Intro

All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

Cry It Out: The Potential Dangers of Leaving Your Baby to Cry

Written by Margaret Chuong-Kim


Among parents of infants these days, there is constant debate about how to respond to a baby’s cries. On one hand, there are proponents of the “cry it out” method, where the baby is left alone to cry in the hopes that he or she will eventually stop. On the other hand, there are the “attachment parents” who respond immediately to their crying babies and attempt to soothe them using various methods including holding and cuddling. While the cry-it-out method (CIO) has been popular in previous years, attachment parenting (AP) is gaining a foothold among new parents today. Results of studies in psychology indicate the AP approach to crying is most likely to result in an emotionally and physically healthy child.

Attachment theory originated in the late 1960s when psychologist John Bowlby postulated that a warm, intimate relationship between caregiver and infant is necessary for optimal health as well as for basic survival. As such, each individual is born well-equipped with reflexes and instincts for interacting with their primary caregiver, which is often times the mother. For example, infants quickly learn to recognize and prefer both their mother’s voice and smell. As babies develop some locomotor control they display their desire to be close to their caregivers by reaching toward their mother or father to be picked up or by crawling toward them. From an evolutionary perspective, these behaviours have survival value. Babies who lack such attachment behaviours will stray from their caregivers and are more likely to get lost, attacked, and perish. An infant’s cry is also intended to increase the likelihood of its survival, as a mother’s instinct is usually to go to her child at the first sign of distress.


We live in an age where we can know that the baby is safe in another room, despite the loudness of his cries. Does this mean we should leave babies to cry on their own? CIO proponents often advise that babies left to cry will eventually stop, and the duration of future crying bouts will decrease. What are the emotional consequences of crying for the infant when she is left unattended?

Bowlby and colleagues initiated a series of studies where children between the ages of one and two who had good relationships with their mothers were separated from them and left to cry it out. Results showed a predictable sequence of behaviours: The first phase, labeled “protest”, consists of loud crying and extreme restlessness. The second phase, labeled “despair”, consists of monotonous crying, inactivity, and steady withdrawal. The third phase, labeled “detachment”, consists of a renewed interest in surroundings, albeit a remote, distant kind of interest. Thus, it appears that while leaving babies to cry it out can lead to the eventual dissipation of those cries, it also appears that this occurs due to the gradual development of apathy in the child. The child stops crying because she learns that she can no longer hope for the caregiver to provide comfort, not because her distress has been alleviated.
 
Do babies cry more when they are attended to? 

A 1986 study concluded just the opposite: the more a mother holds and carries her baby, the less the baby will cry and fuss. Cross-cultural studies also show that parents in non-Western societies are quicker than parents in Western societies to respond to their crying babies, and babies in non-Western societies cry for shorter spans of time. Caregivers in 78% of the world’s cultures respond quickly to an infant’s cries. For instance, Efe caregivers in Africa respond to a baby’s cries within ten seconds at least 85% of the time when the baby is between three and seven weeks, and 75% of the time when the baby is seventeen weeks. !Kung caregivers respond within ten seconds over 90% of the time during the baby’s first three months, and over 80% of the time at one year. In contrast, American and Dutch caregivers have been found to be deliberately unresponsive to an infant’s cries almost 50% of the time during the baby’s first three months. Infants in non-Western societies have been found to fuss just as frequently as those in Western societies, but due to the prompt response of caregivers in non-Western societies, the overall cumulative duration of crying is less than what occurs in Western societies.


According to attachment theory, many babies are born without the ability to self-regulate emotions. That is, they find the world to be confusing and disorganized, but do not have the coping abilities required to soothe themselves. Thus, during times of distress, they seek out their caregivers because the physical closeness of the caregiver helps to soothe the infant and to re-establish equilibrium. When the caregiver is consistently responsive and sensitive, the child gradually learns and believes that she is worthy of love, and that other people can be trusted to provide it. She learns that the caregiver is a secure base from which she can explore the world, and if she encounters adversity she can return to her base for support and comfort. This trust in the caregiver results in what is known as a secure individual.

Children who do not have consistently responsive and sensitive caregivers often develop into insecure individuals, characterized by anxious, avoidant, and/or ambivalent interactions. Long-term studies have shown that secure individuals, compared to insecure individuals, are more likely to be outgoing, popular, well-adjusted, compassionate, and altruistic. As adults, secure individuals tend to be comfortable depending on others, readily develop close attachments, and trust their partners. Insecure individuals, on the other hand, tend to be unsettled in their relationships, displaying anxiety (manifesting as possessiveness, jealousy, and clinginess) or avoidance (manifesting as mistrust and a reluctance to depend on others). North American parenting practices, including CIO are often influenced by fears that children will grow up too dependent.


However, an abundance of research shows that regular physical contact, reassurance, and prompt responses to distress in infancy and childhood results in secure and confident adults who are better able to form functional relationships.

It has been suggested in the past that CIO is healthy for infants’ physical development, particularly the lungs. A recent study looking at the immediate and long-term physiologic consequences of infant crying suggests otherwise. The following changes due to infant crying have been documented: increased heart rate and blood pressure, reduced oxygen level, elevated cerebral blood pressure, depleted energy reserves and oxygen, interrupted mother-infant interaction, brain injury, and cardiac dysfunction. The study’s researchers suggested that caregivers should answer infant cries swiftly, consistently, and comprehensively, recommendations which are in line with AP principles.

CIO supporters tend to view their infants’ cries as attempts to manipulate caregivers into providing more attention. Holding this view can be detrimental to the immediate and long-term health of the baby. In the field of cognitive psychology there exists the premise that our thoughts underlie our behaviour. Thus, if we think positively about an individual, our behaviours toward them tend to be positive as well. Conversely, if we think negatively about an individual, we will behave correspondingly.  

Consider people in your own life whom you consider manipulative – how does that perception influence your behaviour toward them? It is unlikely that the interpretation of a manipulative personality will result in the compassionate, empathetic, and loving care of that individual. Infants, quite helpless without the aid of their caregivers, may suffer both emotional and physical consequences of this type of attitude.
 
When faced with a crying baby, it may be prudent to ask yourself the following questions: Why am I choosing this response? Do I want my baby to stop crying because he feels comforted and safe, or do I want my baby to stop crying for the sake of stopping crying? What is my baby learning about me and the world when I respond in this manner? If I were a baby and was upset, how would I want my caregivers to respond?

References
Campos, J., et al. (1983). Socioemotional development. In P. Mussen (Ed.), Carmichael’s Manual of Child Psychology: Vol. 2. Infancy and Developmental Psychobiology. New York: Wiley.
Craig, G., Kermis, M., & Digdon, N. (1998). Children Today. Scarborough, ON: Prentice-Hall.
Dacey, J. & Travers, J. (1996). Human Development Across The Lifespan (4th Ed). Boston: McGraw-Hill.
DeCasper, A., & Fifer, W. (1980). Of human bonding: Newborns prefer their mothers’ voices. Science, 208: 1174-76.
Gleitman, H. (1996). Basic Psychology (4th Ed). New York: W.W. Norton.
Hunziker, U. & Barr, R. (1986). Increased carrying reduces infant crying: A randomized controlled trial. Pediatrics, 77(5): 641-8.
Luddington, Hoe, S. Cong, X., & Hashemi, F. (2002). Infant crying: Nature, physiologic consequences, and select interventions. Neonatal Network, 21(2): 29-36.
Macfarlane, A. (1975). Olfaction in the development of social preferences in the human neonate. Parent-Infant Interaction. Amsterdam: CIBA Foundation Symposium.
Mikulincer, M., & Shaver, P. (2001). Attachment theory and intergroup bias: evidence that priming the secure base schema attenuates negative reactions to out-groups. Journal of Personality and Social Psychology, 81(1): 97-115.
Miller, R. (2000). Dysfunctional relationships. In R. Kowalski & M. Leary (Eds.), The Social Psychology of Emotional and Behavioral Problems: Interfaces of Social and Clinical Psychology. Washington, DC: APA.
Waters, E., Wippman, J., & Sroufe, L. (1979). Attachment, positive affect, and competence in the peer group: Two studies in construct validation. Child Development, 50: 821-829.
http://www.vancouver.wsu.edu/fac/hewlett/infantcare.html

Reproduced with kind permission of Dr. Ben Kim

16 comments:

  1. My fondest memory as a child is of falling asleep to the rise and fall of my dads chest as I lay on him belly to belly. I must have been 3 or 4 years old. What bedsharing and AP parenting has given me is a sense of knowing I was loved unconditionally and that I was safe. I've practiced AP parenting with my children as it was how I was raised and I hope they will feel the same.

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  2. Gah - now deal with my paranoia that leaving a baby crying to deal with an older sibling or whilst driving etc is *not* the same as CIO....

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  3. A balanced discussion on this subject might be interesting; this "report" is just another series of opinions without accurate references that will cause unnecessary stress and emotional guilt for hundreds of decent parents who have researched and discussed their approach to dealing with crying.
    Everyone has a different approach and whilst neglect is clearly unacceptable, choosing to try and teach your baby to be independent and to understand the difference between care and being tied to them is not.
    Not responding within 10 seconds to a crying baby is not being "manipulative"; publishing an article to try and bend parents to a specific method of dealing with crying is.

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  4. there is a vast difference between purposefully leaving your child to cry when you COULD hold and hug them and soothe them to argh I'm changing a toddler and the baby is waking up - that's different and unavoidable the fac that you respond to your child when they need you means they can hang on a sec and be reassured by you calling hang on sweetie or singing loudly so they know you are there etc

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  5. Anon - if parents have researched their approach, I would suspect it highly unlikely they would use crying as a "sleep technique"; unless you know of compelling research confirming all the above is incorrect?

    I don't suppose it occurs to people that if infants were supposed to be sleeping without comfort - they wouldn't need training to do so? We're soooo advanced that without routines and sleep techniques we will fail to develop into normal functioning adults - fascinating. Leaving a baby to cry is certainly not an "instinctive" behaviour - many talk of how awful it was, but they knew they had to "for their own good"....

    Your statement also assumes we can "teach independence", which is an interesting concept. Which would make you feel most independent, someone reassuring you they were there for you whenever you needed, or someone who frequently left you to sob (at a time that was your only communication method) without a question as to WHY you were distressed? I propose the former actually is the key to true "independence".

    QUOTE to understand the difference between care and being tied to them is not.

    I guess that also depends on your POV. I'm more than happy to be "tied" to my babies when they're little - I figure that's my job - others can care, only I can mother ;)

    Lastly I didn't state at any point that not responding to a child in 10 seconds was manipulative - that appears to be a bit you have added yourself.

    AA

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  6. Anon, I'm really interested in your comment about this post being "without accurate references". Which ones are inaccurate?

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  7. "Attachment theory originated in the late 1960s when psychologist John Bowlby postulated that a warm, intimate relationship between caregiver and infant is necessary for optimal health as well as for basic survival. " What Bowlby did was observe and apply common sense. So, he developed a "theory" based upon the facts of human physiology. He did not manipulate the facts about physiology to try to support his theory--THAT is what sleep trainers try to do. There is no evidence anywhere that supports sleep training as being beneficial in any way. So, as AA said, if anyone does actual research, they have two options--they can practice responsive parenting, or they can ignore the research and facts for the sake of convenience. But that sleep training is harmful is not an opinion.

    "We live in an age where we can know that the baby is safe in another room, despite the loudness of his cries. " The baby has no idea he is safe in the other room and no amount of rationalizing as to why he should will make it so.

    Common sense alone would rule out ever using sleep training--EVER.


    Jennifer

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  8. There's a lot of money to be made from book sales, private consultations and TV appearances and therefore a huge vested interest in persuading parents that sleep training is necessary.

    Not sure I see how AA can benefit from putting the facts out there except a real wish to counter the deep-seated social mores that so many of us have grown up with.

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  9. I have no idea why someone would want to push their baby to be independent. My toddler is independent enough as it is, thank you very much!

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  10. ("Original Anonymous")
    AA - regarding your comments about research - it appears that your research is limited to that which suits your argument "care givers in Efe, 10 seconds, 85% of the time between 3 and 7 weeks and 75% at 17 weeks"? Presumably weeks 8-16 were different somehow?
    You keep using the term "many"; how many is "many" - 80%, 60%, 50%, 30%? And what is your reference for this? Your text does not actually reference the books you have listed at the footnote.
    Apart from how you think they should feel because it is how they naturally behave, where is your EVIDENCE that leaving them to cry whilst you change your other toddlers nappy or dry yourself after a shower is bad behaviour?
    It is exactly this kind of forceful opinion that causes distress for new parents; I would suggest that people read the various CONCEPTS and make their own judgements.
    EA - I am not claiming that the references are inaccurate, simply that accurate references to the figures used are lacking.

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  11. I didn't write this piece - you do see the name at the top of the article yes?

    QUOTE where is your EVIDENCE that leaving them to cry whilst you change your other toddlers nappy or dry yourself after a shower is bad behaviour?

    I've never said this

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  12. I think it's best to go with how you know your own child!! I've tried the CIO method and quite honestly I hated it. My daughter would get so upset she looked like she is goin to pass out. So I'm goin to use the skills I naturally have, cuddle, hug, comfort her and just not give myself a headache worrying of her becoming 'spoilt' for lack of a better word.

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  13. Choose the right method that will foster a healthier baby. It's about knowing how your baby responds.

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  14. Original Anonymous:
    I would love to be enlightened by your idea of sound research and studies that PROVE CIO method is effective without long-term effects. I am a college student at a renowned university and every single one of my professors (who are also researchers) have openly rejected the effectiveness of the CIO method in infancy.
    Why don't you include some sources that you are familiar with, for the benefit of all who read this article.

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  15. When I first clicked on the link I was expecting an article filled with opinion - so I was surprised to see any references at all...I think Original Anonymous is highlighting how the references are biased in favour of AP. For any reliable debate you do have to look at both sides of the argument - I'm sure if you look hard enough there will be CC and CIO supporting research. You are then able to discuss and form educated conclusions. If we look at Bowlby and the social and political era at the time - it was after the war, women had taken up traditionally male working roles - however the men were coming back from fighting and they wanted to get women back in the home raising the family...so it could be argued that guilt tactics were employed...saying that common sense should prevail and for me and my baby we are baby-led and happy breast feeding, co-sleeping and giving as much attention/hugs/kisses as she asks/cries for.

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  16. ...also if you can find evidence for both sides of the debate to draw conclusions from it often strengthens the argument you are trying to make.

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