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?

-----

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.

[tripletmom]

Let me tell you about each child being different. I have triplets. One started sleeping through the night all on her own at 4mos. The other two took turns sleeping with each other and/or mom and dad for the first 7 months. After 7 months of getting no sleep because I simply cannot sleep with a baby in my bed or next to me, I moved all three to their room (all in one room) and each in their own bed. I started the CIO by sleeping with each of them individually to break the bottle habit. My son had no sleep issues once he got over wanting the bottle in the middle of the night. My peanut who started sleeping on her own at 4 mos. continued to sleep through. My other daughter however, needed to CIO because no one in the house was sleeping with her waking up all the time. In discussing it with their pediatrician he recomended ferber but said it takes longer and will continue to keep us up all night for awhile. He said just go for it and do the CIO method and be done. We spent 4 days of CIO with her and I was a different person after some good sleep. Raising kids is hard enough-sleep is necessary for all of us. If you want to discuss barbaric then find a social worker and ask what she/he has seen over the years. I assure you CIO is not barbaric. It just feels that way when your the one listening to your child cry. Recently as I returned to work the kids started being up late, not sleeping and simply wanting to be held all the time. I tried everything in hopes of avoiding the CIO method again. After 2 months of no one sleeping we went 2 nights of CIO and I am once again able to function like a normal human being with happy kids who are much more ready to play and learn. If you don't have to do it GREAT! If you can sleep with your kids in your bed or next to you and not worry about SIDS-GREAT! However, don't knock the parents who have to use CIO for one or more of our kids.

[Dan]

For us co-sleeping, i.e. in bed with us, for the first 2 months worked really well. My partner definitely got more sleep because she could feed him right there and go back to sleep. I've heard some people can't sleep with baby noises, but we didn't even notice. After two months we moved him to his own cot in our room. Once he is asleep he sleeps soundly, so there was no concern that we'd wake him when getting up or moving around the room.

As for letting him cry it out when trying to get him to sleep that never worked. He has proven he can cry for as long as we leave him. We tried it for a while because nothing else seemed to be working. What we eventually found helped was giving him a long hug before putting him into his cot. Sometimes it is necessary to return and give him another. Without a doubt though in his case leaving him to cry would mean none of us ever gets any sleep.

[single dad]

i so like this post... thanks for sharing..

[Janine]

Please help moms - really battling to get my 5 month old to sleep. Swaddle her under her arms, white noise machine, warm flannel sheet, dark curtains, soft music, the works!! As soon as i put her down, she kicks her legs and laughs...what do i do???? She is so cute!! Can I use cry-it out for naps too??

[Amanda A.]

My LO is transitioning from a crib in our room to a crib in his own room. He knows the difference and we let him CIO and suprisingly, after 5 minutes he gave up and went back to sleep.

[Nirva Patel]

hello: i have 3 kids under 3. My daughters (9months and 3yrs) seem to sleep well and I recently joined their rooms. The baby is in a crib and my daughter in her bed on teh floor> my daughter can be "bribed" with a special morn book reading or a small toy if she stays in the room and "goes back to bed." Recently my son, who was a great sleeper since 9 months...he is now 2 yrs old, refuses to sleep. He was ferberized but since he turned 2, he refuses to sleep/nap on his own. He cries and cries and cries. If I go in the room, he doesn't want to go to sleep (even if it is at 2 am) ..he wants to put the lights on and play. Im debating on letting him CIO again, but feel horrible b/c he is older now. Is 2yrs too old to let a child CIO?

[admommy]

My son is 13 months old and a few weeks ago I HAD to try a modified CIO method.We had tried everything else. I use to rock him to sleep for an hour of more and he would wake up within 5 min of putting him in his crib. this would go on from 8pm till 2am and then he would be up again at 5. he was sleepy and cranky all day. the first night was the worst.I put him in his bed at 8 when he was sleepy but not asleep. he cried for 5 min I went in his room and told him I loved him and rubbed his back. I went back to the living room and cried so hard while staring at the clock and telling my husband how heartless he was for making us try this waiting for the next 10 min to pass so I could go back and comfort him. after about 3 min my husband said "shhhh listen" and there was complete scilence. I of couse ran to the room thinking my baby had hit his head or had quit breathing opened the door to find my son sound asleep and smiling. the next night took 5 min. and now he only whines for about a min.

[KPS]

I have a 12 month old son and recently my husband and I decided we had to try the CIO method. Our son had moved into a routine of falling asleep in our arms on the couch and then when we went to put him in his crib he cried and screamed until someone picked him up. For a while holding him would put him back to sleep, but now he still sreams and cries even if you are holding him. He is simplly fighting his sleep, and we know nothing is wrong with him. So yesterday at nap time I tried the CIO and he screamed for the first 5 minutes, I went in and assured him it was ok and then left again. 15 minutes he was asleep. Last night at bed time we put him in his crib, he cried and in 5 minutes I went in and pressed his glow worms tummy and kissed him (as he is screaming) then waited 10 minutes and he was asleep. He woke at his usual 3:30 am wanting comfort and someone to pick him up, but we didn't pick him up this time and let him cry. 5 minutes he was asleep and woke up happy and not crying at 7:30 am. As a mother, I know when something is wrong, and when he is just wanting his way. I feel like the CIO is teaching him to find comfort on his own and to me this is important throughout life. I didn't start it until 12 months though. I comfort him during wake hours and I am a very nourtouring mom, however at sleep times, he must learn to sleep on his own.I do not feel it is barbaric.