Controlled crying: the great debate

This piece was originally published in Sunny Days magazine and it never gets old. I thought it was time to talk about it again.

Controlled crying. For many parents, these two words will conjure up a variety of thoughts and emotions. As with other parenting-related issues, the topic can be a minefield from the definition through to the practice and every conversation in between. There are so many articles and blogs devoted to the efficacy and/or cruelty of the practice, it's clear this issue can be divisive.

When my children were babies I hated the idea of letting them cry, for any length of time, for any reason. With my first child, there was a point at which I attempted to wrap, pat, leave the room, wait it out, then go back in and start the whole process again. But for me it didn’t work. My heart was not in it, and if anything the attempt to 'train' him only made him more distressed. So I went back to my original plan of settling him by rocking, patting, feeding and cuddling. I believe that going with my gut instinct helped me be a more relaxed mother and helped nourish the bond between me and my baby.

Many parents say that the benefits of controlled crying outweigh the negatives. Sure, no one likes to listen to their baby crying, but in the interests of teaching them to sleep independently - and hopefully having a happier, better-rested baby in the morning - it's a price that many argue has to be paid, albeit reluctantly.

Modern-day sleep 'gurus' such as Gina Ford and Tizzie Hall advocate variations on a routine-based childcare technique that includes the use of controlled crying to help baby 'settle'. These two popular authors have no formal qualifications or scientific research to back up their claims; instead they rely on their years of experience and a 'commonsense' approach that delivers the results many parents want. Their ideas can be traced back to Dr Truby King, a physician with an interest in child development who founded the Karitane mothercraft hospitals and established the Australian Mothercraft Society. American paediatrician Dr Richard Ferber also popularised a similar technique in the 1980s.

Opponents of controlled crying have concerns about the impact of the practice on a child's emotional security and brain development. The Australian Association for Infant Mental Health (AAIMHI) states 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.” They go on to say that, “infants are more likely to form secure attachments when their distress is responded to promptly, consistently and appropriately.”

Neurobiologist Dr Bruce Perry says that, “touch and comfort is as essential a nutrient for infant brain development and healthy growth as mother’s milk.” He acknowledges that parents who practice controlled crying are attempting to help a child build self-regulation skills but argues that, “this technique is not going to lead to the desired result.”

Paediatrician Dr William Sears also argues that by training a baby to sleep without crying, you are producing a learned helplessness, the baby has 'given up' on crying out for help.

Popular childcare authors, American Elizabeth Pantley and Australian Pinky McKay, have written books about how to help your child sleep without the use of controlled crying.

Dr Perry is quick to avoid any alarmist tendencies. “I’m not saying that if you’ve done controlled crying your child is going to have profound dysregulation (poor or inappropriate emotional response) or have brain damage. But if the goal is to have a child who is able to self-regulate and be curious and less anxious in new situations then that’s not the best way of getting to that point.” And this is where I think he makes the most sense. We shouldn’t feel guilty about our parenting choices if they have been made taking the overall picture of a family’s health into account. It seems the ‘outcome’ that controlled crying sometimes produces, that is, a baby who sleeps independently, comes at a neurological, and possibly developmental and emotional cost to a child. But a stressed, anxious and potentially depressed parent exact a cost too.

Dr Perry agrees that if the desired outcome is for babies to stop crying, controlled crying does ‘work’. “Absolutely, babies will stop crying,” he says. However he also says that the more you respond to a crying baby when they’re young, the less they’ll cry when they get older, the less demanding they will be, the more curious and the more open to exploring new situations.

Personally I have found the cries of my babies (and children, as they have grown older) like the mythical sirens' call – I am unable to resist responding as quickly as I can, particularly when it comes to helping them sleep well. I have found that hopping into bed with them when they wake is the best way to maximise their levels of security - and my time asleep. I have always reasoned that we help our children do most things during the day - you would not expect a two-year-old to make themselves a meal, for instance, without asking for help or expecting a level of supervision - so why do we demand more of them at night? And to me, it’s such a short time in our lives - they’ll be grown and independent before we know it - I want it to be as harmonious a time as possible.

What it comes down to for me is the old 'cost vs benefits' analysis, which varies for each family. Armed with as much factual information, resources and support as possible, no one can expect us to do more than our best.

What is controlled crying? The Australian Association for Infant Mental Health (AAIMHI) describes controlled crying as a technique that involves leaving the infant or child to cry for increasingly longer periods of time before

providing comfort. The intention of controlled crying is to let babies put themselves to sleep and to stop them from crying or calling out during the night.

How is this different to 'controlled comforting', 'self-settling' or ‘crying it out’? There is some confusion as to the exact definitions of each phrase as they are used widely in different contexts by different groups. There are variations between these techniques but, ultimately, they have the same aim. Some involve waiting a specific number of minutes before going back in to re-settle baby, others involve focussing more specifically on the type of cry (ie whether distressed or grizzly, etc).