Cry it out (CIO): 10 reasons why it is not for us

by phdinparenting on July 5, 2008

Intuitively and instinctively, the cry it out (CIO) method (also known as sleep training or ferberizing or controlled crying) of getting a baby to sleep is not something I ever felt comfortable with. And as I did research on infant sleep, I learned about what normal infant sleep is and I also learned more about the reasons why the CIO method is harmful. There are numerous scientific and emotional reasons why we have chosen not to let our babies cry it out, which I have summarized below.
1. Cry it out can cause harmful changes to babies’ brains

Babies cry. They cry to let us know that they need something. And when we don’t respond to those cries, it causes them undue amounts of stress. Science has shown that stress in infancy can result in enduring negative impacts on the brain. Prolonged cries in infants causes increased blood pressure in the brain, elevates stress hormones, obstructs blood from draining out of the brain, and decreases oxygenation to the brain. Excessive crying results in an oversensitive stress system (likened to a faulty burglar alarm in one book) that can lead to a fear of being alone, separation anxiety, panic attacks and addictions. Harvard researchers found that it makes them more susceptible to stress as adults and changes the nervous system so that they are overly sensitive to future trauma. Chronic stress in infancy can also lead to an over-active adrenaline system, which results in the child using increased aggression, impulsivity, and violence. Another study showed that persistent crying episodes in infancy led to a 10 times greater chance of the child having ADHD, resulting in poor school performance and antisocial behaviour. However, if you consistently soothe your child’s distress and take any anguished crying seriously, highly effective stress response systems are established in the brain that allow your child to cope with stress later in life.

2. Cry it out can result in decreased intellectual, emotional and social development
At an American Academy of Pediatrics meeting, infant developmental specialist Dr. Michael Lewis presented research findings demonstrating that “the single most important influence of a child’s intellectual development is the responsiveness of the mother to the cues of her baby.” More specifically, other studies have found that babies whose cries are ignored do not develop healthy intellectual and social skills, that they have an average IQ 9 points lower at age 5, they show poor fine motor development, show more difficulty controlling their emotions, and take longer to become independent as children (stay clingy for longer).

3. Cry it out can result in a detached baby
Researchers have shown that although leaving a baby to cry it out does often lead to the cries eventually stopping, the cries do not stop because the child is content or the problem has been alleviated. Rather, they stop because the baby has given up hope that a caregiver will respond and provide comfort. This results in a detached baby. Detached children are less responsive, appear to be depressed or “not there” and often lack empathy.

4. Cry it out is harmful to the parent-child relationship
A child that is left to cry it out is less likely to turn to the parents in times of need. Being attended to as a baby is the most basic of needs and if a child learns at that point that she can count on her parents to respond to her needs, then she will also turn to them later in life when she needs their support. But I worry that if I leave my children to cry it out, then they will not see the point in reaching out to us if they have problems later in life and could try to deal with serious issues like bullying, drug addictions, teenage pregnancy, gambling problems, or flunking out of school on their own or turn to peers. Unfortunately, those problems are often too big for a teenager to be left to deal with alone or with peers and it can have disastrous results ranging from making poor decisions all the way to committing suicide out of a feeling of hopelessness.

5. Cry it out can make children insecure
Children whose caregivers are not consistently responsive and sensitive, often become insecure. Long-term studies have shown that secure individuals are more likely to be outgoing, popular, well-adjusted, compassionate, and altruistic. As adults, secure individuals are likely to be comfortable depending on others, can 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). Parents that use the cry it out method often do so because they are afraid that their children are becoming 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.

6. Cry it out often doesn’t work at all
Some babies will not give in. They are resilient or stubborn enough that they refuse to believe that their parents could be so cruel as to leave them to cry to sleep. So instead of whimpering a bit and then drifting off to sleep as some supposed sleep experts would have you believe happens, they end up sobbing and sobbing and sobbing for hours on end. Some end up vomiting. Many end up shaking so hard and become so distraught that once their parents realize that CIO is not going to work, the baby is shaking uncontrollably and hiccuping, too distressed to sleep and too distraught to be calmed down even by a loving parent.

7. Even if cry it out does “work”, parents often have to do it over and over again
I can’t imagine putting my child through one or several nights of inconsolable crying to get her to go to sleep and I certainly can’t imagine having to do it over and over again. However, that is the reality for many parents. I hear people tell me that they always let their child cry for thirty minutes to go to sleep. Or that they have to start the CIO sleep training process all over again after each round of teething, each growth spurt, each developmental milestone.

8. Cry it out is disrespectful of my child’s needs
So-called sleep trainers will tell you that after a certain age, babies do not have any more needs at night. Some claim this is after a few short weeks, others after a few months, others after a year. Regardless of the age that is assigned to that message, to me it seems wrong. I’m an adult and yet there are days when I need someone else to comfort me. If I’ve had a really stressful week at work, if I’ve had a fight with someone that is important to me, if I’ve lost a loved one, then I need to be comforted. But how would I feel and what would it do to our relationship if my husband closed the door and walked out of the room and let me “cry it out” myself? I’m an adult and yet there are nights when I am so parched that I need a glass of water or I am so hungry that I need a snack. I’m not going to die if those needs are not met, but I am going to physically uncomfortable and unable to sleep soundly. If I were to let my child CIO, it would be like saying that his needs are not important and that to me is disrespectful. To quote Dr. William Sears on the sleep trainers, “Parents let me caution you. Difficult problems in child rearing do not have easy answers. Children are too valuable and their needs too important to be made victims of cheap, shallow advice“.

9. Deep sleep from cry it out is often a result of trauma
Babies who are left to cry it out do sometimes fall into a deep sleep after they finally drop off. And their parents and sleep trainers will hail this as a success of the CIO method. However, babies and young children often sleep deeply after experiencing trauma. Therefore, the deep sleep that follows CIO shouldn’t be seen as proof that it works. Rather, it should be seen as a disturbing shortcoming.

10. Our World Needs More Love
Rates of depression are skyrocketing. Violent and senseless crimes are on the rise. As human beings, we need to spend more time being there for each other, showing compassion, nurturing our children. Learning that you can’t count on your parents to be there when you need them is a tough lesson to learn that early in life and can be a root of many of the social problems we are facing today. I want to give my kids every chance possible of escaping depression and staying away from violence. And I’m convinced that nurturing them and responding to their needs at night, as I do during the day, is the first step in the right direction.
Those are our reasons for not using the cry it out method. What are yours?


Do you need some gentle sleep tips? See Gentle Baby and Toddler Sleep Tips
Sources:

The following sources were used in the development of this post:
Dr. Sears – Science Says: Excessive Crying Could be Harmful to Babies
Margaret Chuong-Kim – Cry It Out: The Potential Dangers of Leaving Your Baby to Cry
Paul M. Fleiss, M.D., M.P.H, F.A.A.P – Mistaken Approaches to Night Waking
Australian Association for Infant Mental Health – Position Paper 1: Controlled Crying
Alvin Powell – Children Need Touching and Attention, Harvard Researchers Say
Pinky McKay – The Con of Controlled Crying
Linda Folden Palmer – Stress in Infancy
Gayle E. McKinnon – CIO? No! The case for not using “cry-it-out” with your children
Macall Gordon – Is “crying it out” appropriate for infants? A review of the literature on the use of extinction in the first year
Elizabeth Pantley – The No Cry Sleep Solution (book)
Katie Allison Granju – Attachment Parenting (book)
Dr. William Sears – Nighttime Parenting (book)
Margot Sunderland – The Science of Parenting (book)

FDA Warning on Shock Risk of Breast Pumps

http://online.wsj.com/article/SB10001424052970203917304574415441993714918.html

By JENNIFER CORBETT DOOREN

The Food and Drug Administration said baby-products maker Evenflo Co. failed to properly investigate some complaints involving women who reported receiving electrical shocks while using the company's breast pumps. In an Aug. 25 warning letter released by the agency Tuesday, the FDA said it found manufacturing violations at two Ohio plants that make pumps used by women to express breast milk. The breast pumps are sold nationwide under the "Comfort Select" brand name. Evenflo, of Miamisburg, Ohio, is private firm that makes a variety of baby products including toys, high chairs, car seats and strollers.

The FDA warning letter stemmed from inspections of two Evenflo facilities in January and February. Since then, the FDA and the company have worked to address violations of FDA manufacturing rules, with Evenflo providing monthly updates to the agency.

During the inspections, the FDA found Evenflo wasn't in compliance with the agency's manufacturing practice rules, including "failure to review and evaluate all complaints" and for failing "to establish medical device reporting procedures for your breast pumps." Companies are required to report problems with devices to the FDA.

The agency said it reviewed 37 complaints and, of those, 18 weren't investigated by the company, including at least three reports of women receiving an electrical shock when using the breast pumps. The FDA said companies are required to investigate complaints that involve "the possible failure of a device to meet any of its specifications."

Amy Neff, Evenflo's associate general counsel, said the company does investigate its consumer complaints but said the problem was a "documentation issue." In its letter, the FDA said the company's response to the complaint-investigation problem is now "adequate." However, on the medical-device reporting problem, the FDA said the company has yet to fully address the agency's concerns.

Lindsay Harris, Evenflo's vice president of quality and product integrity, said, "We are working cooperatively with the FDA" to address the agency's concerns. He said the company reports all device complaints to the agency.

Write to Jennifer Corbett Dooren at jennifer.corbett-dooren@dowjones.com