Evidence-based advice to help reduce sleep problems in older babies

10 September 2012

Sleep techniques known as "controlled comforting" and "camping out" are a cost-effective way to help infants sleep better and reduce mothers' depression levels. Some parents and health professionals want to know if the benefits of the sleep techniques are long-lasting.

Murdoch Childrens ran the first study to examine whether an early sleep program has long-term effects.  Researcher Dr Anna Price answers some frequently asked questions from parents that will help all parents make informed decisions when considering using these sleep techniques. 

What is controlled comforting?

Controlled comforting is a technique that helps teach babies to fall asleep by themselves so they don't rely on mum or dad (e.g. to rock, feed, or pat them) to sleep. It involves putting a baby to bed tired but awake, and leaving them for short periods of time even if they cry. It's up to the parent to decide what timing works for them. Common periods are 2, 4, 6, 8, 10 minutes, or 5, 10, 15 minutes. If parents feel they can only leave for the shorter periods of time, that is fine. If the baby cries, the parent leaves them for the set amount of time, comes back in to the room to reassure them and settle the baby, and then leaves them for the next period of time. It usually only takes a few days to work.

What if it takes more than a few days for controlled crying to work?

If it takes longer than a week to work, chances are that it's not going to work for your baby, or you might need some help getting the technique right. It's a good idea then to speak to your maternal and child health nurse or GP for help.

What is camping out?

Camping out is a more gradual method than controlled comforting where a parent sits next to their baby's cot on a chair or camp bed and slowly moves their chair or bed out of the room. It can take 2-3 weeks to work.

What if it takes more than 2-3 weeks for camping out to work?

If it takes longer than a month, chances are that it's not going to work for your baby, or you might need some help getting the technique right. It's a good idea then to speak to your maternal and child health nurse or GP for help.

Is controlled comforting the same as crying-it-out?

Controlled comforting is not the same as crying-it-out. Crying-it-out involves putting a baby to bed and leaving them for the whole night, even if the baby is crying, before returning at morning time. We do not recommend using crying-it-out because it is distressing for parents, and controlled comforting and camping out are options that work well for, and are accepted by, most families.

What do you mean by 'safe'?

Some parents find it very difficult to leave their baby to cry for any period of time, and are worried about not responding to a cry immediately. We found that there are no long-lasting effects, which means, when used correctly, techniques like controlled comforting and camping out are safe to use.

How do you know that leaving a baby to cry for short periods is not harmful?

This was addressed in our study, which showed no negative effects of the program. We need to remember that there are many times when parents can't respond to their baby immediately - you might be stuck in traffic, or you have a toddler or a phone call to manage - and this isn't harming your baby, especially if you're caring and responsive when you're with them.

Could parents leave their babies for longer?

It's often very difficult for parents to leave babies to cry at all. If you're baby is not settling at all, and is inconsolable, it's ok for parents to stop the techniques and try again another night.

Why is 6 months of age the minimum for using these techniques?

We don't think that babies are developmentally ready before six months. Six months is around the age that children understand that something still exists when it is out of sight. Using these techniques before that age will probably not make sense to a baby.

What can parents do before 6 months of age?

The most important thing a parent can do is set a good bedtime routine, which reinforces to the baby when it's time to go to bed. This may be a feed, a bath and a little cuddle or a story or massage, and then in their cot in a room with low light. Keeping the sleep area dark with low stimulation helps our bodies know that it's time for sleep.

Can parents use these techniques for older children?

 The same principles apply - helping the child learn to fall asleep by themselves without relying on mum or dad. There are some different challenges when children are old enough to walk and talk. A great starting point for parents looking for this information is the Raising Children Network which is a government-funded not-for-profit website that is free to use and provides excellent, evidence-based information on children's development.