Cry It Out – Sleep Training Method for Babies

Experts believe that the ability to fall asleep on their own is an important life skill that babies must know and the ‘crying it out method’ is a good approach to sleep training which does just that. The idea behind the cry it out method is that by the time babies are six months or older, they are aware that crying results in being picked up, rocked and comforted, which leads to poor sleep associations during bedtime. But the CIO method discourages that and babies give up crying before bedtime within four or five nights of undergoing this training and learn to sleep on their own.

What is Cry It Out Method?

Cry it out method (CIO) is a sleep training approach devised for babies in which they are allowed to cry for a specific period of time before being comforted by the parent. CIO involves a variety of approaches and is often misunderstood as an approach where a baby is let alone to cry for as long as it takes before falling asleep. More appropriately called ‘graduated extinction’; the idea behind it is to teach the baby to soothe herself to sleep when placed in bed without the presence of a parent.

What is the Ferber Method?

The Ferber method is the most popular of the CIO approaches. Developed by Dr. Richard Ferber to solve sleep problems in infants, the method became popular as Ferberizing after the publication of his book Solve your Child’s Sleep Problems in 1985. Ferber says that is it possible to teach babies to soothe themselves to sleep between the ages 3 and 5 months when they are physically and emotionally ready.

Benefits of Cry It Out Method

As opposed to popular belief, practising CIO method does not mean that you are a ‘bad parent’ for letting your baby cry uncontrollably. In fact, the method is practised in a set pattern and has clear how-tos of going about it. CIO also has several benefits, some of which are listed below:

1. Lesser Stress on Babies

In a recent study conducted on infants trained in the CIO method, researchers found lower levels of cortisol, also known as the stress hormone. Decreased stress levels correlated with better sleep throughout the night with less or no disturbance in between.

2. Good for the Parent’s Mental and Emotional Wellbeing

The same study tested for stress in parents, and found that not having to wake up at multiple times in the night to soothe their crying child, meant that the parents were lesser stressed as well. This improves their mental health and motivates them to be better at raising their infants.

3. Babies Fall Asleep Faster

CIO method starts showing results in a matter of days and after about a week of training, babies are known to fall asleep within 15 minutes of being in their crib. Experts believe that falling asleep alone is an important skill in life and the CIO makes it possible to develop that.

4. Does not Affect Baby’s Long-term Behaviour or Social Skills

Contrary to popular belief, cry it out trained babies show no difference in behavioural traits and social skills from their non-cry counterparts as shown by long-term analysis.

5. Recommended by the American Academy of Paediatrics

The American Academy of Paediatrics considers CIO methods for infant sleep training as safe and recommends it to parents and physicians to try it out.

Theory Behind Cry It Out Method

The theory behind why cry it out works for babies is that when given the opportunity, it is possible for babies to fall asleep on their own and is a skill that can be mastered in time. A baby who is rocked or nursed to sleep every day won’t learn to fall asleep on her own without these routines in place. This could be a problem when they wake up in the middle of the night as part of their regular sleep cycle. When they find that their parents are not around, it becomes a cause for concern and they stay awake and cry rather than going back to sleep.

On the other hand, babies trained in this method can soothe themselves to sleep when they wake up at night or during a nap. The method sees crying as a side effect and not the goal, as the baby gets used to sleeping on her own. At first, the training seems to make it worse, but the short-term discomfort endured by the baby and the parents is outweighed by the long-term benefits of a baby who sleeps effortlessly on her own and the parents getting a good night’s rest.

How Quickly Does the CIO Method Work?

Most parents who have tried the method report that it works steadily over three to four nights and babies fall asleep with fewer bursts of crying by the time the training reaches seven days.

Steps to Perform in Ferber Method

The method can be tried between the ages 4 and 6 months when the baby is physically and emotionally ready for a full night’s sleep.

Step 1: Place your baby in her crib while she is sleepy but still awake.

Step 2: Say goodnight to her and leave the room even if she is crying. Give it about 3 minutes and let her cry.

Step 3: Go back into the room while the lights are still off and pat your baby reassuringly with a quiet soothing voice for no more than two minutes. Leave the room again even if t she continues to cry.

Step 4: Follow the same routine, but this time stay out of the room a little longer before returning to reassure your baby and leaving while she is still awake or crying.

Step 5: Continue the routine with longer time intervals until your little one falls asleep while you’re out of the room.

Step 6: If your baby wakes up in the middle of the night and cries, restart the routine from the minimum time interval and repeating until the maximum interval for the night is achieved.

Step 7: Increase the time interval between each visit every day. In most cases, a baby goes to sleep on her own by the third or fourth night or a week at the most according to Ferber. If your baby is still resistant after a few days, give her a break for a few weeks and try again.

Ferber Method Chart

Day	First interval	Second Interval	Third and subsequent intervals.
One	3 min	5 min	10 min
Two	5 min	10 min	12 min
Three	10 min	12 min	15 min
Four	12 min	15 min	17 min
Five	15 min	17 min	20 min
Six	17 min	20 min	25 min
Seven	20 min	25 min	30 min

Ferber Method Alternatives

Ferber’s CIO method is extremely popular and effective in most cases. However, there are other methods available to help your baby sleep independently. Here are a few of them:

1. Modified Ferber Method

This variant of the Ferber method involves checking on the baby at every five minutes interval. Unlike the original Ferber method, the waiting time to soothe a baby is kept at a constant of five minutes until the baby falls asleep. It’s also called the controlled cry it out method as once the baby stops crying, the parent can check on the baby only when she cries again.

2. The No Tears Method

In this method, the baby is put in a crib and a parent sits next to the baby on a chair until she falls asleep. The following night, the parent sits a little further away from the crib. The distance is gradually increased every night and the chair is just left in the room eventually giving a false assurance to the baby that the parent is close to her watching.

3. The Sleep Lady Shuffle

This is a modification of the No Tears method in which the parent increases the distance of their chair to eventually placing it outside the door and yet sitting on it till the baby is asleep. The following night, the door is left open and the chair is left at the door, but the parent is not on it.

4. Bedtime Fading Method

The idea behind this method is that a tired baby sleeps better. The parents wait for the baby to be totally exhausted and fall asleep. The baby is then put in the crib and her sleep time is noted. This routine is repeated every day at the same time which sets up the baby’s schedule to sleep at the specified time and sleep without much fuss.

5. The Weissbluth Method

Perhaps the harshest of all the CIO methods, this method is similar to the Ferber method. The baby is put in her crib at the first sign of drowsiness and allowed to cry unattended no matter how distressing her cries are. The baby is left completely on her own to fall asleep.

Tips from Parents & Experts for Trying Cry It out Method

1. Discuss with your Partner and Develop a Plan

Both the parents need to be ready to cooperate and take turns to help each other out in the sleep training. It is best when both have enough time on their hands and are not caught up with work, business trips or visiting relatives that could upset the schedule. On the emotional front, both the partners need to have an understanding and how to proceed so they can support each other during rough patches.

2. Maintain a Bedtime Routine

With activities such as a bath, a lullaby or a book reading session, build activities up to the sleep time and maintain the routine so the child can get accustomed to it and fall asleep easily.

3. Prepare Yourself for Disappointments

Your baby may not be ready for the sleep training and it may not work initially. However, try again after a few weeks. There will be plenty of sleepless nights while the baby will wake up in the middle of the night and you will have to repeat the whole routine again.

4. Expect Relapses

Even when the baby is fully trained to sleep on a regular schedule, it might regress during times of illness or when travelling.

5. Stick to the Plan and Make It a Team Effort

Consistency is the key. Once the routine is established, it’s important to follow through unless the baby isn’t up to it physically or emotionally and then the training can be put on hold. Even when she wakes up in the middle of the night and the urge is strong to rock her to sleep, start over from square one. Discuss with your partner on taking turns and planning on what role each one of you plays during the training.

Do’s and Don’ts of Cry It Out

• Do explore other methods of sleep training and try the existing CIO methods with variations that suit you and your baby. Since all babies are different, and the same approach may not work for all, try a modification that works.
• Do make sure that the child isn’t crying for reasons such as hunger, pain or the need for a diaper change before bedtime.
• Don’t try the method with babies younger than six months of age. It is better to start with other gentler approaches while they are young.
• Don’t try CIO with babies that are sick or are teething. Babies tend to wake up in the middle of the night and the training would add to stress and anxiety.
• Don’t force the baby to adapt to the sleep routine. They may need some time to adapt to it and if it doesn’t work the first time, give it a break and try again when they are a little older.

Drawbacks of Cry It Out

While there are pros and cons to this method, there isn’t enough research done either way to support or to contradict the CIO approach strongly. Some of the drawbacks of the method are:

1. It May Cause Brain Damage

Ignoring your baby’s cry might cause damage to the brain’s neurons which can lead to hypersensitivity due to trauma in the long run. Since infants need to be frequently touched and given plenty of attention, the lack of it could alter the way in which the nervous system functions.

2. Babies Could have Prolonged Stress

Another body of research which challenges the ‘low infant stress’ hypothesis shows that babies undergoing CIO sleep training have elevated levels of the stress hormone cortisol. This persists even after sleeping and can have negative repercussions on the baby during her waking hours.

3. Affects Relationship between Parent and Baby

Crying is the mode through which babies communicate many of their needs and if it doesn’t generate a positive response from the parents, the baby could develop a sense of detachment. The first two years are crucial for building a strong attachment with parents and detached infants could have insecurities growing up.

4. Could Affect Maternal Bonding

The CIO methods require mothers to override their maternal instincts to comfort their babies. This could lower her confidence in raising her child properly and erode the love and bonding between mother and child.

5. Could Increase the Risk of SIDS

The isolation of the CIO methods could increase the risk of Sudden Infant Death Syndrome (SIDS). Leaving an infant in a dark room with the door closed can lead to an unforeseen incident that can be fatal.

Can You Use CIO for Naps?

The Ferber method is primarily for night time sleep rather than naps during the day. As they get older, babies sleep less during the day. Therefore, the method is useful for a full night’s sleep and babies trained in CIO can nap on their own.

Can Baby Sleep With Pacifiers & Toys?

The Ferber method recommends against the use of toys or pacifiers or any other object that babies may identify with sleep. Toys also pose a choking hazard while the baby is left alone and increase the risk of SIDS. However, the American Academy of Paediatrics recommends the use of pacifiers during bedtime and the choice is entirely yours depending on what works well for your baby.

The cry it out method may not be suitable for all parents and babies, but it has been effective for many. Although hearing your baby cry for a long time can be torturous, a little pain initially can yield plenty of good night’s sleep for you and your baby.