Parenting style the new front in culture wars

Pinky McKay worries about the distress experienced by babies when they are left to cry.
Pinky McKay worries about the distress experienced by babies when they are left to cry. Photo: Supplied

Ten years ago, a young academic set out to study the impact of controlled crying on babies and learned what it was to be crucified.

Michael Gradisar had been concerned about the lack of evidence for claims that the strategy of leaving babies for graduated periods of time until they fell asleep to teach them to re-settle, was damaging to babies.

“I thought, well let’s test it,” says Gradisar, now a professor in clinical child psychology at Flinders University. “And that was probably a bit naive.”

Marie Gallien and Ziggie, aged 8 months.
Marie Gallien and Ziggie, aged 8 months. Photo: James Alcock

An online mothers group committed to the philosophy of "attachment parenting" caught wind of the study during the recruitment phase and started a petition against it, complained to the university's ethics committee and told Gradisar he should be "hung up and castrated".

Gradisar had hoped to recruit 200 participants. He ended up with just 43.

“There are these two opposite groups and I feel really sorry for parents who are in the middle of it,” says Gradisar.

Controlled crying has become a lightning rod in a philosophical clash between those who believe in attachment parenting and those who believe in strict routines. Health workers attribute the claims used by both sides to unprecedented levels of anxiety among new mothers.

Bestselling baby author Robin Barker has emerged from her retirement to call out what she sees as “fear mongering” by attachment parenting advocates, who claim that controlled crying can cause lasting psychological damage to babies and toddlers.

In a piece posted to her blog in April, Barker argued that proselytising by attachment parents had caused an upswing in anxiety among parents and that sleep had gone from being a practical issue to a “flag waving cause”. She received a vicious response from some readers.

Advertisement

“It’s identity politics on the raising of children," she says.

"Now everybody is giving advice on the raising of children, including people who don’t have any practical experience - academics, people like that - and there’s this kind of thing where they want to convert parents to a particular way of thinking. That’s what I mean when I say it’s political.”

Attachment theory was formulated by psychiatrist John Bowlby based on his work with psychologically disturbed children in London in the 1930s and popularised by paediatrician William Sears in 2001 when he published The Attachment Parenting Book. Sears encourages mothers to carry their babies next to their skin, sleep with them, breastfeed them long-term and respond quickly to their cries.

But some of the researchers whose work Sears has cited have rejected his claims that babies will suffer psychological harm if their parents do not respond instantly to their cries, saying the work referred to babies in neglected homes.

Barker, a former midwife and child health nurse, has witnessed first-hand the entrenchment of parenting philosophies and all the angst that followed.

Studies on the psychological needs of babies started to emerge during the 1980s and there was a shift away from the routine-based care that had dominated the middle of the century to a more flexible model. No longer were mothers prescribed four-hourly feeding routines, but rather to respond intuitively to their babies' needs.

“A lot of that research was really good and it pointed in the right direction, and then as humans do people went over the top with it and suddenly it transferred from being a practical thing to a moral thing.”

Those who described themselves as attachment parents boasted that their method would lead to more empathetic, confident, intelligent children and that sleep training techniques which involved leaving babies to cry were a form of child abuse.

Increasingly, the educated, middle class and loving parents who conscientiously attended their baby health appointments were obsessing about "detachment disorder" - a phenomenon that had been observed in relation to Romanian orphans.

Pinky McKay is among those whose work Barker cites as alarmist in its claims about the harms done by controlled crying. McKay, a lactation consultant and baby care author, is also concerned by the rise in anxiety, which she attributes to a "pathologisation of normal baby behaviour".

But she is concerned that babies are the last ones whose needs are considered when parents think about sleeping strategies. "You put it through the check list: is it safe? Is it respectful? Does it work for me? If there's distress for the parents, there has to be distress for the baby."

She questions the validity of studies that indicated controlled crying works because they are carried out in a clinical environment and not a home where myriad variations occur.

There are some winners in this skirmish of the culture wars.

The ensuing confusion has created fertile conditions for an emerging industry in baby sleep consultants, who range from sole practising mothercraft nurses, to web-trained whisperers and multimillion dollar businesswomen. Their market is middle-class parents who are as anxious to do the right thing by their children as they are desperately tired. The fees for an overnight consultation range from about $800 to $2000.

Woolloomooloo mother Marie Gallien employed a sleep consultant to help with her daughter Ziggie when the baby was four-months-old. Gallien hated the idea of controlled crying but was at her wit's end with a baby waking every two hours, and found a mothercraft nurse through a mother's group on Facebook. The nurse quickly wrote her a referral to a residential stay at Karitane.

"I was at the peak of my sleep deprivation and I was totally lost and very emotional and crying and not especially liking motherhood anymore," Gallien says. "Julyanne came and I think she identified the issue was more me than Ziggie. I had reached my breaking point."

Not all sleep consultants are trained in nursing or mothercraft. One sleep consultant contacted by The Sun-Herald said she had decided to do an internet course after she had success with her own son and other parents were asking her advice.

Sarah Blunden, director of the Australian Centre for Education in Sleep, describes the urge of mothers to outsource sleeping decisions as the "professionalisation of motherhood".

"They will ask if they should give their babies a dummy or they should co-sleep and I say, 'Do you want to?' and they say, 'Well I haven't had that thought, it's whether we're allowed to or not'."

But she worries about the lack of qualifications held by some consultants. She is aware of one consultant offering sleep plans by algorithm if parents submit their child's age and problem.

"I can only think that people are desperate so there's certain money to be made," she says.

Kylie Barlow has seen three sleep consultants for her daughters, now aged five and three. The first two were trained mothercraft nurses and she credited them with identifying problems that were later solved with medical intervention. But the third charged $2500 for a three night stay and made no difference to her child, who has since been treated for sleep apnoea.

"We should never have gone with a non-professional but we were desperate," she says.

"She'd been on TV and radio and I thought surely she must be good."

The handwringing over sleep settling techniques has percolated into research.

In 2004 The Murdoch Children's Research Institute carried out the world’s largest study of infant sleep strategies, comparing babies who had no intervention to those who were subjected to controlled crying or camping out. It found that babies who had been taught to sleep through either method slept longer than those who had no intervention and their mothers reported significantly lower postnatal depression symptoms. Five years later, a second study indicated there was no difference between the children in the long term.

Harriet Hiscock, who led the first study and supervised the second, said the critics only became more shrill between the studies.

“They just have very strong beliefs and I don’t think that any amount of evidence will convince them otherwise,” Hiscock says.

But she worries about the effect on mothers, and spends a lot of time at the Unsettled Babies Clinic at the Royal Children's Hospital in Melbourne trying to undo the harm.

“I think there’s a lot more information and misinformation out there that makes parents feel guilty and adds to their anxiety,” she says.

“They’re terrified that they’re going to do long term damage to their children, that they’re bad parents and they’re failing because they can’t get their babies to sleep. And then if they want to do something they feel they can’t tell anyone about it because people are so judgmental. It’s terrible.”

To Barker, the trend in sleep consultants is more confirmation of parental anxiety.

“What all this means is parents don’t have the confidence, or they’re not getting the right advice, to deal with what I call normal sleep hassles. If parents ... think I’m destroying his brain or I’m hurting him, they call in a sleep consultant.”

“And they say to the sleep consultant, 'I hope you don’t do controlled crying,' and the sleep consultant says, ‘No no no, I don’t do controlled crying, I do comfort settling,' or whatever they call it. But in the end the baby or toddler has to be left."

Gradisar, whose study concluded that sleeping interventions provided significant benefits and conveyed no stress responses or long term affects on the parent and child relationship, is still perplexed by the reaction to his work.

"It was important to have the data," he says. "A lot of emotion has taken over rational thought."