Does Sleep Training Your Baby Cause Long Term Harm?

Almost every exhausted new parent has wondered about the pros and cons of sleeping training their baby. Will it work? What method should I use? And the big question: Will it cause harm? While it’s still unclear which method will work best for each baby and family, mounting research suggests that the practice of letting a baby cry for short intervals while learning to put herself to sleep is not inherently harmful —and does not seem to cause long term emotional problems for the baby or disrupt the parent-child bond. However, there are some caveats, explains Kimberly Schneider, M.D. pediatrician at Indiana University Health. Here’s what you need to know about the latest research on sleep training.

In a recent study published in the journal Pediatrics, researchers evaluated 43 sets of parents and babies in Australia. In one group, the parents didn’t follow a particular sleep training method, and instead were given basic sleep information. In a second group, parents used a method called bedtime fading in which they delayed bedtime by prescribed increments each night to land on a time for sleep when their babies were tired enough to doze off easily. (Some proponents of the bedtime fading method also say it’s key to keep a consistent wake time.) A third group followed a method called graduated extinction, which involves letting the baby cry for a short interval, then coming back to check on the baby, and then increasing the intervals between check ins. This is done over several nights.

When the researchers measured the stress levels of the babies by analyzing their saliva for the stress hormone cortisol, the babies in the sleep training groups showed slightly lower cortisol levels than the babies who had no sleep training. This suggests that in the bedtime fading group and the graduated extinction group, the babies had less stress and anxiety. What’s more, the babies that did follow a sleep training method feel asleep more quickly and woke up less frequently in the middle of the night.

The results were positive 12 months later as well. The study authors found that after a year, there was no difference among the groups in the children’s emotional and behavioral health or in the parent-child attachment. “It is an encouraging study and should help parents feel less guilt about sleep training,” says Dr. Schneider. “Though the study is too small to say definitely that there are no long term consequences to the crying, it supports what pediatricians have thought for a long time.”

It’s important to point out, though, that graduated extinction, which is often called “crying it out,” does not mean that you simply let your baby cry indefinitely. “It’s a misconception that ‘crying it out’ means you don’t ever go in and check on your baby,” says Dr. Schneider. “You should not leave a baby in the nursery crying for hours, and not check to be sure he is okay.” This can cause severe stress and could be unsafe as well. “With graduated extinction, you’re letting your baby know with each check in: ‘I’m still here, do you really need me?’” adds Dr. Schneider. “If you see your baby is okay, you let her know you’re going to leave again.”

So what should parents take away from the latest research? “Parents have to decide for themselves if and how much they can listen to their baby cry, but this study suggests that as long as you are there, persistently and gently guiding the way, it’s okay to let your baby cry for short periods of time as he learns to self soothe and put himself to sleep,” says Dr. Schneider. Once he masters that skill, he’ll be able to fall asleep more easily at bedtime and put himself back to sleep when he wakes in the middle of the night. This can, of course, minimize sleepless nights and improve overall wellbeing for babies and parents.

Before you start a sleep training plan, Dr. Schneider recommends that you check with your pediatrician to make sure that your baby is healthy, growing well, and able to skip nighttime feedings. “This usually happens when a baby is around 6 months,” she says. It’s also important to develop a consistent bedtime routine (such as a bath, book, and lullaby) that your baby learns to associate with getting drowsy and going to sleep. Also, keep the room dark for sleep and naps, which will cue your baby that it’s sleep time.  

Finally, one of the best things you can do to set the stage for sleep training, says Dr. Schneider, is to lay your baby down for sleep when she is drowsy but awake, from the very beginning of her life. “That way, your baby learns early on that she doesn’t need you to put her to sleep,” says Dr. Schneider.

-- By Rachel Rabkin Peachman