Thursday, July 22, 2010

Great Article

Cry It Out: The Potential Dangers of Leaving Your Baby to Cry

By Margaret Chuong-Kim





Among parents of infants these days, there is constant debate about how to respond to a baby’s cries. On one hand, there are proponents of the “cry it out” method, where the baby is left alone to cry in the hopes that he or she will eventually stop. On the other hand, there are the “attachment parents” who respond immediately to their crying babies and attempt to soothe them using various methods including holding and cuddling. While the cry-it-out method (CIO) has been popular in previous years, attachment parenting (AP) is gaining a foothold among new parents today. Results of studies in psychology indicate the AP approach to crying is most likely to result in an emotionally and physically healthy child.

Attachment theory originated in the late 1960s when psychologist John Bowlby postulated that a warm, intimate relationship between caregiver and infant is necessary for optimal health as well as for basic survival. As such, each individual is born well-equipped with reflexes and instincts for interacting with their primary caregiver, which is often times the mother. For example, infants quickly learn to recognize and prefer both their mother’s voice and smell. As babies develop some locomotor control they display their desire to be close to their caregivers by reaching toward their mother or father to be picked up or by crawling toward them. From an evolutionary perspective, these behaviours have survival value. Babies who lack such attachment behaviours will stray from their caregivers and are more likely to get lost, attacked, and perish. An infant’s cry is also intended to increase the likelihood of its survival, as a mother’s instinct is usually to go to her child at the first sign of distress.

We live in an age where we can know that the baby is safe in another room, despite the loudness of his cries. Does this mean we should leave babies to cry on their own? CIO proponents often advise that babies left to cry will eventually stop, and the duration of future crying bouts will decrease. What are the emotional consequences of crying for the infant when she is left unattended? Bowlby and colleagues initiated a series of studies where children between the ages of one and two who had good relationships with their mothers were separated from them and left to cry it out. Results showed a predictable sequence of behaviours: The first phase, labeled “protest”, consists of loud crying and extreme restlessness. The second phase, labeled “despair”, consists of monotonous crying, inactivity, and steady withdrawal. The third phase, labeled “detachment”, consists of a renewed interest in surroundings, albeit a remote, distant kind of interest. Thus, it appears that while leaving babies to cry it out can lead to the eventual dissipation of those cries, it also appears that this occurs due to the gradual development of apathy in the child. The child stops crying because she learns that she can no longer hope for the caregiver to provide comfort, not because her distress has been alleviated.

Do babies cry more when they are attended to? A 1986 study concluded just the opposite: the more a mother holds and carries her baby, the less the baby will cry and fuss. Cross-cultural studies also show that parents in non-Western societies are quicker than parents in Western societies to respond to their crying babies, and babies in non-Western societies cry for shorter spans of time. Caregivers in 78% of the world’s cultures respond quickly to an infant’s cries. For instance, Efe caregivers in Africa respond to a baby’s cries within ten seconds at least 85% of the time when the baby is between three and seven weeks, and 75% of the time when the baby is seventeen weeks. !Kung caregivers respond within ten seconds over 90% of the time during the baby’s first three months, and over 80% of the time at one year. In contrast, American and Dutch caregivers have been found to be deliberately unresponsive to an infant’s cries almost 50% of the time during the baby’s first three months. Infants in non-Western societies have been found to fuss just as frequently as those in Western societies, but due to the prompt response of caregivers in non-Western societies, the overall cumulative duration of crying is less than what occurs in Western societies.

According to attachment theory, babies are born without the ability to self-regulate emotions. That is, they find the world to be confusing and disorganized, but do not have the coping abilities required to soothe themselves. Thus, during times of distress, they seek out their caregivers because the physical closeness of the caregiver helps to soothe the infant and to re-establish equilibrium. When the caregiver is consistently responsive and sensitive, the child gradually learns and believes that she is worthy of love, and that other people can be trusted to provide it. She learns that the caregiver is a secure base from which she can explore the world, and if she encounters adversity she can return to her base for support and comfort. This trust in the caregiver results in what is known as a secure individual.

Children who do not have consistently responsive and sensitive caregivers often develop into insecure individuals, characterized by anxious, avoidant, and/or ambivalent interactions. Long-term studies have shown that secure individuals, compared to insecure individuals, are more likely to be outgoing, popular, well-adjusted, compassionate, and altruistic. As adults, secure individuals tend to be comfortable depending on others, readily develop close attachments, and trust their partners. Insecure individuals, on the other hand, tend to be unsettled in their relationships, displaying anxiety (manifesting as possessiveness, jealousy, and clinginess) or avoidance (manifesting as mistrust and a reluctance to depend on others). North American parenting practices, including CIO, are often influenced by fears that children will grow up too dependent. However, an abundance of research shows that regular physical contact, reassurance, and prompt responses to distress in infancy and childhood results in secure and confident adults who are better able to form functional relationships.

It has been suggested in the past that CIO is healthy for infants’ physical development, particularly the lungs. A recent study looking at the immediate and long-term physiologic consequences of infant crying suggests otherwise. The following changes due to infant crying have been documented: increased heart rate and blood pressure, reduced oxygen level, elevated cerebral blood pressure, depleted energy reserves and oxygen, interrupted mother-infant interaction, brain injury, and cardiac dysfunction. The study’s researchers suggested that caregivers should answer infant cries swiftly, consistently, and comprehensively, recommendations which are in line with AP principles.

CIO supporters tend to view their infants’ cries as attempts to manipulate caregivers into providing more attention. Holding this view can be detrimental to the immediate and long-term health of the baby. In the field of cognitive psychology there exists the premise that our thoughts underlie our behaviour. Thus, if we think positively about an individual, our behaviours toward them tend to be positive as well. Conversely, if we think negatively about an individual, we will behave correspondingly. Consider people in your own life whom you consider manipulative – how does that perception influence your behaviour toward them? It is unlikely that the interpretation of a manipulative personality will result in the compassionate, empathetic, and loving care of that individual. Infants, quite helpless without the aid of their caregivers, may suffer both emotional and physical consequences of this type of attitude.

When faced with a crying baby, it may be prudent to ask yourself the following questions: Why am I choosing this response? Do I want my baby to stop crying because he feels comforted and safe, or do I want my baby to stop crying for the sake of stopping crying? What is my baby learning about me and the world when I respond in this manner? If I were a baby and was upset, how would I want my caregivers to respond?



References

Campos, J., et al. (1983). Socioemotional development. In P. Mussen (Ed.), Carmichael’s Manual of Child Psychology: Vol. 2. Infancy and Developmental Psychobiology. New York: Wiley.

Craig, G., Kermis, M., & Digdon, N. (1998). Children Today. Scarborough, ON: Prentice-Hall.

Dacey, J. & Travers, J. (1996). Human Development Across The Lifespan (4th Ed). Boston: McGraw-Hill.

DeCasper, A., & Fifer, W. (1980). Of human bonding: Newborns prefer their mothers’ voices. Science, 208: 1174-76.

Gleitman, H. (1996). Basic Psychology (4th Ed). New York: W.W. Norton.

Hunziker, U. & Barr, R. (1986). Increased carrying reduces infant crying: A randomized controlled trial. Pediatrics, 77(5): 641-8.

Luddington, Hoe, S. Cong, X., & Hashemi, F. (2002). Infant crying: Nature, physiologic consequences, and select interventions. Neonatal Network, 21(2): 29-36.

Macfarlane, A. (1975). Olfaction in the development of social preferences in the human neonate. Parent-Infant Interaction. Amsterdam: CIBA Foundation Symposium.

Mikulincer, M., & Shaver, P. (2001). Attachment theory and intergroup bias: evidence that priming the secure base schema attenuates negative reactions to out-groups. Journal of Personality and Social Psychology, 81(1): 97-115.

Miller, R. (2000). Dysfunctional relationships. In R. Kowalski & M. Leary (Eds.), The Social Psychology of Emotional and Behavioral Problems: Interfaces of Social and Clinical Psychology. Washington, DC: APA.

Waters, E., Wippman, J., & Sroufe, L. (1979). Attachment, positive affect, and competence in the peer group: Two studies in construct validation. Child Development, 50: 821-829.

10 comments:

Robyn said...
This comment has been removed by the author.
Jessica said...

Hi Roy,

The CIO method refers to methods of "sleep-training." You are certainly not the only person who reads my blog that lets their kids cry it out. I can appreciate that the technique "works" in that eventually the child will fall asleep and in time no longer expect a parent to come to them. The point of the article though, is that at what cost? I agree that as parents, we all have to make the decisions for our kids that we deem best. I think this article articulates well why we choose to avoid the CIO method, and our purpose in embracing methods of attachment-promoting behaviors though it's more time-consuming and taxing. :)

Jessica said...

Just saw that you deleted your post- I like the discussion though and am not offended that you disagree. :)

Erica said...

\I think there are times when the parent has to determine what is best for his or her own individual child. I tried letting June cry it out once for a very short time and never did it again because it wasn't the right method for her. And after that experience I really looked down on people who let their child cry for an extended period if time, thinking they were just doing it for their own needs. Wesley is a TOTALLY different baby. He cried it out for the first 9 months of his life. If I were to rock him and try to help him fall asleep he would cry even louder and struggle like mad and become overly stimulated; I tried for hours and hours to soothe him. He NEEDED to be alone and work it out on his own. And believe me I HATED to hear him cry. And I would even go so far to say that I think letting him CIO was more stressful and time consuming for me than holding him and helping him get to sleep. Now that he finally figured it out, he is a great sleeper and truly the happiest baby I know (and I'm not just saying that because I know him and love him, people say it to us all the time). So by no means was letting him CIO an easy way out for us nor did it come at a cost to his happiness, in the end it probably made him happier.



It's interesting what life's experiences (and each child) teach us :)

Emalei said...

I don't have kids yet, but I think about this topic often. My parents let me cry it out, and I think I'm emotionally healthy and also grew up with a healthy relationship with my parents. They did the same with all us kids, and we're all confident, secure, outgoing and are totally connected (and always have been) with my parents.

My husband on the other hand, never cried it out (constant attention from la mamma), and throughout different phases of his life has had serious issues with anxiety, avoidance and mistrust.

My point is that our personalities totally contradict this study. I know that these studies are general and that there are ALWAYS exceptions though. Plus, other events in my husband's life could have contributed to his previous "issues."

I remember reading about these studies in my human development class though, and thinking to myself that I didn't want to let my child cry it out.

I like what Erica said. I think it depends on what the child needs. When we have babies, I think we'll do what's best, and still love and adore and be available for our children, and I think they'll turn out just fine. That said, I think every parent should do what they feel is best for their baby, whether that be letting them COI or not.

Robyn said...

So I guess since it refers to sleep-training, then I guess it is ok to say that I disagree with the attachment thing. (I mean, I know it is OK:), but parenting can get touchy and I didn't want to put my opinion where it wasn't asked for). Anyway, that is what is great, is we each get to do it our own way. I guess I just don't like some one telling me *meaning the article* how I choose to sleep train my kid is wrong. Cute pictures, she is getting big and I see some longer hair is comin'!!

nicole said...

This is a perfect example of the paradoxical nature of parenting. It seems that for every "idea", "method", or "technique" in parenting there is an exact opposite one, as well, and there are always sound reasons and explainations for both sides.
Just wait 'til you get to potty training!! :)

What I love is that you are so committed to your daughter and "doing right" by her upbringing and nurturing. I have always admired your commitment to parenting and its ideals. Thanks so much for sharing this information and starting a discussion that illustrates what excellent mothers you have reading your blog. There are obviously a lot of good parents reading this and trying to do the best they can. I simply love that.

Kelsey said...

I love you Jess! I,as you know, wouldn't consider my parenting or sleep training to fall under CIO or AP. I do think that learning a little bit about responding to your childs cries and considering why they are crying has benefited me. I think a lot of parents think that when their babies/toddlers come over crying or whining to them to be picked up, it's annoying. I know there are times that I feel that way a little. But after learning more, I realized that I never consider why they're crying. They want your affection and attention...they need it. So why not give it to them as much as they need it. It's not like they're asking for candy or money or even a pony...they just want your attention and affection. If they could speak and came up to us and said "mom, dad, I just want to be near you. I need to be comforted, please hold me." ,we'd probably never say no. Crying to us is their only way to get that across. I don't think we can ever spoil our children with too much love... Anyway, just what I got out of learning about to AP style. Sorry I just rambled forever. It's late and I'm a little sleep deprived.

[M] said...

My mom never let me cry (day or night) and always held me and I have very high self esteem (probably shouldn't admit that) and no emotional problems. But I think genetics play a huge roll. I don't think babies can be spoiled or held too much, but I also think it is important to research all sides. They say that babies that don't develop healthy sleeping patterns as infants will have sleep problems for the rest of their lives and other health problems(apparently studies have been done). And there are other ways to encourage babies to sleep through the night besides letting them CIO. The interesting thing about attachment parenting to me is that people point out the fact that babies in countries like china, africa, india, etc. don't have colic because they sleep in the same bed as their parents and are carried in a sling all day. I think they don't have colic because those countries don't drink milk and have way healthier diets than most americans. But who knows.

McDorky said...

I just found your blog through your crafty blog, which I found looking for crafty printables for my unborn baby's nursery! It just so happens that we live in the Portland area, too!

I totally agree with this article. I am a kindergarten teacher with two degrees (BS and Masters) in early childhood development and no matter how parents try to justify "sleep-training" the research just does not support it. Listening to your child's individual needs (whether that be closeness to sleep or more space) is what research has said to be consistently best for babies (and co-sleeping/room sharing reduces the risk of SIDS, as well). I think it is horrendous that people ignore their baby's only was of communicating (crying) as a way to control their child or show their child "who's boss." This does not support secure attachment, nor a sense of self-efficacy in the child. I have no desire to "train" my child, only to find a parenting style that is respectful of and works for ALL members of our family :) Loved this article :) Thanks for sharing!