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Is sleep training a form of neglect or harmful?

One of the most popular schools of thought regarding modern parenting is that not immediately responding to an infant's (typically age 6 months to 1 year) crying will result in long-term emotional damage.

This argument is usually brought up in response to the suggestion of employing one of the various methods of sleep training that involve allowing the baby to cry for varying periods of time in order to help train them to sleep through the night (e.g. the Ferber Method).

The idea that allowing a child to cry is harmful is widely espoused, particularly by notable Parenting author and Associate Clinical Professor of Pediatrics Dr. William Sears.

He lists a variety of reasons why children crying should immediately be responded to, every time. Among these reasons are:

  • Since the cry is a baby's language, a communication tool, a baby has two choices if no one listens. Either he can cry louder, harder, and produce a more disturbing signal or he can clam up and become a "good baby" (meaning "quiet"). If no one listens, he will become a very discouraged baby. He'll learn the one thing you don't want him to: that he can't communicate.
  • Baby loses trust in the signal value of his cry – and perhaps baby also loses trust in the responsiveness of his caregivers.
  • When you go against your basic biology, you desensitize yourself to your baby's signals and your instinctive responses. Eventually, the cry doesn't bother you. You lose trust in your baby's signals, and you lose trust in your ability to understand baby's primitive language.
  • Baby loses trust in caregivers and caregivers lose trust in their own sensitivity.

I have heard these arguments repeated from a variety of sources. However, I have yet to see any evidence that these are anything but speculation on the part of someone who has, by his own account, written over 30 books on the subject, and therefore has a vested interest in exaggerating risk in order to sell more copies of his books.

Is there any reputable scientific evidence to back up the claims of long term communication problems resulting from delays between a child crying and their parents responding? Let's exclude newborns from this, as no one seems to advocate for allowing newborns to cry as a means of sleep training, so we'll define our target population as anywhere from age 6 months to 2 years.

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Beofett
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  • I doubt there are any hard-and-fast rules that will work for everyone (although there have been many authors throughout recent history who have provided a wide variety of parenting advice). The way I see it is that each child has many unique aspects to their personalities that influence how they express physical and psychological needs and wants (and crying can be due to many different reasons). Each instance of a new behaviour really needs to be handled on a case-by-case basis (which is one reason so many parents are so busy). – Randolf Richardson Oct 20 '11 at 17:51
  • A couple of possibly related things. Babies can sleep through the night when they're 4-5 weeks old (just cuddle them when they cry and put them back), so maybe the target population should start at 1 month. Furthermore, I read that babies that are carried in slings cry a lot less daily than the pram-bound ones. I presume that means there are studies on that :-) It also means that there are significant populations where babies cry little vs where they cry a lot so perhaps psychological studies for US vs South-East Asian kids would be interesting. – w00t Oct 21 '11 at 07:19
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    You may want to try this question on http://parenting.stackexchange.com/. – mxyzplk Oct 22 '11 at 15:10
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    @mxyzplk I think this is better suited for skeptics since the question is about the evidence behind the claim, and not about the parenting question itself. We have several questions related to this topic already, but many of the answers there are based upon the assumption that this theory is accurate. – Beofett Oct 22 '11 at 15:31
  • I think we need to define cry. Babies make a verity of cry like noises. Some are urgent, other's are not. Some cries can be solved by attention, other cries might be a desire to not have attention. For example, a baby crying cause it's wet, needs attention. In reverse, a baby that wants to sleep but is being disturbed (over tired) will also cry. – Rincewind42 Oct 29 '11 at 12:55
  • @rincewind42 I don't believe we do require a definition of crying, since we're looking for any existing studies. There's no reason to exclude any existing studies because they don't meet whatever arbitrary definition we arrive at. Incidentally, the examples you gave aren't ones where a baby would desire to be left alone. An overtired baby will still crave active soothing (e.g. Cuddling, rocking, etc.). – Beofett Oct 29 '11 at 15:14
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    Another interesting point I heard from a Pediatrics Prof: If the parents get up at night every time the baby cries and feed it, it takes the baby longer to sleep through because it learns that when it cries, it gets food. Research on this would be interesting, but arguably very difficult if you play by the ethics rules. – Pascal Dec 06 '11 at 23:47
  • @BrianM.Hunt I feel my question is focused on a different aspect of the question, looking for the specific claims of Dr. Sears regarding the signal value. Looking at the answers posted for your question, none of them really seem to address what I am looking for. Even the accepted answer's best evidence, a document by Dr. Sears, is full of questionable references, where it seems there is some significant "unscientific" assumptions being made by Dr. Sears (e.g. he makes the assumption that any CIO method == neglect). – Beofett Dec 19 '11 at 14:14
  • As a side note, I contacted Dr. Sears several weeks ago directly through his website. I (politely and respectfully) expressed an interest in the research underlying those claims, and asked if he could point me in the direction of any peer-reviewed or otherwise published studies from which he derived those claims. Despite the promise "we will do our best to respond to you within 3 - 5 business days" I have received absolutely no response. Absence of evidence is not anything but absence of evidence, but I still think it is pointing towards Dr. Sears confusing assumption with fact. – Beofett Dec 19 '11 at 14:17
  • Thanks @Beofett, that helps me understand. I'd be very interested in hearing what Dr. Sears has to say (particularly if it's something other than silence ... ). – Brian M. Hunt Dec 19 '11 at 14:43
  • Here's a [recent article from BBC talking with a neuroscientist](http://news.bbc.co.uk/2/hi/8636950.stm) about this that might be apposite (not a primary source, so nowhere close to a comprehensive answer.) – Joseph Weissman Dec 22 '11 at 22:33
  • Note: this question and the duplicate cover the same ground. One should be merged in the other. Please specify which you think should be the one surviving. At the moment, it's the other since it has upvoted answers. – Sklivvz Jan 30 '12 at 16:30
  • I came across this http://www.psychologytoday.com/blog/moral-landscapes/201112/dangers-crying-it-out the other day. Might be of interest. – Sam I Am Jan 31 '12 at 23:07
  • @SamIAm That's exactly the type of article that prompted me to ask the specifics of this question, rather than the other "Are cry it out techniques harmful" question. There are hundreds of articles like this, but when you try to check references, they usually are on studies that aren't related to CIO at all (e.g. they take studies on extreme stress of 3 week old infants and apply it to practices applicable to 6 month old+ infants, and never define what "extreme stress" is). I do notice that the claims I mentioned are included in the article, but don't even pretend to reference studies. – Beofett Feb 01 '12 at 00:33

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UPDATE:

After further research I have found NO references to any actual paper, and no direct assessment of the phantom paper. I was under the false impression that the harvard gazette would be more responsible with information. A link to someone claiming the hypothesis to be bogus: http://mainstreamparenting.wordpress.com/2008/01/23/when-proof-is-not-proof-apnp-research/

Babies should not be left to cry.

From most of the sites I have found there are no references to studies. One study that seems to stand out is a study by Michael L. Commons and Patrice M. Miller.

A quote from an article mentioning the study:

The pair examined childrearing practices here and in other cultures and say the widespread American practice of putting babies in separate beds -- even separate rooms -- and not responding quickly to their cries may lead to incidents of post-traumatic stress and panic disorders when these children reach adulthood.

There is a comment by a traumatoligist about said study:

The Harvard researchers' work is unique because it takes a cross-disciplinary approach, examining brain function, emotional learning in infants, and cultural differences, according to Charles R. Figley, director of the Traumatology Institute at Florida State University and editor of The Journal of Traumatology. "It is very unusual but extremely important to find this kind of interdisciplinary and multidisciplinary research report," Figley said. "It accounts for cross-cultural differences in children's emotional response and their ability to cope with stress, including traumatic stress."

http://news.harvard.edu/gazette/1998/04.09/ChildrenNeedTou.html

Tjaart
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    Have you a link to their abstract or paper? I'm seeing a lot of conjecture, and assumptions of causation, but little that suggests it is evidence-based. – Oddthinking Jan 25 '12 at 22:14
  • Sorry, but I think more information about the paper is required. The claims being made seem unlikely to result from formal scientific methodologies (i.e. a finding that being left to cry "unnecessarily" could lead to an increased likelihood of trauma in adult life doesn't seem like what I'd expect from a study that uses the scientific method), and seems no more conclusive than Dr. Sears' similar claim. – Beofett Jan 25 '12 at 23:23
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    After further research I have found NO references to any actual paper, and no direct assessment of the phantom paper. I was under the false impression that the harvard gazette would be more responsible with information. A link to someone claiming the hypothesis to be bogus: http://mainstreamparenting.wordpress.com/2008/01/23/when-proof-is-not-proof-apnp-research/ – Tjaart Jan 25 '12 at 23:50