. 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
USA

For information on safe Co-sleeping see these articles
http://www.attachmentparenting.org/idealsleep.shtml

API Position review
http://www.attachmentparenting.org/API%20Position%20Paper%20to%20AAP%20recommendations%2010-21-05%20FINAL.pdf

CPSC Data on Co-Sleeping
http://www.mothering.com/articles/new_baby/sleep/kimmel.html

Co-Sleeping Research
http://www.mothering.com/articles/new_baby/sleep/fleming.html

UK Research
http://www.mothering.com/articles/new_baby/sleep/ball.html

NZ Discussion paper; SIDS and Maori Co-Sleeping/Smoking
http://www.mothering.com/articles/new_baby/sleep/maoris.html

Invoking sudden infant death syndrome in cosleeping may be misleading; Letter;
http://bmj.bmjjournals.com/cgi/content/full/321/7267/1019

Infant Stress

2006-06-27T18:25:00.000+10:00

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

Excerpt:
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
http://www.naturalchild.com/guest/linda_folden_palmer2.html

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

2006-06-27T18:24:00.000+10:00

See this article…

Excerpt:
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."
http://www.mother-2-mother.com/wisdom.html

Gentle Parenting Books

2006-06-27T18:16:00.000+10:00

Really great parenting books can be bought on line from
http://www.mothersdirect.com.au/

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 http://www.breastfeeding.asn.au/contact/groups.html

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; http://www.psychology.sunysb.edu/attachment/online/inge_origins.pdf).

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

More Research....

2006-06-26T13:12:00.000+10:00

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. mr8u@nih.gov

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.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15499048

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....
http://www.apparenting.com/research_shows_prolonged_crying_lowers_iq_in_babies.html

Information for all parents....

2006-06-25T17:47:00.000+10:00

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.

Gentle Options

2006-06-24T12:06:00.000+10:00

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
http://www.askdrsears.com/

Pinky McKay - Melbourne based author and parenting expert (this website links to MANY great resources world wide!)
http://www.pinky-mychild.com/

Elizabeth Pantley - author of "The No Cry Sleep Solution"
http://www.pantley.com/elizabeth/

Children, Youth and Women's Health Service - South Australia
http://www.cyh.com/Default.aspx?p=1

Dr James McKenna - Director at the Centre for the Study of Maternal-Infant Sleep
http://www.nd.edu/~jmckenn1/lab/index.html

The Continuum Concept Website - Articles by Jean Liedloff
http://www.continuum-concept.org/

The Natural Child Project
http://www.naturalchild.com/

Byron Child
http://www.byronchild.com/

Mothering Magazine
http://www.mothering.com/

Forums

http://www.lrc.asn.au/forum/index.php
http://www.alternativebaby.net/
http://www.realferal.com/
http://www.naturalparenting.com.au/
http://www.joyousbirth.info/
http://www.babywebcentral.com.au/news.php

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

Government Website

2006-06-23T19:11:00.000+10:00

This is from a new Government Website...
http://raisingchildren.net.au/articles/controlled_comforting.html/context/613

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.....

2006-06-23T18:50:00.000+10:00

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

2006-06-23T18:44:00.000+10:00

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
http://www.blackwell-synergy.com/doi/abs/10.1111/1467-8624.00621

Other Terms for Controlled Crying

2006-06-23T18:40:00.000+10:00

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)
Self-settling
Self-soothing
Lay down approach
Sleep training
Ferberizing
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.

2006-06-23T11:38:00.000+10:00

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.
http://www.aaimhi.org/documents/position%20papers/controlled_crying.pdf

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.
http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=122&id=1902

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.
http://www.breastfeeding.asn.au/bfinfo/crying.html
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.
http://www.breastfeeding.asn.au/bfinfo/control.html

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.
http://www.askdrsears.com/html/7/T070700.asp

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)
http://www.naturalchild.com/research/emotional_learning_infants.html

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.
http://www.naturalchild.org/research/harvard_attention.html

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.
http://www.todaysparent.com/toddler/sleep/article.jsp?content=418

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.
http://www.atlc.org/Resources/commons_newspaper.php

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
http://www.mothering.com/articles/new_baby/bonding/science-of-attachment.html

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.
http://education.umn.edu/Pubs/ResearchWorks/Gunnar.html

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
http://www.babyreference.com/EarlyPuberty.htm

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.
http://friendlyvillage.com/lotsofslings/center.shtml

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
http://breastfeed.com/resources/articles/expectation.htm

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).
http://www.nwrel.org/cfc/frc/beyus3.html

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.
http://www.primalspirit.com/pr2_1solter_tears.htm

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.
http://www.mothering.com/articles/new_baby/bonding/connection.html

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
http://www.timesonline.co.uk/article/0,,2087-2179265,00.html

Definitions

2006-06-20T18:43:00.000+10:00

con·trol
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.

cry·ing
adj.
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"

a·buse
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.

ne·glect
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

trau·ma
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;
http://www.thefreedictionary.com

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).
From; www2.uta.edu/ssw/trainasfa/glossary.htm

Controlled Crying

2006-06-18T17:33:00.000+10:00

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.

Why use controlled crying?

2006-06-14T13:30:00.000+10:00

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......

BawlingBabies

Being "Fully Informed"

Trust in Yourself!

Controlled Crying - some facts and information

Reasons not to use "Controlled Crying"

The Play

Mums told to ditch controlled crying

The Nazis were beaten and left to cry as children

Sleeping with the baby

Helping your baby to sleep - A fantastic new book!

A Baby Speaks

Kindred Magazine

Infant Mental Health - Update

Medical news today - study

Disembodied from the beginning

Independence Learnt?

Parent Responsiveness - A Study

Elizabeth Pantley's views

Sleep deprivation

What is attachment parenting?

How should we respond to cries?

Dr Sarah Buckley's views

Do you have any information?

Kellymom's thoughts on CIO

Dr Sears on crying

Controlled Crying in the Media

More Articles

Perinatal Neuroscience

Sleeping through the Night

Guilt

"Sleeping Like a Baby"

Attachment Workshop Sydney, Australia

"He won't remember it anyway!"

A Baby Cries: How Should Parents Respond?

More Research....

Controlled Crying and Routines

What is Controlled Crying?

UK Infant Mental Health

How Babies Sleep

Comfort babies rather than let them cry

The Benefits of Co-Sleeping

Infant Stress

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

Gentle Parenting Books

More Research....

Information for all parents....

Gentle Options

Government Website

Questions to ponder.....

More research

Other Terms for Controlled Crying

Definitions

Controlled Crying

Why use controlled crying?