Letting babies cry out at nighttime is OK

Letting babies cry for short periods of time while teaching them to sleep by themselves doesn't cause long-term psychological problems or damage the parent-child relationship, says a study being published Monday in the journal Pediatrics.

The study, which followed children until they were 6 years old, will likely add fuel to an emotional debate that rages on playgrounds, on Facebook and within marriages: whether or not exhausted parents should "sleep train" their babies.

The behavioral techniques used in the study didn't include the most controversial method, known as extinction, or "cry it out," in which parents put the baby to bed, close the door and don't open it until morning, no matter how long and vociferously the baby sobs. While effective, cry it out "is very distressing to parents," said Anna Price, the lead author of the study and a postdoctoral research fellow at the Centre for Community Child Health, the Royal Children's Hospital in Parkville, Australia. "It is hard to do. We don't recommend it."

Instead, the study used two somewhat gentler approaches. In "controlled comforting," parents return to the room of a crying baby at regular intervals to offer some limited soothing. (Parents often refer to this as a version of cry it out.) It is the technique known colloquially as "Ferberizing," after Richard Ferber, the doctor who popularized it. The method generally takes a few days to work, but some babies can need several "booster" rounds in later months.

In "camping out," parents start by sitting in a chair next to the baby's bed and slowly—over several weeks—move the chair until they are out of the room and the baby is falling asleep alone. Both techniques still usually involve some—sometimes a lot of—crying.

But some critics, including proponents of "attachment parenting"—which also advocates parents and baby sleeping in the same bed—assert that the Ferber method, too, weakens the bond between parent and child and can lead to behavioral and emotional problems later on.

On the other side, some advocates of sleep training have also said teaching children to go to sleep on their own is critical to helping prevent later sleep problems. But this study found no significant long-term benefits of the behavioral techniques. About 9 percent of children in both the intervention and the control group had sleep problems at age 6.

Earlier data from this study, and other research, have shown that the behavioral techniques do work and have clear short-term benefits: Babies go to sleep more quickly at bedtime and wake up less during the night. And infant sleep problems can lead to a whole host of family issues: They double the risk of depression symptoms in mothers and can fuel marital problems.

"In the short term, the infants and parents get more sleep," said Judith A. Owens, the director of sleep medicine at Children's National Medical Center in Washington, D.C. "A well-rested parent is going to be a better parent in the daytime."