Popular techniques that help babies fall asleep on their own don't have any long-term impact on mental health, sleep quality or the parent-child relationship, a new study finds. The new study is a follow-up, done when children were 6 years old. The study included 225 children. It began when they were 7 months old and were having sleep problems. They were randomly divided into 2 groups. One group of parents received training in techniques called "controlled comforting" and "camping out." With controlled comforting, parents put their babies down for sleep and leave the room. They let the babies cry for increasing amounts of time before comforting them, to encourage them to fall asleep on their own. Parents who camp out stay in the room, but gradually move farther away. People in the other study group did not receive training in these techniques. By age 6, there were no differences in behavior or mental health between children in the two groups. The children's sleep habits, stress levels and parent-child closeness also were similar. The journal Pediatrics published the study. HealthDay News wrote about it September 10.

By Claire McCarthy, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

It's okay to teach your baby to sleep on his or her own. It's not going to hurt your baby, or your baby's relationship with you.

That's the message of a study out today in the journal Pediatrics.

Researchers in Australia did the study. They noted that there was a lot of contradictory information about whether it was a good idea or not to teach babies to sleep on their own. Some doctors and others encouraged it. Others warned parents that it was a bad idea. If you don't respond "consistently and sensitively" to babies, the naysayers warned, it can be bad for the parent-child relationship. They said it also could cause long-term mental health problems for the children.

There didn't seem to be any evidence that this was the case. The researchers wondered if these concerns were related to using a "let them cry it out" approach, which isn't generally recommended. What is recommended for teaching independent sleep is a more stepwise approach. First, parents put babies down to sleep. Then they either let them fuss for short periods of time before going in to comfort them, or they stay in the room but move back, bit by bit, then out of the room.

These kinds of approaches do appear to work. They also have been shown to help parent sleep, mental health and child-parent relationships. But what about down the road? Could they have negative effects then?

To figure this out, researchers focused on more than 300 children whose parents reported sleep problems at 7 months of age. The children were randomly divided into 2 groups. One group of parents got teaching about techniques to encourage independent sleep. The other group did not get the training. Five years later, researchers looked at all sorts of measures of child and parent mental health, as well as the parent-child relationship.

There was no difference between the two groups. Teaching babies to sleep on their own does no long-term harm, the researchers said. And there's no long-term benefit, either.

What Changes Can I Make Now?

The real message of this study is that it's okay to do what you need to do as a parent when it comes to sleep.

It can be incredibly hard to have a baby who wakes up all night. It can be absolutely exhausting, and that exhaustion has a way of taking its toll on parents. But it can also be incredibly hard to "make" a child sleep on her own. Many parents feel tremendous guilt about this, or just feel that it's more "right" to respond to their baby's cry. Deciding what to do can be an excruciating decision for parents, especially first-time parents.

This study is very helpful. It says that it's okay to do what you need to do. If you are being undone by lack of sleep, or just would like your baby to sleep through the night, it's fine to use one of the stepwise techniques to teach him to do that. You aren't going to do your baby any harm.

You don't, however, have to do it. If for whatever reason you want to get up with your baby or otherwise respond when she wakes up, or if you just don't mind, it's fine to keep doing what you’re doing.

What Can I Expect Looking to the Future?

The researchers point out that it's unlikely that we'll have another study like this one. We know that the techniques have real benefits. Now we know that there is no harm, it wouldn't be ethical to randomly assign parents to a group that didn't get teaching on these techniques.

I hope, though, that more studies will expand what we know about infant sleep and how the responses of parents do and don't matter when it comes to mental and physical health. Because parents really do want to do the right thing -- and they also want to get some sleep.