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The Crying-in-arms Approach for Helping Babies Sleep Through the Night
by Aletha Solter, Ph.D.
(Dutch version: Laat je baby huilen in je armen, zo help je hem met doorslapen)
See Aletha Solter's book, The Aware Baby, for a full description of this approach.
The problem of night waking
The problem of night waking ranks high on the list of parents who consult with me. In a typical scenario, the mother has co-slept and nursed her baby on demand from birth on. She has started the baby on solid foods, but feels dismayed and perplexed when he continues to awaken at night wanting to nurse. When frequent night waking continues for months or years, many mothers become exhausted, frustrated, and resentful.
Some mothers see only two possible solutions for this problem: 1) continue to nurse the baby at night, or 2) night wean the baby by using the cry-it-out approach (also known as controlled crying). Neither approach feels right to them. Continuing to nurse throughout the night only increases the motherís frustration and anger, whereas letting the baby cry alone can cause the baby to feel abandoned, terrified, and powerless.
The crying-in-arms approach offers a third possibility. This approach can help babies sleep better without ever leaving them to cry alone. Parents who implement the crying-in-arms approach hold their babies lovingly at bedtime without nursing them. Most babies cry hard, but then begin to sleep longer stretches at night. Some even sleep straight through the night for the first time.
Why babies cry
To understand how the crying-in-arms approach works, it is necessary to understand why babies cry. Crying has two important functions: communication and healing. Everybody knows that babies cry to communicate basic needs such as hunger, coldness, or the need to be held. But the healing function of crying is not as widely understood. Babies sometimes cry in order to heal from stress or trauma, even when all of their immediate needs have been met.
Studies have shown that babies in all cultures cry for no apparent reason, and that this crying typically peaks at six weeks of age. The term "colic" is used when the crying seems excessive, but studies have shown that the majority of "colicky" babies have nothing wrong with their digestion. This crying often represents an emotional healing process. Evidence comes from studies showing that babies who had a traumatic birth or whose mothers suffered from high levels of stress during pregnancy cry more than those who did not experience these stresses.
Many babies continue to have crying spells well past the typical period of "three-monthsí colic." They may cry following over-stimulation or out of frustration before developmental milestones such as crawling or walking. Crying also increases when there is stress in the home. Even with the best of parenting, babies experience numerous hurts, frights, and frustrations, and these can all result in a need to cry. When babies reach the toddler stage, their desire for autonomy sometimes results in frustration and tantrums. Temperament also plays a role. Highly sensitive babies cry more than those who are less sensitive.
This stress-release crying represents a normal and beneficial healing process, and we do babies a disservice when we try to stop it. When babies are left to cry alone, they feel terrified, and their cortisol levels increase. However, there is no research indicating that crying in a parentís loving arms increases a babyís stress hormone levels or harms healthy babies in any way (assuming all immediate needs have been met). In fact, studies have shown that stress hormones are excreted in tears, and that people have a lower pulse rate, lower blood pressure, and more synchronized brain wave patterns after a good cry.
Accumulated stress as a cause of frequent night waking
There are many reasons why babies and toddlers awaken at night, including hunger, pain, illness, nightmares, fears, coldness, loud noises, or simply the need for closeness. An additional reason is accumulated stress and the need to cry. If your baby regularly awakens more than once at night past the age of six months, itís possible that he is trying to "catch up" on stress-release crying in order to complete some emotional healing. Perhaps you didnít recognize his attempts to heal early on, and tried to stop or distract him from crying. Maybe you were misled into thinking that nursing was an appropriate response for all crying, so you frequently offered your breast to comfort him even when he wasnít hungry. Thus, your breast may have become his pacifier.
The fact that he now demands your breast repeatedly throughout the night does not necessarily mean that he needs to nurse that frequently. It could mean that he has acquired a habit that serves to repress his emotions, just as you might eat something sweet or reach for a glass of wine when you are feeling stressed or depressed. What you really need at those times is probably a warm hug and a loving shoulder to cry on.
In addition to frequent night awakenings, you can look for additional signs that your baby or toddler has not cried enough. Does he have difficulty settling down at night? Is she clingy or demanding during the day? Does she whine a lot? Is he hyperactive or aggressive? These behaviors could all be signs of accumulated stress with insufficient opportunities to cry.
Implementing the crying-in-arms approach at bedtime
To help your baby or toddler sleep longer stretches at night, you do not need to wean him or make him sleep alone. I do NOT recommend any kind of sleep "training" or "cry-it-out" approach. Babies should always be held and comforted when they cry. I highly recommend co-sleeping and holding babies in arms until they fall asleep. However, if you are already co-sleeping, and your baby is still waking up a lot past the age of six months, you may need to change the way you put him to sleep. Instead of nursing him down, you can nurse him a little earlier in the evening (on both breasts). After teeth brushing and perhaps a bedtime story, you can then simply hold him lovingly until he falls asleep. If he needs to cry, he will probably do so in your arms. Offer him water, but refrain from using your breast to settle him down.
Donít be surprised if he seems angry. Those angry feelings may be part of the accumulation of stress that he needs to release. Your role is to love and comfort him, but not with the goal of stopping the crying. He will eventually stop crying of his own accord. Some parents like to sing a lullabye when their baby reaches the calm, sleepy state that follows a good cry. Afterwards, your baby will probably drift peacefully to sleep in your arms, and you will then be able to put him down.
If you use the crying-in-arms approach at bedtime and also at nap times, your baby will have a chance to catch up on her crying, and will probably begin to sleep longer stretches at night. She will also get used to falling asleep without sucking. However, if she is used to frequent night feedings, it may take a few days for her body to adjust to fewer calories at night. So if she still awakens at night wanting to nurse, you can continue to nurse her at those times. Be sure to offer plenty of solids during the day, as well as several full daytime feedings of breast milk.
In my experience, most parents who implement the bedtime crying-in-arms approach (with babies six months of age or older) find that their babies spontaneously begin to sleep longer stretches at night within a week. Some babies sleep through the night for the first time. These parents also report that their babies seem much happier and calmer during the day. If your baby continues to awaken frequently at night after implementing this approach for a week, and if you are becoming resentful of night feedings, you can gradually increase the intervals between night feedings over a period of three weeks (3-hour intervals the first week, 4-hour intervals the second week, and 5-hour intervals the third week). These intervals refer to the time elapsed since the beginning of the previous feeding. If your baby awakens between these intervals, she may need to cry. You can hold her lovingly and allow her to cry in your arms, while offering water. Most babies begin to sleep through the night before the 5-hour interval is reached. However, I donít recommend total night weaning because some babies may still need one night feeding past the age of six months. Please note that this approach is only for babies who are co-sleeping. If your baby sleeps alone in a separate room, the reason for night waking may simply be a need for closeness.
The role of fathers
Fathers can help implement the bedtime crying-in-arms approach. Remember that babies always need connection and closeness when they cry, and they also need closeness before falling asleep. However, they do not always need to nurse, nor do they always need their mothers to put them to sleep. If your baby screams in his fatherís arms, it does not necessarily mean that he needs his mother. It may simply mean that he needs to release accumulated stress. When parents alternate bedtime duties right from the start, their babies fall asleep just as easily in either parentís arms. As toddlers, they willingly accept either parent to put them to bed.
Supporting your childís daytime crying
In addition to supporting your babyís pre-sleep crying, you can also take a look at how you normally respond to daytime crying. Do you immediately offer your breast when your baby or toddler hurts himself? Do you distract her from expressing emotions when she is sad, frightened, or frustrated? Do you try to stop his tantrums? While itís important to reduce stress in your childrenís lives, your job is not necessarily to keep your children happy every moment of the day, but to support them while they work through lifeís challenges.
All children need to be comforted when they cry, but thereís a difference between comfort that represses emotions and comfort that allows emotions to be felt and released. A good cry with loving support can help children release stress, while restoring calmness and joy. The more your baby or toddler cries freely following daily upsets and frustrations, the better he will sleep.
Aletha Solter, PhD, is a developmental psychologist, international speaker, consultant, and founder of the Aware Parenting Institute (www.awareparenting.com). Her books have been translated into many languages, and she is recognized internationally as an expert on attachment, trauma, and non-punitive discipline. The titles of her books are The Aware Baby, Helping Young Children Flourish, Tears and Tantrums, Raising Drug-Free Kids, and Attachment Play.
Aware Parenting is a philosophy of child-rearing that has the potential to change the world. Based on cutting-edge research and insights in child development, Aware Parenting questions most traditional assumptions about raising children, and proposes a new approach that can profoundly shift a parent's relationship with his or her child. Parents who follow this approach raise children who are bright, compassionate, competent, nonviolent, and drug free.
For more information about the crying-in-arms approach, see Aletha Solter's book, The Aware Baby.
Other articles by Aletha Solter about crying:
What to do when your baby cries
Understanding tears and tantrums
Crying for comfort: Distressed babies need to be held
Interview with Aletha Solter on crying and high-need infants
Interview with Aletha Solter: How can we respond to babies' emotions?