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Can Sleep Training Be Harmful?

by
author image Elizabeth Hurchalla
Elizabeth Hurchalla has been a writer and editor since 1993. She has authored three books and written for “InStyle,” “Cosmopolitan” and the BBC, among other outlets, covering family, food and entertaining, lifestyle and self-help. Hurchalla earned a Bachelor of Philosophy in interdisciplinary studies from Miami University.
Can Sleep Training Be Harmful?
Can Sleep Training Be Harmful? Photo Credit David Pereiras Villagrá/iStock/Getty Images

Overview

Waking up every couple of hours to tend to a crying baby can feel like torture to many new parents. But is letting your little one cry it out with sleep training a harmless solution that ensures better sleep for parents and baby alike, or is it a surefire way to damage your relationship with your child?

Some experts say sleep training works. Others suggest the practice is neglectful. Still others say it depends on the child.

One thing is clear: Losing sleep night after night isn’t good for anyone. Chronic sleep deprivation has been linked to everything from heart disease to obesity. There are also mental-health risks. According to a 2009 study published in “Archives of Women’s Mental Health,” sleep-deprived moms are at greater risk for post-partum depression. Another study from 2011 shows a link between sleep deprivation and marital problems. It’s tough to be a patient, loving, present parent and spouse or partner when you’re exhausted. Even if you’re willing to sacrifice your own well-being for the sake of your child, sleep deprivation is unhealthy.

What Is Sleep Training?

Pediatric sleep specialist Jill Spivack typically recommends teaching a baby who is at least four to six months old to self-soothe by establishing a consistent bedtime routine, making sure the room is quiet and dark and putting the baby to bed sleepy but awake. But babies who are used to being rocked, sung, nursed or otherwise helped to sleep tend not to like it when you stop. That’s why the most common form of sleep training is sometimes called “cry it out.”

Although there are many variations on the theme, including just leaving your baby on her own until she stops crying, most experts recommend periodic brief checks on your baby if she starts crying. This is known as the “controlled crying” technique.

Will Crying It Out Harm My Baby?

“There are absolutely no studies that have found any such thing,” says Jodi Mindell, Ph.D., author of Sleeping Through the Night and associate director of the Sleep Center at the Children’s Hospital of Philadelphia. “All the studies that have looked at short-term outcomes have actually found that babies are more securely attached and benefit in multiple ways following sleep training.”

An Australian study published in the journal Pediatrics in 2012 suggested no longer-term issues either. Of babies whose parents reported sleep problems at seven months, half were sleep trained with controlled crying or camping out (staying in your child’s room while she cries until she falls asleep, moving farther away on successive nights until you’re outside her room), and half were not. Five years later, the researchers followed up with the then six-year-olds and found “behavioral sleep techniques have no marked long-term effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.”

However, Elizabeth Pantley, author of “The No-Cry Sleep Solution,” calls the study flawed: “Thirty-one percent of the participants dropped out. The parents told the researchers that their babies weren’t negatively affected by sleep training — would they say otherwise?”

In Pantley’s view, “If a baby is left to cry it out at sleep times, he cannot understand why his calls are answered only some of the time. Responding to your child’s cries is one way to build that trust from a young age so that your child knows that when he needs you, you will be there.”

Michael Commons, Harvard University assistant professor of psychiatry, and Patrice Miller, Salem State University psychology professor, have even speculated that the American and Northern European inclination to promote early independence (for example, expecting infants to sleep in a crib in a separate room and leaving them to cry rather than co-sleeping and consoling them anytime they are upset) may contribute to a greater risk of post-traumatic stress disorder later in life. In a paper presented to the Association for the Advancement of Science in Philadelphia in 1998, the pair wrote, “Early stressful practices may produce lasting effects, as the brain is still developing. There may be permanent alterations in stress-related neurotransmitter systems (such as the release of higher levels of cortisol).”

And indeed, a 2011 study from the University of North Texas found that babies undergoing sleep training did experience high levels of the stress hormone cortisol even after they stopped crying. In other words, despite quieting down, they stayed stressed.

Mindell, however, questions the study’s significance: “This study only looked at a few nights; thus, it is hard to interpret the results.” Furthermore, if your child is waking frequently and therefore not getting enough sleep (defined as 14 to 15 hours for infants, 12 to 14 hours for toddlers and 11 to 13 hours for preschoolers, according to the National Sleep Foundation), that, too, affects the brain.

First, children who don’t get enough sleep tend to exhibit increased aggression and tantrums. Lack of sleep may also affect children’s ability to learn. According to a 2003 study published in the journal “Child Development,” older kids whose sleep was restricted experienced a significant increase in teacher-reported academic and attention problems. In addition, a 2013 study by Swiss researchers published in the journal “Nature Neuroscience” found that children were significantly better able to recall information they had learned after a good night’s sleep. Long story short, your child needs solid rest to be at her best.

Won’t My Baby Learn to Sleep Through the Night?

Don’t count on it. One study published in the “Journal of Pediatrics” showed that 84 percent of kids who had trouble going to sleep or waking up at night still had the same problem three years later.

If I Feel Guilty, Is That a Sign I Shouldn’t Do It?

Pantley thinks so. “Crying is a baby’s main way of communicating a state of unhappiness, fear, discomfort, loneliness or pain. A mother is biologically wired to respond to her baby’s cry and feels a physical need to respond. A mother who is letting her baby cry it out must fight this maternal instinct and often finds it a difficult task, frequently resulting in a mother’s tears in addition to the baby’s.”

Admittedly, hearing your baby wail can be heartrending, but according to Jennifer Waldburger and Jill Spivack, licensed marriage and family therapists and authors of “The Sleepeasy Solution,” continuing to respond doesn't allow her to change her habits. “Whether your child is learning to walk, tie a shoe, ride a bike or do math homework, each time your child struggles, it’s going to be tempting to jump in and rescue her,” says Spivack. “But when you do this, you are actually preventing her from learning for herself what she can do to alleviate her frustration.”

What Are My Alternatives?

One option is to just sleep with your baby. Co-sleeping babies rarely cry out at night, and when they do, they settle down four times faster than solo sleepers. Although the American Academy of Pediatrics recommends room-sharing — but not bed-sharing, to reduce the risk of SIDS — other experts, such as pediatrician Dr. William Sears and Dr. James McKenna, director of the Mother-Baby Behavioral Sleep Laboratory at the University of Notre Dame, claim co-sleeping promotes parent-child bonding and actually decreases the risk of SIDS.

However, some parents find it tough to get much sleep with their baby in their bed, and others simply prefer to have their child in a crib in a separate room. If that’s your preference, start by setting a positive, consistent bedtime routine and schedule with quiet activities your child enjoys. Some lucky parents find that’s all it takes.

If that doesn’t do the trick, you may want to try the camping-out method of sitting with your child while he cries until he falls asleep and moving your chair further away from the crib every night until you’re out of the room. Some consider it a middle ground between the controlled-crying and no-cry methods, and Mindell often recommends it.

Or you may prefer to try Pantley’s approach: The key to the no-cry method, says Pantley, is to “tune in to your child, learn their sleepy signals, identify their sleep needs and set up a routine that supports their natural biology. First, find out why your child is waking up, and then see if you can solve that problem to help your child sleep better.” To that end, Pantley advises creating a sleep log for a couple of days: “Chart when baby falls asleep, how long it takes him to fall asleep and how he does it. (Is he being fed or rocked?) Jot down nap times and bedtime along with any night wakings. Review the log to identify patterns that may need to be changed.”

If you do decide to pursue a no-cry approach, however, keep in mind that it is likely to take longer than controlled-crying sleep training. Though some children do respond quickly, no-cry alternatives can sometimes “take so long to accomplish that many parents are too exhausted to hold the course,” says Spivack. “And worst of all, babies still cry, but instead of crying for four days, they may cry for months.”

But some feel more comfortable always answering those cries. As Pantley writes, “The irrefutable truth is that we cannot change a comfortable, loving-to-sleep (but waking-up-all-night) history to a go-to-sleep-and-stay-asleep-on-your-own routine without one of two things: crying or time. Personally, I choose time.”

Whichever method you choose, it’s important to be consistent. As Waldburger and Spivack write, “You need to feel comfortable with the method you use to help your child sleep, or the method won’t work. If it feels better for you to hug your child or stay in the room, follow your instincts. Just know that no matter what you do, you can never completely erase your child’s frustration as she learns to sleep; unfortunately, she will protest no matter what you do.”

READERS – DO YOU HAVE CHILDREN? WHAT METHOD DID YOU USE TO SLEEP TRAIN THEM? DID YOU TRY THE CONTROLLED-CRYING METHOD OR A NO-CRY OR CO-SLEEPING METHOD? HOW DID THE METHOD YOU CHOOSE WORK FOR YOU? DO YOU HAVE OPINIONS ON WHICH METHOD WORKS BEST? LEAVE A COMMENT BELOW AND LET US KNOW.

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