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In my last post Controlled Crying: Historical Perspectives (origins of the idea) I said this one would be about recent research but I’ve changed my mind.
The reality is that people will, in general, do what they want to do regardless of the research.
This is mainly because of what is known as ‘confirmation bias’ - our tendency to favour information that confirms our beliefs, especially when it comes to issues which are charged with emotion.
Ultimately parents will decide for themselves what level of stress (if any) results from their attempts at controlled crying/sleep training.
Having recently read a comment on another blog by a mother having suicidal thoughts related to her baby's night-waking, it is with respect and compassion for parents who are, or have been in similar dark places that I put forward the information in this post.
The Center on the Developing Child at Harvard University uses the three terms below to refer to the effects on the body of the stress-response systems (not to the stressful event itself):
- Positive – brief increases in heart rate, mild elevations in stress hormone level
- Tolerable – serious, temporary stress responses, buffered by supportive relationship
- Toxic – prolonged activation of stress-response systems in the absence of protective relationships
MAJOR SHIFT IN POLICY UNDERPINNING EARLY HUMAN DEVELOPMENT
In January 2012 the American Academy of Pediatrics (AAP) released a Policy Statement and Technical Report...
urging all those working in the field of Pediatrics to have a:
“…greater focus on those interventions…that reduce external threat to healthy brain growth.”
and stating that:
“the prevention of long-term, adverse consequences is best achieved by the buffering protection afforded by stable, responsive relationships that help children develop a sense of safety, thereby facilitating the restoration of their stress-response systems to baseline [steady state].”From the Technical Report:
“The…framework that guides this report suggests that many adult diseases are, in fact, developmental disorders that begin early in life.”
- "early experiences are built into our bodies;
- significant adversity can produce physiologic disruptions or biological memories that undermine the development of the body’s stress-response systems and affect the developing brain, cardiovascular system, immune system, and metabolic regulatory controls;
- these physiologic disruptions can persist far into adulthood and lead to lifelong impairments in both physical and mental health."
- HPA axis (hypothalamic-pituitary-adrenocortical); and the
- SAM system (sympathetic-adreno-medullary), which results in
- increased levels of stress hormones, such as
- CRH (corticotropin-releasing hormone), cortisol, norepinephrine and adrenaline.
- elevated inflammatory cytokines; and the
- response of the para-sympathetic nervous system, which counterbalances
- both sympathetic activation and inflammatory responses…
(Summarised from Technical Report mentioned above)
Common beliefs about controlled crying:
- It teaches babies to be independent and deal with adversity
- It is a realistic expectation to think babies ‘should’ sleep through the night
- Too much attention will 'spoil' babies - create a 'rod for your back'
- We don't remember what happens to us as babies
- It is an essential part of the treatment for post-natal depression
“…abundant clinical research indicates that the successful treatment of a mother’s depression does not generally translate into comparable recovery in her young child unless there is an explicit therapeutic focus on their dyadic [two people treated as one] relationship.”
(AAP Technical Report: The Lifelong Effects of Early Childhood Adversity and Toxic Stress, Jack P Shonkoff & Andrew S Garner, Pediatrics 2012;129;e232)
"Neuroscience has demonstrated that all mammals share a…developmental attachment mechanism and a common stress-regulating neurophysiology." (Nature, Vol 33, 2005, p807)
|Copyright Neil Matterson, Pharmasoft Pub|
My beliefs influence my objections to controlled crying and any other form of sleep- training. Depending upon the frequency, duration and intensity of each attempt, I believe it can be disrespectful of babies’ efforts to communicate and undermine their ‘sense’ of trust and safety.
I also believe controlled crying to be a ‘cultural construct’ ie an attempt to manipulate normal infant sleep behaviour to fit our lifestyles. Importantly, it also goes against what we are pre-programmed to do as mammals, including our vital need for skin-to-skin contact.
Just like we see in other species of mammals...
“The infant actively seeks to adhere to as much skin surface on the mother’s body as possible.” (Harlow 1958, in Effects of a Secure Attachment Relationship on Right Brain Development, Affect Regulation and Infant Mental Health, A N Schore, Infant Mental Health Journal, Vol 22, 2001)
“...we know from daily life that we exist for other people first of all; for whose smiles and well-being our own happiness depends.” Albert EinsteinIn concluding I suggest we would all benefit from a willingness to re-evaluate beliefs and attitudes which undermine normal human development; including those surrounding controlled crying/sleep-training.
Wishing you joy & peace for the year ahead.
PS: After an extensive search, the only official policy/position statement that relates specifically to controlled crying was published in 2004 by the Australian Association of Infant Mental Health Inc (AAIMHI). If you know of any others I would really appreciate a link.
PSS: I've been a bit slow off the mark with my first post for 2013. At the beginning of December I had successful surgery in Sydney to 'fix' a brain aneurysm (via an artery in my groin - amazing). It's a huge relief not to have to walk around with a time bomb in my head! How lucky I am to live in Australia and have access to some of the best medical care in the world.