Educating the Experts – Lesson One: Crying

You can read the entire Educating the Experts series, including new content not available online, in the eBook offered through this site.  You can read more about it by clicking here.

Clique aqui para transferir o artigo no português – Thank you to Andreia K. Mortensen for the translation

Click here to read the article in Hebrew – Thank you to Idan Melamed for the translation

You call yourselves “baby whisperers” and “experts” on how to get babies to sleep and though you write books telling parents exactly how to care for their children, it seems as though you all require a bit of a brush up on your education.  You see, when I see some mother buying your books, or hear of your appearances on TV talking about your “advice”, my heart breaks for the children of the parents who are blindly following what you promote.  You make assumptions that shouldn’t be made, and all the while parents follow your advice without knowing any better and hoping they’re doing best for their baby.  And you do so with no regard for the plethora of scientific evidence that is out there suggesting your methods not only are wrong, but can actually harm babies.  I thought, given the fact that I am a doctoral candidate in developmental psychology with access to every peer-reviewed journal there is, I would offer you some free (a word you hardly use) lessons on the myriad topics of parenting you are so fond of writing about.  At first I thought this would be a one-off lesson covering everything, but I have realized that is foolish and would be way too long for one lesson – you obviously need time to integrate everything and learn what it is that’s out there before you start preaching to the masses again – so we will do this over several lessons, each covering one topic.

Where to begin?  I thought about this and settled on a history of what we know about crying.  Given your overarching mission of getting babies to stop crying either during the day or at night, it seems that you require a bit more of an understanding of both why babies cry and what it can mean when a baby isn’t crying.  So let’s begin…

 
Why does a baby cry?

The simple answer to this is to have his or her needs met.  The more complex answer starts with the fact that crying is the only form of communication young babies have (until they start to learn to vocalize or sign), and evolutionarily it has developed in such a way to make parents want to stop it.  (Of note, parents can use their baby’s cues to pick up on what he or she needs, but these cues are technically not a form of communication as they are not done by an infant with the express intent of telling the other what they need.)  It grates on your ears and breaks your heart so that you will address your baby’s needs promptly, NOT so that you ignore it in hopes of it ending.  And depending on the type of cry (because your child will have different cries for different needs), the way they expect you to respond will differ, but they will expect you to respond.  It doesn’t matter if you’re sleeping or not or if your baby is sleeping, physiologically a baby will cry when it needs something unless he or she has a) been trained not to, or b) is in a physiological state that would reduce his or her ability to cry.  All of you, whether you claim to be against crying-it-out or not, promote forms of leaving an infant to cry.  And all of you promote ways of “training” your baby not to cry.  So really, you’re proposing to ignore your baby’s needs and train them to stop communicating those needs with you.  We need to be clear about this as it is critically important that you fully understand the key role crying plays in an infant’s life.

However, the question of why babies cry is pretty simple.  Most people are aware on some level that it’s telling you something which is why mothers will change dry diapers or put a baby on their breast even if they just ate, all in the name of trying to meet that need.  The real question that needs to be asked is that when you have a child who isn’t crying or stops crying, why is that?

Why does a baby stop crying?

This is a question that you assume the answer to in all of your training methods and books and sites and advice.  You assume that because a baby stops crying, he or she is okay.  Or that if after two weeks a baby no longer cries before falling asleep, the baby has learned about sleep time and routines.  Most unfortunately for the babies who have to endure the advice you give, this isn’t the case.  So why do babies really stop crying?

a)      The best answer for baby is that his or her needs have been met.  Baby was hungry and mom fed her.  Baby had a wet diaper and it was changed.  The amazing part about this is that attending to a baby’s needs promptly will actually reduce crying in the long run in a healthy way.  Mary Ainsworth and Silvia Bell, two developmental psychologists, performed a longitudinal study back in the 1970s while at Johns Hopkins University looking at how mothers responded to their infants’ cries and how this affected later infant behaviour[1].  What they found was that the more prompt a mother was to respond to her child’s cries, regardless of how effective she was at reducing the crying at that particular moment, the less a child cried later on.  Furthermore, they also found that close maternal contact (i.e., touch) was the most effective at terminating crying during a given episode.  To summarize, when their needs have been met babies will cease to cry.  Furthermore, the more responsive a parent is to an infant’s cries, the less likely that child is to cry in the future.  Taking this further, the wealth of research on attachment theory demonstrates that the more responsive a parent is in the first year of life, the more securely attached their child is and thus the better the relationship between child and parent[2][3][4][5].

In line with this, Dymphna van den Boom tailored interventions for mothers of irritable 6-month-old infants with a focus on increasing maternal responsiveness and sensitivity to their child[6].  At the end of the 3-month intervention, she found that the mothers in the intervention group were more sensitive, responsive, and stimulating than mothers in the control group and furthermore, the children of these mothers were more sociable, showed greater self-soothing and exploration, and also cried less than their counterparts.  The effects of maternal responsiveness on child behaviour also extend into the older ages.  Maayan Davidov and Joan Grusec examined maternal responsiveness to distress and maternal warmth in 6-8 year olds and found that greater responsiveness to distress (but not warmth) predicted a child’s level of empathy, prosocial behaviour, and negative affect regulation (which would be crying in infancy)[7].

Why is this?  Well, you are all right about one thing – babies learn and they learn rapidly.  What you are wrong about is what they learn.  At a young age, the only thing a baby will truly internalize is a feeling of being responded to and cared for or not and this will play out in future behaviour, including crying, empathy, and helping.  We can only know what we have learned, and so a child who learns love and compassion and sensitivity will pass that along in his or her own behaviour, while a child that knows neglect will simply withdraw into themselves.  Let us continue to understand more…

b)      A second reason an infant may not cry is because there is a physiological or physical reason preventing her from doing so.  The most common would be a drastic change in temperature, specifically becoming too hot.  While a baby will cry when overheated to a certain degree, as the overheating increases, the chances of crying decrease as the effort it takes to cry increases the core body temperature even more, resulting in an even greater increase in temperature which is antithetical to the infants’ well-being.  One of you (I’m looking at you Ms. Tizzie Hall), has promoted quite a bit of layering in order to keep babies from waking up in the middle of the night, under the assumption that babies wake because they’re cold (not because of the myriad nutritional and comfort benefits of that breast they look for).  What are the risks of overheating your infant?  The dangers of overheating, or hyperthermia, include seizures, coma, neurological damage, and death[8].  A case study in the late 1970s found that the extreme illnesses of 5 infants (4 of whom died), which included fever, shock, and convulsions prior to death, was most likely due to the overwrapping of infants leading to heatstroke[9].  There is also ample evidence to suggest that hyperthermia plays a role in Sudden Infant Death Syndrome[10][11][12], making it hugely important to remember the general rule that babies should have one more layer than adults and that’s it.  By promoting practices that lead to infants being too warm, you not only lower their ability to cry, but increase their risk of mortality.

 
c)       Finally, the most likely reason a child stops crying during baby training that he has given up or learned that he will not be attended to.  If you view a baby crying as a creature trying to manipulate you (as almost all of you do), you will see this as a positive outcome.  Indeed, this was the prominent view of children’s behaviour in the mid-twentieth century when parents were told not to pick up their children for fear of spoiling them and turning them into little tyrants[13].  This view took hold once learning theory took the helm in psychology, demonstrating people behave in ways related to rewards and failures.  John B. Watson was the first psychologist to promote behaviorism as a form of learning and the first to extend it to childhood with his famous ‘Little Albert’ experiment.  The Little Albert experiment was a case study demonstrating classical conditioning (exactly what you all propose in your books) on an 8-month old boy.  In this study, the little boy is conditioned to become afraid of white rats.  To do this, the boy was brought into a room and sat on a mat while a white lab rat was allowed to roam around.  At this time, the boy showed no fear of the rat at all.  As he reached out to touch the rat, Watson and his assistant Rayner struck a steel bar with a hammer, scaring Albert and causing him to cry.  They continued to do this every time the boy reached for the rat.  Eventually Albert tries to get away from the rat, showing he has been conditioned to fear the white rat.  Amazingly, at a follow-up over two weeks later, Albert showed distress towards any furry object, showing his conditioning had been generalized and sustained[14].  Based on his work and strong belief in behaviorism, Watson also wrote about child-rearing[15].  His focus was on keeping an emotional distance from children so as not to spoil them; it was his work that led to the promotion of not touching your child too often (sadly he later admitted that he regretted writing about child behaviour because he realized he didn’t know enough to do so, but the damage had been done).

So you can teach your child not to cry by conditioning them to not cry.  Not responding to them will tell them that their cries will not get them what they need.  While you all may view this as a positive, it has a very serious consequence – learned helplessness.  The concept of learned helplessness was devised by Martin Seligman in response to behaviorism.  Seligman had been doing work with dogs and found that they were not behaving the way behaviorism would predict they should when conditioned[16].  Specifically, he tested dogs who were conditioned to electrical shocks.  In two of the groups, the dogs were tethered together such that only one had control over when the electrical shocks would end; to the other dog, it was seemingly random.  Seligman (and Maier, his partner in these experiments) found that the group of dogs who did not have control over ending the shocks displayed behaviour much like clinical depression in adults.  Furthermore, when these dogs were then given a situation which they did have control over, they failed to act – they simply sat down and gave up.  These results have been replicated with other animals, including babies (though in a benign paradigm)[17], all with the same findings – once animals and infants have learned that they do not have control, they cease to attempt to affect their surroundings, even when the surroundings change.  Crying it out, strict schedules, and simply behaving as though an infant is attempting to manipulate will lead to the removal of control a child has over his or her environment.  Crying is the main form of control an infant has and needs to be treated with the respect we would show another adult talking to us about what they need.  And while experiments have not been done that put an infant in harm’s way, noted psychologist Dr. Kevin Nugent has found many depressive symptoms in babies whose communication with their parents is lacking.  Parents who are unable to respond to or are simply non-responsive to their infant’s attempts at communication have babies who display classic signs of major depression[18].

In short, not responding to an infant’s attempt at communication will cause them to give up at the very least and possibly demonstrate long-term learned helplessness.  This type of non-crying is damaging to a baby’s long-term psychological well-being, no matter how beneficial it may be for mom and dad in the present moment.

Conclusions

I hope you have learned here that a) crying is simply a form of communication and the primary one that an infant has, and b) that not all forms of not crying are equal.  Infants need to learn that they have control over their environments and can effect change in their lives; they also need to know they are loved and cared for.  They do not manipulate their parents – in fact, they are incapable of doing so, and the work of Mary Ainsworth has gone a long way to demonstrate that far from being manipulative, crying leads to communication between caregiver and infant and that this communication leads to a natural reduction in crying as time goes by[1][2].  And most important for you to realize is that simply because a child has stopped crying – as I acknowledge that your trainings will get a child to stop crying – that is not always a good thing.  In fact, the only type of crying cessation that is good is that which results from a child’s needs being met.  The rest is simply setting up the child for either a risk of illness or death (hyperthermia) or psychological damage (learned helplessness).  (Note that there is also neurological damage but we’ll get to that in another lesson on crying-it-out techniques.  You can read about crying-it-out here, including discussions of post-partum depression and sleep.)

Of course, this leads us to what will be the topic of Lesson Two: What are an infant’s “needs”?  The main thrust of your programs is that you’re telling parents that they can leave their child to cry because all of their needs have been met.  But you are wrong, so stay tuned…

You can read the entire Educating the Experts series, including new content not available online, in the eBook offered through this site.  You can read more about it by clicking here.