Is “crying it out” not so bad after all?

Sleep trainers rejoice! A study published recently in the medical journal Pediatrics came to the conclusion that sleep training babies over age six months did not impact their stress hormone levels or cause behavioral or bonding issues, and it positively impacted the mental health of parents. It was also effective — decreasing the time it took for babies to fall asleep and the frequency they awoke each night.

The small study aimed to settle the debate that allowing an infant to “cry it out” causes elevation in their stress hormones and decreases bonding between parent and child due to abandonment.

The infants, who were all in good health, over six months of age, and identified by their parents as having “a sleep problem,” were divided into three groups. One group used the technique of graduated extinction, or putting the baby to bed while awake then entering the room to soothe after a set number of minutes that slowly increased. One group used a method called bedtime fading, where the infant was put to bed later each night, gradually shortening the babies’ sleep opportunity. The third group received information about sleep but no prescribed method. Salivary cortisol (stress hormone) levels were measured in the morning and afternoon and parents self-reported about their own stress and emotional levels.

The good news is that the babies who were subjected to the graduated extinction method began to sleep better! Their sleep onset, length of sleep, and frequency of awakening all decreased. Perhaps even more important, neither their stress hormones nor their behavior suffered due to the sleep training. Parents were pleased, as well, with their own stress improving and parent-child bonding intact.

In a world where there are so many mixed messages regarding sleep training, this study should serve to allay fears that sleep training causes long-term elevations in stress hormones and leads to permanent remodeling of the brain in a negative way. Important points here are that all babies in the study were over six months old. Before age four months, we know that babies’ stress hormones increase when their needs are not being met, so it’s not fair to use this study to support sleep training in younger infants. Also, all babies were healthy. None had chronic medical issues or problems with failure to gain weight. All parents in this study willingly volunteered to participate and were allowed to switch groups if need be (only two did so). Finally, all participants had the benefit of training and working closely with the research team.

The take-home message is that if your infant’s sleep is causing stress for both child and parents, there are solutions. Pediatricians can be your greatest resource, helping you understand your infant’s sleep patterns and how to problem solve any issues. Sleep training is safe and can benefit the entire family when it allows for everyone to have healthy, safe sleep.

To learn more about healthy sleep practices, check out Bundoo’s Infant Sleep articles!