The Evidence Against Leaving Your Baby to Cry-It-Out.

May 16

Many families feel stuck in their sleep struggles, believing they have to accept their sleep deprived life because well-publicised methods such as cry-it-out (CIO) simply don’t sit right with them. These methods suggest they have been well researched but analysis of the scientific research suggests otherwise.

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My work as a Gentle Sleep Coach ® provides an alternative, less traumatic, way for your baby to sleep through the night. Some families come to me because they knew from the start that CIO or controlled crying (CC) wasn’t for them. Others tried CIO/CC and found it didn’t work for them.

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The purpose of my work is to support families, not to add any shame, guilt or judgement for previously used methods. I have been there - a desperately sleep deprived mother searching the internet and friends for advice, trying CC and just about everything I possibly could and it never working out.

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Of course, there are families who find success with the crying-it-out methods, often because of the temperament of the baby: babies with an easy going, flexible temperament often just need the opportunity to get themselves to sleep and consistency to master the skill. However, for many babies, my daughter included, their temperament and needs just don’t align with these methods and the end result of trying them is to create more distress than was ever needed. This is usually the case with highly alert children who have quite an impressive ability to resist sleep and fight change. When trying controlled crying with my daughter for naps she refused to lie down to the point that she’d fall asleep sitting up and then each time her head bobbed down she’d wake up again hysterically crying, sometimes to the point she was sick.

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Parents have every right to find another way to improve the whole family’s sleep. There’s a fairly new movement on social media which promotes an all-natural and baby-led approach to sleep. A lot of this movement resonates with me however it also creates guilt for parents who can’t co-sleep or are in need of more time for self-care. My approach offers a middle ground for parents. A way to help your baby or child sleep through the night without leaving them to cry.

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Through my training I have discovered the evidence against, and lack of evidence for, the safety of using CIO. Whilst many baby sleep books will tell you leaving your baby to cry has not been shown to cause any harm, that isn’t an accurate reflection of the research. Here is some evidence summarised for you, to reassure you that your instinct against this approach is empirically justified.

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The impact of CIO/CC on infants under 6 months is unknown

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Many books and courses have you start CC as early as 1-3 months old to ‘lay the foundations’ for healthy sleep. Firstly, a baby of this age doesn’t have the cognitive or developmental capacity to self-regulate. From 0-3 months the only basic skills babies have falling under the category of self-soothing would be head turning, eye closing and sucking (Kopp, 1989). They have no sense of object permanence so when a caregiver is not in view they can’t comprehend where they are or that they are safe. By 6-9 months babies begin to grasp object permanence and can increasingly direct their attention to manage distress (Mangelsdorf et al., 1995).

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Secondly, there is little to no scientific research on sleep training infants under 6 months (Gordon & Hill, 2007). So, these books are making unjustified claims.

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Relatively few studies on sleep training have met the gold standard of scientific research

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A high standard scientific study would include a representative and large sample, follow them over time, use control groups and objective measures. Many studies use samples with children with medical sleep conditions yet generalise the results to typically developing children. Samples are often small and unrepresentative. The measures being used are often unreliable and indicate a lot of parental bias. For example, some studies show an increase in parental reports of sleep improvement but no actual improved sleep (Hall et al., 2015).

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Many claim there is no evidence of CIO causing any harm to infants.

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Middlemiss et al. (2012) found increased cortisol levels (a stress-related hormone) in both mother and child after CIO based interventions. During periods of brain reorganisation (of which babies go through many) even a small amount of stress can create unbalance in their development (Heimann, 2003). Interestingly, in this study (Middlemiss et al., 2012) the babies showed increased levels of cortisol even after finishing the intervention successfully meaning even when the babies were no longer crying for the caregiver’s assistance, they were still stressed at a biological level.