Will cry-it-out hurt your baby?

The Pediatric Insider

© 2013 Roy Benaroch, MD

Jess, like many parents, has been hearing conflicting information about what crying can do to your baby. She wrote: “So, my husband and I accidentally let our kiddo (5.5 months) cry it out. So of course, I’m spending all sorts of time on Google finding out that I’ve caused long-term damage to my son and he’ll be more likely to get ADHD and be dumber now that I’ve let him cry. I know the studies on cortisol show that some longer-term stress may be evident (at least for a few days), but are there any other real, scientific studies that show long-term damage due to cry it out? I’m pretty sure the other studies cited in the article above are irrelevant to this–am I right? I know you’ve written about cry it out before, but with all the hype, can you clarify?”

A friend of mine is working on a project called “Guilt Free Childbirth”, meant to dispel the guilt and hand-wringing that so many families seem to experience during and after childbirth. What if I need a c-section? What if I can’t do it “naturally”? What if I can’t “bond” instantly with my baby?

This cry-it-out worry—I think I could make an entirely new blog, “Guilt Free Parenting,” just to try to dispel this nonsense. Parents are so saturated with messages telling you that everything—I mean everything—we do is wrong, it’s a wonder we don’t all just curl up in a ball in the closet sucking our thumbs.

Wait, thumbsucking. That’s bad, too.

Anyway: the sky isn’t falling. We are not raising warped, worthless, sick, incompetent kids. There are always things parents could do better (including me!), but that doesn’t mean that if we don’t do everything “right”, our kids will suffer.

Back to cry-it-out: babies don’t always learn to sleep straight through the night on their own, and there are several competing “methods” to help nudge them towards independence. Some parents are very eager to help train, others take a more “easy-going” approach. How you tackle this depends on how parents feel about the importance of a good night’s sleep, and also on the temperament of the baby. I am not going to declare that any one method is perfect for everyone.

But if sleeping through the night is a priority, I have offered up one simple solution that works well for many families. Yes, there is crying. No, I don’t think there is any good evidence that shows any lasting ill effects from letting your baby cry some. There are certainly lots of web sites, pro and con, and lots of people with strong opinions—sometimes they’ll even comment in ALL CAPS for emphasis. But you are not damaging your child by letting tears fall without instant intervention.

Babies have been crying for many, many years. It is how they get our attention. If crying were so damaging, well, I don’t think any of us would have survived.

Jess included an example of reporting that stressed the damage done by cry-it-out sleep training, a list of 10 reasons it’s bad for babies. Most of the reasons were undocumented opinions from the author, who has clearly made up her mind on this issue. The references that were included are rife with methodologic issues—especially retrospective bias (of course parents with children who are thought of as problematic are going to report more sleep issues, in retrospect, when asked), or skim though the complex issue of cause-and-effect. That is, did the excessive crying cause the later problems, or are children who are temperamentally difficult more likely to resist sleep and more likely to later experience emotional problems? One thing may not cause the other, even if they are correlated.

Studies of levels of the cortisol rely on that hormone as a biomarker of stress, and cortisol does indeed increase with stress in humans and other animals. But is that bad? Didn’t human babies always have stress in their lives? Some studies point out that cortisol can change the way brains develop, or can perhaps contribute to the pruning of interconnections between neurons- but that is a normal process that occurs in the development of the human brain. Interfering with this process by avoiding undue “stress” may actually be harmful in the long run.

Or maybe not. I am not saying that babies need to cry to be healthy. Certainly I spent a lot of time holding and reassuring my babies (and even babies in my practice!) But these studies that some claim show cry-it-out = bad for babies, it’s a stretch. And it is not something that parents ought to be worrying about.

Though there aren’t a lot of great, long-term, clinical studies of the consequences of these different sleep approaches, one published last year was reassuring—a method that allowed more crying didn’t lead to scary consequences later.

Also: there are consequences to poor sleep, both for babies and for parents. Underslept babies are fussy and unhappy. Underslept parents are irritable and miserable, and may be more likely to get in car accidents, get divorced, or smack their child. It’s not unreasonable for parents to want to take an active role in pushing towards a good night’s sleep.

A great website with far more detail and insight into baby sleep issues is at www.troublesometots.com—including a detailed guide to one common-sense way to help babies learn to sleep better. Yes, there may be some crying. It’s OK.

Explore posts in the same categories: Guilt Free Parenting, In the news, Medical problems

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7 Comments on “Will cry-it-out hurt your baby?”

  1. oldmdgirl Says:

    The troublesometots website really is a lifesaver. Seriously.


  2. araikwao Says:

    I love that website too! Although Alexis is a big proponent of swings for sleeping, which doesn’t agree with a recent post (but Dr Karp is also for it, I believe)….feel free to jump in Dr B!!


  3. Dr. Roy Says:

    Babies will occasionally fall asleep in a swing, or a car seat– parents don’t need to immediately remove them or worry about these kinds of naps. But they’re not for routine sleeping.


  4. Alexis Says:

    I second the guilt-free parenting idea. There’s also a bit of “fear of the day” coming out of the news. Mold in your sponge will poison your baby! Chemicals in the bottles are poisoning your baby! Too much floor time is bad for baby! Not enough floor time is bad for baby! It’s unending!


  5. Jess Says:

    Thanks for addressing my question so thoroughly! My rational/scientific mind knows that it can’t be THAT bad, but those damn parents out in I’m-awesomer-than-you land can get to you when your (sleep-deprived) mind lets them. Thanks again for the perspective!


  6. Micah Says:

    Dear Dr. Roy,

    Thank you for this article. Nothing should be more obvious that each baby is different, and that each one will respond to different techniques. If these “correct answer machines” that are always forcing tips down the throat of other parents felt confident about their methods, they wouldn’t feel the need to force it down the throats of every other parent they meet, which is a sign of insecurity, not confidence, in one’s parenting style.

    These people should understand that babies are not homogenous, like a batch of quality controlled milk duds, and there is not “one right way” that works for every baby. I’m sure the tricks they used for their babies worked fantastically and they swear by them. But if their tricks really worked that great, they wouldn’t be trying to raise other people’s kids. This is why I like your blog, because your advice is unobtrusive and considers multiple angles. Thanks for what you do.


  7. Wiebke Says:

    Sorry, but your arguments are weak. Crying is not bad because we have not died out? Seriously? Also that supposedly reassuring study only followed up for a few years. Unless you follow up until adulthood of the children, you cannot conclude that letting them cry does not cause harm on the long term. I would be very interested in a study that examines the relation between psychological problems of adults with how they were treated as babies.

    I think parents should listen to their instincts, which likely tell them to soothe their crying baby.


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