Childhood/Parenting

Why I No longer Believe Babies Should Cry Themselves to Sleep

‘Some of our friends see us as weak parents because we haven’t Ferberized our children,” says my niece Rachel Maté, a 33-year-old Vancouver lawyer and mother of two. ” ‘You’re letting your baby control your lives,’ they argue. But it would break my heart to let my baby cry without comforting her.”

Named after Dr. Richard Ferber, the pediatric sleep expert quoted in Jan Wong’s article (in this section last week) on parents who share their beds with their children, Ferberization is the process of “training” an infant to sleep by ignoring her crying. As a family physician, I used to advocate the Ferber technique and, as a parent, practised it myself. Since then, I have come to believe that the method is harmful to infant development and to a child’s long-term emotional health.

Ferberization seems simple: “After about one week, your infant will learn that crying earns nothing more than a brief check from you, and isn’t worth the effort. She’ll learn to fall asleep on her own, without your help,” reads Dr. Ferber’s advice. The question is, what else does a baby learn when treated this way and what is the impact of such learning?

People cannot consciously recall what they “learned” in the first year of life, because the brain structures that store narrative memory are not yet developed. But neuropsychological research has established that human beings have a far more powerful memory system imprinted in their nervous systems called intrinsic memory. Intrinsic memory encodes the emotional aspects of early experience, mostly in the prefrontal lobe of the brain. These emotional memories may last a lifetime. Without any recall of the events that originally encoded them, they serve as a template for how we perceive the world and how we react to later occurrences.

Is the world a friendly and nurturing place, or an indifferent or even hostile one? Can we trust other human beings to recognize, understand and honour our needs, or do we have to shut down emotionally to protect ourselves from feeling vulnerable? These are fundamental questions that we resolve largely with our implicit memory system rather than with our conscious minds. As psychologist and leading memory researcher Daniel Schacter has written, intrinsic memory is active “when people are influenced by past experience without any awareness that they are remembering.”

The implicit message an infant receives from having her cries ignored is that the world — as represented by her caregivers — is indifferent to her feelings. That is not at all what loving parents intend.

Unfortunately, it’s not parental intentions that a baby integrates into her world view, but how parents respond to her. This is why, if I could relive my life, I would do much of my parenting differently.

When the infant falls asleep after a period of wailing and frustrated cries for help, it is not that she has learned the “skill” of falling asleep. What has happened is that her brain, to escape the overwhelming pain of abandonment, shuts down. It’s an automatic neurological mechanism. In effect, the baby gives up. The short-term goal of the exhausted parents has been achieved, but at the price of harming the child’s long-term emotional vulnerability. Encoded in her cortex is an implicit sense of a non-caring universe.

The concepts behind Ferberization precede the publication of Dr. Ferber’s 1985 bestseller Solve Your Child’s Sleep Problem. Forty years earlier, Benjamin Spock proposed the very same approach in his seminal book Baby and Child Care. The cure for what Dr. Spock called “chronic resistance to sleep in infancy” is straightforward. The way to ensure that the infant doesn’t “get away with such tyranny,” he wrote, was to “say good night affectionately but firmly, walk out of the room, and don’t go back.”

Dr. Spock was a great pioneer of humane and loving child rearing and much of his advice refuted the harsh Victorian practices prevalent in his days. On this sleep issue, however, he ignored his own admonition that parents should trust their own instincts and gut feelings and not defer to the opinion of experts.

Monica Moster, an 80-year-old grandmother of seven, recalls what it felt like for her to follow such advice with her own children. “It was torture for me to do it,” she says. “It went against all my motherly emotions.”

Rachel Maté reports that even some of her friends who believe in Ferberization have a hard time of it. “I know women who have to stand in the shower with their hands over their ears so they can’t hear their baby crying. It’s traumatic not just to baby, but also to parent.”

In our stressed society, time is at a premium. Beholden to our worldly schedules, we try to adapt our children to our needs, rather than serving theirs. More “primitive” aboriginal peoples in Africa and North and South America kept their infants with them at all times. They had not yet learned to suppress their parenting instincts.

The baby who cries for the parent is not engaging in “tyranny,” she is expressing her deepest need — emotional and physical contact with the parent. The deceptive convenience of Ferberization is one more way in which our society fails the needs of the developing child.

7 thoughts on “Why I No longer Believe Babies Should Cry Themselves to Sleep

  1. Tony says:

    Hi Dr. Mate,
    As a new parent myself, your perspective on leaving babies to cry resonates with me. You mentioned that if you were to able to redo being a parent, you would have done things differently. I’m curious what models/perspectives you would draw on now? Any recommendations for readings. Many thanks.

  2. dhx says:

    This is a great question, I’m also interested to know 🙂

  3. Tom Sanderson says:

    Hi Dr Maté
    Thank you for everything you have learned and released.
    I would like to second Tony questions – could you give some specific examples?
    Thank you
    Tom

  4. Henry says:

    Hi Dr,
    Appreciate your perspective so much. I just want add a perspective: There are many ways to structure sleep with babies and toddlers and I don’t think it’s fair to say any one perspective is totally right or wrong. There are obvious nuances to this topic. For example, from what I understand of Ferberization, most parents go through this process later in their child’s development (I do not advocate it’s use with very young infants, I’m not sure who does). Also, there are many subtleties to the process such as intermittently soothing, touching, singing etc. so the child is not left alone to cry for extended periods, having a deep and intimate relationship with the child in question and making a bedtime routine that supports them learning how to fall asleep knowing there needs are being met and that you love them. I understand your reservations around this extreme method, my main point is this technique is not quite as cut and dry as you have made out. With thanks, H

  5. lucy borne says:

    I really respect your work. I would be interested to hear what you think of my situation. I am a complete advocate for attending to a babies needs. However at four months our son refused to sleep longer than 30 minutes and it was clear the sleep deprivation he was experience was detrimental. To him and me for my own exhaustion. We sleep trained and he now sleeps very well but I am scared that I am teaching him we are indifferent to his needs. Is there a middle ground here?

  6. Prof Michael Gradisar says:

    It’s great to have Dr Maté inform of historical trauma. I would however caution the extrapolation to Ferberization. The notion that it leads to later attachment issues or “harming the child’s long-term emotional vulnerability” has been disproven with studies such as those conducted by Price et al. (2012) in Pediatrics, and my own 2016 Pediatrics study. These studies are direct evidence showing sleep treatments help and do not cause harm. In contrast, children exposed to violent homes is indirect evidence. Please incorporate all of the scientific literature so that parents can make an informed decision. Thank you.

  7. Kirsten says:

    Bed sharing, breastfeeding during the night, contact naps, baby sleeping on a parent for the first part of the night, etc. All demonised. All made to seem like this is ‘bad’ parenting when actually this is biologically normal, necessary and healthy! All of these things helps baby and parent get more sleep, bond and feel happier and healthier. We have such a broken way of thinking on infant sleep in our culture and it’s not only heartbreaking it has an enormous impact on generations of children.

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