Do Babies Who Cry It Out Get Anxiety and Addiction Later in Life?

As a pediatrician expecting her first child, Mary asked me a question that keeps countless parents awake at night – both literally and figuratively. She sees parents following popular sleep training methods, doing what they believe is best, yet she wonders about the long-term impact. Her question touches on something I’ve witnessed throughout my career transition from general surgery to addiction medicine: the profound connection between our earliest experiences and our lifelong patterns of stress, anxiety, and self-regulation.

The answer requires us to look beyond conventional parenting advice to understand what’s actually happening in a baby’s developing nervous system. In my conversation with Dr. Darcia Narvaez, a renowned professor whose research on the “evolved nest” has revolutionized our understanding of infant neurodevelopment, we explored how those early moments of distress create patterns that can last a lifetime. 

This conversation matters because we’re facing epidemics of anxiety, depression, and addiction that seem to appear from nowhere in adolescence and adulthood. But they don’t come from nowhere. They often trace back to those earliest experiences when our nervous system was learning whether the world was safe or dangerous, whether we could trust others to help us regulate, or whether we had to shut down to survive.

The Neurobiology of Infant Distress: What Really Happens When Babies Cry

When we understand that babies are born with only 25% of their adult brain volume, the significance of early experiences becomes crystal clear. Every moment, every interaction, every response or lack thereof is literally building the architecture of their brain. Dr. Narvaez explains that the baby’s neurobiology is constructing itself based on the care it receives, and this construction happens at an astounding pace – things are growing and changing every second.

The conventional wisdom that “babies cry, it’s normal” misses a crucial understanding of infant communication. Crying is actually a late distress signal. Long before a baby cries, they communicate through facial expressions and body movements. They make faces, they wiggle, they turn their head – all attempting to signal their needs. When we miss these early cues and wait for crying, we’re already allowing the baby to reach a state of dysregulation that impacts their developing nervous system.

What makes this particularly significant is that babies cannot regulate themselves. They’re born without this capacity. Their nervous system depends entirely on co-regulation with caregivers to maintain stability. When left to cry, they experience something far more profound than simple frustration. Dr. Narvaez describes it as entering “the abyss” – a state of complete overwhelm where the baby’s entire system believes survival is threatened.

This isn’t melodrama or anthropomorphizing infant experience. It’s neurobiology. When a baby cries without response, their sympathetic nervous system floods with stress hormones. Their heart rate accelerates, their breathing becomes rapid and shallow, and their entire body enters a state of emergency. If no one comes, something even more concerning happens: the parasympathetic system forces a shutdown to conserve energy. Parents often interpret this quieting as the baby “self-soothing” or “learning to sleep,” but it’s actually a dissociative state – the nervous system’s last resort for survival.

The Long Shadow: How Early Crying It Out Affects Adult Mental Health

During my years in addiction medicine, I noticed patterns that initially puzzled me. Why did so many people struggling with substance dependence describe feeling an inexplicable void, an emptiness they couldn’t name? Why did benzodiazepine dependence often begin with genuine anxiety that seemed disproportionate to life circumstances? The answer frequently traced back to these early experiences of overwhelming distress without comfort.

Dr. Narvaez’s research confirms what I observed clinically. When babies experience repeated episodes of uncomforted distress, they develop what she calls a “minimal self” – a contracted way of being in the world. This isn’t a psychological concept; it’s a neurobiological reality. The neural pathways for self-protection become superhighways while the pathways for connection and regulation remain underdeveloped.

These children grow into adults who carry “a hole in their heart,” as Dr. Narvaez poetically describes it. They’ve learned at the deepest level of their nervous system that when distress comes, no one will help. This creates a fundamental distrust not just of others, but of their own ability to navigate difficult emotions. The abyss they experienced as infants becomes a felt sense they spend their lives trying to avoid.

The connection to addiction becomes clear when we understand that these individuals are seeking external regulation for a nervous system that never learned to regulate internally through co-regulation. They’re not weak or lacking willpower. They’re trying to manage a neurobiological state of dysregulation that began before they had words to describe it. Whether it’s alcohol, benzodiazepines, opioids, or behavioral addictions, they’re attempting to fill that void, to quiet that sense of impending abyss that can be triggered by seemingly minor stressors.

Beyond Crying: The Cascade of Modern Practices That Disrupt Attachment

Sleep training represents just one of many modern practices that can disrupt the developing nervous system. During my work with adoptive families through Family Challenge camps, I discovered that a high percentage of children with attachment challenges had experienced NICU placement at birth. This separation during the critical bonding window – when both mother and baby’s neurobiological systems are primed for connection – creates a disruption that can echo through decades.

The cascade often continues with other well-meaning but potentially harmful practices. Early return to work, often at six weeks in the United States due to lack of paid parental leave, forces another separation before the baby’s nervous system has developed any capacity for managing distance from primary caregivers. Dr. Narvaez points out that this contributes to postpartum depression in mothers as well, as their neurobiology is also expecting continued connection with their infant.

Circumcision and other painful medical procedures performed in the early days of life add another layer of neurobiological stress. These procedures were often instituted when medical professionals believed babies didn’t feel pain. We now know that not only do babies feel pain, but early painful experiences can create lasting changes in pain sensitivity and stress response patterns. The nervous system learns early that the world can be unpredictably painful and that comfort may not be available.

Even practices considered progressive can miss the mark when we don’t understand infant neurobiology. Educational toys and early learning programs, while well-intentioned, often replace the simple physical connection and co-regulation that babies actually need. We’ve created a culture focused on cognitive development while ignoring the foundational emotional and neurobiological development that makes later learning possible.

The Evolved Nest: What Human Babies Actually Need to Thrive

Dr. Narvaez’s concept of the “evolved nest” isn’t idealistic or romantic – it’s based on how human beings developed for 99% of our evolutionary history. Understanding these components helps us see why modern life creates such challenges for infant development and points toward solutions that honor both biological needs and contemporary realities.

Responsive caregiving from multiple adults stands as the first pillar. This doesn’t mean just mom or even mom and dad, but a true village of caregivers who can read infant cues and respond before distress escalates to crying. In our ancestral context, babies had numerous adults who could provide comfort, allowing no single caregiver to become depleted. This distributed care network ensured babies rarely experienced prolonged distress.

Breastfeeding on request for several years provided not just nutrition but ongoing co-regulation. The physical act of nursing regulates breathing, heart rate, and temperature while providing neurochemical communication between mother and infant. This isn’t about creating dependence – it’s about providing the biological foundation for later independence. When we cut this short due to work demands or cultural pressure, we remove a primary source of nervous system regulation.

Near-constant physical contact, especially in the first months, keeps the infant’s nervous system stable. Dr. Narvaez notes that in our ancestral context, babies were carried almost continuously until they initiated movement on their own. This constant contact provides proprioceptive input, temperature regulation, and the reassuring presence of a regulated adult nervous system. Modern practices of placing babies in containers – cribs, bouncers, car seats – for extended periods remove this fundamental source of regulation.

The absence of negative touch or painful procedures protected the developing nervous system from unnecessary trauma. While some medical interventions are necessary, many routine procedures could be delayed until the nervous system is more developed or eliminated entirely. Each painful experience without adequate comfort creates stress patterns in the developing nervous system.

Free play in nature as children grow builds right hemisphere development, creativity, and self-regulation skills. This unstructured play, particularly with mixed-age groups, teaches social skills and emotional regulation in ways that no structured program can replicate. The natural world itself provides regulatory input through its rhythms, textures, and gentle challenges.

The Vagus Nerve: Your Child’s Built-In Regulation System

Understanding the vagus nerve transforms how we approach infant care and nervous system development. This remarkable nerve, whose name means “wandering,” travels from the brainstem through every major organ system. It’s our primary pathway for the parasympathetic nervous system – the rest, digest, and connect branch of our autonomic nervous system.

In infants, the vagus nerve develops through co-regulation with caregivers. When a parent holds, rocks, or soothes a baby, they’re not just providing comfort – they’re literally helping to build and myelinate the vagal pathways that will serve that child throughout life. Dr. Narvaez emphasizes that the myelinated vagus, which develops through positive social experiences, enables later capacities for intimacy, compassion, and emotional regulation.

The gut-brain connection via the vagus nerve explains why early feeding experiences impact more than just nutrition. Martha Welch’s research at Columbia shows that the vagus nerve in the gut activates during mother-child connection and co-regulation. This connection influences immune system development, as most of our immune system resides in the gut. When we disrupt early feeding and holding patterns, we impact not just emotional development but physical health trajectories.

Without proper vagal development through co-regulation, children develop what we might call “vagal weakness.” They struggle to activate their parasympathetic nervous system to calm down after stress. They may have difficulty with digestion, immune function, and social connection – all functions mediated by the vagus nerve. This isn’t a character flaw or parenting failure; it’s a neurobiological consequence of insufficient co-regulation during critical development periods.

Repairing Early Attachment Wounds: Hope for Healing at Any Age

One of the most hopeful findings from neuroscience is that repair remains possible throughout life. While early experiences create strong patterns, our nervous system retains plasticity – the ability to form new neural pathways. This means that whether you’re a parent realizing past mistakes, an adult recognizing your own attachment wounds, or a practitioner helping others heal, change is possible.

Dr. Narvaez shares practical repair strategies that work across ages. For parents with young children, it might mean instituting regular “huggling” sessions – extended hugging and cuddling that allows nervous systems to sync up. Even if you practiced cry-it-out sleep training, you can begin offering more physical comfort during waking hours. The key is consistency and presence rather than perfection.

For older children and teenagers, repair might look like acknowledging past disconnections without shame or blame. Dr. Narvaez describes interventions where mothers openly acknowledge their sadness about missed connections, creating space for authentic reconnection. This vulnerability, combined with consistent efforts to be present, can begin rewiring those early patterns.
Adults carrying these wounds can engage in somatic practices that provide the regulation they missed. During my clinical practice, I discovered that simple interventions like placing tennis balls under my feet during sessions helped me maintain grounding and boundaries. Weighted blankets can provide the containment and pressure that helps nervous systems settle. These aren’t childish needs – they’re biological needs that were unmet in childhood.

The repair process also involves grieving what was missed. This isn’t about blaming parents who did their best with the information they had. It’s about acknowledging the legitimate needs that went unmet and allowing the emotions around those unmet needs to surface and release. This grieving process, when held in a safe therapeutic container, allows the nervous system to finally complete the stress cycles that have been frozen since infancy.

Creating a New paradigm: From Trauma-Inducing to Wellness-Informed

Dr. Narvaez distinguishes between two pathways that societies can take: trauma-inducing or wellness-informed. The trauma-inducing pathway, which dominates modern Western culture, prioritizes independence, productivity, and cognitive development over emotional and neurobiological wellbeing. This pathway creates adults who are dysregulated, disconnected, and constantly seeking external sources of regulation.

The wellness-informed pathway recognizes that meeting children’s biological needs isn’t coddling – it’s providing the foundation for true independence and resilience. This pathway creates adults who can regulate their emotions, form secure relationships, and contribute positively to their communities. They don’t need external substances or behaviors to manage their internal states because they developed robust internal regulation systems through early co-regulation.

Shifting from one pathway to the other requires cultural change, not just individual parenting changes. We need policies that support extended parental leave, allowing parents and babies to maintain connection during critical development periods. We need healthcare practices that minimize unnecessary separations and painful procedures. We need communities that understand infant carrying, extended breastfeeding, and responsive nighttime parenting as normal rather than extreme.

This shift also requires us to question deeply held beliefs about independence and self-reliance. The idea that babies need to learn to “self-soothe” or that responding to cries creates “spoiled” children reflects cultural values, not biological reality. True independence grows from a foundation of secure dependence. Children who receive responsive care in infancy actually become more independent, not less, because they develop the internal resources to manage challenges.

Practical Integration: Living These Insights in Modern Life

Understanding the ideal doesn’t mean we can always achieve it, and that’s okay. Modern life presents real challenges – single parents, economic pressures, lack of community support. The goal isn’t perfection but rather informed choices that move us closer to meeting our children’s biological needs within our actual circumstances.

Start by learning your baby’s early communication cues. Spend time observing without intervening, noticing the subtle facial expressions and movements that precede crying. Respond to these early cues when possible, preventing the escalation to full distress. This single change can significantly reduce the amount of crying and stress both you and your baby experience.

Create carrying solutions that work for your life. While constant carrying might not be feasible, baby wearing during daily activities provides more contact than container devices. Even an extra hour of carrying per day makes a neurobiological difference. When you must put baby down, stay close and maintain voice contact, letting them know you’re nearby.

Build your village, even if it looks different from ancestral models. This might mean trading childcare with other parents, involving grandparents more actively, or hiring help when possible. The goal is distributing care so no single person becomes depleted. Exhausted caregivers can’t provide the co-regulation babies need.

When sleep challenges arise, consider gentler alternatives to crying it out. Room sharing, bed sharing with safety precautions, or gradual withdrawal methods honor your baby’s need for nighttime connection while working toward sustainable sleep for everyone. Remember that biologically normal infant sleep includes frequent waking – they’re not broken and don’t need fixing.

The Larger Implications: Healing Generational Patterns

Every parent who chooses responsive care over conventional wisdom doesn’t just impact their own child – they begin healing generational patterns. Dr. Narvaez points out that parents tend to recreate their own early experiences unless they’ve done healing work. By choosing different practices, we interrupt cycles of trauma that may have persisted for generations.

This healing ripples outward. Children who receive responsive care develop greater empathy, better emotional regulation, and stronger social skills. They’re less likely to bully or be bullied, less likely to develop anxiety or depression, and less likely to need substances for emotional regulation. They become adults who can provide responsive care to their own children, creating positive cycles rather than perpetuating negative ones.

On a societal level, investing in early childhood experiences offers perhaps the greatest return on investment possible. Adults who received responsive early care require fewer mental health services, have lower rates of addiction, and contribute more positively to their communities. They’re more creative, more collaborative, and more capable of solving complex problems – all capacities that develop through early secure attachment.

Answering Mary’s Question: The Direct Truth About Crying It Out

To return to Mary’s original question: Yes, babies who repeatedly experience crying it out are at higher risk for anxiety and addiction later in life. This isn’t fear-mongering or judgment – it’s neurobiology. When we leave babies to cry alone, we’re not teaching independence or self-soothing. We’re creating neurobiological patterns of overwhelm and shutdown that can persist throughout life.

The risk isn’t absolute – many factors influence outcomes, and resilience can develop through other relationships and experiences. But why create additional risk when responsive alternatives exist? Why start life with experiences of overwhelming distress when we could provide comfort and co-regulation?

For parents who have already used crying it out methods, remember that repair is always possible. Your child’s nervous system continues developing throughout childhood and maintains plasticity throughout life. Every moment of connection, every response to distress, every effort to understand and meet needs contributes to healing. Focus on moving forward with new understanding rather than dwelling on past choices made with incomplete information.

The beauty of understanding the biology of trauma® lies in its empowerment. Once we understand how early experiences shape nervous system development, we can make different choices. We can advocate for policies that support responsive care. We can heal our own early wounds. We can raise children who don’t carry forward the trauma patterns that have plagued previous generations.

This isn’t about perfect parenting – it’s about understanding the profound importance of those early months and years. It’s about recognizing that when a baby cries, they’re not manipulating or testing limits. They’re communicating the only way they can, asking for the co-regulation their nervous system desperately needs to develop properly. When we answer that call with presence and comfort, we’re not just soothing momentary distress. We’re building the neurobiological foundation for a lifetime of resilience, connection, and wellbeing.