The crying baby and The BabySleep Doctor

Dr Brian Symon.
Dr Brian Symon. Photo: Supplied

His methods may not be for everyone, but Dr Brian Symon is adamant that his sleep advice is safe for babies. Here is his method in his own words.

Crying in babies is a major problem in Australia. It is the single most common problem in families in the first 12 months of life, affecting up to 40 per cent of Australian families. The average length of crying varies according to the author and the study; it may vary between 90 minutes and up to three or four hours per day. One recent paper from the University of Queensland reported researchers were able to improve daily crying from six hours down to three hours per day.

The common theme here is that crying is occurring in large volumes across Australia. I regard this crying as distressing and unnecessary. A major theme in my work with families is to avoid excessive crying.

Persistent crying is associated with a range of problems. For the mother, it is associated with increased levels of postnatal depression, anxiety and stress. For parents there are increasing levels of relationship stress and relationship breakdown. There is increased association between prolonged crying and child abuse. For the child, prolonged crying is associated with a range of behavioural problems later in life and impaired academic performance. For the health care system, the most common presentations in both primary and tertiary care for children in the first 12 months of life are requests for assistance with crying in various forms. We are discussing a problem which is common and has significant consequences. Prolonged crying in a child is not a benign problem.

In my work, I divide crying into two forms. Firstly there is the normal cry of communication. This is a cry where the child is announcing hunger or fatigue. These cries are readily interpreted by the parents and lead to an appropriate response. The cry of the baby awakening from a sleep and simply calling to be fed causes no stress. In fact, once easily interpreted by the mother or father, the simple insight gives a sense of wellbeing in that they are interpreting their baby successfully.

The real problem is crying where the cause is unclear. Almost universally it is obvious to the parents that the child is distressed. As parents, they seek to provide a solution and commonly their attempts are unsuccessful. These distressed cries can persist for minutes, hours and then days, weeks, months or sometimes years. It is these distressed cries without clear cause which create family distress. It is the repeated inability to interpret and provide a solution which saps a mother's confidence and wellbeing.

In my work as the Babysleep Doctor it is absolutely routine for me to be asked for help by mothers who have been up five to 10 times per night for months or years. This experience can reach the point where it is unsustainable and where the mother is exhausted to the point of desperation. My role is to decrease infant crying, decrease infant distress and fatigue, and return a life balance and the joy of being a mother to a woman who is experiencing major stress on a daily basis.

My approach can be divided into two sections. Problem resolution, and, better still, problem avoidance.

In an ideal world I will see a woman at about 36 weeks’ pregnancy and provide knowledge and strategies which avoid infant hunger and fatigue. This consultation lasts 45 minutes, so summarising into a few paragraphs is difficult. Basically with a newborn baby I recommend strategies which avoid tiredness, over-tiredness and hunger. It is my unambiguous experience that the vast majority of distressed crying in newborn babies is caused by hunger or tiredness or a combination of both. Avoiding these problems decreases crying quite dramatically.

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It is common for mothers whom I have cared for from the birth of their child to report that their babies do not cry at all. This is interesting in that clearly the babies are crying to announce hunger or tiredness. What the mothers are reporting is that they are able to interpret their babies cry on the large majority of occasions, and as a result they are not experiencing distress or anxiety.

I was recently involved in the care of my newborn grandson. I found myself saying to people that “he just did not cry at all”. Once I was immersed again in the caring environment I realised that I had fallen into the same pattern. Of course he was crying. However, these cries were cries of communication where he was simply informing his parents and me about appropriate needs. Generally he cried, or, more correctly, just called out to be fed. It was more a “Hey guys, I'm here, time to be fed.” Once fed, he simply became drowsy and went to sleep with zero or minimal protest. Caring for him was an absolute delight. It is this experience which I try to provide to those mothers who seek my care while pregnant or very early in their babies’ lives.

The second group of families are those who have an established sleep problem. These children are commonly over six months of age and are being fed solids successfully, but for different reasons have come to use parental support as the preferred technique for both achieving and maintaining sleep. Parental interaction can occur in a vast number of ways, such as breastfeeding, bottle feeding, rocking, patting, pushing pushers, driving around the block, lying with a child, popping in dummies, etc.

Because sleep is a cycle process with repeated bouts of awakening within a block of sleep, if a child achieves sleep using parental care it is preordained that the child must awaken at some point in the block and request repeated parental support. The problem is that this precipitates tiredness in the child, tiredness in the parents, and ultimately disrupts sleep for the entire family unit. Because I teach that achieving and maintaining sleep function are learned skills, as a child becomes increasingly tired, the ability to perform the skills of sleep achievement and sleep maintenance are decreased. Long-term fatigue in the baby or toddler then interferes with their ability to learn and play successfully, results in poor behaviour and often decreases appetite and growth. For the parents, there is ongoing fatigue, family disharmony and a vast array of personal and family consequences which can continue for years.

The strategies I teach to resolve these established sleep problems vary with each child and each family, and cannot be summarised in a sentence or paragraph. The aim is to make sure that the child is well, fully fed, put to bed at an appropriate time with affection and confidence, and to assist the parents and the child to learn independent skills of sleep achievement and maintenance as quickly as possible. For those families who take my advice, approximately 90 per cent will show dramatic improvements in overnight sleep after between two and four nights. Distressed crying decreases within days after sometimes months or years of stress and fatigue.

My aim is to assist children achieve full nights’ sleep, to decrease and remove distressed crying: for the parents to return a balance to their life where they have an evening for parental time, a full nights’ sleep and then a day where the mother is refreshed and enthusiastic in providing care for the child that she loves without hesitation. The baby who sleeps well is so easy to love. A mother who has a full nights’ sleep and has returned to an appropriate life balance provides unparalleled love, care and teaching to her children during the day.

Sleep well.

Dr Brian Symon, The Babysleep Doctor