Crying for Comfort: Distressed Babies Need to be Held
|Crying for Comfort: Distressed Babies Need to be Held|
The term “cry it out” refers to the practice of leaving babies in their cribs without picking them up, and letting them cry themselves to sleep. A modified version of this approach is to go to the baby every few minutes to pat her on the back or reassure her verbally (but not pick the baby up), and to increase the length of time gradually so that the baby eventually “learns” to fall asleep alone.
But there is no doubt that repeated lack of responsiveness to a baby’s cries—even for only five minutes at a time—is potentially damaging to the baby’s mental health. Babies who are left to cry it out alone may fail to develop a basic sense of trust or an understanding of themselves as a causal agent, possibly leading to feelings of powerlessness, low self-esteem and chronic anxiety later in life. The cry-it-out approach undermines the very basis of secure attachment, which requires prompt responsiveness and sensitive attunement during the first year after birth.1
The attachment parenting movement is a healthy reaction to the harmful promotion of crying it out found in many parenting books. Attachment parents are aware of the possible emotional damage from leaving babies to cry alone, so they strive to meet their babies’ needs for physical closeness and responsiveness. However, attachment parents can overlook the beneficial, healing function of crying, and believe that their job is not only to respond to, but to stop all crying. This article describes how parents can further promote babies’ mental health by learning to recognize stress-release crying, and implementing what I call the “crying-in-arms” approach.
History of the Cry-It-Out Approach
The question of whether or not to let a baby cry it out at night does not arise when a baby sleeps close to his mother. The history of the cry-it-out approach is therefore linked to the history of cosleeping. There is sufficient anthropological evidence to assume that, during prehistoric times, babies slept on their mothers’ bodies or very near their mothers, and that babies were never ignored when they cried. Cosleeping is a common practice in many traditional tribal cultures today. However, where civilizations became more technologically complex, parents gradually abandoned the practice of sleeping with their infants and adopted the practice of separate sleeping arrangements, especially in Europe and North America.
When and why did parents in Western cultures abandon the natural practice of sleeping with their infants? During the 13th century in Europe, Catholic priests first began recommending that mothers stop sleeping with their infants. It is likely that the primary, perhaps unconscious reason for this advice was the rise of patriarchy and the fear of too much feminine influence on infants—especially male infants. However, the reason the priests gave for this advice was the danger of smothering the infants, commonly known as “overlaying.” Historians now believe that most of the infant deaths during the Middle Ages in Europe were caused by illness or infanticide. When accidental smothering occurred, it was probably caused by parents who were under the influence of alcohol.
After the industrial revolution in the 18th century, the notion of “spoiling” became widespread in industrialized countries, and mothers were warned not to hold or respond to their infants too much for fear of creating demanding monsters. If the home was big enough, parents moved cradles and cribs to a separate room. With the infants sleeping alone in another room, it was easy for parents to follow the cry-it-out advice, even if it went against their gut instincts.
The decline in breastfeeding further contributed to the separation of mothers and infants. With bottle-feeding from birth on, the last remaining link to the mother’s body was removed, resulting in the deplorable, detached methods of child-rearing that predominated in Western civilizations during the 20th century.
Dr. Luther Emmett Holt, an American pediatrician and childrearing expert, was the first person to make the cry-it-out approach explicit and popular in the United States. Over 100 years ago, his best-selling book, The Care and Feeding of Children, was the child-rearing bible of the time. The book is structured as a series of questions and answers. One question is, “How is an infant to be managed that cries from temper, habit, or to be indulged?” The very wording of this question reveals Holt’s bias. His answer: “It should simply be allowed to ‘cry it out.’ This often requires an hour, and, in some cases, two or three hours. A second struggle will seldom last more than ten or fifteen minutes, and a third will rarely be necessary.”2 Several generations were raised according to this advice.
Dr. Benjamin Spock, the medical and parenting guru of the second half of the 20th century, recommended a similar cryit- out approach in his best-selling book, Baby and Childcare. Modified versions of the cry-it-out approach can be found in many current, popular parenting books.
The Trend Toward Attachment Parenting
Beginning in the 1960s, there has been a healthy trend in the opposite direction, commonly known as “attachment parenting.” This approach recognizes the infant as a vulnerable, feeling human being who needs sensitive attunement, prompt responsiveness, and nurturing. Proponents claim that the need for physical closeness is paramount, and that babies should never be left to cry it out alone. They advise parents to respond promptly to crying and to soothe babies, generally by rocking or nursing. Attachment parenting is the exact opposite of the cry-it-out approach.
Several factors have contributed to the growth of attachment parenting. One of the original influences came from British psychoanalyst John Bowlby, who coined the term “attachment” in the 1950s to refer to a child’s bond with her mother.3 Thanks to Bowlby’s work, people became aware of the potential damage to a child that can result from a prolonged separation from his mother.
Researchers in the field of attachment have discovered that it is impossible to spoil babies by responding to their cries. On the contrary, prompt responsiveness leads to a solid foundation of trust and a secure attachment in the infants by one year of age. Infants whose parents delay in responding to their cries become demanding and clingy by one year of age, and are described as being “insecurely attached.”4
One influence on the growth of attachment parenting has been the gradual return to breastfeeding. Organizations such as La Leche League have encouraged mothers to trust their own bodies to produce the perfect food for their infants. A revival of the age-old practice of cosleeping is another important aspect of attachment parenting.
Further support for attachment parenting has come from research in stress physiology. Cortisol levels are a reliable measure of stress, and can easily be measured from a sample of saliva. Researchers have found that even brief separations of human infants from their mothers can affect the infants’ cortisol levels. In one study, nine-month-old infants who were briefly separated from their mothers and left alone in an experimental situation experienced an increase in cortisol levels, indicating a physiological stress response. However, when the babies were left with a substitute caregiver who was warm and attentive, their cortisol levels did not increase as much.5 The researchers concluded that it is quite stressful for infants to be left alone.
The Recognition of Stress-Release Crying
While the attachment parenting approach is a healthy trend in the right direction, it is possible that, in an effort to counteract the harm caused by the cry-it-out approach, parents may overlook an important function of crying. In our eagerness to persist in soothing and hushing our babies, we may be missing opportunities to help them release stress and heal from trauma. Although it is stressful for babies to cry alone, there is no evidence that crying in a parent’s arms is harmful, once all immediate needs are met. On the contrary, crying in arms can be beneficial for babies who have an accumulation of stress.
Many psychotherapists recognize the therapeutic value of crying and encourage their clients to cry. There is a current trend toward deep-feeling therapies (sometimes known as “regression therapy,” “primal therapy,” or “emotional release therapy”) in which therapists encourage clients to relive early childhood traumatic experiences, and to cry and rage.6-8
The therapists assume that people who did not feel safe enough to cry as children can “catch up” on their crying later in life and heal themselves from the effects of early traumatic experiences.
Our culture tends to block and suppress the healthy expression of deep emotions. Some adults remember being punished, threatened, or even abused when they cried as children. Others remember their parents using kinder methods to stop them from crying, perhaps through food or other distractions. This early repression of crying could be one factor leading to the use of chemical agents later in life to repress painful emotions. The goal of deep-feeling therapy is to help adults overcome the inhibition against crying, thereby allowing them to cry as much as needed in a supportive environment with an attentive, empathic listener.
Researchers have measured physiological changes in adults following therapy sessions in which they cried hard. The results showed lower blood pressure and body temperature, slower heart rate, and more synchronized brain-wave patterns. This state of physiological relaxation was greater following crying than following physical exercise for an equivalent period of time.9 Biochemical studies have discovered greater concentrations of stress hormones in emotionally induced tears than in irritant-induced tears, leading to the theory that one purpose of crying is to rid the body of excessive amounts of these hormones.10 It is obvious that, when we cry, something important happens.
A growing number of psychologists believe that the healing function of crying begins at birth, and that stressrelease crying early in life will help prevent emotional and behavioral problems later on.11-14 However, babies should never be left to cry alone. This healing process will be effective only if babies are allowed to cry in the safety and comfort of a parent’s loving arms. When toddlers and older children cry or have temper tantrums, it is still important to stay close and be attentive, even when holding may not always be appropriate.
The stress-release function of crying in restoring emotional health is comparable to the beneficial function of fever in fighting an infection and restoring physical health. Wise doctors know that it is often best to let a fever run its course rather than use drugs to cut it artificially short.15 Stress-release crying and fever both help children (and adults) regain homeostasis. There is no easy shortcut to emotional or physical health.