It’s the big choice for every new parent desperate for their infant to get some sleep – to leave to cry, or not to leave to cry.
For many, the notion of letting a baby blub at night without rushing to cuddle, rock or sing is too much to bear, despite the advice of countless parenting ‘gurus’.
But new Australian research suggests that such techniques as controlled crying – although not the more extreme “cry-it-out” methods - have no ill effects and are genuinely effective for babies over six months old.
The world-first study by the Murdoch Children’s Research Institute examined whether so-called “controlled comforting” and “camping out” have long-term detrimental impact on the child.
It followed 225 children from seven months old through to six years to track whether imposing a “sleep programme” had lasting effects on their mental health, their stress levels, the child-parent relationship or the mother’s mental health.
Half were the subjects of either “controlled comforting”, where parents responded to their child’s cry at increasing time intervals to teach the infant to self-settle, or “camping out”, in which the parent sits with the child as they learn to independently fall asleep, gradually removing their presence from the room.
In both instances, improvements to the children’s and mothers’ mental wellbeing were “still evident as late as two years”.
And by age six there was no significant difference between those who had been subject to a sleep programme and the control group that had not – in terms of mental and behavioural health, sleep quality, stress and relationship with their parents. The mothers also suffered no ill-effects.
Lead researcher Dr Anna Price said the findings should help parents feel “confident about the effectiveness and safety of sleep interventions in infants aged six months and older”, particularly where the mother is suffering from postnatal depression and sleep issues are compounding her distress.
She said: "Using sleep techniques like controlled comforting with babies from six months helps reduce both infant sleep problems and the maternal depression associated with the baby's sleep problems, and these effects are still apparent up to two years of age.
“Parents can feel reassured that using sleep interventions like controlled comforting and camping out are effective and safe. Given that the techniques work for most families and are cost-effective, parents and health professionals can feel confident using these sleep techniques to manage infant sleep."
Controlled comforting is a technique used to teach babies to fall asleep by themselves, without relying on their parents for cuddling, feeding, rocking, singing or other modes of comfort.
Generally a baby is put to bed tired but awake and left for short but increasing periods of time, even if they cry.
Dr Price explained: “Common periods are 2, 4, 6, 8, 10 minutes, or 5, 10, 15 minutes. If parents feel they can only leave for the shorter periods of time, that is fine.
“If the baby cries, the parent leaves them for the set amount of time, comes back in to the room to reassure them and settle the baby, and then leaves them for the next period of time. It usually only takes a few days to work.”
Meanwhile, camping out is a more gradual method – said to take two or three weeks to work - where a parent sits beside their baby's cot and slowly moves their chair out of the room.
Dr Price stressed, however, that controlled comforting is not the same as the more drastic “cry it out” method, where a baby is put to bed and left, even if he or she is crying.
And she insisted: “We do not recommend using crying-it-out because it is distressing for parents, and controlled comforting and camping out are options that work well for, and are accepted by, most families.”
She also added that sleep techniques were not recommended before six months of age because “we don't think that babies are developmentally ready [then]. Six months is around the age that children understand that something still exists when it is out of sight. Using these techniques before that age will probably not make sense to a [tiny] baby.”