Cry It Out, Baby

The cry-it-out method is usually attributed to Ferber.  His sleep method, however, is actually a variation of the CIO method.  So is Weissbluth's.  The CIO method I'm talking about is the one maybe your mother or grandmother used.  It's the one my own pediatrician told my mother to use with me so she could stop spending her nights driving around only to have me finally fall asleep and then awaken as soon as she turned off the car.  It's the method Mary's father recommended when he saw she was having difficulty getting her first child to sleep.

What does this method entail?  It's pretty simple: put the baby down asleep at bedtime and don't return to the room until the end of the sleep period.  So, at nap-time, you put the baby down cooing and gurgling, walk out of the room, close the door, and don't return for two hours -- even if your baby is crying the entire time.  Same thing at nighttime.

According to those who use/d this method, after 3-5 days the baby should stop screaming and start sleeping.  Why does this method work in such a short period (though it may feel like forever as you're listening to your little one wail)?  Crying, some claim, actually acts as an amnesic (Fagen, Ohr, & Fleckenstein, 1985).  When little Johnny is crying in bed and you go to him, take him out of bed, and comfort him, he's learning that crying gets you to come to him.  His crying is rewarded.  If, however, you don't respond, then he'll forget you used to come when he cried in his bed, and instead of crying, he'll sleep. 

Other researchers, however, claim that crying raises cortisol levels, adversely altering the baby's brain and making it more likely that little Johnny will have PTSD as an adult.  (Admittedly, I couldn't find an actual study verifying this claim in any way.  All I could find was this opinion paper.  If anyone knows of an actual study, please let us know!)  This claim has some merit.  It's true that stress raises cortisol levels, and if a baby isn't getting his reward, then that can be stressful. 

So who's right?

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Fagen, J. W., Ohr, P. S., Fleckenstein, L. K. (1985).  The effect of crying on long-term memory in infancy.  Child Development, Vol 56(6), 1584-1592.

Comments

[Gwen]

When we were at our wit's end trying to get our son to sleep at all, we tried the Weisenbluth book. I found that all this method did for me was make everything worse. My son would cry for over an hour and it didn't stop after 5 days. We gave up after 3 weeks, and eventually our bedtime routine, nothing like the CIO, started to work and he started to sleep. Those three weeks of CIO were the worst of my life and I swear that I will never try anything like this on another child should I have one. All that book did was make an already hard situation worse. Who needs to feel like a total failure and heartbroken as well? I would never recommend this book to anyone.

[Mary P]

Your experience is not an uncommon one. In fact, I experienced something similar with one of my three kids. Let's clarify something, though: Weissbluth and Ferber are NOT what Laura's describing here. Weissbluth and Ferber are *modified* CIO . Laura is describing full-blown CIO.

Just as you experienced, modified CIO didn't work for my second child (though it worked like a charm for my third). For my son, as for yours, it just made things worse, much worse, and so I had to try something different.

That's why knowing the range of options available to you is so important! What works for one child may not work for another - even within the same family!

[Peter]

These kids are smart and coniving, we have to be smarter and more coniving. That is what we, as parents have going for us, experience and intelligence.
The child may be able to tug at your heart strings but if you can keep your head, which may not be easy, victory is achievable.

[Peter]

p.s. Mary P. and Laura really know their stuff.

[Kat O+]

For a paper that takes great care in emphasising its cross-cultural focus, I found its conclusions rather myopic. I also don't consider a comparison of US and Gusii parents an adequate cross-cultural study. To derive any meaningful conclusions, you have to test as few variables as possible and keep everything else equal. I'd be more impressed with a study of, say, US parents with similar cultural backgrounds who adopt different parenting techniques to see if there are significantly different outcomes for their children.

What I've learned in my very limited experience with sleep training is that not all techniques work with some babies, and sometimes they won't even always work with the same kid. I've used at least 3 different methods for my 2-year old, at different times and in different circumstances. I also know you have to be consistent and give the technique a little time to work. And...know when to give up and try something else.

Oh, and buy earplugs.

[dreadmouse]

From what I've read, the uniqueness of children doesn't permit any sort of blanket strategy. What works perfectly for one kid sometimes won't work for another.

That said, given my choice I will always try a gentler method first before I resort to CIO. Sometimes tough love is what needs to happen, but I would far rather do things in a less stormy way if it will be effective. Fortunately, I didn't have to resort to CIO with my daughter (or at least not yet.)

Daddy's little girl has me firmly wrapped around her finger, so if we ever do have to CIO then I'll find it even tougher than she will.

[MamaBear]

Have you ever heard of Baby Wise book/ method? Some one gave it me when I was pregnant (another preggers friend at work) and highly recommended it. I read it, along with other infant books, and it seems to logical it would make sense. it seems reasonable because it claimed it met in the middle of the "by the clock", and "attachment" methods, therefore it was superior to both. I'm so sorry I ever read it and tried following it with my infant. I later read horrible reviews of what a scammer the writer is (no real merit) and how much harm he has actually done. My opinion has definitely changed before and after the baby. Before I was even pregnant I recall watching "Mad About You" and how they were Ferberizing Mable. How bad she felt sitting outside of the baby's room yet how "right" it was to do so. Even when pregnant, I would think CIO method is to "teach a child" sleep patters. That's why Baby (Un)Wise made sense a bit. When she was born - completely changed my world and my view. Luckily, she has been sleeping 8 hrs at night at 3 months and up to 11 hours by 5 months (she sleeps in her own crib in her room, but was in a bassinet up to 3 months next to us). She only wakes up if she is sick or something is off, very rarely. I think most of the success is her. Rest- maybe the fact that we tried to keep her feedings on schedule and same with nap and bedtime. I recently read the "The no-cry sleep solution" recommended here on this site and it makes a lot of sense! I guess we were doing some of the things all along. We put her down sleepy and drowsy but still awake. Sometimes she cries before she falls asleep and we come in to comfort her, pat her head or rub her belly, etc, she calms down and falls asleep (or sometimes we repeat it several times), but we never ignore her cries. It was too heartbreaking even if I believed in it. I just couldn't do it. Luckily, I don' think I have to. I do agree, we are lucky that she is the way she is and not all kids are the same. Maybe one day we will have another one and do the same exact thing but she/he will be different in sleeping patters (and otherwise of course).
Anywa, what I learned is I could never do CIO myself, but for ourselves I also wouldn't go with co-sleeping, rocking to sleep or other classic attachment methods, so I guess I'm somewhere in the middle. I also learned I wouldn't criticize other parents efforts (as long as they don't hurt their kids of course!) because each kid is truly different.

[shiso mama]

Mary P, I somehow feel very consoled by the fact that YOU've had mixed results with CIO. Over the months, we've tried different approaches for our son's sleep issues, and some methods work some times and others work at others. I think for us, the cause of the current sleep issues really dictates the appropriate solution.

[Mary P]

Shiso mama: The woman you read these days has been dealing with babies and toddlers for over twenty years. All that experience has to be good for something! Back when my son (my second child) was giving me night-time grief, I'd been at it less than four years - and my first child was a better sleeper. I wasn't quite a newbie, but I wasn't as experienced as I am now. Just like any mother, I had to cast about a bit to find what worked. But I did find something - because this momma? She NEEDS her sleep!

[Amanda]

No, babies are not coniving, babies cry because they have a need that requires adult intervention. They don't cry becasue it's annoying, to be difficult, or manipulate. They cry becasue it is their only means of communication. Of course they learn when they cry, we come, becasue WE DO! We SHOULD! Maybe it is an emotional need. Maybe it is a physical need (hunger, pain, cold, hot,messed etc...) Babies are only little for a short period of time. They need to be reassured that their needs will be met. This will build in them independence, not leaving them to cry helplessly for hours on end. Leaving them to cry simply becasue we as parents want to impose sleeping regimes is not the fault of the child. Babies wake up at night, sometimes toddlers wake up at night. If you "need sleep", consider this; Women who breastfeed and co-sleep, get much more sleep than those who formula feed and crib sleep. CIO, even modified CIO is simply barbaric in my opinion.

[Laura S.]

Amanda -- I've heard that mothers who breastfeed and co-sleep sleep more, but is that really a "fact?" I know plenty of mothers who tried co-sleeping (including myself -- co-sleeping meaning "in the same" room, not "the same bed"), and who just couldn't sleep with their little one next to them.

Plus, moms who use CIO are not doing it for their beauty rest, they're enforcing sleep regimes because it is absolutley necessary for their child's brain devlopment, just the way food is necessary. I don't think it's fair to say suggest that moms are being barbaric when they're merely teaching their little ones how to sleep.

It's true that crying is the baby's only form of communication, but maybe a crying baby is saying, "I'm angry because I don't want to sleep!" Should a mother give into that anger when really what the child needs is sleep for proper development?

[kathrynaz]

I'm late weighing in on this one... but I have to say, I read a lot of the "sleep" material and really loved the Weissbluth book. I found the data he collected impressive, and his advice on napping (and the constantly changing nature of infant's napping needs)DEAD ON. Whenever my son's sleep pattern seemed "disrupted," I would reconsult the Weissbluth book and the answer for why this was happening would be right there- (e.g. the shift from two naps to one longer nap). Fortunately, our son is a champion sleeper so CIO was never an issue for us. But I do believe in childrens' need for strong guidance in building sleep routine, and would not be adverse to using a modified CIO for a child who seemed to need it (echoing the experience and advice of Mary here.)

[Mary P]

Kathryn - I discovered Weissbluth late in the day, only a couple of years ago. It was heartening to see in those pages so much of what I'd discovered. Even when you're pretty sure of yourself, confirmation/affirmation is always nice!

His insistence that sleep begets sleep, that if your child fights bed, put them to bed earlier, give them MORE sleep, not less, was something I'd learned through the years, but it seems so counter-intuitive to so many parents that it was nice to have an "expert" back me up!

Now, if only the next edition could be properly edited, I'd be a very happy woman...

[kathrynaz]

I couldn't agree more, Mary! It IS counterintuitive. Before reading Weissbluth, we were keeping our son up a little longer thinking that would cause him to "sleep in." When we moved his bedtime up to 7PM SHARP, he actually slept LONGER. Amazing.

Yeah, that book needs a big ole edit. Lots of good advice and data, but way too repetitive and not user friendly (that's what happens when science geeks try to write!). I lend my copy out all of the time, and have highlighted pages for my friends to read, advising them to do a serious skim! Still, I really do appreciate how he has really thought out the "science" of sleep.

[Heather]

"I know plenty of mothers who tried co-sleeping (including myself -- co-sleeping meaning "in the same" room, not "the same bed"), and who just couldn't sleep with their little one next to them."

Thanks from this nursing mom for this comment, Laura - I thought it was just me! I found that baby sleeping in the same room meant that I woke the baby up every time I needed a drink of water or went to the bathroom. I moved Lindsay's bassinet into her room at 2 months and found that we both got more sleep.

I'm unsure of the source, but I've seen the cosleeping correlate to breastfeed argument particularly as they relate to SIDS.