ControverSunday: Free Topic Week

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This week is free topic week. So please join us if you would like! Check out Accidents to get the badge code (and to thank her for the cool badge) and start writing. Then head over to our lovely host, Perpetua to tell us you are in this week.

Here is the current list of blogs with ControverSunday posts:

The Mothering Life

Mommy-in-Chief

Accidents will happen.

Our Lady of Perpetual Bread Crumbs

I have decided this week to get really controversial. I am taking a stand and I just don’t care. I will do my best to do it in an un-judgy way, but I just can’t hold it in anymore. My topic: Sleep. Baby sleep.

I get really frustrated seeing claims that Cry-it-out (CIO) causes brain damage. It is just an other example of people trying to scare parents into (or out of) making a particular choice in parenting, rather then making decisions based on the unique nature of their child.

(Quick definition of CIO: A Sleep ‘training’ method whereby you put sleepy baby in crib and let them cry themselves to sleep. There are different methods, typically going in to sooth baby at regular intervals. But the main idea is that baby learns to fall asleep on their own without parental intervention.)

I can more then accept if any given parent decides CIO is not for them and not right for their baby. There are lots of babies and families for whom it is just not right for. I have no problem with that. I am not going to tell you how to get your baby to sleep. Do whatever works for you. You know your child better then anyone else- so trust yourself.

But please, oh please, do not give me the ‘letting your baby cry causes brain damage’ line. Now I am sure that my little blog is not going to be able to put this debate to rest, wish as I may. I also realize I may be setting myself up for quite the lashing should this post get read by someone who strongly advocates against CIO. I don’t know what I am thinking taking on this battle. But I am going to give it a go anyway.

Here is an excerpt from an article by Dr. Stephen Juan that sites three different sources/studies regarding brain damage and CIO. I found this article quoted on quite a few blogs, but I think it was originally published here in the National Post.

“According to a University of Pittsburgh study by Dr M DeBellis and seven colleagues, published in Biological Psychiatry in 2004, children who suffer early trauma generally develop smaller brains.

A Harvard University study by Dr M Teicher and five colleagues, also published in Biological Psychiatry, claims that the brain areas affected by severe distress are the limbic system, the left hemisphere, and the corpus callosum. Additional areas that may be involved are the hippocampus and the orbitofrontal cortex.

The Science of Parenting by Dr Margot Sunderland (Dorling Kindersley, 2006) is a recently published book that points out some of the brain damaging effects that can occur if parents fail to properly nurture a baby – and that means not allowing them to “cry it out”.”

“Allowing a baby to “cry it out” when they are upset will probably be regarded as child abuse by future generations.”

My first problem is that this article doesn’t provide any context. How much crying are we talking about? 45 minutes everyday for a week? Three hours every day for six months? Did it look at babies that had colic (who often cry for more then 3 hours a day, especially in the first 3 months)? How old were these babies (most CIO methods discourage using this method for babies under 4 months, usually 6 months)? Were they generally neglected or were they generally loved and responded to? Was CIO used even when they had an unmet need (for example- they were still hungry or wet or sick)? Did they look at babies who had different personalities and responses to CIO (I will explain what I mean below)? How big were these studies? What was the result for the children in terms of their actual abilities? What kind of brain damage are we talking about? (No brain damage is good, but I think it is important to quantify the impacts, as the range of possible impacts of brain damage could vary from undetectable within the normal range of development to unable to function in society.)

I think it is so irresponsible to site and and make claims based on studies without giving the reader at least some context. The author and reader of the original study are making conclusions that could be very biased by their perspective. For example, I found the article in Biological Psychiatry by Dr. Teicher. The study was of children whom had been neglected and abused, not a study of any particular sleep training method.

I suspect that the other studies were also not on the effects of varying sleep ‘training’ or non-training (like co-sleeping) methods, but rather on the effects of excessive crying due to neglect. I very much doubt these were babies older then 6 months whose parents are loving and responsive to their needs, but chose to use CIO because they felt it was the most appropriate method for the personality of their particular baby.  If anyone can actually find either of the other studies and wants to send them to me to read, that would be awesome. Otherwise, my best guess is that this a case of taking a study and using it to back up ones beliefs and agenda by going beyond what one could reasonably concluded.

When I read each of these paragraphs I sited above I don’t question the author claims about what these studies are saying: “children who suffer early trauma generally develop smaller brains”; “brain areas affected by severe distress are the limbic system, the left hemisphere, and the corpus callosum”;”the brain damaging effects that can occur if parents fail to properly nurture a baby.” This all seems relatively reasonable to me.

What I question is the leap the author has made that CIO actually causes the type of “early trauma”, “severe distress” and ‘failure of nurturing’ that these studies were looking at.

Don’t get me wrong- I don’t think CIO is the responsible choice for every parent and every child. I 100% agree the concept suggested by Moxie of Ask Moxie that some babies are tension releasers and some babies are tension increasers. This means for some babies, the act of crying gets them more and more upset. They can very quickly reach full panic that I don’t doubt isn’t in the child’s best interest if parents let it go on too long on a regular basis. If you have a ‘tension increaser’ baby CIO is probably not the best option, especially if used very strictly. Then again, I don’t have a ‘tension increaser’ baby; I trust that each parent can make the decision for their particular child as to the appropriateness and effectiveness of CIO. However, if you happen to have a ‘tension decreaser’ baby, in that they fuss and cry on and off and in decreasing severity until they are relaxed and fall asleep, I very much doubt it would have any ill effects. Especially if that child is well bonded to their parents and it shown lots of love and affection throughout the day.

I also have to say that I don’t think we give babies enough credit in terms of their ability to learn limitations. If my daughter can learn at 9 months to “pat your head” when you say that phrase, then she can understand that at night, when all her needs are meet and Mommy and Daddy have shown her love all day, that it is time to sleep. It is a reasonable boundary and limitation that is set there. It is not ignoring her for the sake of ignoring her. It is telling her that it is time to sleep, something that is very important to her well-being. Babies are far more aware of what is happening around them then we think. When we assume that they won’t understand that letting them fuss to sleep doesn’t mean we are not responsive to their needs, then we are doing them a disservice, in my opinion. Again, this is not an argument for any given parent to use CIO, just an argument against branding CIO as being unresponsive and neglectful by definition.

There are so many choices that we make as parents that someone will try and tell us are harmful, even abusive, to our children. I will say it again, I think this is irresponsible. If you want to promote your suggested method of getting babies to sleep as being the most beneficial and effective- go for it. Any tired parent is up for suggestions. But don’t build your method up by leveling ridiculous claims of harm and abuse on an other method. Or by making a false connection beyond the scope of a study to the application of a particular parenting choice. Furthermore, if you are going to critique a particular parenting choice do by looking at the way that parenting choice is typically applied, rather then its extreme application. I have seen many Anti-CIO posts that refer to how cruel it is to put a baby in a crib and leave them there for 12 hours come hell or high water. But very few, if any, parents I have heard of actually apply CIO this strictly. Most parents I have talked to using CIO err on the side of responding too much crying rather then ignoring it.

Because I think context is important, I will share with you how we have used CIO:

Based on the suggestions of the book “Bed Timing” we waited until our daughter was 5 1/2 months to try CIO. As the book argues, that is the first window of opportunity where it is appropriate in the babies development to attempt any type of sleep ‘training’ method, be it CIO or ‘No-Cry’. At about the same time, our daughter, who we rocked and held until she feel asleep from birth, suddenly rejected any attempt on our part to help her fall asleep by soothing her. She would SCREAM and arch her back. We tried everything. We tried all the “No Cry Sleep Solution” techniques, which are fabulous, by the way. That book really helped us to create a soothing, calming, predictable routine that helped her get ready for bed. But in terms of actually falling asleep- if either my husband or I were within eye sight of her, she would not fall asleep. It was taking hours to put her down. There was A LOT of crying going on. A LOT, A LOT. Our baby was not a happy baby at bedtime and I am sure it was possible that she felt her need (which we discovered was to be left alone) was not being met. Eventually, we used a calm, soothing bedtime routine and then put her down in her crib and walked away.

The first night she cried, on and off, for about 45 minutes. The next night it was about 30. I think the next night was about 25. Within a week or so she fussed for a couple minutes on and off and then went to sleep. From then on, she was good. She doesn’t always go to sleep right away, sometimes she fusses or babbles for up to 45 minutes- but she rarely crys. When she does cry it is typically for only 5 minutes. This will sometimes happen during a change of routine (like being on vacation as I recently found out), or if she can tell I am a bit stressed out (like when I do our monthly budget- ekk!), or if she is going through a particularly clingy developmental stage (like the onset of separation anxiety at 8 months) or if she is sick (like the ‘flu like symptoms’ she got after her H1N1 shot). These are exceptions and we treat them as such.

I should also note, that when we started CIO we went in at regular intervals to soothe her. She would have none of it; holding her up, talking to her, rubbing her back, all of this just seemed to keep her awake, rather then help her fall asleep. My instinct told me to let her be. So we did, and she had a much easier time falling asleep after that.

We also learned pretty quickly that there was a difference between her “I just need to fuss to fall asleep cry” and her “come and get me because I need something” cry. And if she did the “I need something” cry we are in their faster then you can say ‘baby.’ She gets what she needs: new diaper, more formula, an extra hug, a kind soothing word, advil if she has some serious teething going on, ect. She is never neglected. But she will not fall asleep unless we leave her be. That is just how she is.

I have said this a number of times, but I am going to say it again. We need to stop judging and making broad universal claims about how to raise our kids. They are all built differently, they all need different things and they are all unique. We need to treat them as such. I believe it is important to take into account their uniqueness when we making parenting decisions. And accept that we aren’t all going to do this gig they call parenting the same way. This is a good thing- not a bad thing. Trust your fellow parents that they know their kids better then anyone else and they are trying their best to do what is right by their kid. Share ideas, great tips and support. But enough with the scare tactic bull, its not helping anyone.

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20 responses to “ControverSunday: Free Topic Week

  1. Cheryl March 7, 2010 at 11:55 am

    Please always trust your gut when you have something to say! Because when you do, it is valid, well thought out and thought provoking.

    I said many times when asking for or receiving parenting advice that, even though everyone else had kids, no one else had my kid. Every book, every theory, every parenting style has it’s faults and there will be never be a one-size-fits-all answer. We do have to try harder to support, rather than judge, one another.

  2. Perpetua March 7, 2010 at 12:06 pm

    This is really great. I’ve actually never heard the “CIO causes brain damage” claim. I have no doubt that “severe trauma” causes changes in brain development, but in what way does CIO count as severe trauma? I’m fairly sure that the medical definition of “crying too much” is 3 hours of non-stop crying (this is always the rule of thumb when caring for a sick child, at least). I would imagine most parents would give up CIO at that point anyway, but in any case, I can’t see how CIO could constitute severe trauma. (On the contrary, if it were a trauma, wouldn’t it make the child’s sleeping habits worse?)

    I’m glad it worked for you guys!

    • amoment2think March 7, 2010 at 8:11 pm

      Interesting. Yes, I would agree that most parents would likely give up CIO before that point. I certainly would have given up far before the 3 hour mark.

  3. Cheryl March 7, 2010 at 1:04 pm

    I’ve never heard about the CIO brain damage “connection” (I use the term loosely) either. I am mortified that anyone would say, “Allowing a baby to “cry it out” when they are upset will probably be regarded as child abuse by future generations.” Sure, terrify every parent whose child has cried at bedtime. Great.

    You’re so right about the scare tactics; I am so tired of fear mongering and judgment that pushes parents into decisions they aren’t happy with. Why set us all up for failure by parading around this illusion of a “perfect” parent we have to live up to?

    • amoment2think March 7, 2010 at 8:12 pm

      I totally agree about the illusion of the perfect parent. None of us are perfect and we are all just trying to get through the day and do the best for our children.

  4. Brooke March 7, 2010 at 1:36 pm

    I have seen that at some point nearly every parent, whether they started CIO-friendly or not, has to eventually let them cry to sleep. It has worked wonders for us, and I agree that my son doesn’t seem to exhibit any signs of brain trauma or damage.

  5. Fearless Formula Feeder March 7, 2010 at 1:43 pm

    I love you more each day. 🙂

    First of all – I know how scary it can be to take a stand. But you are actually taking more of a middle ground than a position that should be taken as inflammatory. Not that this will stop certain people from taking it as such, but I think it’s an important distinction. There are 2 types of people in the blogosphere, I’ve found: those that think things are black and white, and those that allow for the possibility that their own choices are not right for everyone. You are obviously the latter and there is NOTHING offensive about anything you’ve written. So there.

    Now, to your subject… I had never heard people claim that CIO caused brain damage. Geesh. I had heard interviews with Dr. Ferber, who seems quite downtrodden by the attachment parent faction who’ve villianized the guy… but no matter how many times he tries to explain that his methods have been misunderstood, it falls on deaf ears.

    We did Ferber after trying all the no-cry methods, around 5 months or so. I was scared to death about it, and prepared for hell – my kid was not shy about the wailing, in any situation, so I figured it would be a horrible battle of wills, and my son would win. But we were all shocked by what happened. He cried for 1 hour total, but since we were doing Ferber, I went in and soothed him by putting a hand on his back and whispering to him in increasing increments – first 2 minutes, then 4, then 8, etc. The longest I ever let him cry was 10 min. And the whole thing lasted an hour, and then he started sleeping through the night the very next day. He was a way happier kid after that too. Obviously, for my son, Ferber was the way to go.

    I’ve seen it fail miserably for other parents, though, and I would never tell them that they should keep at it, or that it is a cure-all. As you said, it works for some, not others.

    I think it comes down to trust. Trust that other parents know how to do their job. And trust in our OWN parenting, not to assume that Dr. Sears, or Spock, or Ferber, or whoever, knows what is right for us or our children. If you try someone’s methods and they don’t feel right for you, then stop. But don’t assume that the same method won’t work for someone else, you know?

    As for the article you cited… welcome to my lovely, angst-filled world. You’ve found Waldo. (I’m assuming you’re my age and will catch that reference…;) ) This is the problem with most parenting “science”. The studies are flawed, inherently, and then you have journalists who are either misinformed or with an agenda… add parents who take news reports as the word of god, and it’s a recipe for disaster.

    This was a FANTASTIC, amazingly well-thought out and researched post on a hot topic. I am constantly amazed by your ability to cut through the bullcrap and write eloquently about it. Good for you, lady.

    • amoment2think March 7, 2010 at 8:25 pm

      Thank you, you are always so supportive.

      Yes, I totally agree about the blogosphere- it is the ‘black and white’ types out there that frustrate me. LOL- waldo. Yes, I find it so frustrating to read stuff like that article, especially as it was originally published in a major national newspaper! And then to see it on at least a dozen blogs as the definitive answer… grrrrr.

      And yes, I totally agree it is about trust of each other and trust in our own parenting instincts. Reading the ‘experts’ is great, but I think too many parents don’t listen to their instincts about what is the best way to parent their child.

  6. Briana March 7, 2010 at 5:55 pm

    We let Wesley cry for brief periods, even though he turned out to be a ‘tension increaser’ just to give him some space to tell us what to do (and us space to calm down!). I don’t think it’s harmful in small doses, as long as the baby is cared for. Nora does cry to release tension, and I try to give her a moment to calm herself before I go pick her up just to see if she can (and sometimes it works!). I am still philosophically opposed to CIO as a cure-all, but I have come to believe there are lots of ways to handle this sleep thing, and a little bit of crying isn’t going to harm a baby in the long run. I do worry when parents let a baby cry for long periods however. It may not damage their brain but I think it probably does harm the parent-child bond somewhat.

    • amoment2think March 7, 2010 at 8:42 pm

      I totally agree that CIO shouldn’t be a cure all, especially because there are a lot of kids that it doesn’t work for at all. And even if it does work for some, that doesn’t mean any parent should feel pressured to use it if they don’t feel comfortable doing so.

      I think because every new parent, especially new Mom, is asked by every stranger, acquaintance, friend and family member if their baby is ‘sleeping through the night’ on an almost daily basis, we feel that somehow we have failed if our babies don’t sleep through the night. I have seen the point made on some attachment parenting blogs that we need to re-evaluate success when it comes to sleep, and I believe I have heard you say that we need to give babies time to figure out the sleep in their own time (I hope I am not putting words in your mouth). I totally agree on both points. I also don’t doubt there are parents out there, whom feeling the pressure from others and in a state of desperate exhaustion, try CIO and let their babies cry a bit to long. And yes, it may have an impact on the parent-child bond. Although I think most babies are pretty resilient, provided they live in a loving environment. But I think that this is just an other argument for providing more support and less judgment to parents. I think parents who feel less judgment and pressure to achieve “perfect” parenthood will trust their instincts more and therefore make better decisions for their child, be that not using CIO at all or using it when appropriate.

  7. Sophie March 7, 2010 at 8:51 pm

    Very interesting post! I was philosophically opposed to CIO methods until at about 5 1/2 months our baby went from sleeping 6 hours in a row to 4, then 2, then 1, then 30 minutes, then he would wake up 15 minutes after I had nursed him to sleep again. At that point, I was simply going crazy. I was so exhausted that we had to do something. That something, for us, was to let him cry a bit.

    I don’t think I could have done it by myself – it was so hard at first, I would cry as much as he did. But Zak helped me see that there was no other way for us, because I was really at the end of my roll. And lo and behold, it worked! I don’t think he ever cried for much more than 15 minutes at a time, even though it seemed like the longest 15 minutes of my life.

    So I agree with you that it doesn’t work for everyone, but if it’s what it takes, in my book, it’s better to have sane parents who are somewhat rested and can take good care of their child all day long – even if that comes with the price of crying for a few minutes in the evening – than having zombie parents who get increasingly frustrated with their child all day, but respond to his needs at night. Just my two cents…

    • amoment2think March 7, 2010 at 9:39 pm

      Yes! I totally agree with you- “it’s better to have sane parents who are somewhat rested and can take good care of their child all day long – even if that comes with the price of crying for a few minutes in the evening – than having zombie parents who get increasingly frustrated with their child all day, but respond to his needs at night” That is such a good point.

      I think in both of our cases we let our babies take the lead- they got to a point that what we were doing just wasn’t working for them anymore (because the little buggers change all the time) and so we needed to adjust by changing our methods. I think it is that kind of responsiveness to our individual babies needs that is most important. We both choose to use CIO, not because we felt pressure to get our babies to sleep through the night by a particular developmental milestone, but because their behavior around sleep dramatically changed, signaling to us that they needed something different from us.

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  9. Megan March 8, 2010 at 9:30 pm

    Okay, I’m late to the party here, but I wanted to throw in my two cents.

    I, like many of you, never heard of the brain damage thing. But, I have seen people on the internet referring to CIO as cruel, unnatural, torture, etc. I was never opposed to it, but I didn’t think it was for us. Charlotte would start the night in her crib, wake a couple hours later, at which point I would just bring her to bed with us. Then she’d sleep and nurse alternately the rest of the night. It wasn’t restful sleep, but it was working out.

    But, much like Sophie’s situation, the intervals between wakings were getting shorter and shorter until she just wasn’t sleeping at all. Nursing her wasn’t putting her back to sleep, rocking her didn’t work because she would wake up as soon as we put her down, and bringing her to bed stopped working because she wanted to play with us. I really feel that we had no other option.

    It was a gut-wrenching 30 minutes the first night. But then she slept all night, and she continued to do so from that point on. And she was happy and rested and still loved her mommy and daddy. Unfortunately, due to a possible case of separation anxiety or because we fell back into bad habits with nursing her to sleep, etc. she isn’t sleeping so well these days, and CIO is NOT working. So, we adjust.

    But, I stand by my claim that it was necessary and NOT cruel. I think allowing a baby to never sleep is worse than doing what’s necessary to help her get the rest she needs. So, whatever method works for you, go for it.

    Great post!

    • amoment2think March 9, 2010 at 8:59 am

      Here her. Whatever works.

      Also, just a note to those of you who have mentioned here, or on twitter, that CIO/any type of sleep training has not worked for you…. I really do recommend the book “Bed Timing” by Lewis and Granic. It is a wonderful resource because it talks about ‘when’ in babies development that using any ‘sleep training’ method (including the ‘No Cry’ Methods) are most likely to be effective. The authors argue that many many parents try various methods of trying to get their kids to sleep through the night and it doesn’t work out because of when they try, not what they try. And it is my favourite brand of parenting book because it is un-judgy and takes a new perspective on the whole thing.

  10. Kader March 9, 2010 at 1:15 pm

    Great post. Thanks so much for writing it. We did CIO, and it worked. Our now 7-month-old is good at soothing himself to sleep. He is a happy, smiley guy during his waking hours. Despite that obvious evidence, I still feel sick when I see references to the CIO causes brain damage crap. I *know* CIO didn’t harm our child–in fact, I think his increased sleep has been really good for him. But the idea that someone thinks we would purposely cause permanent damage to our sweet child makes me both ill and angry.
    So, as I said, great post!

  11. Ellen M March 10, 2010 at 9:35 am

    What bugs me about the CIO/Anti-CIO debate is how both sides lay claim to science. I’m sorry, you cannot do true scientific sleep studies on babies, the end. So it comes down to a lot of what you say — experience, feelings, instinct, knowing your own baby and yourself. I can’t tell you how many times I’ve heard, “well, you just need to….” or “babies need to….” or “if you don’t….” as if what came after was actual fact.

    We have not CIO’d, though starting at 9ish months, I would put my son down “drowsy but awake” as all the sleep trainers tell you to do ad nauseum. Sometimes there was a little crying, which I’d let go on for a few minutes. If it was more than a few, I’d go in and start over, because I felt that he was a winder-upper, not downer.

    He still has yet to sleep through the night, and wakes 2-3 times/night to nurse . What? you say. Don’t you know that “babies his age don’t need to eat over night, he’s just getting up out of habit”? Well, he’s a small guy, I want him to eat as much as he can, I work full time, and if he needs his mommy, so be it.

    But that’s me, and where I’ve evolved as a mother over the course of a year. Where you’ve evolved is some place different, and in the end, we all have great kids.

    • amoment2think March 10, 2010 at 10:01 am

      Ellen, I think you make two really great points.

      1) You can’t do true scientific sleep studies on babies- it would be incredibly difficult for any study on CIO/not CIO to meet ethical standards. Very good point. And you are totally right- both sides seem to lay claim to science, when that is not really on the table.

      2) Also, that we, as parents, but especially mothers, get told a lot of those “babies need to…” “if you don’t….” phrases. And I agree, they are frustrating, because, every baby is different.

      We do a disservice to each other as parents when we present these phrases as fact. No parent should feel like, if their baby isn’t doing what “they” say babies should be doing, that they should go against what they feel comfortable with to force their baby to change habits before they are ready. Whoever ‘they’ is, they aren’t your kids parent. I do believe in letting baby take the lead, unless the situation is so unbearable to the parents that it is causing major problems. And if change is needed, I think it is best to try and suit the method of change to the personality of the child, if at all possible.

      Thanks for your comments!

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