Search This Blog

Thursday, 16 October 2014

The Sleep Doctor isn't alone


Image source

Earlier this week, the now-controversial Australian GP Brian Symon, aka ‘The Baby Sleep Doctor’ was removed as a speaker from Melbourne’s Pregnancy, Baby and Children’s Expo following an onslaught of concerned parents, professionals and public approaching the Expo.

Alarm arose over Dr Symon’s appearance at the PBC Expo after a story was aired in The Daily Telegraph on 11 October 2014. In the article, that has since been removed from the site, Symon’s advice to parents of healthy, well-fed children over than six months was quoted as:
‘The steps start with the child having dinner at about 5.30pm, followed by a bath and being in bed about 7pm. They are then read a story and given positive reinforcement before the light is turned off and the bedroom door is closed … As hard as it is, do not re-enter the room until 7am the next day—unless you fear the baby is unwell … The child will cry but do not enter the room. If your baby cries for three hours and you eventually go to them they will know their reward—you—will be given to them if they cry for long periods.’
Several parents then went on to detail their experiences using Dr Symon’s advice, and their accounts included hours of babies screaming and crying, vomiting, and even one parent having to hold the door closed whilst the child threw objects at the door.

While the discussions that are now taking place regarding Dr Symon and his techniques are important, what isn’t being said is how entirely unoriginal his advice actually is. Although one recent unfortunate-for-him article has seen him receive backlash, Brian Symon is far from the first person to spread this kind of advice, and nor is he alone.

‘It is with great pleasure I see at last the preservation of children become the care of men of sense,’ wrote Dr William Cadogan, British physician in his essay An Essay Upon Nursing and the Management of Children in 1748 ‘…this business has been too long fatally left to the management of women, who cannot be supposed to have proper knowledge to fit them for such a task.’

Although Cadogan was a proponent of exclusive breastfeeding, he warned against ‘overfeeding’ for fear of diarrhoea, and therefore advocated only four-hourly feeding and forbade feeding at night.(1)

Gabrielle Palmer, author of the bestselling The Politics of Breastfeeding, writes, ‘Cadogan pioneered a dynasty of well-intentioned but dogmatic men whose ideas influence ... to this day. Throughout the 19th and 20th centuries, Doctors Budin, Cooney, Pritchard, Truby King and many more strove with amazing energy and zeal to manage infant feeding the way they thought best. Somehow they ignored, or were frustrated by, the fact that women’s bodies had their own way of working.’

From these early pioneers of rigid schedules and routines, we have evolved over two centuries into an industry that today gives us so-called ‘baby whisperers’ and ‘sleep experts’ that includes Dr Brian Symon with authors such as Tizzie Hall, Gina Ford, Elizabeth Sloane, Tracy Hogg, Jo Tantum and many others.

So whilst children enduring Symon's advice are locked in rooms uncomforted, Tizzie Hall has often been quoted as advising of babies vomiting for "attention"; Elizabeth Sloane forbids eye contact and instead utilises loud knocking on the door as comfort; Gina Ford reckons women should just 'grin and bear it' in more ways than one.

And to be honest, between Cadogan's 4-hourly feeds and nothing overnight, to Tizzie Hall's 3-hourly feeds and only 1-2 feeds overnight (2), have we really come very far?

As society becomes increasingly wary of the risks involved with sleep training such as cry-it-out and controlled crying, those making huge whacks of money from this advice distance themselves from the concern by arguing semantics, claiming their techniques don’t use those methods.
"I'm not a fan of controlled crying, and for most people that term conjures up horrible upsetting images of screaming babies being left in their room for hours. I call my program 'controlled comforting' ... I think the longest I ever ask parents to stay outside the nursery is maybe 10 minutes." Elizabeth Sloane
‘I do not recommend controlled crying, as walking in and out of the room will only tease your baby. It will make him emotional and he will continue to sob after falling asleep. Rather than this ‘cry yourself to sleep’ method, I recommend the ‘laying down approach.’ Tizzie Hall
‘Nowhere in Gina's book or on this website does she say that controlled crying should be used with young babies of three weeks old. She advises that as a last resort controlled crying could be used with older babies…’ Gina Ford
And so, whilst researchers, physicians, psychologists and a host of neuro-specialists increasingly share the science behind why sleep training being a bad idea (hint: learned helplessness), those who stand to make money (a lot of money) selling this advice label their techniques something else and counter claim their own science to convince parents that their particular brand of advice is gold:
Brian Symon's Facebook page
Now, we could all sit around and argue science all day. I don't doubt that there is evidence that suggests sleep training 'works' in achieving a baby who sleeps with minimal (or no) parental involvement, because if any animal is denied something for long enough they will eventually cease signalling for it. Furthermore, with a baby who appears outwardly 'fine' and who sleeps more according to the biologically-warped views of social expectation a parent is more likely to report feeling more confident, of having improved mental health outcomes.

But at what cost?

And more to the point—why has the simple fact of being biologically human become a topic for which we need scientific approval?
Robin Grille, Australian psychologist and author says, ‘Does it not seem a little eerie that we treat this as an issue of “science”? … do we need a laboratory report to tell us it is OK to respond to a child? What else? Do we wait for test results to confirm that we need a hug? Do we argue the statistical significance of our need to breathe clean air? Do we need to cite medical journals to endorse our urge to eat?’

Before I became a mother, my perceptions on infant care were that of dominant culture: don’t worry if/when breastfeeding doesn’t work, quickly establish routine and independent sleep habits, and don’t let the baby change you.

And then, I had a baby of my own. While my entire body cried out to hold her, to be with her, society told me that she was being 'spoiled', that she was not a 'good baby' simply because she cried. And suddenly, the child in me who’d been left to cry-it-out as a baby, who’d always apparently been ‘fine’, actually wasn’t fine. I wasn’t fine at all.

And nor are the 1 in 5 adults at any one time suffering metal illness—nor the almost 100 per cent of adults who will in their lifetime suffer mental illness. Take a look at the nightly news, or your social media feed, or the newspaper headlines—violence, intolerance, hatred, disconnect, fear—to see just how ‘fine’ we as a society we really are.

It wasn’t science or studies or peer-reviewed double-blind randomised controlled trials that convinced me to hug my baby, it was the warm voice of another mother, another woman, comforting me to do so and validating how I felt.

The quiet power of positive voices is a heartening triumph. That a group of concerned individuals can murmur, ‘hey, this isn’t right’ and have their voices heard is a wonderful thing for parents and their children, and for us as a society.

Because this advice is still so widespread, we need to keep being that voice. Keep being that source of comfort in a sea of disconnect that says, ‘of course it’s okay to hold your baby.’

So, in the words of Peggy O’Mara, “Don't stand unmoving outside the door of a crying baby whose only desire is to touch you. Go to your baby. Go to your baby a million times. Demonstrate that people can be trusted, that the environment can be trusted, that we live in a benign universe.”


1) Palmer, Gabrielle. The Politics of Breastfeeding: How Breasts are Bad for Business Pg 23-24. (Pinter & Martin, 2009)
2) Hall, Tizzie. Routine Breastfed Baby Aged 1-2 Weeks (2008)

3 comments:

  1. Great article. I always like to read your take on issues like this. It was your earlier articles that made me realise the way I was parenting (attachment) was not going to ruin my daughter's sleep forever. Also loved your book! I read it last year when I was pregnant with my 2nd daughter and it was great to read about homebirth. :)

    ReplyDelete
  2. Beautiful. Thank you for sharing. <3

    ReplyDelete