There is perhaps no parenting decision that tugs on the heartstrings as strongly as whether to let a baby cry him- or herself to sleep.
At one end of the spectrum are parents who use some form of "cry-it-out" method to teach their baby to sleep through the night. The method is characterized by periods of letting a baby cry - from a few minutes to more than an hour - without picking him or her up. At the other end are the "no-cry" types who consider letting a baby cry for any length of time to be cruel and unusual punishment.
Stuck in the middle are a lot of exhausted parents hoping to make the right choice - especially since sleep deprivation in infants has been linked to behavioural and cognitive problems, not to mention its effects on mom and dad.
New research on infant sleep appears to deal a blow to those in the cry-it-out camp. Penn State researcher Douglas Teti examined the role of emotional availability on infant sleep and found that regardless of a family's night-time routine, infants with parents who were responsive and warm had fewer night wakings and an easier time drifting off. In his study, which involved infrared cameras placed in families' bedrooms and nurseries, a lapse of more than a minute resulted in a lower emotional availability score.
While more research is under way to further test those findings, Dr. Teti, a professor of human development and psychology, says his work adds to a growing skepticism toward sleep training - not only that it may not work, but that it may, in turn, affect the parent-child relationship itself.
"An emotionally available parent would probably not let their baby cry it out," says Dr. Teti, who included babies aged one month to 24 months in his study. "Quite frankly, there aren't too many researchers that advocate that any more. I don't want to diss sleep-training programs per se, but the way we construed emotional availability is that an emotionally available parent is not a parent who is going to abandon a child at night and let the child cry it out."
On both sides of the issue, the way parents handle sleep is increasingly seen as a microcosm of their overall parenting skill. Dr. Teti admits that this association is a driving force in his work.
"Bedtime heralds the longest separation of the day between parents and their children," he says. "I've always been curious about how well or poorly parents prepare their children for that separation, because I think that could be a pretty important index of parenting competence."
No wonder there is an industry of experts at the ready offering solutions.
Since his landmark book Solve Your Child's Sleep Problems was published in 1985, pediatric sleep expert Richard Ferber has became the best known advocate of a "controlled-crying" approach. He advised parents to leave their infants in their cribs for increasingly longer periods of time, starting with a few minutes (the method spawned the verb "to Ferberize"). They were instructed to pat and comfort their baby through the crying, but not pick up or feed the baby.
Other authors and consultants have since added and subtracted behaviours to create their own formulas - staying in the room or not, being visible or not, soothing by voice or not, touching or not - though many caution against sleep training under six months. Parents often pick and choose from the methods, and some, misinterpreting Dr. Ferber's technique, simply shut the door.
In Dr. Ferber's second edition, published in 2006, he added a preface clarifying the difference between his method and a shut-the-door approach. "Simply leaving a child in a crib to cry for long periods alone until he falls sleep, no matter how long it takes, is not an approach I approve of," he wrote.
Dr. Teti's study was good news for British parenting guru Penelope Leach, who recently launched a salvo into the debate. In her new book, The Essential First Year, she strongly advises against the method, citing research on the role of the stress hormone cortisol as toxic to a baby's developing brain - and with possible permanent negative effects, especially at the age of six months or younger.
In her native Britain, the book has caused a renewed debate between the "huggers" and the "schedulers," as they're known.
"People are going to have to accept that extensive, uncomforted crying is actually risky for infants," says Dr. Leach, a child development psychologist. "I'm sorry, don't shoot the messenger. You won't find any evidence to the contrary. Except the evidence of people saying that it works, which is valid in its own way, but unfortunately it seems that it doesn't work for terribly good reasons.
"If you leave a baby crying long enough, it will go to sleep and after crying enough nights in a row it will eventually not bother," she says. "Leaving aside the toxicity of stress hormones, it's hard to believe that people really want to teach babies not to bother to communicate."
Many parents, however, feel they have no other choice but to try some form of controlled crying.
First-time Ottawa father Mike Reynolds and his wife successfully used a form of sleep training - the book The Sleepeasy Solution, by Jill Spivack, a psychotherapist and pediatric sleep consultant, and Jennifer Waldburger. He wrote about it on his blog, Puzzlingposts.
"We were prepared to listen to up to an hour of crying with only sporadic check-ins at our disposal. She did cry for the first five minutes, then we checked and then she cried for a few more and went quiet," he says in an e-mail interview.
Although the method worked for them and their daughter, now eight months old, Mr. Reynolds is reluctant to discuss it with all the parents he knows.
"With some friends, we don't really bring it up, as there is a lot of criticism out there."
Toronto mom Carolyn Weaver is so pleased with how sleep-training worked for her, she jumps in to support friends when they want to try cry-it-out, even offering to stay on the phone with them while their baby cries.
"It's gotten so controversial," she says. "People who are opposed truly believe that you are torturing and tormenting your child."