Almost every parent has been there. You rock your six-month-old to sleep. You place her in her crib willing her to sleep through the night, but you know you’ll be back in at midnight, then 2 a.m., then 3:30 a.m. and so on. You might as well say, “See you later,” instead of, “Good night.” What’s a desperate parent to do?
There are several methods for helping your baby sleep. In this article, we’ll discuss the highly popular, and hotly debated, method of cry it out (CIO). CIO is just one of many sleep training methods, and there are several ways to practice it. The following guide is for informational purposes only, and we by no means advocate one method over another. Remember to consult with your child’s pediatrician before employing any sleep training strategy.
There are many misconceptions about sleep training, and with so many strong opinions surrounding the subject, it’s important to define what it actually is. Sleep training is simply any strategy to help your baby fall asleep and stay asleep through the night. “Sleep through the night” is also a bit of a misnomer. All of us wake up during the night as part of our natural sleep cycles, but we’re able to quickly fall back to sleep and often don’t even remember waking. It’s thought that this ability to fall back to sleep on one’s own is a learned skill, not instinctual, and that sleep training can help babies develop it. Many sleep training methods rely on the concept of “self-soothing,” or allowing babies the space to comfort themselves to sleep.
There are several different techniques that fall under the CIO method that we’ll explore in this guide. Most assert that while crying is certainly not the goal of sleep training, it’s usually an unavoidable side effect of a child learning to self-soothe. While several studies have shown that CIO is effective and safe, it’s certainly not for everyone. There are several sleep training strategies that minimize or avoid crying altogether. Consult our Baby Sleep Guide for more information about a variety of methods.
When people, especially nervous new parents, hear “cry it out,” they often have visions of letting their babies cry for hours at a time without comforting them. The truth is there are several variations of CIO and many include reentering your child’s room to reassure him or her.
The main thinking behind CIO is that if babies are used to parental interventions to get them to sleep—activities like rocking and nursing—then they won’t know how to get to sleep without them. Again, crying isn’t the goal of CIO, but rather a temporary side effect of transitioning babies to falling asleep on their own. After all, crying is a baby’s main form of communication, and by the ages of four to six months or so, babies have learned that crying will get their parents to come pick them up. While these cries for attention aren’t necessarily a bad thing, when they interfere with both the baby’s and the parents’ sleep, it may be time for a change.
CIO appeared in parenting literature as early as Dr. Emmett Holt’s The Care and Feeding of Children in 1895, but it really became well-known after Dr. Richard Ferber’s 1985 book Solve Your Child’s Sleep Problems. Different styles have since been developed by different medical professionals and parenting specialists, and we’ll outline the main ones below. Just note that very young babies aren’t physically or emotionally developed enough for sleep training and that most pediatricians recommend waiting to try until your baby is between four and six months old.
As mentioned above, the Ferber Method was developed by Dr. Richard Ferber and involves what’s known as “graduated extinction.” Essentially, the method includes leaving your baby in his or her crib to cry for a short period of time before returning to provide comfort and then leaving again. These crying intervals are gradually increased until the baby falls asleep. Main steps include:
- Complete your normal bedtime routine, ensuring it includes a lot of affection and cuddling.
- Place your baby in his or her crib sleepy but awake and leave the room.
- If your baby cries, allow him or her to do so for five minutes.
- Re-enter the room to give your baby a few back rubs and comforting words before leaving again. Try not to pick your baby up.
- Wait another eight minutes before re-entering. Then wait ten minutes.
- Keep increasing the interval time until your baby falls asleep.
- Expand the intervals for the next few nights until your baby falls asleep quickly with little fussing, which usually takes a few days.
The Weissbluth Method was developed by Dr. Marc Weissbluth and differs from the Ferber method in that it doesn’t involve re-entering your baby’s room after bedtime. Obvious exceptions should be made for emergencies or if your child sounds unusually upset. The thought is that children are best able to learn self-soothing when given the space to do so. Many parents see results after a few nights when following these steps:
- Complete a comforting bedtime routine that includes a lot of affection.
- Place your child in his or her crib sleepy but awake and provide a kiss good night.
- Leave the room and do not enter again (unless necessary).
- Your child may cry as long as 45 minutes to an hour the first night, but this will decrease significantly each night following.
- After a few nights, your child will likely be able to fall asleep on his or her own with minimal fussing.
On Becoming Babywise was first written by Dr. Robert Bucknam and Gary Ezzo and is currently in its fifth edition. The book focuses on developing a parent-led feeding and sleeping schedule and on prioritizing sleep. Though Babywise doesn’t advocate one sleep training method, many see the book itself as a sleep training method. It instructs parents to follow a strict “sleep, eat, play” schedule tailored to the baby’s age. The thinking goes that if babies never go directly from nursing or bottle feeding into sleep, they’re less likely to develop “sleep associations.” In other words, they won’t need to be nursed or held to go to sleep.
While it doesn’t promote CIO per say, Babywise does note that some crying may occur as your baby gets used to his or her new schedule. The book and its methods are somewhat controversial because they discourage on-demand feeding that’s advocated by most pediatricians and many think it encourages letting your baby cry at too young of an age. Some also find the strict sleep, eat, play schedule unrealistic, especially for newborns who almost inevitably fall asleep when feeding.
Basic Bedtime Method
Sleeping Through the Night by Dr. Jodi Mindell outlines a sleep training method that’s similar to the Ferber Method in that it advocates checking in on your baby at regular intervals. Dr. Mindell, however, places great emphasis on a solid bedtime routine. She advocates for the following:
- Early bedtime: Dr. Mindell asserts that babies need an early bedtime, around 7 or 8 p.m., so they don’t become overtired and fight going to bed.
- Consistency: Babies tend to thrive when they have some sort of routine. By having the same bedtime and pre-bed routine every night, babies know what to expect and know that going to sleep comes after bath, pajamas, feeding and storytime.
- Keep it positive: Bedtime should be enjoyable and include comforting activities like singing, reading books and cuddling. If your child has a negative association with his or her crib, spend some time playing there during the day.
Dr. Michael Cohen, founder of Tribeca Pediatrics in New York City and author of The New Basics: A to Z Baby & Childcare for the Modern Parent, advocates for employing CIO as early as eight weeks. Dr. Cohen asserts that babies are able to sleep through the night at this age, but many consider his advice to be highly controversial as eight weeks is often considered too young for CIO. Some parents, however, contend that they’ve had success with the method.
CIO advocates, including many medical professionals, assert that CIO is an effective way to teach babies to fall asleep on their own. Because sleep is so important, especially for young children, this skill can be vital for long-term wellbeing. The method is thought to have several other benefits:
- Teaches self-soothing: Self-soothing is a skill that babies can use to fall asleep and can also help them throughout their lives. Techniques for self-soothing might include using a pacifier, sucking thumb or fingers, holding hands together or simply snuggling into a comfortable position.
- More sleep for everyone: While it’s important for your baby to have a good night’s sleep, we often forget that parents’ sleep is just as vital. If CIO helps your child go to sleep easier and for longer, it will mean more rest for you, too. While the first few months of parenthood are necessarily marked by frequent wakings to feed, this doesn’t need to be the case as your baby grows. And if you’re well-rested, you’re better able to parent.
- Quick results: CIO doesn’t work for every baby, but most parents who have tried the method report that they saw results in under a week. The first night or two may be difficult, but by night three, you’ll probably notice your child falling asleep faster. By a week, he or she may start going to sleep independently with little or no fussing. Other “no-cry” methods tend to take longer.
- Healthy boundaries: Very young babies need their parents almost constantly and don’t necessarily even see their parents and themselves as separate beings. As children get older, creating healthy, but loving, boundaries can help everyone thrive. Establishing your child’s crib as his or her safe space and nighttime as a time for sleep, can help your child feel independent but safe while allowing you some necessary alone time.
Is CIO Safe to Practice?
While many agree that CIO is effective, some parents are concerned whether the practice is safe. The issue is hotly debated, and some versions of CIO—such as those that involve no parental intervention—are more controversial than others.
Many pediatricians, as well as the American Academy of Pediatrics (AAP), reassure concerned parents that CIO is a safe method for helping babies sleep when employed at an appropriate age of at least four to six months. No parent likes to hear his or her baby cry, and it can feel unnatural to not immediately respond, but most agree that CIO is likely harder on you than on your baby. Plus, you may come to the conclusion that helping your child sleep better is worth a few tough nights.
CIO detractors assert that the practice can lead to higher stress levels in infants and even damage the relationship between babies and parents. Some studies have shown that excessive crying can lead to behavioral problems later in life, but children in these studies cried for three or more hours and the studies weren’t necessarily related to sleep training.
CIO advocates counter that as long as children feel loved and safe during the day, then CIO will have no long-term negative effects. One recent study found that infants using the graduated extinction (Ferber) method fell asleep faster and had less stress than infants with no sleep training. Parents in the study also experienced less stress. Another looked at the long-term effects of CIO five years after the technique was used. Researchers found no long-term impacts in either children who engaged in sleep training and those who didn’t, and it also saw lower rates of depression in mothers who employed sleep training.
It’s important to remember that CIO should only be practiced with healthy babies. Not responding to the cries of a baby with a health problem could be detrimental, so be sure to consult your pediatrician before trying CIO. And remember that every family and every baby is different, so choose the sleep training method (or no method) that feels right to you.
Regardless of what sleep training method you choose, if any, it’s important to remember to practice safe sleep with your baby. The AAP outlines safe sleep guidelines to help keep your baby sleep safe at night and to reduce the risk of Sudden Infant Death Syndrome (SIDS). SIDS is the sudden, unexplained death of an infant who is younger than one year old, and it’s most often associated with times when babies are asleep. SIDS is frightening to think about, but following these guidelines can help reduce your baby’s risk:
- Back to sleep: Always place your baby on his or her back to sleep to minimize the risk of SIDS and keep your baby’s airway from being blocked by the mattress.
- Room share: The AAP recommends that babies sleep in their parents’ rooms for the first six months, if not a full year.
- Bare sleep surface: Infants under a year should sleep on a firm mattress with nothing in the crib except a fitted sheet and wearable blanket.
- Avoid bed-sharing: The AAP recommends against sharing a bed with your baby, but if you choose to, do so as safely as possible.
It goes without saying that every baby, and every family, is different. Some babies have had great success with CIO and have developed into excellent sleepers. Other families struggle with the method, and still others choose “no-cry” methods of sleep training or ignore sleep training altogether. At Tuck, our goal is to arm you with accurate information. At the end of the day, you know what’s right for your family and can decide the best way for everyone to get the most sleep possible.