Neither is there proof that sleep training causes long term damage

I’m so sorry.

I’m afraid I’ve got more to say about that sleep training study.  As you know I have attacked a study that claims to show that sleep training causes no long-term harm to children.

I want to be crystal clear about one thing. I’m not criticizing that study out of a belief that sleep training does cause harm to children. In fact, I rather suspect that, all things being equal (i.e. generally good parenting and parent/child relationships), it doesn’t. But I can’t prove that.

One of the things that concerns me in this debate is that so many people are focused on defending their already entrenched ideological positions rather than using this study, and perhaps more importantly, the huge discussion it has sparked, to deepen our understanding of how to help and support parents looking for solutions to night waking.

Some people who believe in sleep training (including some who simply see it as one of a number of options for parents) are twisting themselves into knots defending this study. On the other hand, people who are against sleep training are jumping all over this study, in some cases, I suspect, to defend a belief that sleep training damages kids.

I’m on record as saying that this study definitely does not prove that sleep training causes no long-term harm.

Now let me go on record as saying that those who suggest that sleep training damages children don’t have any proof either. And just like I think that the sleep trainers should stop telling parents that their method always works, and that they have proof that it never harms children, I think the anti-sleep training crowd should stop suggesting that it is damaging. Because they don’t know.

There are sound reasons to think that sleep training could be harmful under certain circumstances – for example, if a parent doggedly stuck with it, leaving their child to cry for long periods night after night, when the technique clearly wasn’t working. I also think it’s not a good idea to sleep train very young babies (under six months). Waking up at night is not only normal at that age, it’s appropriate and necessary on an evolutionary level, meaning, it helps to keep them nourished, breathing properly, and in some cases, most likely, alive. (For the record, oodles of research, including studies conducted by some sleep training proponents, show that waking at night continues to be one kind of normal many babies in second half of the first year of life, and beyond that sometimes.)

I think it’s fair to say that there can be little doubt that sleep training is distressing to babies (some more than others). But lots of things that happen in childhood are distressful, including some of the things that children experience in the course of positive discipline and social relations with siblings and peers. It’s not temporary distress that harms children, it’s long-term, unrelieved distress that is damaging.

So, if parents try sleep training with older babies or toddlers and it works fairly quickly (which it sometimes does – research shows this and I’ve also heard it from numerous good, loving parents) I can’t imagine that it would cause harm. And when it works, it would cause benefit – less distress and more sleep for parents, and possibly, more sleep for the child in the short term.

But when sleep training doesn’t work – which I also know to is common, both from research and conversations with good, loving parents – there is potential for harm, particularly if the parents have been ingrained with the idea that sleep training is the only legitimate solution to sleep problems or that prolonged night waking damages children (which conservative sleep pundits often imply).

But, when sleep training fails I think it can cause harm, probably short-term harm for the most part, and actually a lot of that harm is to parents. Here’s how parents are harmed.

• A method the parents have been told is “effective” and constitutes “authoritative” parenting (Spare me!), didn’t work for them, thus the parents feel useless.

• If a method that is supposed to work doesn’t work, the parent might think there is something wrong with their child, or  blame the child,  both potential stressors on the parent/child relationship.

• The parent might just get mad at experts and refuse to take any of their advice, some of which could be helpful.

• The parent still hasn’t solved the problem and the family is still suffering. If they haven’t been given other options – such as ways to live with night waking – parents may feel hopeless. Hopelessness hinders good parenting.

So I think we should put less energy in to arguing about whether or not sleep training is harmful or not or whether attachment parenting is superior or not, or whatever and more into helping parents figure out how they want to (and are able to) work through sleep issues. Not every parent will be comfortable with sleep training, and those parents are unlikely to succeed with it (Dr. Lynn Loutzenhiser of the University of Regina and I have data on this which we hope to publish soon).

But not every parent will be comfortable with co-sleeping, or nursing their 7-month old three times a night, or walking the floor, or whatever else might be required to live with night waking.  And those parents need to feel OK about trying a solution (sleep training) that has worked for some people. And they should not be derided for harming their child.

It’s a question of weighing risks and benefits. Leaving kids to cry in the night is not ideal. Neither is being parented by a chronically tired, unhappy parent. And having a stressed-out parent lose it in the middle of the night and shake a baby is definitely harmful.

That’s why parents need options, and also why those who work with them should be supportive of different options (by the way, I know that many professionals are already doing this) rather than pushing the method that suits their ideology.

So I have no objection to professionals who help parents sleep train their kids, as long as they don’t -excuse my long list of provisos

• push parents into it by implying that the baby’s future depends on it

• imply that it’s easy, that it always works

• say that it constitutes authoritative parenting (one of the most outrageous claims I have ever heard)

• and as long as they frame as one possible solution to a problem the family is having and not as question of treating a sleep or “sleep behaviour” disorder the child has (with exceptions, of course, some babies can have sleep problems that could justifiably be called sleep disorders.).

And I have no objection to – actually, I’m favour of – supporting parents who want to live with night waking, as long as parents aren’t made to feel they have to live with it if they feel they can no longer do so.

Further, parents should be supported if they want to co-sleep for whatever reason, including as a way of coping with night waking (which conservative sleep researchers have pejoratively labelled “reactive” co-sleeping), as long as they are shown how to do it safely (which is easily done BTW)

The main thing I object to is people saying that their method is the only legitimate one and that the others are harmful.

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About uncommonjohn

I am one of Canada's top parenting writers. My areas of expertise and interest include debunking bad parenting advice (especially about sleep), self-regulation, fatherhood, child development, children's mental health, childbirth and breastfeeding.
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4 Responses to Neither is there proof that sleep training causes long term damage

  1. Juliette says:

    As much as I really don’t like the idea of CIO-based sleep training, and think it’s a pretty mean thing to do to a baby, I find I’m in complete agreement. I haven’t ever, and I’ve tried, found a piece of research that convinces me it’s harmful to the baby. Even studies that have found higher levels of cortisol don’t convince me, because I haven’t seen any studies that definitively link higher cortisol to long-term damage. There’s a lot of extrapolation, guesswork, etc. My gut is that if CIO doesn’t work quickly and easily, there could be problems down the road. But, that’s a big maybe.

    The one other gut feeling I have (the Searses say the same thing but I thought it long before I read Dr. Sears) is that following a long-term CIO philosophy could be detrimental to the parenting relationship in that it starts to harden parents. I’ve found the same thing when visiting friends and family who choose to ignore crying for different reasons – eventually I start to be able to ignore it too. Again, maybe that doesn’t have long-term effects, but my gut is that it does – you’re not really supposed to be ignoring your child’s distress. Again, though, it’s gut. Not research.

  2. uncommonjohn says:

    I agree Juliette. That is a risk. That’s why I’d like sleep trainers to get past this practice of dismissing concerns about sleep training by simply saying “it’s not harmful.” They need to think about and help parents think about the disconnect between their advice to selectively withhold comfort from a crying baby at night and the advice that parents get (and not just from attachment parenting gurus, but from virtually all early child development experts) that it is important to respond promptly to a baby’s distress.

    But they almost never talk about that in any detail. They just say, “don’t worry it’s not harmful.” Meanwhile, many parents are thinking, “well, if it’s not OK to ignore my baby’s distress during the day, why is it OK at night.”

    • Juliette says:

      Yes, or perhaps even more worryingly “if it’s okay to ignore my baby at night, perhaps it’s okay in the day too”. And suddenly you have a baby who is being ignored, full stop. I have seen that happen. That can’t be good.

  3. Thank you for this thoughtful post, which makes some very reasonable points, arguing against the extremes on both sides. I have to agree that the most important aspect of this issue is supporting parents to find their own way to cope, in a way that they are happy with. Even though I do find myself convinced by the anti-CIO research, I don’t really believe people make decisions based solely on research – we are probably most convinced by the research that supports our gut feelings. My gut feeling is that if a baby is crying, I want to help that baby, which for me means holding and comforting the baby. But I recognize that others may have other gut reactions.

    Not sure if you allow links in your comments, but we offer a personalised method on our website (it’s completely free), aiming to help parents find their own ways of coping, or of modifying their baby’s sleep, while avoiding leaving the baby to cry. We include practical summaries of many popular methods, and different things to try. We don’t include crying methods as we believe that, deep down, many parents would prefer not to leave their baby crying, and turn to those methods in desperation. We’d like to help support parents avoid controlled crying. Anyway, here’s the link to our website if you are interested 🙂 (or if you have any other comments or feedback, please do let me know) http://www.betterrestmethod.org

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