Sleep training your baby with ‘controlled crying:’ Con or comforter?

Controlled crying is a method mums and dads have used for many years but it’s always marred with controversy

Eve Dugdale

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From the first smiles to the cuddles and that overwhelming sense of love you get when you meet your child for the first time – having a baby is just fantastic.

Most of the time.

Then there’s the sleep deprivation. The sheer exhaustion is unbearable at times and it’s no wonder parents try anything to get their little ones to sleep better.

Controlled crying is a method mums and dads have used for many years but it’s always marred with controversy regarding how good it is for the child.

However, a recent study by Flinders University in Australia has revealed that using the technique, which involves parents allowing their baby to cry for a certain amount of time, does no harm to either parent or child.

With researchers finding that controlled crying can improve sleeping patterns of children, they also said there were no significant differences in emotional, behavioural problems or attachment issues a year later.

It’s something Dr. Mudit Kumar from Dubai’s Mediclinic Welcare Hospital has certainly seen the benefits of.

The Consultant Paediatrician and Specialist Neonatologist says that in a recent review, 94 per cent of published studies of sleep behavioural interventions showed clinically significant improvements in settling and night waking problems in infants and children using controlled crying.

He explains: “The most extreme of such techniques is ‘Extinction’- leaving children to cry until they stop. ‘Graduated extinction’ involves attending to children at increasing time intervals and providing reassurance. ‘Camping out’ is where parents gradually remove themselves from the room. Under the age of six months these interventions are not recommended, however for older infants they can be effective.”

‘Controlled’ is a key word in the technique, believes Italian dad William. While he allowed both of his daughters to cry it out he says it ‘never got the point of hysterical crying’.

He explains: “You know as a parent when your child is distressed. With my first daughter it took four or five days of controlled crying - going in at certain points to reassure her - but with the second it only took two and she was in a pretty good routine. I can understand someone's point of view who is worried about creating an issue for the child if they were left to scream for ages which I don't agree with.”

In the Flinders University study, 43 babies aged 6 – 16 months were split into groups. One that used controlled crying, another that tested bedtime fading, which involved parents gradually delaying bedtime in an attempt to help them fall asleep faster and a final group who were simply given advice on healthy sleeping habits.

After three months, the researchers found babies in the first two groups were falling asleep up to 13 minutes faster whereas there was no difference in the babies in the final group.

Dr. Kumar admits that infants left to cry can have increased cortisol levels which suggest activation of the ‘stress-axis.’ But he also said that close sleep-proximity, i.e. in the same room, to parents is associated with reduced infant-crying at night. However, he suggests if a child is generally well-looked-after, controlled crying could be a method worth trying.

He says: “For many families, controlled crying remains a useful technique. A five-year follow-up study found no adverse effects on psychosocial functioning or relationships which concluded that there were no significant long-lasting effects of behavioural sleep interventions for infants.”

Dr. Kumar says it’s important parents realise that young children all have different habits and urged them not to panic if their child struggled to sleep all through the night.

He adds: “Behavioural sleep problems are common in otherwise well children and parents often overestimate or underestimate the degree to which their child’s sleep is disturbed.

“Sleep duration alters significantly over the life span, with average daily sleep duration ranging from 10–17 hours at 6 months of age to 8–11 hours at 11 years of age. If children are otherwise developmentally and physically well, they may be getting enough sleep for them.”

Get some rest!

Parents who are struggling to get their babies into good sleep habits but can’t face controlled crying, all is not lost. There are other things you can try!

Dr. Kumar has provided his top tips for ensuring your little one (and you!) get a good night’s rest:

• Make sure they have plenty of physical exertion in the afternoon.

• Stick to a consistent daily bedtime.

• Give them their last drink 1–1.5 hours before bed. This reduces the chance of nocturia.

• Avoid stimulating food and drinks like sugar and caffeine.

• Engage in wind-down time in the hour before attempting to settle them to sleep like reading, board games and calming music.

• No screens whatsoever for at least an hour before bed.

• Low light during settling: red coloured light if night light is needed as this does not interfere with the natural melatonin production.

• Having a transitional object like a soft toy to develop sleep confidence and a healthy sleep association.

• Limit the fuss after lights out such as phrases like: ‘I am going to give you one last kiss then it’s time to sleep’.

• Reduce your attention to the child after ‘lights out’ to prevent reinforcing messages of attention - avoid eye contact and conversation for example.