Ignoring a child's cries may result in better sleep for infants and parents, say researchers.
The study suggests a behavioral technique known as "graduated extinction" - which involves letting a baby cry until they fall asleep - can lead to longer sleep duration for the child and their parents.
Study co-author Michael Gradisar, Ph.D., associate professor in the School of Psychology at Flinders University, Australia, and colleagues recently published their findings in the journal Pediatrics.
The study results may come as a surprise to parents, who are likely to have become accustomed to waking from slumber in response to their infant's persistent cries.
"It's natural for parents to worry about having their babies cry at bedtime," says Gradisar.
"While it's well documented that sleep deprivation can cause family distress, including maternal depression, we're hoping these results will add another element to how parents view their responses and how they manage their own and their babies' sleep behavior."
Graduated extinction and bedtime fading
The researchers conducted a randomized, controlled trial, which involved 43 infants aged 6-16 months and their parents. All infants had been experiencing nighttime sleep problems from around the age of 6 months.
The parents of 14 of the infants were required to use the graduated extinction method for 12 months.
Also known as the "Ferber method," this technique involves ignoring a child's cries, checking on them only at specific times with increasing intervals. The idea is to teach the child to accept that nobody will come to their aid when they cry, which will reduce their crying and improve their sleep.
The parents of 14 of the infants used a "gentler" technique called "bedtime fading" for 12 months. This involves gradually delaying a child's bedtime each night. The idea is that this will make a child drowsier and more likely to fall asleep.
The parents of the remaining 14 infants acted as controls and did not use any of the sleep behavior interventions.
Less disruptive sleep with graduated extinction
The researchers found infants of parents who used the graduated extinction technique fell asleep an average of 13 minutes sooner each night than those in the control group, and they woke up less frequently during the night.
On assessing levels of cortisol - the "stress hormone" - from saliva samples of infants, the team found that there were no significant differences in stress levels between the groups.
There were also no significant differences between the groups for parental stress and mood.
The authors note that many parents remain concerned about using the graduated extinction technique, but their study showed the method is not harmful; they found no significant differences between the groups for parent-child attachment or infant emotional and behavioral problems.
Infants of the parents who used the bedtime fading technique fell asleep an average of 10 minutes sooner each night, compared with the control group. However, no differences were identified in the number of times they awoke throughout the night.
Gradisar and colleagues say their findings suggest that graduated extinction and bedtime fading may be beneficial for infants and their parents, though further studies are required to confirm their results.
For parents who still have concerns about using graduated extinction, they recommend trying bedtime fading first.
"We hope parents of children 6-16 months can become more aware of bedtime fading which helps babies fall asleep at the start of the night.
It may not resolve awakenings during the night so if a child is waking up several times a night, then there is now some more evidence that graduated extinction is a technique that may not be harmful to their child."