THE CRY-IT-OUT CONTROVERSY

I’m coming out. My name is Alice, and I sleep-trained my daughter. I let her cry while she learned to go to sleep on her own. Yes, I let her cry-it-out.I have since learned that letting babies cry is very controversial. Spend a little time on parenting forums or blogs, and you will find that some feel cry-it-out (CIO) is akin to child abuse. Recently, there have been several online articles that claim there is scientific evidence that CIO can cause lasting damage to a child’s brain. The Psychology Today article by Darcia Narvaez (Dangers of “Crying It Out”) was widely shared and retold to huge audiences on Babble, Huffington Post, and Yahoo Shine.I read these articles with concern. Many, many families use some form of CIO and find that it helps everyone in the family sleep better. As the theories about CIO and brain damage bounced around parenting communities, I wondered how many families were second-guessing the choices they had made. Were their kids really at risk for brain damage and long-term relationship problems?Closer to my heart, had my decisions put BabyC at risk? My love for my daughter is beyond words. The focus of my every day is on doing the best thing for her, and to me that means being sensitive, respectful, responsive, and patient. Some days, I am overwhelmed by the weight of that responsibility, but that is motherhood, isn’t it? When someone tells me that I may have harmed my child, I take it very seriously.Sleep is intensely personal, and writing about this topic is hard for me, but I feel that CIO is something that I have to write about. When a parenting practice becomes controversial and “hot-button,” as CIO has, we often shy away from talking about it. None of us like to feel judged, and I personally have no interest in judging others. While the loudest voices continue to shout rhetoric, many parents internalize the self-doubt and then feel paralyzed with fear that they are making the wrong choices for their kids. I want to write about this topic with open-hearted honesty and respect for all the different ways families find to get sleep.This is the first in a series of at least three posts on sleep and stress in babies. In future posts, I will focus on what science tells us about the risks and benefits of sleep training. My goal is to provide parents with an honest interpretation of the science so that they can make informed decisions about sleep in their families. This is important to me, because while I have seen many articles citing science in discussing the risks of CIO, all of these writers have an obvious anti-CIO bias and are not presenting a balanced view of the research with all its limitations. (As a rule of thumb, if you ever read an article citing scientific evidence that doesn’t_mention its limitations, the author has not presented the full story.)Of course, how sleep looks for any given child depends on age and temperament, as well as parenting philosophy. For example, families that choose to co-sleep may find there is never a need for CIO, but co-sleeping is not right for all families. Even with co-sleeping, there is sometimes a need for a transition (less nighttime nursing, for example) that is faced with resistance from baby. My hope is that my posts on this topic will empower parents to focus on trying to understand and respect the needs of each child, within the context of their family, rather than worry about someone else’s opinion about how you and your baby should get sleep.One problem with talking about CIO is that it has many definitions. Some assume that CIO means putting the baby down for bed, shutting the door, and not returning until morning, but I think that very few families actually try this method. Most families use some version of the method popularized by Richard Ferber, which involves letting the baby cry but returning to comfort her at gradually increasing intervals. Other families may allow the baby to cry but stay with her during this time, perhaps gradually removing that presence as the baby becomes more comfortable falling asleep on her own. There are countless variations of “sleep training” and CIO, because all babies and all parents are different in the way they handle this transition. I use the term CIO, but to me, it means asking the baby to fall asleep, at some point without parental presence, and accepting that some crying may be involved in this process. I also want to separate this discussion from night wakings. We can ask babies to fall asleep on their own but still respond to their needs for food and comfort during the night.What did sleep training look like in our house?Beyond the first week or two of her life, sleep did not come easily to BabyC. She rarely fell asleep while nursing, and while my friends’ babies were lulled to sleep in the car, BabyC screamed through entire car rides. The one magical combination that worked to sooth her and help her sleep was to swaddle her, put her in a sling, and bounce on an exercise ball. Husband and I spent more time bouncing on that ball, day and night, than any other single activity during the first few months of BabyC’s life.Soon, BabyC knew of only two ways to go to sleep: going for a walk in a front carrier and bouncing on that damn ball. We took lots of walking naps during the day, but I couldn’t walk all night long. And so, we bounced. As BabyC got older, she required more and more bouncing to get to a deep sleep, often 30-60 minutes by the time she was a few months old. Then we would stealthily ease her into her bed, but she would often wake up as soon as the bouncing stopped, and we’d have to start the process all over again. She was also waking about every 45 minutes between her initial 9 PM bedtime and midnight. At these times and later in the night, I would see if BabyC wanted to nurse, and then we would go through the bouncing routine all over again to get her back to sleep. It is one thing to bounce for an hour at 9 PM, but at 3 AM, it is an entirely different endeavor.At this point, we had already “sleep-trained” BabyC. We had trained her (or she had trained us, depending on your perspective) to need bouncing in order to sleep. I hated the thought that her brain only knew how to transition to sleep when it was bouncing up and down. And I hated the feeling that I was trying to trick her by bouncing her to sleep and then sneaking her into bed, fingers crossed that she wouldn’t notice that the movement had stopped. Of course, all babies have developed strong sleep associations by this age. Some require a nipple in their mouth, be it boob, bottle, or pacifier, to fall asleep. Some babies need to be rocked to sleep, and some prefer a mechanical swing. A friend’s baby simply needed to be swaddled in his crib – his eyes drifted shut just as she was tucking in the blanket.None of these things worked for my baby. In hindsight, I wonder what we could have done differently from the very start so that we didn’t end up in this bouncing dilemma, but I think many new parents find themselves in a similar situation. After all, everyone tells you to do whatever works to soothe the baby and help her sleep. Bouncing worked, until it didn’t.When she was three months old, we decided that we needed to break BabyC’s sleep association with bouncing. I decided to transition her to rocking to sleep. That at least seemed more restful than bouncing, and I figured we could then slowly work on falling asleep without motion. We would snuggle into the rocking chair for a quiet bedtime routine of nursing and reading. Finally, I held her close and sang her sweet lullabies. And BabyC? She wailed. She cried in my arms for up to an hour at a time before every nap and every nighttime sleep. She was exhausted but didn’t know how to go to sleep. She looked at me, pleadingly, as if to ask, “It is time to sleep – why won’t you just bounce me?” I told her, in my calmest, most patient voice, “BabyC, we aren’t going to bounce to sleep anymore. This is the new way to fall asleep.” I kept this up for two weeks – trying fast rocking, slow rocking, and simply holding her with stillness – but she wasn’t buying it. Letting her cry in my arms wasn’t working, and I had a sense of doom that if it ever did, we would then be saddled with a new sleep association that we would need to break.At this point, I finally had to admit that my presence wasn’t helping BabyC in her struggle to fall asleep. This is a very difficult thing for a new mother to do. For the first time, I had to accept that I couldn’t buffer her from every struggle in life. She needed a little space to learn to sleep on her own.And so, one night, after our bedtime routine, Husband and I put a tired BabyC in her crib and told her that it was time to go to sleep. We told her that we knew this was hard for her and that it was hard for us, too. We told her that we loved her more than anything, and then we left. She cried, and we returned periodically to reassure her with a gentle voice and touch. The first night, there was a lot of crying, but by the third night, she fussed for only a few minutes before falling asleep.Over the course of a few days, BabyC went from being a baby who struggled to fall asleep, despite all of our soothing, to a baby that went to sleep easily on her own and only woke once per night to nurse. (She continued to have one nighttime feeding until she dropped it on her own around 8 months.) She went from having fragmented nighttime sleep of about 8 hours to sleeping 12 hours per night. We would often wake to the sound of her babbling contentedly in her crib after a good night’s sleep, whereas before our mornings began abruptly with the sound of her crying. She was more cheerful and engaged during the day, and she cried less_ overall, certainly less than she did when I was letting her cry in my arms. I was finally getting some sleep, too, and I no longer had that horrible feeling of resentment that sometimes crept into my heart when I was bouncing BabyC at 2 AM, my back and neck aching. I was well-rested and able to be a responsive, sensitive mom, day and night.I don’t doubt that sleep training was stressful to BabyC for a few nights, and I would probably do things a bit differently the next time around, but for us, the benefits to our entire family were beyond measure. However, I want to assure you that I did not set out on my research on this topic looking for justification for CIO. Husband and I hope to have another child someday, and I genuinely want to know if CIO is safe before I consider using it with kid #2. And as always, I take very seriously the responsibility of explaining science honestly on this blog.  I did not pick and choose research to support one side or the other – I simply describe what I found and what I think it means.Stay tuned for my posts on the science of sleep and stress in babies. In the meantime, I would love to hear how you helped your babies get to sleep, whether or not it involved crying. The more stories we can share with each other about what worked in our families, the more we realize that there is no one-size-fits-all solution.Want to read more about my research on infant sleep? I became slightly obsessed with it and wrote lots about it! Be sure to read the comment threads – there is great discussion and parental wisdom in the stories from other parents!