Will Sleep Training Harm My Baby?

Apr 6

One of the most common fears parents have about sleep training is that sleep training will harm their child emotionally, mentally, or physically (or damage their attachment or bond).

This post is intended to encourage parents by providing some of the relevant evidence based research that has been done on sleep training.

DISCUSSED IN THIS POST:

Where did the Anti-Sleep Training movement come from?
Will the stress or rise in cortisol caused by sleep training harm my child’s development or their emotional or physical wellbeing?
What about the well known Middlemiss study that proves sleep training is dangerous?
Will sleep training damage my child’s bond with me or their attachment?
The numerous high quality studies that show the benefits and effectiveness of sleep training for both children and parental well being.

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Where did the Anti-Sleep Training movement come from?

A good place to start when it comes to sleep training and whether or not it is harmful is to go back to where some of the anti-sleep training movement came from: Romanian Orphanages.

In the 1980’s, Romania began to incentivize its citizens to have as many children as possible. They outlawed contraception and penalized families with few or no children. This resulted in many children being sent to orphanages due to the inability of their families to care for and financially support them.

These Romanian orphanages have actually been called “Child Gulags” and “The Slaughterhouse of Souls” because of how neglected and abused the children were. They were basically left completely to themselves, confined to cribs for years, and never had meaningful interactions with any caregivers.

There have been many studies done on the effects these orphanages (and others like them) have had on children in their adult years. The children who spent their early years at the orphanages entered into adulthood with serious mental and emotional challenges.

Read some of the relevant evidence based research here, here, here, and here.

What does this have to do with sleep training?

When the Romanian orphanages came to light, it reinforced how important meeting not only a child’s physical needs are, but how important loving, nurturing, responsive caregivers are for a child’s growth, development, and overall mental and emotional well being.

Many people have made a comparison between leaving a baby to cry during the sleep training process to what these poor orphans went through during their time in the Romanian orphanages.

Obviously this is an unfair and inaccurate comparison. Children in loving, responsive, nurturing homes whose parents make an intentional decision to allow their children the space to learn healthy sleep habits is nothing like being left alone in a crib and neglected and abused for years.

Keep reading for the research and explanations that support this.

Will the stress or rise in cortisol caused by sleep training harm my child’s development or their emotional or physical wellbeing?

Another question that comes up in regard to sleep training is whether or not the stress (or more specifically, the rise in cortisol) caused from crying during sleep training is enough to cause damage to a child’s development, their emotional wellbeing, or their physical well being (i.e. brain damage?)

There has been extensive research done on stress and childhood development and outcomes.

The first thing we need to talk about is the hormone Cortisol. This is often referred to as “the stress hormone.” Cortisol is a very important hormone in the human body that helps regulate our body’s stress response and can affect almost every single organ.

Cortisol isn’t bad. It’s a very important and necessary part of how the human body works and regulates itself.

We can reasonably conclude that sleep training would fall into the, “positive stress response” and be comparable to starting daycare.

Parents find themselves dropping their child off in a new environment to be cared for by strangers. Babies and children often cry for the first several days of daycare, but after getting used to their new environment, they adapt and become comfortable. They realize they are safe, secure, and cared for.

No one is accusing parents of subjecting their child to severe trauma or irreparable damage, even though leaving their child at daycare the first few times is undeniably very stressful for a small child who can’t understand what’s happening.

Read more evidence based research about stress and childcare HERE.

There is no evidence based research that shows that sleep training done in a loving, responsive home will cause a child to experience a toxic stress response. This is supported, in part, by the fact that toxic stress has measurable effects.

Additionally, cortisol levels can easily be measured by a simple saliva test.

If sleep training resulted in toxic stress, researchers would be able to show this.

Numerous studies have been done on sleep training that show no physical or emotional consequences nor attachment issues. More on this, including the relevant research linked, below.

Learn more about the types of stress responses and the evidence based research: HERE, HERE, HERE, HERE, HERE, HERE and HERE.

What about the well known Middlemiss study that shows sleep training is dangerous?!

You may have heard of a study done that specifically tested cortisol levels in relation to sleep training.

This study was conducted for five days in a lab with 25 mother/baby sets while the babies underwent Extinction (which is the “Cry it Out” version of sleep training where babies are put in their crib and receive no other intervention or support from caregivers for the remainder of the night).

The researchers tested the mother’s and baby’s cortisol levels before and after the babies fell asleep on night 1 and night 3.

Mothers and babies started out having correlating cortisol levels on night one. On the third day of the study, the mother’s cortisol levels had gone back down, but the baby’s hadn’t, even though they were no longer crying.

Many claim that the results from this study indicate sleep training is harmful to babies and that babies stop crying even if they are still distressed.

However, this is misleading.

The Middlemiss study was not conducted using the appropriate standards scientists require for evidence based research. A few examples:

The study did not have a control group (there was not a group of mothers and babies who were not undergoing sleep training to compare results to).
The study’s results were only taken from 10 of the 25 participating pairs (which was already a small sample size).
The researchers did not find the baseline cortisol levels of each individual participant before attempting to measure their stress response during sleep training (there’s no way for us to know if their cortisol levels were high, normal, or low). Normal ranges of cortisol vary from time to time and person to person. https://my.clevelandclinic.org/health/articles/22187-cortisol
The babies were in an unfamiliar environment, put to sleep by strangers (nurses), while their mothers stood outside the door (this would cause a rise in cortisol, or stress, levels whether or not they underwent sleep training).
They only tested cortisol levels on day 1 and 3. No additional nighttime data was taken.
They used the wrong statistical analysis

All this to say, the Middlemiss study should be considered inconclusive at best (neither supporting nor discouraging sleep training). Using it to scare parents of the dangers of sleep training is unethical.

Will Sleep training cause my baby to shut down and stop calling out when they have a need (“Shut Down Syndrome”)?

You may have heard about something called, “shut down syndrome” or the idea that crying during sleep training will result in your baby no longer calling out for help even if they have a need. This idea was made popular by Dr. Sears (see more on Dr. Sears below) and anti-sleep training advocates.

While many people claim this to be factual, there is actually no evidence based peer reviewed research to support this idea and “Shut Down Syndrome” is not an accepted medical diagnosis or condition.

Will sleep training damage my child’s bond with me or their attachment?

Many parents worry that sleep training their child will negatively impact their child’s attachment or their bond.

To answer this question, we need to explore what secure attachment actually is.

Attachment parenting and attachment science are often confused and assumed to be the same thing. However, they are completely unrelated.

What is attachment parenting?

Attachment Parenting is a parenting philosophy developed by Dr William Sears and his wife.

Attachment parenting is characterized by continuous physical closeness between parent and child and encourages the utmost empathy and responsiveness from parents. A big goal of attachment parenting is to prevent any crying.

The seven B’s of attachment parenting:

Birth bonding
Breastfeeding
Baby wearing
Balance
Baby’s cues
Beware of baby trainers
Bed sharing

Learn more about attachment parenting HERE.

While many families choose an attachment style of parenting, it is important to note that there is no evidence based research supporting it as an actual intervention and it is simply a parenting philosophy.

What is attachment science?

Attachment Science, or attachment theory, is a field of study that originated from work done by John Bowlby and Mary Ainsworth.

One of the main components of attachment science is the idea that young children need to develop a relationship with at least one primary caregiver for healthy development (i.e. have a secure attachment).

Attachment science says that secure attachment is fostered by an overall caring and responsive caregiver (please note, responsive doesn’t equal promptness). Attachment isn’t achieved by checking off a list of parenting approaches or strategies, it’s more complex than that. Additionally, research has shown that attachment isn’t something that can be easily ruined or broken. Studies show that over 60% of children have secure attachment.

Secure attachment is often misunderstood as physical closeness or the child’s response to separation from their caregiver. However, secure attachment is more about a child’s reunion with their caregiver, than their reaction to being separated from their caregiver (as that is determined more by a child’s individual personality).

You can have a secure attachment regardless of your parenting style or parenting strategies (i.e. baby wearing, breastfeeding, bed sharing, sleep training, using time-outs etc). One single event (in this case, sleep training) is not able to break or ruin a child’s secure attachment to their caregiver.

The benefits of sleep training + relevant research

As we’ve discussed, evidence based research does not support the claims that sleep training in a loving, supportive home can damage a child emotionally, mentally, or physically.

The research also does not support the idea that sleep training can damage a child’s attachment or bond to their parent(s).

There are, however, numerous high quality studies that show the benefits and effectiveness of sleep training for both children and parental well being.

Studies show that sleep training results in positive changes in sleep, as well as improving a child’s security, overall mood, and a decrease in overall crying.

Parents experience less depression and overall improved mental health and parenting confidence, marital satisfaction, and reduced stress.

See some of the relevant research HERE and HERE.

There are several studies that show no change or a positive impact on a child’s attachment and, to date, there are no valid studies that show that sleep training is harmful.

jessica martin

Will Sleep Training Harm My Baby?

Where did the Anti-Sleep Training movement come from?

What does this have to do with sleep training?

Will the stress or rise in cortisol caused by sleep training harm my child’s development or their emotional or physical wellbeing?

We can reasonably conclude that sleep training would fall into the, “positive stress response” and be comparable to starting daycare.

What about the well known Middlemiss study that shows sleep training is dangerous?!

Will Sleep training cause my baby to shut down and stop calling out when they have a need (“Shut Down Syndrome”)?

Will sleep training damage my child’s bond with me or their attachment?

What is attachment parenting?

What is attachment science?

The benefits of sleep training + relevant research

Additional evidence based / peer reviewed studies on sleep training:

Sleep Training Effectiveness:

Attachment + Sleep Training:

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