Controlled crying can improve infants' sleep and reduce mothers' depression - and doesn't cause any long-term harm, either, a Melbourne study has shown.
Researchers from the Murdoch Childrens Research Institute analysed outcomes at six years for children whose parents used different behavioural techniques to regulate their sleeping as infants.
The techniques, designed to teach babies to fall asleep by themselves, included controlled crying. In this method, parents put their baby to bed tired then leave them for short periods, even if they cry, only returning to reassure and settle them if necessary.
Another technique adopted by parents in the study was 'camping out', in which a parent sat next to their baby's cot on a chair while the baby fell asleep. Over a period of a few weeks, the parent slowly moves fruther away from the baby, until they're no longer in the room while the child falls asleep.
Writing in the journal Paediatrics, the researchers said there was strong evidence that the techniques reduced infant sleep problems and associated maternal depression for up to 16 months afterwards.
It's really important to conduct these studies so you can reassure families that what they're doing is going to help and it's not going to harm
But they said unproven concerns about potential long-term effects on children's mental health had provoked vigorous debate and limited uptake of the techniques, despite their effectiveness. Their study, the first to follow up children as late as age six, compared outcomes for children whose parents used the techniques at age eight to 10 months to those whose parents didn't.
The researchers found there were no differences in mental and behavioural health, stress levels, and relationships of children across the two groups after five years.
Lead researcher Anna Price said parents and health professionals should feel confident about the effectiveness and safety of sleep interventions in infants aged six months and older.
The researchers said information currently available to parents about the effects of behavioural sleep strategies was inconsistent and outdated. They cited peak bodies such as the Australian Breastfeeding Association, which argued against their use but hadn't updated position statements for about seven years.
Dr Price said infant sleep problems were widespread and had a significant effect on families.
"It's really important to conduct these studies so you can get the evidence and reassure families that what they're doing is going to help and it's not going to harm," she said.
Among the participants in the study was Georgie Girardau, who found controlled crying a highly effective technique for her twins, Thomas and Rachel, who are now healthy nine-year-olds.
'"You're a new mother and you don't know what you're doing," she said. "It was something you learnt, that in some respects you almost needed to be a little bit cruel to be kind.
"They were in a great routine and I kept the two of them together, side by side. I'd wake them and feed them four-hourly and then put them back to bed."
Dr Price said the techniques worked for many families, "but if you're finding it's not working for you, you might need to try something else or get some extra help from your nurse or GP".
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