Reproduced from 'Essence' magazine
Volume 37, Number 6
Exclusively for ABA subscribers

Lesley McBurney, Australian Breastfeeding Association Counsellor

The Australian Breastfeeding Association's policy statement on breastfeeding contains the following sentences "Every baby is an individual, with different feeding, sleeping and crying patterns. A mother should be encouraged to respond to all of her baby's needs". This ties in nicely with the phrase from our Code of Ethics that says we aim "to create in mothers an interest in breastfeeding as an aid to the art of skilled and loving mothering, thus encouraging close and happy family relationships."

It is for this reason that many in the association are concerned about the increasing popularity of 'controlled crying' techniques, sometimes called 'controlled comforting'. The idea is to train babies to fall asleep by themselves. This is achieved by leaving the baby in its cot to cry for increasingly longer periods before the parents respond. These recommended time periods vary, but can be anything from fifteen minutes up to an hour. Originally, controlled crying was not recommended for babies under six months of age, but it seems to be suggested for younger and younger babies these days, right down to newborns.

Many parenting experts are concerned about the appropriateness of controlled crying. In the newborn period, for example, babies need to be fed around the clock so that the mother establishes her milk supply. They also have tiny stomachs (about the size of their clenched fist) which empty quickly, and breastmilk is the most readily digested food for the human stomach. It is simply not realistic for little babies to be expected to go for long periods without food, and not be extremely distressed.

Doctor William Sears, in his book Night-time Parenting, explains that babies sleep differently to adults, because of their rapidly developing brains. They need to sleep lightly for their very survival: if their bodies become cold, they must arouse quickly and alert a caregiver by crying, otherwise they may die of exposure. The same applies to hunger.

Studies of hunter-gatherer societies by the anthropologists Lozoff and Brittenham have shown that their infants are carried constantly, they sleep with their mothers, crying babies are fed immediately and feeds are frequent. It is very hard to expect babies in the 21st century to suddenly change from a three million-year-old human pattern to one where they are expected to sleep alone for long periods without human touch or sustenance, and not be unhappy about it.

Desmond Morris, the author of Babywatching, says that just being alone can make babies insecure and they will cry unless they are 'scooped up in parental arms'. Before about eight months of age, babies have no idea of 'object permanence'. This means that if they can't see something it doesn't exist. A baby does not know the parent will be back in five, ten or fifteen minutes. All it feels is abandonment.

In his book The Prehistory of Sex, Timothy Taylor says that typical behaviour of young mammals and birds is to signal distress and wait for a response. If there is no response, the juvenile understands that it has been abandoned, and will die unless it conserves energy. Crying expends energy so crying must be stopped to ensure survival. This leads to 'learned helplessness' where the baby whose needs are not met detaches from reality, and numbs itself into sleep.

We mothers have, at our disposal, the perfect sleep-inducers. They are called breasts. Breastmilk contains a wonderful hormone called cholecystokinin (CCK). CCK induces sleepiness, both in the baby and the mother. When the baby sucks, CCK is released within the mother to help her rest and relax. Many mothers say that breastfeeding tires them out. Certainly caring for a new baby is tiring for all mothers, but the sleepiness caused by breast-feeding is to ensure that the mother gets the rest she needs.

In the baby, CCK release is caused by sucking and when food, especially fat, enters the stomach. There are actually two CCK peaks, one at the end of a feed, and the other higher peak between 30 and 60 minutes after the feed. The baby sucks, gets sleepy, dozes off for a while then wakes again for a top-up feed. That higher-fat feed causes the second peak and the baby goes into deeper sleep. Top-up feeds are also great for the mother's milk supply.

Feeding a baby to sleep is therefore not spoiling him or her; it is helping sleep to come in the most natural way possible. The baby feels satisfied and secure and learns to trust. Attending to a crying baby quickly also is not spoiling. The work of Ainsworth and Bell at John Hopkins University showed that parents who responded quickly to their babies during the first months of life had infants who cried less often and for shorter periods later, and were more likely to show healthy independence when they were ready.

Many couples are not made aware of these facts when they are told that 'controlled crying' is the only way to get their babies to sleep. In the end, only parents can decided what is best for themselves and their babies, but their decisions need to be informed ones.