A New Lullacry for Babies

'Controlled crying' helps little ones develop better sleep patterns

THURSDAY, May 2, 2002 (HealthDayNews) -- If your baby has trouble falling asleep, you might try some "controlled crying."

No, not you, the baby. Although new research does show that the tactic also significantly lowers post-partum depression in new mothers.

Controlled crying is an increasingly popular method in which parents let their baby cry alone for a while. Then they walk into baby's room and offer some comfort. Then they leave and allow the crying to continue a bit longer before returning with more soothing words and gestures, repeating the cycle until the crying stops and baby falls asleep.

The tactic offers a better chance of solving a baby's sleep problems than alternative methods, a carefully controlled Australian trial shows.

"What we showed is that controlled crying has a good effect for up to four months," says Dr. Harriet Hiscock, a research fellow at Royal Children's Hospital in Melbourne, who reports the results of the trial in tomorrow's British Medical Journal.

Of the 76 parents who were bothered enough by their babies' sleep problems to try controlled crying, 53 reported that the problem was resolved after four months. Only 36 of the 76 parents who tried different methods reported the same kind of success.

The method benefited mothers as well as babies, with the incidence of postpartum depression significantly lower in those who practiced controlled crying, Hiscock says.

"These mums had significantly reduced depression scores," she says.

It's a technique that more and more American parents are practicing, says Jodi Mindell, an assistant professor of psychology who runs a sleep clinic at St. Joseph's Hospital in Philadelphia, and is a spokeswoman for the American Sleep Foundation.

In this country, it's called "sleep training" or the "Ferber method," after Dr. Joseph Ferber of Boston Children's Hospital, who popularized the technique in a 1985 book.

Mindell, the author of the book Solving Children's Sleep Problems, says about 25 percent to 30 percent of babies and toddlers have trouble falling asleep or sleeping through the night.

The benefits of sleep training "have been known anecdotally, but this is a confirmatory, carefully controlled study which indicates that it is an effective intervention," she adds.

Hiscock says, "What was different was that we were the first to look at the effects of controlled crying on the baby for a long period of time, and also its effects on depression among the parents."

Mothers who were designated to try controlled crying got training in the method and were given a sleep management plan and information about normal sleep patterns in infants and were told about management of sleep problems. The other mothers weren't given advice on how to manage infant sleep problems.

Some parents who didn't practice controlled crying chose to let the baby go on crying for as long as it took for him or her to fall asleep. Others chose to stay with the baby, sleeping next to the crib for several nights. Over the short run, neither of those methods worked as well as controlled crying, Hiscock says.

But after four months, the results were pretty much the same for all the babies, no matter which method the parents chose.

That's because many of the parents who said they would not try controlled crying actually did, on advice they got outside the boundaries of the trial, Hiscock says.

Controlled crying is advisable "only for babies who are 6 months or older and whose parents both agree to do it, where they can manage the baby crying for a short period of time," he adds.

What to Do: For insights on babies and sleep, visit the American Academy of Child and Adolescent Psychiatry, or InteliHealth.

SOURCES: Harriet Hiscock, M.D., research fellow, Royal Children's Hospital, Melbourne, Australia; Jodi Mindell, Ph.D, assistant professor of psychcology, St. Joseph's Hospital, Philadelphia; May 3, 2002, British Medical Journal
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