I read with considerable dismay that an academic in USA was now advocating ‘letting your baby cry him or herself to sleep’. The problem with anyone called a ‘professor’ or with similar title, writing and anything called ‘research’ is that people will take what they say on board and believe it.

However, to those of my age who have lived through different ‘fads’ of child rearing, this is a throw back to the bad old ‘Dr Spock’ days.

This suggestion was apparently for the benefit of parents so that the baby would not make their parents tired and exhausted with sleepless nights. The onus is put on the baby to give the parent a good night’s sleep, not the other way round! Poor child, such a responsibility at such a young age!

Babies are born knowing how to sleep and do so, unless something is causing a problem. Getting a baby into a routine of regular feeds and an intervening sleep pattern is something that all young mothers have to learn. All babies are different, but all can cry, all can have ‘wind’ after a feed and all can have pain or discomfort. The skill and duty of parenthood is to learn about your baby and act accordingly to keep the baby not only safe but comfortable.  This takes time and effort, and a new Mum may need guidance from another, experienced mother or from professional help.

A baby will eventually develop his or her own pattern, but is not to blame if this does not happen.

A baby will cry if hungry or in discomfort or pain of any kind, or when too hot or cold. Many do not like to lie in a wet or dirty nappy, quite rightly, and simply want their nappy changing. Many have painful ‘wind’ after feeding and needing to ‘burp’. Some cry when they are tired and need a little help e.g. rocking, to get to sleep, either in a pram or in the mother’s arms.

If a child feels lonely or frightened, then it cries and needs to be comforted. The baby has spent nine months in a warm, secure environment provided by their mother, without any hunger, and listening to muffled sounds. He or she has now to cope with external feeding, bodily sensations, unknown sounds and sights without any knowledge and is totally reliant on others.

Why then would you leave a baby to cry? I have never been able to tolerate hearing a baby crying, as I know he or she is in need of help of some kind. A baby has neither the will nor understanding to be doing this deliberately to upset or anger an adult.

A mother should spend enough time with their baby, to know the ‘meaning’ of different cries. Unfortunately, more and more tiny babies are left in nurseries all day at very early ages. How then does a mother, who has worked all day and is tired, either know or maybe even care what the cry means? Someone has to take the time and effort to be responsible for understanding their baby as, unfortunately for many these days of material needs, a baby cannot rear itself.

Yes, the older child can pick up the bad habit of not going to sleep or waking or wanting the attention. But how and why does this happen? Whose fault is that?

I agree that firmness and a routine is necessary – but how can that be acceptable to a child if they only see their parent for a short time, having been put in a nursery all day with strangers. Imagine yourself in that situation – I can guarantee that you would want to be with them as long as possible, when possible, not spending that time asleep. But how is letting a child cry themselves to sleep meant to give the child emotional security or teach them anything except that no one cares or an attitude of defiance?

Young children should have a regular bedtime, with a routine time spent relaxing before sleeping e.g. with the parent or older sibling/grandparent reading a story quietly and slowly or singing a quiet song, holding their hand and such like. They should not be read exciting stories or watch TV just before bedtime, though many find letting a child sit in front of the TV is an easy option. Anything that stimulates the brain will take time to settle before sleep is possible. How can a child learn if the ‘rules’ change each day, usually to suit the parents activities – sometimes being allowed to stay up and other times not?

I have written a book of gentle, meaningful poems entitled, ‘Poems for 3-7 years’, which is intended to be read by parents to young children. This is an ideal book for bedtime reading.

As long as the child is neither hungry nor in pain, nor having nightmares or frightened for some reason, firmness is necessary – but not isolation or ignoring. The child needs to know that bedtime is a time to sleep, and that ‘no’ means ‘no’, not ‘yes, if I make enough fuss’. Even sitting next to the child’s bed, holding a hand but no longer talking, or staying outside the room but speaking quietly to the child, returning a child to bed if he/she gets out, and such like may be necessary in order that the child accepts that going to bed means staying there and sleeping. But, letting a child, who has left his or her bed, just ‘watch the last bit of the TV programme so Mum doesn’t miss it’ is not the answer!

Every parent has had times when their young child didn’t want to go to sleep, e.g. after an illness or when the routine has been broken for unavoidable reasons.

But children should be put first and parents need to understand the need for long hours of sleep for their children. Young children should not be taken out and about in an evening and kept awake to suit the parents need for socialising or entertainment.

There are times in life when such activities should be secondary to the welfare to the child. Life is not the same once anyone becomes a parent and the child’s welfare has to be a priority.

Why? Because babies and children cannot look after themselves and are reliant on those who care for them to care enough to make the right decisions on their behalf. They did not ask to be born. A child should only make decisions compatible with their age, not those which affect their health.

As a junior doctor I worked in a paediatric department and in outpatients, every week, the Consultant would say, ‘there is nothing wrong with that child except lack of sleep.’

I just trust that ‘leaving your baby to cry’ remains something that was advocated by Dr Spock over half a century ago.

Sensible, unselfish, gentle, firm but consistent caring from day one of a child’s life is their birthright – if only this was something that all children could expect.

I wish that women who become mothers could realise, as their grandmother’s generation did, that spending time caring for their child is not second rate, but the most important job they will ever do, whatever their position in the field of career work. This role should be regarded as too important to hand over to others after a few weeks unless a dire necessity for food and shelter.

The first few years of a child’s life are vital to the future welfare and emotional health of their child and can never be repeated.

I speak and write as a psychiatrist with over 35 years of clinical experience. I was a doctor before I had children. I worked and studied in that profession after my children went to school and then worked part time for many years to fit in with their school hours. I have never regretted one moment of that decision. With my extra income as a doctor we could have had plenty material assets, but instead we chose the option of me being with the children and having little spare money, and few possessions. But I regard it, even with hindsight, as the most important work and the most enjoyable time of my life.

Finally, time cannot be turned back. No one is a perfect parent and all babies will cry and it may often be hard to know what to do or what the reason is. But, crying with someone who loves them and who is trying to comfort creates a different emotional ‘memory’ to crying in isolation.

Heaven forbid that that regime will return to popularity and acceptance again.

Audrey Coatesworth MB ChB MRCPsych