Beyond controlled crying: a new way to get babies to sleep

Controlled crying is not for everyone.
Controlled crying is not for everyone. Photo: Stocksy

Anna Ciccarelli, of Adelaide, still remembers trying to get her 16-year old daughter to sleep as a baby. "Your heart breaks just listening to them cry, and you want to go in there but you're told not to. You just stand at the door, and you're crying with them." 

Anna is one of many parents advised to adopt "controlled crying", a method that advocates leaving babies to cry unattended – gradually or cold turkey – so they get used to sleeping on their own. The method is commonly used to reduce nighttime crying in western societies where babies sleep separately from their parents. 

When Anna visited a residential facility, she observed how controlled crying works for some parents. For her it was the total opposite. "My pediatrician said it starts off really bad the first night and gets less and less every night. But by the end of the week she was crying all night long." 

Dinah Fear, from Newcastle in NSW, tried it with her baby but gave up. "I lasted seven minutes outside her room before I ran in to comfort her – never did that again, too traumatic for both of us."

In studies of controlled crying, babies fall asleep sooner and wake less. However, it's not for everyone, and there's a call for alternative methods to help babies and parents get a restful night's sleep.

Professor Sarah Blunden, director of the Australian Centre for Education in Sleep in Adelaide, is addressing this need.

As a clinical psychologist and researcher, helping babies and parents solve sleep problems has been a driving force in Blunden's work for over ten years. She acknowledges controlled crying can achieve faster settling of babies – hence why it dominates research and is advocated by experts. But she's conscious it's not a one-size fits all approach.

"For 40 years parents have been saying they don't want to do controlled crying, they don't like it, but no-one's been listening." 

In fact, surveys have found 63 per cent to 71 per cent of parents do not want to try, or continue, controlled crying methods. 

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Blunden says she wants to give parents and clinicians other choices. She has developed a responsive, non-ignoring technique, which her pilot research found produces less crying, more settled babies and greater parent-child connectedness – with positive ripple effects on babies' and parents' physical and emotional wellbeing. 

Now her team is running the Baby Sleep Study to compare this new way with controlled crying. The ongoing study is comparing how effectively each method reduces infant sleep disturbance, and impacts parent and baby stress, maternal mood, infant temperament and mother-baby attachment. 

Scientists who advocate controlled crying are concerned with looking after mums, so they can get some sleep. Blunden seeks to address this need.

She explains her technique helps babies learn to fall asleep on their own while allowing parents to respond to them, describing it as "a middle-of-the-road approach that recognises the realities of modern life where people are busy, and don't have a village to help bring children up". 

The technique draws from neuroscientists' observations that it takes about ten practices to change a behaviour.

"With my responsive method we teach a graduated desensitisation of a behaviour and replace it with a less intensive behaviour."

Blunden compares it to a jigsaw, comprised of a sequence of babies' associations while falling asleep, like mum's voice, smell, touch, cuddling, and breast in mouth. "To desensitise baby, we take each of them away."

For instance, mum might take her breast out of baby's mouth just before sleep onset. The baby is still getting mum's touch and all the other comforting associations, bar that one.

"She will cry at first, but eventually form a new neural connection in her brain – and a newly learned behaviour. Then we can move onto changing the next association."  

Prolonged sleep disturbance has multiple negative effects on babies and parents. But what is a sleep problem? Blunden is concerned about misinformation in the community.

Initial findings from the Baby Sleep Study confirm her clinical experience that many parents think their baby has a serious sleep problem when their behaviour is normal.

"If they think their baby should settle themselves to sleep from a young age, and they're not, the parents think they're doing a bad job, and that feeds into a loop of anxiety and worry," she says. 

Furthermore, Blunden says, "the belief is so strong that if you let your baby fall asleep in your arms at three weeks, they're going to be doing that for the next two, three, four years. That is not true. Babies need to be touched by their mother."

And, as for cuddling your baby to sleep? Blunden reassures parents they can do that as much as they like.

"When it's a problem—change it. It doesn't have to be forever."