Saturday, February 28, 2009

At what point is CIO abuse?

Now I'll start with, yes, this will be offensive to some. I'm sorry but I can't be quiet on this topic when I heard that there's this thing called "cry it out bootcamp." On a message board I'm on, someone posted that they thought they were going to have to resort to CIO. As you know I am not in favor of CIO or any other form of child "care" that means you're not responding to that individual child as an individual who has needs, desires and rights.
Anyway, apparently in this "bootcamp" a mother chronicled that they cried it out for FIVE HOURS. I went to some "baby wise" blogs and browsed through some usergroups and hardly ever do they follow some of the "responsible" decision making when someone determines that CIO would be best.

From babywisemom on blogspot (sorry I am not linking it because then more of you may end up there than otherwise and I'm whole-heardedly against CIO),
" I feel like to do CIO responsibly, the we need to do several things. Some of these are a given, but when you’re a first-time mom, they might not seem intuitive. And yes, the we should do ALL of these things, not some of them:
Make sure baby is well fed. Monitor your supply closely if you are BF’ing. Make sure your pediatrician is monitoring your baby’s growth.
Make sure baby is not sick in any way (reflux, ear infections, food sensitivities, etc.).
Stick to the eat/awake/sleep routine.
Stick to the schedule consistently.
Be sure to put baby down at the optimal wake time (which includes feeding time).
Have a routine before you put baby down to transition him to sleep, whether that’s rocking, singing, dancing, closing the curtains, whatever. But always put baby down awake (a little drowsy is OK).
Have a reason for CIO. It should only be necessary for initial sleep training or when going through phases like rolling over, standing up, weaning from swaddle, etc. If crying happens out of the blue for a baby who has always slept well, CIO cannot be the first course of action. You need to consider the context and characterization of the child. You need to investigate all possible causes including a visit to the doctor. Offer Tylenol 20 minutes before the nap if you suspect teething. Evaluate the baby’s behavior during awake time. If you are still stumped, I would comfort the baby until you can figure out the reason.
Don’t start CIO while other changes are going on. If you are weaning, changing formulas, visiting family or experiencing any other disruption to your routine, wait until that disruption is over before you start CIO.
Keep track of how long the baby is crying. It’s best to distract yourself during CIO, but you need to monitor it. Write it down if that helps. When done effectively and responsibly, the CIO shouldn’t take more than 3-5 days and the crying should be less and less each nap/bed time. Initially, baby might cry for an hour. The next time it should be closer to 45 minutes, then 30 minutes and so on. When I have done CIO with Lucas, my youngest, it realistically never took more than 3-4 naps before we were over the problem. The first time was always the hardest but then it got better very fast. With a baby on a 3-hour routine with an awake time of one hour, the most the baby would cry is 2 hours. Even that is a little long in my book, so consider doing a 2.5-hour schedule (which BW condones), meaning the longest CIO would be 1.5 hours.
Above all, be consistent. Being wishy washy about it will only drag it on, confuse the baby and make matters worse. If you can’t handle the CIO, don’t do it at all. Don’t set time limits. Don’t get them up some times and not others. Don’t rock/nurse the baby to sleep some times and not others. You need to decide what you want your baby to learn. Set the rules and stick to them. It’s OK if you can’t handle doing CIO consistently. It’s not for everyone. If it’s not for you, don’t do it at all. Read other books, like Secrets of the Baby Whisperer, and find another method
."

So those are good recommendations, but how often do you hear people talking about CIO as not being the option for an over-tired parent and a kid who just learned they can stand up? I also read a comment regarding how long you should let a baby cry that said "No limit. Unless you want it to grow up spoiled. ... " WAIT>>> WHAT? So I guess this 5 hour mom isn't the only one who believes a child should learn that it is a cruel, cruel world and your parents can't be trusted to help you out.

Anyway, this baby-unwise mom started the expectation that the baby should CIO at 5 days. Yep, 5 days. Fresh from the hospital and already left on his own in the world. I'm sorry but if you CHOOSE to become a parent, then you have to realize your life will not fit in a perfect little package anymore. Your schedule will be disrupted. The more you're with your child, the more you hold your child, the better you'll get to know your child and his/her needs. If your child is tired but is having difficulties falling asleep, put your baby in a sling, nurse her and get some exercise... V loved taking walks in the sling. I got out of the house (even if it was just around the apartment complex). On these message boards I hardly ever see anyone recommend they are sure that CIO is "right" for them and at the "right" time and that they know their baby's schedule like the aforementioned blog (and presumably the book) does.

So back to this 5 hour marathon CIO session. Imagine yourself, as the adult you are, shut into a dark room, alone. You're not sure why you're there so you start calling out "hello, hey... anyone? anyone there?" After a few minutes you get no response. So you call again "hey is anyone out there..." then a bit later, you get louder. You're calling out because you hear someone out there, but you can't get out because you're in some sort of cage (or, you find, the door is locked). After a while, I'm sure it would get a bit stressful. Since you know someone's out there, you continue to try to get their attention. After some time, you may give up, but your stress level is bound to be still high.

Now think of a child, alone in a crib, put down to sleep by (loving) parents. Not ready or able to soothe themselves to sleep (because the parent doesn't feel it is in their job description or because they fear they are spoiling their child?), the child is left alone to make their way to bed. If they aren't at the point where they are ready to go to sleep, they may start crying. Good night little bug, says mommy and the door shuts. Perhaps there is a nightlight for comfort, or maybe some nursery music, I'm not sure of the exact rules. The baby then may start the same as you would as an adult, but since they may not have words yet, or just know how to say (scream/cry) mamamamam... they start calling for you... and calling for you... but, the books and the websites (and doctors??) say to let them cry it out. Let them learn to self soothe. Let the baby be... After a few hours, like you, the baby will get pooped out. The baby may fall asleep, but it doesn't mean damage hasn't been done. It doesn't mean the baby isn't stressed. It doesn't mean that there isn't some type of psychological damage. Of course I'm not saying every child who is let to cry is damaged, but what I am saying is that there are alternatives and that cry it out shouldn't be the first answer, nor is it the answer to your child's sleep question.

Now, if you are having an emotional breakdown, it may be better to let your baby cry for five minutes while you de-steam, than going in and getting upset or screaming at your baby... but that should be your warning that something has to change and that you may need help. Stop thinking you can't let anyone know that you need help and ask a friend, relative, or neighbor to help you a few hours a week so that you can face your child appropriately. It is NOT the baby's fault that you're going through what you are.

My recommendations are these
1) (and foremost) give up your belief that there are good sleepers/bad sleepers
2) give up the idea that a baby should 'sleep through the night by X weeks/months/years"
3) realize that for young infants a five hour period of sleeping non stop is considered great
4) realize that every child is an individual so you can't compare one child to the next as to what they need
5) consider a co-sleeper or a family bed (if you are non-smokers, not over weight, not heavy sleepers, not on drugs or alcohol and both (or the single parent) agrees to it so that you're next to baby and don't have to get up because they do... plus when you're breastfeeding, even less waking time when they need to eat at
night
6) engage in night time parenting. Parenting is a 24x7 job after all!
7) You (your family) and your baby should decide what is positive and not some book (or blog haha).
8) Have balance. If your baby is waking often and you need more sleep. Have someone come help you for two hours in the afternoon so you can nap. Alternate who wakes with the baby at night if you're not breastfeeding
9) Listen to this Harvard study (I hate name dropping but sometimes it works!) "
parents should keep their babies close, console them when they cry, and bring them to bed with them, where they'll feel safe" and ... " 'Parents should recognize that having their babies cry unnecessarily harms the baby permanently," Commons said. "It changes the nervous system so they're overly sensitive to future trauma.' "
So, do you think it is ethical to sleep train? Do you think it is fine to leave a young child alone when they aren't comfortable but not an adult? If you let a baby cry it out, apparently it is okay, but if you do the same to an adult (vulnerable or not) it is considered false imprisonment and is punishable by law.

Oh yeah... and Ferber recanted. I love saying that!
Some links for your pleasure:
http://naturalparentingcenter.wordpress.com/2008/12/17/never-ever-ever-let-baby-cry-it-out/
http://www.phdinparenting.com/2008/08/11/cry-it-out-cio-is-it-harmful-or-helpful/
http://www.askdrsears.com/html/10/handout2.asp
http://www.awareparenting.com/comfort.htm
http://pedsinreview.aappublications.org/cgi/content/abstract/10/1/17
http://www.naturalchild.com/guest/linda_folden_palmer2.html
http://www.hno.harvard.edu/gazette/1998/04.09/ChildrenNeedTou.html

4 comments:

geekmonkmom said...

I totally agree that Cry It Out is abusive. Parents have to stop and think about what FEELS right to them - and letting your baby (or toddler) cry it out for a long period is absolutely not right. We need to make our children feel safe! We need to make sure we are worthy of their trust. Thanks for your post. I wish every parent would read it.

Amanda said...

Thanks for your response to my post. I do agree that many parents just listen to others rather than their babies. They feel they are raising adults rather than guiding human beings.

Amanda said...

Cry it out, modified cry it out, has been shown to relate to failure to thrive because of the lack of respond to a child's needs. While each family needs to decide what works for them - this current plan is not NOT working for your family. Your baby is uncomfortable and cranky... you're sad and not comfortable with the idea.

Babywise is probably the most controversial, but a very popular "program" for sleep training. Here are a few links http://www.ezzo.info/Aney/aneyaap.htm

http://aapnews.aappublications.org/cgi/content/abstract/14/4/21

A nice "recovery" letter from a former babywise mom
http://www.ezzo.info/Voices/failed.htm

Nursing to sleep doesn't cause "issues" - if you feel less comfortable "standing up" to your husband, you might compromise and nurse to sleep in bed and then transition out of the nursing and place baby in her crib/bassinet once she's fully asleep so she's waking in her crib. I started out nursing until dozed off but not fully asleep and then putting her in her bassinet and patting her back until she was back to sleep. Now at almost 14 months, we nurse to sleep 95 percent of the time. She's happy 99 percent of the time, and it works so I am not changing it.

Many cultures believe that children are 9 months in the womb and 9 months on momma. Your baby is not even half way there. There's nothing wrong with holding your baby.... your instincts are right!! :)

The things we expect a baby to do, but wouldn't think of doing to an adult who CAN communicate their needs/desires to us... it really amazes me.

Stardust said...

Hi- I think there are a lot of parents who hear "cry it out" and then decide to let their child "cry it out" and that's it. They don't understand the method.

I have some understanding of the method, and I still couldn't do it.

My daughter is 19 months old and just about a week ago we began "sleep training" (sleep learning) with a gentle sleep coach. She is doing beautifully with it- and it's been a huge relief to us. For gentle sleep coaching, you stay in the room with your child as they learn to go to sleep on their own. So there may be crying, but you are able to soothe them until they get used to it. My sleep coach is able to work with any family- breastfeeding and cosleeping is fine, too! There is a lot more to helping your child learn to sleep and get enough sleep than just self-soothing.

However, my daughter is 19 months old and showed signs of being ready to sleep on her own. I think parents have to do what is best for their child in all cases and it will be different for each family. But I do think that for people who children who don't sleep, or don't sleep well, or don't nap, etc, etc, it is okay to research different sleep training methods and it is great to work with someone who knows what they're talking about. I know I couldn't have done it on my own!

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