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Ask Dr. Sears: Crying It Out?

Q  My mother watches our 5-month-old while I'm at work. When he starts to cry she puts him down to cry himself to sleep. Because he's a high-need baby, I'm worried that this will hurt our son.
A As the parent of a high-need baby, you know that these spirited children need a high-touch, high-response style of parenting. So it's important that your mother first understand what it means for a baby to be "high-need." To this end, it may help to show or read her excerpts from our book, The Fussy Baby: Parenting the High-Need Child. Also bear in mind that your mother grew up in a different era, when parenting styles did not make allowances for differences in babies' temperaments. Your mother may have been led to believe high-need babies are simply "spoiled," although this is absolutely not true. As your son's parent, you know what he needs and it's important he gets the same style of nurturing from other caregivers, too.

Once you've explained to your mother what "high-need" means and why you believe your son falls in this category, ask her to trust your intuition as to what he needs. Then try these tips that will, I hope, help your mother understand your baby so he can thrive in her care:

Play show and tell. It's not enough just to tell your mother that your son needs a high level of care - show her what this means. Teach her how to "wear" Baby around in a carrier several hours a day. Tell her about research that shows that carried babies cry less. Once your mother sees how content your son is, she'll be more motivated to wear him around the house. Tell her that you want your baby to be parented to sleep, not just put down, because you'd like him to think of going to sleep as a pleasant part of his days and nights. Ask her to lie down with him and cuddle him off to sleep, a sort of grandmother naptime nursing (remember that nursing means comforting, not just feeding).

Talk about "cue feeding." Your mother may have practiced the rigid feeding schedule that was popular when you were an infant. Simply tell her that you've noticed that your baby does best when he is fed smaller amounts more frequently rather than larger amounts on a schedule. You might even tell her he's going through a "growth spurt" and needs to be fed more frequently. Impress upon her how important it is not to prop the bottle while feeding him. Let her know, too, that you believe feedings should be a time to interact with your baby; again, you may want to show her how you talk to and cuddle him while feeding him. Discuss with your mother your views on spoiling infants. You can even use me as your "doctor" on this occasion, saying that I've advised you that attachment parenting doesn't spoil infants, and that high-need babies need to be parented to sleep in order to thrive. In short, you'll need to ask your mother to trust your style of parenting because you know what your baby needs, while at the same time confirming that she is doing a good job, too.

In regard to your concern about whether letting your son cry himself to sleep will harm him, I would say that this is possible. Some infants do not adjust well to drastically different styles of care. Inconsistent patterns can interfere with the development of trust because an infant may not know what style of care to expect. If your baby stores patterns that tell him, for example, "When I cry, I get picked up; when I'm hungry, I get fed; and when it's time to go to sleep, I'm rocked to sleep," he learns trust. So the reverse may be true, too: If he cries and he isn't picked up he may learn that his signals to his caregivers don't work and he learns not to trust their value. But this is not a hard and fast equation. It is sometimes healthy for a high-need baby to be cared for in another set of loving arms. This is especially true if a mother becomes very anxious when hearing her baby cry, immediately scoops him up, and passes on her anxiety to her child. Other caregivers may not be bothered as much, and Baby in turn senses from the calmer caregiver that maybe there really isn't anything to fuss about and stops crying. Let your infant be the barometer of whether or not your mother's style of caregiving is working. If you come home from work to a happy baby, chances are that your mother is doing just fine.