Why NOT Sleep Train Infants

As part of CAPPA’s Postpartum Doula Scope of Practice, doulas DO NOT teach a “cry it out” approach for infant sleep.  Why is that?  There has been an abundance of research on infant sleep and the possible results of using a controlled crying method to get babies to “sleep through the night”.  The bottom line is that the chronic stress these methods produce, is bad for the infant’s brain, just as chronic stress is bad for anyone.   Many studies have shown that even though the baby seems to be quiet and sleeping after a controlled crying method has been implemented, their cortisol levels are still very high.  Neurons die when the baby is stressed.    Chronic stress in infancy and early childhood has been identified as a major contributor to adult health problems. 

The rise of Behaviorism over the last few centuries has said that if you respond to crying babies you are just reinforcing the crying.  Anthropological and psychological research demonstrates that the opposite is true. Babies whose cries are answered in infancy tend to cry less in later infancy and beyond.  Neuroscience confirms that letting babies get distressed is a practice that can damage children and their relational capacities in many ways over the long term.

Self-soothing and regulation is not something babies are able to do.  Human babies are one of the most immature mammals at birth and are not ready for the world for another 9 to 18 months.  Unrealistic expectations about infants’ abilities to self-regulate and sleep longer, uninterrupted cycles, cause parental anxiety and more stress for the whole family.  Understanding that babies don’t self-comfort in isolation when left to cry alone, they learn to shut down in the face of overwhelming distress.  They may stop growing, stop feeding and stop trusting.  Responsive care is what’s needed for all infants at least for the first year.  This means meeting the baby’s needs before he gets stressed.  This tunes up his body and brain for calmness. Forcing independence on a baby can lead to greater dependence.  Research has proved that giving babies what they need can lead to greater independence later.  Sleep training is the opposite of this responsiveness.  Caregiver responsiveness is also related to intelligence, empathy, lack of aggression or depression, self-regulation and social competence. 

Sleep training assumes that babies can be taught to sleep, wake and be hungry on someone else’s timetable, and to understand that they are really safe and cared for even when they are left alone and unattended.  There is also the assumption that babies can and should adapt to parents’ desires rather than parents adapting to babies’ needs.  Sleep training techniques work for about 80% of babies and parents are generally pleased with the short-term results.  But research confirms that sleep training of any kind can be damaging in the long-term and isn’t actually doing in the short-term what is claimed.  Sleep training research tends to gauge success by adult satisfaction and the speed and extent of infant compliance, not by the physiological effects and long-term consequences.  The Australian Association of Infant Mental Health was so concerned about the controlled crying techniques for infant sleep that they issued the following statement, “controlled crying is not consistent with what infants need for their optimal emotional and psychological health and may have unintended negative consequences.”