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Jul052008

Cry it out (CIO): 10 reasons why it is not for us

Intuitively and instinctively, the cry it out (CIO) method (also known as sleep training or ferberizing or controlled crying) of getting a baby to sleep is not something I ever felt comfortable with. And as I did research on infant sleep, I learned about what normal infant sleep is and I also learned more about the reasons why the CIO method is harmful. There are numerous scientific and emotional reasons why we have chosen not to let our babies cry it out, which I have summarized below.

1. Cry it out can cause harmful changes to babies' brains


Babies cry. They cry to let us know that they need something. And when we don't respond to those cries, it causes them undue amounts of stress. Science has shown that stress in infancy can result in enduring negative impacts on the brain. Prolonged cries in infants causes increased blood pressure in the brain, elevates stress hormones, obstructs blood from draining out of the brain, and decreases oxygenation to the brain. Excessive crying results in an oversensitive stress system (likened to a faulty burglar alarm in one book) that can lead to a fear of being alone, separation anxiety, panic attacks and addictions. Harvard researchers found that it makes them more susceptible to stress as adults and changes the nervous system so that they are overly sensitive to future trauma. Chronic stress in infancy can also lead to an over-active adrenaline system, which results in the child using increased aggression, impulsivity, and violence. Another study showed that persistent crying episodes in infancy is linked with a 10 times greater chance of the child having ADHD, resulting in poor school performance and antisocial behaviour. However, if you consistently soothe your child's distress and take any anguished crying seriously, highly effective stress response systems are established in the brain that allow your child to cope with stress later in life.

2. Cry it out can result in decreased intellectual, emotional and social development


At an American Academy of Pediatrics meeting, infant developmental specialist Dr. Michael Lewis presented research findings demonstrating that “the single most important influence of a child’s intellectual development is the responsiveness of the mother to the cues of her baby.” More specifically, other studies have found that babies whose cries are ignored do not develop healthy intellectual and social skills, that they have an average IQ 9 points lower at age 5, they show poor fine motor development, show more difficulty controlling their emotions, and take longer to become independent as children (stay clingy for longer).

3. Cry it out can result in a detached baby


Researchers have shown that although leaving a baby to cry it out does often lead to the cries eventually stopping, the cries do not stop because the child is content or the problem has been alleviated. Rather, they stop because the baby has given up hope that a caregiver will respond and provide comfort. This results in a detached baby. Detached children are less responsive, appear to be depressed or "not there" and often lack empathy.

4. Cry it out is harmful to the parent-child relationship


A child that is left to cry it out is less likely to turn to the parents in times of need. Being attended to as a baby is the most basic of needs and if a child learns at that point that she can count on her parents to respond to her needs, then she will also turn to them later in life when she needs their support. But I worry that if I leave my children to cry it out, then they will not see the point in reaching out to us if they have problems later in life and could try to deal with serious issues like bullying, drug addictions, teenage pregnancy, gambling problems, or flunking out of school on their own or turn to peers. Unfortunately, those problems are often too big for a teenager to be left to deal with alone or with peers and it can have disastrous results ranging from making poor decisions all the way to committing suicide out of a feeling of hopelessness.

5. Cry it out can make children insecure


Children whose caregivers are not consistently responsive and sensitive, often become insecure. Long-term studies have shown that secure individuals are more likely to be outgoing, popular, well-adjusted, compassionate, and altruistic. As adults, secure individuals are likely to be comfortable depending on others, can develop close attachments, and trust their partners. Insecure individuals, on the other hand, tend to be unsettled in their relationships, displaying anxiety (manifesting as possessiveness, jealousy, and clinginess) or avoidance (manifesting as mistrust and a reluctance to depend on others). Parents that use the cry it out method often do so because they are afraid that their children are becoming too dependent. However, an abundance of research shows that regular physical contact, reassurance, and prompt responses to distress in infancy and childhood results in secure and confident adults who are better able to form functional relationships.

6. Cry it out often doesn't work at all


Some babies will not give in. They are resilient or stubborn enough that they refuse to believe that their parents could be so cruel as to leave them to cry to sleep. So instead of whimpering a bit and then drifting off to sleep as some supposed sleep experts would have you believe happens, they end up sobbing and sobbing and sobbing for hours on end. Some end up vomiting. Many end up shaking so hard and become so distraught that once their parents realize that CIO is not going to work, the baby is shaking uncontrollably and hiccuping, too distressed to sleep and too distraught to be calmed down even by a loving parent.

7. Even if cry it out does "work", parents often have to do it over and over again


I can't imagine putting my child through one or several nights of inconsolable crying to get her to go to sleep and I certainly can't imagine having to do it over and over again. However, that is the reality for many parents. I hear people tell me that they always let their child cry for thirty minutes to go to sleep. Or that they have to start the CIO sleep training process all over again after each round of teething, each growth spurt, each developmental milestone.

8. Cry it out is disrespectful of my child's needs


So-called sleep trainers will tell you that after a certain age, babies do not have any more needs at night. Some claim this is after a few short weeks, others after a few months, others after a year. Regardless of the age that is assigned to that message, to me it seems wrong. I'm an adult and yet there are days when I need someone else to comfort me. If I've had a really stressful week at work, if I've had a fight with someone that is important to me, if I've lost a loved one, then I need to be comforted. But how would I feel and what would it do to our relationship if my husband closed the door and walked out of the room and let me "cry it out" myself? I'm an adult and yet there are nights when I am so parched that I need a glass of water or I am so hungry that I need a snack. I'm not going to die if those needs are not met, but I am going to physically uncomfortable and unable to sleep soundly. If I were to let my child CIO, it would be like saying that his needs are not important and that to me is disrespectful. To quote Dr. William Sears on the sleep trainers, "Parents let me caution you. Difficult problems in child rearing do not have easy answers. Children are too valuable and their needs too important to be made victims of cheap, shallow advice".

9. Deep sleep from cry it out is often a result of trauma


Babies who are left to cry it out do sometimes fall into a deep sleep after they finally drop off. And their parents and sleep trainers will hail this as a success of the CIO method. However, babies and young children often sleep deeply after experiencing trauma. Therefore, the deep sleep that follows CIO shouldn't be seen as proof that it works. Rather, it should be seen as a disturbing shortcoming.

10. Our World Needs More Love


Rates of depression are skyrocketing. Violent and senseless crimes are on the rise. As human beings, we need to spend more time being there for each other, showing compassion, nurturing our children. Learning that you can't count on your parents to be there when you need them is a tough lesson to learn that early in life and can be a root of many of the social problems we are facing today. I want to give my kids every chance possible of escaping depression and staying away from violence. And I'm convinced that nurturing them and responding to their needs at night, as I do during the day, is the first step in the right direction.

Those are our reasons for not using the cry it out method. What are yours?

Do you need some gentle sleep tips? See Gentle Baby and Toddler Sleep Tips

Sources:

The following sources were used in the development of this post:

Note: Please note that not all of these sources look specifically at crying it out. Some of them look at the risks of excessive crying in general. It is my opinion that excessive crying is excessive crying, whether it happens at night or not. Also, as I discussed in my follow-up post Cry it Out (CIO): Is it harmful or helpful? and Another Academic Weighs in on CIO there is no evidence that cry it out is safe, despite what its supporters will tell you.

Image credit: Anna Szozda on flickr

 

 

   

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Reader Comments (464)

Fantastic post! What an incredible summary of the research on CIO.

July 5, 2008 | Unregistered CommenterCarla Moquin

By the way, thought you might be interested in this research paper on the biological and anthropological bases for AP practices. It's really incredibly thorough:
http://www.epjournal.net/filestore/ep05102183.pdf

Carla

July 5, 2008 | Unregistered CommenterCarla Moquin

Thanks for sharing that article Carla. I'll have to take some time to read it in detail.

July 5, 2008 | Unregistered Commenterphdinparenting

[...] have big emotions. And a good temper tantrum is a great way to let them out. Science has shown that leaving kids to cry on their own can be damaging to their brains and their development, but there is an increasing movement recognizing the value of a “crying in arms” [...]

[...] is followed by a barrage of bad advice about “tough love” or other variations of the ill advised “cry it out” method. They are made to feel like they are doing something wrong by loving and tending to their children [...]

hey phdip,
curious - did my FB status prompt you to write this? (was something like "...is so glad he let kid cry himself to sleep so long ago") cuz if it did, good! You have excellent points and if it helps ensure more children are well-adjusted in the future than may be negatively affected by same advice, so much the better!
now, i'd like to put my own nickel in (time to get rid of the penny). i see a lot of arguments against CIO based on fear and insecurity (which is interesting in itself but I won't go there right now). I agree with many of your points, but some - like let your baby CIO and he'll end up killing himself later - are a bit over the top. It took a few days of our kid crying himself to sleep before he started singing or chatting or happily role-playing himself to sleep - and now, the routine leading up to bedtime is so much fun (a few books on the potty, brush the teeth, read another book, a final trip to the potty, turn out the lights, start twinkle twinkle, ok another trip to the potty if you must but no piggy back this time, restart 'TTLS' and he's tucked in for the night).
I think the point I'd like to make most is that letting kid CIO does NOT mean you're distant from him/her - if he calls (insistently enough), we'll visit to make sure he's ok and hug him over the rails as long as it takes for him to settle down. If he's ever hurt or upset, we acknowledge/validate the state he's in and hold him close until he knows he's going to be ok.
I think the research you're referencing has a bias - insofar as those parents who let CIO are more probably the same parents that neglect their kids 24/7 and raise them in an unwholesome environment - that surely has more to do with long-term emotional distress than whether you let CIO a few days now and sometimes again.
My comment above on FB was prompted by friends whose kid is SO entirely dependent on his parents to sleep at night, that he is depriving them of their couple time and their desperately needed sleep, and as a result, they are constantly frustrated, at odds with each other, and left feeling helpless and misunderstood and "joke" about divorce. Is that a wholesome family environment? I hardly think so.
It is therefore, like everything else, a matter of maintaining a healthy balance, a middle ground that works well (or at least well enough) for everybody. And if that requires a few bouts of CIO and him learning that sometimes you have to look after yourself first to look better after others later, then I think that's important to acknowledge. Wouldn't you agree?

July 18, 2008 | Unregistered Commentercrammer

Hi crammer,

Nope, it wasn't your FB status (I didn't even see that!). Goodness, that would have been awfully passive aggressive of me if that had been my reason.

In any case, I wrote it for a few reasons:

1) There is a lot of research on this topic out there, but I hadn't seen it summarized well in one article before. I posted the links to those studies and articles on my FB profile a while back, but then later took the time to review them all again and write this summary.

2) Both IRL and on a message board that I moderate, I see a lot of parents that are being told by others that their baby must sleep through the night (as if it were a developmental milestone) and that they must let them CIO to achieve that. In a lot of cases, those parents feel instinctively that it is not something they want to do, but feel so much outside pressure to do it that they give in. Or there are moms being pressured by their husbands to give it a try and they just want some research to show them to support their decision not to do it. In any case, I wanted to confidently present OUR reasons for OUR choices and also arm those that feel that they need to justify their choice not to CIO with some information to help them do so.

3) If someone is on the fence and not sure what to do, maybe this info will help them.

In any case, your comments are interesting and I want to reply in more detail, but I have to work now....I'll get back to you this evening (after I parent my child to sleep....).

July 18, 2008 | Unregistered Commenterphdinparenting

You said: I agree with many of your points, but some - like let your baby CIO and he’ll end up killing himself later - are a bit over the top.

My reply: To be fair, I didn’t say let your baby CIO and he’ll end up killing himself later. I said that was one extreme in the range of possibilities. (“Unfortunately, those problems are often too big for a teenager to be left to deal with alone or with peers and it can have disastrous results ranging from making poor decisions all the way to committing suicide out of a feeling of hopelessness.”). Some human beings manage to deal with extreme pain and suffering (war, hunger, abuse, etc.) and still come through it with a smile. But other human beings, for whatever reason, are more fragile and have more difficulty coping. As a result, I think that some babies will be able to pick up and move on easily from being left to CIO while others will become more withdrawn. Some kids are bullied and escape unscathed, while others are scarred for life. I don’t know which way my baby’s brain is wired, so I err on the side of caution and make sure that she knows that we will always be there for her. We will give her tools as she grows older to deal with problems on her own, but I will not teach her the lesson that we won’t always be there by letting her CIO.

You said: I think the point I’d like to make most is that letting kid CIO does NOT mean you’re distant from him/her - if he calls (insistently enough), we’ll visit to make sure he’s ok and hug him over the rails as long as it takes for him to settle down. If he’s ever hurt or upset, we acknowledge/validate the state he’s in and hold him close until he knows he’s going to be ok.

My reply: You’ve chosen a modified version of CIO that is certainly more responsive than what a lot of people do. I know of people that put their baby to bed at 8pm and don’t go back into the room until 8am, no matter what. I still wouldn’t be comfortable using your approach, but I can see that it is a better alternative to what a lot of people are practicing.

You said: My comment above on FB was prompted by friends whose kid is SO entirely dependent on his parents to sleep at night, that he is depriving them of their couple time and their desperately needed sleep, and as a result, they are constantly frustrated, at odds with each other, and left feeling helpless and misunderstood and “joke” about divorce. Is that a wholesome family environment? I hardly think so.

My reply: We all have our limits as parents. Personally, I am able to say “this too shall pass”. I recognize that my kids will only be small for a few short years and I’m willing to put aside some of my own needs and wants to give them the best start in life. We had the advantage of 10 years of couple time before we had kids and I know that our marriage is resilient enough to withstand a few years where nighttime parenting might need to cut into our couple time. But if someone else is on the verge of having a complete breakdown, is at extreme risk of neglecting or abusing themselves or their kids during the day due to nighttime problems or feels that their marriage is going to fall apart, then they need to do something about their sleep situation.

However, I don’t think that CIO needs to be the solution. There are so many other things that people can do (The No Cry Sleep Solution is a great book full of suggestions). Not every solution is going to work for every child or every family, but I think there is a route to better sleep for everyone that doesn’t involve CIO. In our case, I know that a couple more hours of exercise and fresh air each day makes a world of difference in my son’s sleep and is good for him too.

July 18, 2008 | Unregistered Commenterphdinparenting

... and since what goes around comes around, if all other things are equal, if its good for your son it'll be good for everybody. Isn't that what we all strive for! :)

July 19, 2008 | Unregistered Commentercrammer

Exactly! Thanks again for stopping by and commenting....

July 19, 2008 | Unregistered Commenterphdinparenting

What if you're a working mother and your baby will not sleep unless she is breastfed...and even then, will not fall into a deep enough sleep to get her to her crib before she wakes? We've tried CIO for the past few days and my wife hates it, but our baby will actually fall asleep. We've been having her get in bed with my wife and lay down and nurse. After 30 minutes or so, she'll fall asleep for 2 hours (maybe). She has also been sleeping in our bed most nights and nursing between naps...

any advice....my wife heads back to work in 5 weeks and our nanny is expecting a baby in 4. Our nanny can't exactly nurse our baby to sleep; this is why we are trying CIO to get our daughter to sleep. Our daughter is 11 weeks today.

thanks

July 21, 2008 | Unregistered CommenterSasha

I'm a working mother too, which is exactly why I co-sleep. It means that I can nurse at night without having to get out of bed and it also gives me more time to connect with and be close to my baby, who I miss so much during the day.

At first, I didn't find that I necessarily slept more while co-sleeping but with time as the baby got older and as I got more used to it, I found that I hardly needed to wake at all to feed the baby. And sometimes my kids even latched themselves on and helped themselves while I continued to snooze.

Incidentally, both of my kids slept much longer stretches right next to me than they would if they were sleeping on their own. Both of them also fell into a pattern of sleeping through the night most of the time while being in my bed, but would wake fairly easily if I wasn't there.

I would suggest getting the No Cry Sleep Solution. It has great suggestions for improving a baby's sleep without crying and has ideas for both co-sleeping or crib sleeping. Crib sleeping was never really a good option for us, but if that is your preference, the book might be able to help.

My husband and my mom care for my kids while I am at work. Sometimes a bottle works to get them to sleep. Sometimes rocking them. Sometimes a walk in the stroller or the sling. There are lots of ways to get a baby to sleep without crying.

I hope you find something that works for you!

Let me know if you have any follow-up questions...

July 21, 2008 | Unregistered Commenterphdinparenting

Great summary! Here are two related articles from the Natural Child Project site:

A Baby Cries: How Should Parents Respond?
http://www.naturalchild.org/jan_hunt/babycries.html

Ten Reasons to Respond to a Crying Child
http://www.naturalchild.org/jan_hunt/crying.html

They also have a bumper sticker "Teach babies love - answer their cries." I think that says it all!

Jennie M.

July 22, 2008 | Unregistered CommenterJennifer

Amen Amen Amen!!!

I'm always confused when I read women's posts that say "I hope I don't have to CIO"... doesn't that mean that deep down, somewhere, they know this is not the right choice to make?

Yup.... I have children as old as 15, and I can tell you none of them have cried longer than it ever took me to drop what I was doing to hold them. What a loving gift to give a child!

July 29, 2008 | Unregistered Commentergeriatricmama

[...] Cry it out (CIO): 10 reasons why it is not for us: This appears to be the bread and butter of my blog. This is what brings people back, day in and day out. It does well on the search engines and people like to link to it on message boards. Most days it is this post, along with the most recent post, that tops the traffic on the board. [...]

You know, I'm really conflicted right now about CIO. My 5-mo old wakes up every 40-mins to an hour all night. He tosses and turns and fusses and wakes up every 20 mins or so from 3:30-5. The longest he'll sleep is two hours. He is so exhausted he'll wake up if I so much as rustle the sheets.

Yes, he's in my bed. We also use a co-sleeper but it's very difficult to get him into it w/out waking up and starting the screaming all over again. And, FWIW, I breastfeed on demand and nurse him to sleep. And yes, we have a routine, etc. etc. Yes I "wear" him. Yes I read No-Cry Sleep Solution and no it hasn't worked for us and yes I'm really following it.

Now, while I appreciate a mother's disinclination to CIO and am more against it than for it, I find these "scientific" sources--that you and other CIO-opponents use--to be dubious. If you're going to list Sears as a "scientific source," then why can't someone list Ferber or WEissbluth as a source?

Also, there are lots of logical flaws in the "scientific" connections between studies and the implications for CIO. For example, this study is often cited: "Infant developmental specialist Dr. Michael Lewis presented research findings at an American Academy of Pediatrics meeting, concluding that 'the single most important influence of a child’s intellectual development is the responsiveness of the mother to the cues of her baby.'"

Sure! Of course! No sane person would argue that or any of the other studies SEars cites.

But were these studies directly dealing with babies crying at night for one or two nights? No. And of course a baby whose cries are habitually ignored is going to have increased stress, trauma and poor development. That's pretty obvious. But is this research, and the other research cited by Sears, directly speaking to CIO? No.

I'm not defending CIO, per se, I'm just asking that we be intellectually honest in these discussions.

Say there was a study done on people who are traumatized by living in war zones. And one particular study shows that people who live in these war zones have increased levels of stress. Any time one of these people is exposed to very loud noise, the noise triggers a severe anxiety attack.

Would it be fair to say, Loud noises trigger severe anxiety attack? No--because you're leaving out an essential piece of the equation. Same with these studies that are often used to "prove" how harmful CIO is.

What about a mother who is so exhausted because she's been guilted into thinking that CIO is going to irreparably harm her child that she hasn't slept for more than 40 minutes for months. She is so tired she can barely play with her child all day. She is so depressed and exhausted she can't eat properly. She argues with her spouse. She falls asleep while her baby stares at the ceiling fan in bed next to her despite her best efforts to stay awake. She's so exhausted and numb that when he baby does fuss during the day she can't even respond right away.

Are you really telling me this is better for a child's development than "controlled crying" for a few nights? Sure, I know. It doesn't work all the time. And no, it's not a great solution. It sucks. And I'm sure many many parents only turn to CIO because they are at the end of their respective ropes.

It's easy for some moms to look down on other moms who have to turn to CIO. Maybe their babies only wake up 4 or 5 times a night. Maybe they are able to let their husbands get the baby to sleep so they can nap.

It's not such an easy decision. I of course think moms shoudl try all of the other options before turning to CIO. But A) sometimes it seems to be the lesser of two evils. and B) I wish people would think about the logical connection between "studies" and their parenting practices before demonizing others.

August 11, 2008 | Unregistered CommenterMeghan

[...] 2008 by phdinparenting About a month ago, I wrote a post outlining the scientific and emotional reasons why we have chosen not to use the Cry It Out (CIO) method with our children. In brief, the ten reasons [...]

Meghan -

http://phdinparenting.com/2008/07/05/no-cry-it-out/#comment-277" rel="nofollow">Comment 17 provides a link to http://www.phdinparenting.com/2008/08/11/cry-it-out-cio-is-it-harmful-or-helpful/" rel="nofollow">today's post which is my attempt at being intellectually honest about this stuff.

With regards to the rest of your comment, I do feel for you. It does sound like you are sleep deprived and I remember being there sometimes with my son. As I said in http://phdinparenting.wordpress.com/2008/07/05/no-cry-it-out/#comment-129" rel="nofollow">Comment 8, "If someone else is on the verge of having a complete breakdown, is at extreme risk of neglecting or abusing themselves or their kids during the day due to nighttime problems or feels that their marriage is going to fall apart, then they need to do something about their sleep situation. However, I don’t think that CIO needs to be the solution."

You say that you have tried the No Cry Sleep Solution and it didn't work for you. Does that mean that you did the logs for 3 days, chose your solutions and implemented them for 10 days (and continued the log) and saw no improvements, made some adjustments and chose different strategies and did it for another 10 days with no improvement at all?

The NCSS is a gradual process. By being consistent with the strategies that you've chosen, you will see incremental success. It isn't an overnight solution and the "plan" needs to be adjusted over time. You also need to account for things like teething, developmental milestones, growth spurts, etc. impacting the process.

Meghan, I know this is hard. See if you can get some help from someone during the day sometime so that you can get some extra sleep. Try to get out and get lots of fresh air (if you put your baby in a sling or stroller, maybe he'll go to sleep and you can have a "break" too - mine both took some of their best naps outdoors).

August 12, 2008 | Unregistered Commenterphdinparenting

Thank you for this webpage.

I'm so glad I'm not the only one that thinks this is too much for a child to handle - despite the fact that almost every mom I know has done this.
I'll share my story.

Just like Meghan (above), I was extremely sleep-deprived, going through post partum depression, and desperate for some hours of sleep; so finally we agreed to do the cry it out method. Surely, if I got some sleep, I'd be a better mom.

For one month we heard our baby scream when bed time came. Not cry; scream.

By the second week, I was hearing him scream (in my mind) during the night, although he was deeply asleep. He slept the first 5 days through the night; after that he was waking up again. (So, no different than before)

According to the book we were following, we were not to respond for 10 minutes if he woke at night. One night his room was so hot because the temperature rose, and we didn't know about it. He was sweating extremely by the time he had screamed for 10 minutes.

By the last week, I was hating bed time so much. Then while our son cried and screamed, my husband and I were almost at each other's throats. During the day our baby was witnessing our arguments.

We gave up.
And our baby has become more whiny, more aggressive, and fears more the unknown - he used to explore the world more.

We were desperate and believed that Weissbluth was correct that every baby can sleep.

As a happy ending, our little one is back to himself. It took a few months. That's my story. Thank you.

August 26, 2008 | Unregistered CommenterTati

Some contrary opinions that are quite critical of the science behind many of the anti-CIO arguments you might be interested in:

http://mainstreamparenting.wordpress.com/2008/06/25/of-sources-and-straw-houses-the-annotated-dr-sears-handout-on-cio/

http://mainstreamparenting.wordpress.com/2008/01/23/when-proof-is-not-proof-apnp-research/

As I said in my comment on your other post, I also think you are missing an important part of the equation - the detrimental effects of sleep deprivation on parent and child. Is 2-3 nights of attended crying, resulting in good sleep for everyone, really going to be that much worse than months or years of no one getting enough sleep? Some will say of course the crying is worse; all I know is that my then 7 month old became a completely different baby after 2 nights of us using the Ferber baby. She went from crying, cranky, and barely sleeping at all, with HUGE bags under her eyes, to a happy baby who almost never cried. The change was amazing, and it appeared to all have to do with her finally getting enough sleep.

Not sleeping was having a seriously negative effect on my baby. CIO fixed that. Co-sleeping made it worse. Everything else we tried failed.

September 14, 2008 | Unregistered CommenterEgrrrl

@Egrrrl

As I said http://phdinparenting.wordpress.com/2008/08/11/cry-it-out-cio-is-it-harmful-or-helpful/#comment-550" rel="nofollow">in reply to your other comment, if you do have to resort to some sort of crying approach because you've tried everything else and are still sleep deprived, then that is your choice, but I don’t think you can assume that there is no harm at all.

If my child wouldn’t eat anything but pop tarts, then I would feed him pop tarts rather than having him starve and sure he would look healthier and happier than when he was eating nothing, but I wouldn’t pretend that it was a healthy diet and that it was having no ill effects on his health.

My http://phdinparenting.wordpress.com/2008/08/11/cry-it-out-cio-is-it-harmful-or-helpful/" rel="nofollow">other post on this topic was a reply to "critiques" like the ones you listed, so I won't rehash that here. Lets just say I'm glad I don't have to justify being a "mainstream parent", I'm glad to be an attached parent instead.

September 14, 2008 | Unregistered Commenterphdinparenting

[...] we would read a book or work on a laptop in his room while he fell asleep. We never left him to cry it out. We never left him calling out for “Mommy” or “Daddy” or [...]

September 27, 2008 | Unregistered CommenterA new chapter « PhD in P

This was a great posting. I don't understand why people have children if they aren't willing to take the steps necessary to have a happy baby. Of course infants are "needy", they are babies! Ignoring a crying baby and emotionally stunting their growth early on is just poor parenting. It's that simple.

I usually try not to be judgmental, but it's pretty clear to me why we have so many "messed up" children in this world.

Infant experiences are a lot more far reaching that most people would think.

September 29, 2008 | Unregistered CommenterJoshua Starr

@joshua

Ok, so in the interests of coming back to reality, let's just identify here and now that your comments:

"Ignoring a crying baby and emotionally stunting their growth early on is just poor parenting. It’s that simple.

I usually try not to be judgmental, but it’s pretty clear to me why we have so many “messed up” children in this world."

are the most foolish I've read through this and the other post. These are ridiculous comments, and I'm sure phd will agree with me. In fact you've tainted a level-headed and lively discussion.

So, in the interests of keeping the discussion going, hopefully my post will ward off the ire of many parents who read these articles because they need help and assistance, then come across your post blaming the world's problems on parents who try/do CIO.

No, I'm not a fan of CIO either, but you need to get a grip.

October 6, 2008 | Unregistered CommenterBrett

[...] to teach empathy from infancy through to adolesence. It starts with things that are as simple as responding to your child’s cries and learning to share and goes up to more complex concepts and in depth ideas about equality, [...]

[...] and let their baby scream. And sometimes those searches bring them here, to my blog, to my posts on Cry It Out: 10 reasons why it is not for us and Cry it Out: Is it harmful or [...]

My 6-month old wakes every hour or two in his crib OR when he's next to us. My husband and I sleep on a futon matress on the floor in his room so we can tend to his cries as soon as possible. We reject the CIO method, we've tried the Pantley way (to the letter, and no, it did not work), and we're just wondering what DO we do? He hated the car seat and the stroller for five months, which made the simplest of chores out of the house a nightmare, but he's better in both places now. Is it possible for a high-needs/previously colicky/non-napping baby to simply MATURE into better sleeping patterns?

October 27, 2008 | Unregistered CommenterKrista Greene

@ Krista

One of my kids has always been high needs and a bad sleeper and the other one is easy going and a good sleeper, so I have had the opportunity to experience both.

We went through some really awful periods with my son sleepwise, where it seemed like he was nursing all night long. The No Cry Sleep Solution (NCSS) helped to improve things somewhat, but wasn't a perfect solution.

In the section on improving mom's sleep, NCSS talks about the importance of exercise. However, this isn't mentioned anywhere as a solution to improving the baby's sleep (that I could see/ recall). It is mentioned briefly in the NCSS for toddlers and preschoolers.

Ironically, exercise and fresh air turned out to be THE most important things in encouraging better sleep for our son. I think this is common in high needs kids. They have so much energy and need an outlet for it. I thought our son was getting plenty of time outdoors and time to exercise (2 hours or so per day), but when we doubled or tripled that, his sleep got so much better!

Obviously a 6 month old can't run around outside, but getting out in the fresh air and being given the opportunity to move around and explore in the outdoors as much as possible can really make a difference.

That said, to answer your question about whether it is possible for a baby to simply mature into better sleeping patterns, I think some part of being a good sleeper does just come with time. But part of it is creating a healthy sleep environment for the child. That includes good nutrition (food sensitivities or allergies can often contribute to poor sleep), lots of exercise and fresh air, no TV or at least no TV in the evenings, regular bedtime and calming bedtime routine, sleep space that is the right temperature, comfortable but firm, free from clutter and free from environmental pollutants/allergens.

October 27, 2008 | Unregistered Commenterphdinparenting

How kind of you to take the time to reply to my question, and so quickly!

Thanks for the advice. He has some good nights, but the bad ones just make me feel so sad for him. Never mind me - I've accepted that being a mom means being there for my child - day or night. And I don't intend to sound like a martyr. That's just the way it is. I go to bed when he does around 7:00, so I'm getting my rest!

Your suggestion to try the outdoors approach was a "well, yeah, duh!" moment for me. When our son was at the height of his colic, he'd cry, no, scream, solidly from 3-7pm (and various other parts of the day). One day we walked outside with him, and he stopped crying! It didn't always work that easily, and with winter in Wisconsin on its way, we won't always have the option, but something as simple as fresh air and a change of scenery may just be the trick to better sleep. After experiencing a baby with colic, when all our desperate and persistent attempts to nurse him, cuddle him, rock him, sing to him, failed, I cannot just walk away when he's crying. Now that Jude cries less, there is no way I'd go back to hearing him cry without responding. We'll keep on trying!

October 28, 2008 | Unregistered CommenterKrista Greene

Great post. Thank you for the great info and excellent research. Also seems to be a lively discussion in these comments, which is a good reminder that every child is different, and what works for some will not work for others. It's so important for parents to be in tune with how their child acts, even if it is sometimes at the expense of expert opinion. But I also think that babies are more resilient than we think sometimes--we're fortunate to have a very sootheable kid (knock on wood!), but parents should not feel bad if their kids may need a little bit of a cry now and then.

October 31, 2008 | Unregistered CommenterDrew Fu

hi
could i copy and paste your article to my blog. am against controlled crying and would like to refer to your article. will provide link to ur blog of course

November 5, 2008 | Unregistered Commenterfrancesca

@francesca

Thanks for your interest! I would prefer that you link to it rather than copying the whole thing. Maybe list the 10 reasons without the full detail and then refer people over here?

Here are the 10 reasons in short form:

1. CIO can cause harmful changes to babies’ brains
2. CIO can result in decreased intellectual, emotional and social development
3. CIO can result in a detached baby
4. CIO is harmful to the parent-child relationship
5. CIO can make children insecure
6. CIO often doesn’t work at all
7. Even if CIO does “work”, parents often have to do it over and over again
8. CIO is disrespectful of my child’s needs
9. Deep sleep from CIO is often a result of trauma
10. Our world needs more love

November 5, 2008 | Unregistered Commenterphdinparenting

I’ve already posted a long comment on the other post, at http://phdinparenting.com/2008/08/11/cry-it-out-cio-is-it-harmful-or-helpful/#comment-996, explaining some of my objections to this post. (Thanks for replying, Annie; I'll try and respond to that as soon as I can. Which should be, um, about three months at the rate I normally find time to write things...) However, I know not everyone will read that post, so I do want to say this here as well:

*None* of the studies cited or referred to in this post is into effects of controlled crying or sleep training. The three studies that have been done into psychological effects of sleep training showed either no effect or beneficial effects. Despite what Annie says, the available scientific evidence does not support any of the claims she's making here about supposed harms of sleep training.

There is certainly evidence that children who experience *long-term* neglect or unresponsiveness on the part of their parents are likely to suffer harm as a result, but that doesn't mean we can assume that sleep training has the same effect. I've often likened it to research into nutrition – we know that children who *regularly* get too little to eat suffer long-term ill effects and that the result can even be fatal. But that does *not* mean that a child is going to suffer the same kind of ill effects if you're sometimes half an hour late with his dinner or tell him he can't have a biscuit every time he wants one; and it wouldn't be good science to claim that that was the case.

Of course, lots of people prefer to err on the side of caution and try to avoid ever leaving their baby alone crying for any reason anyway. If that's how you feel, then good for you! I've also aimed to use gentle methods with getting my children to sleep where they worked (in some cases they didn't, but that's another story), for the simple and obvious reason that it's more pleasant for all concerned. But it is not true to say there's scientific evidence that the Ferber method is harmful. By all means believe that it *might* be harmful, but it isn't accurate to claim that the research supports this; and I don't think it's responsible to mislead parents in the way that this article does.

Annie, one last thing here. In Comment 21 above, you state that you’re glad to be an attached parent ‘instead’ of a mainstream parent. Did you really mean that the way it sounded? Because it sounds to me as though you’re trying to claim that ‘mainstream’ parents (what a vague term!) aren’t attached to their children. Attachment has nothing to do with how mainstream you are. I find your comment quite offensive to the millions of wonderful, caring, responsive parents out there who are just as likely to have strong attachments to their children as you are despite not making the same choices as you about every detail of their lives and parenting practices.

November 15, 2008 | Unregistered CommenterSarah V.

[...] a comment on my anti-CIO post, a reader asked what I meant when I said I was glad I didn’t need to justify being a [...]

@ Sarah V

Thanks for your comment. Most of what you raise above, I addressed in my follow-up post and yours and other comments on that post: http://phdinparenting.com/2008/08/11/cry-it-out-cio-is-it-harmful-or-helpful/

With regards to your last question on attachment parenting versus mainstream parenting, I decided to address that in today's new post: http://phdinparenting.com/2008/11/16/what-is-attachment-parenting/

November 16, 2008 | Unregistered Commenterphdinparenting

Thanks for the article and the list of reference material. Not that I was considering CIO with my son, but I am going to send this to anyone who tries to pressure me to do so.

If someone wants to do this with their own kid, okay...I mean, go for it, but don't push it on me. K? K.

December 19, 2008 | Unregistered CommenterGreta

[...] of Elizabeth Pantley’s other No-Cry books. As many of my readers know, I am supportive of a no-cry approach, so when I was given the opportunity to read and review the No-Cry Nap Solution on my blog, it [...]

You might be interested in my recent work evaluating the research literature that underpins CIO. In short, I found that most of the research on CIO has not been conducted on infants, but on toddlers and preschoolers and virtually no research has been conducted on infants under 6 months. Further, the majority of the research only looked at whether or not the intervention "worked" (ie. did the child stop waking and crying). Only 3 studies with some infants looked at their behavior after the intervention. These three used a scale that is outdated and had never been thoroughly validated. I've put this summary, as well as a copy of the poster I presented at conferences on my website.

January 5, 2009 | Unregistered CommenterMacall Gordon

@Macall - thank you for your comment and for providing another wonderful resource for my readers on this topic: http://www.infantsleep.org/

January 5, 2009 | Unregistered Commenterphdinparenting

[...] 15, 2009 by phdinparenting A few weeks ago Macall Gordon dropped by my blog and left a comment on my post about why we don’t use the cry it out method to get our children to go to sleep. [...]

[...] to teach empathy from infancy through to adolescence. It starts with things that are as simple as responding to your child’s cries and learning to share and goes up to more complex concepts and in depth ideas about equality, [...]

Oh, I agree. I agree. I was just thinking today that I don't think Ivy has even cried a total of 10 straight minutes since she was born. I feel this is how she communicates with me. I know her so well I can anticipate her needs before she needs to cry. I could go on and on-

Steph

January 21, 2009 | Unregistered CommenterAdventures In Babywearing

[...] of Elizabeth Pantley’s other No-Cry books. As many of my readers know, I am supportive of a no-cry approach, so when I was given the opportunity to read and review the No-Cry Nap Solution on my blog, it [...]

[...] few weeks ago Macall Gordon dropped by my blog and left a comment on my post about why we don’t use the cry it out method to get our children to go to sleep. [...]

[...] a comment on my anti-CIO post, a reader asked what I meant when I said I was glad I didn’t need to justify being a [...]

As a pediatrician who was frustrated by how many parents failed to find help using CIO, I did extensive research and even have published an ebook about this important subject (When "Crying it Out" Doesn't Work, by Mary Kathleen Fay, M.D.) I think the fundamental problem is that for CIO to work, the child must be completely healthy and sleeping normally once they fall asleep. Few doctors consider the fact that sleepless children may be suffering from insomnia as the presenting sign of a sleep disorder. Once I took information from the adult medical literature and started to apply this to my patients, I found that in virtually every case where CIO failed to work within the first day or two, the child was suffering from an undiagnosed sleep disorder, usually caused by a mild breathing problem. The symptoms I learned to look for to make the diagnosis were restless sleeping, mouth breathing during the day or during sleep, drooling during sleep and excessive daytime drooling ( a product of mouth breathing), and daytime problematic behaviors like ADD, school problems, and difficulty with discipline. These children don't respond to CIO because they are sick and unable to sleep normally. Most pediatricians were not taught to link these symptoms to sleep disorders until quite recently, and many more in practice were never taught anything about sleep disorders, so the diagnosis is frequently missed. Instead, pediatricians lump all sleep problems together as "behavioral" and blame the parents what is rarely their fault. A t this point, most pediatricians are aware that snoring is abnormal in children and dictates getting a sleep study in a poor sleeper, but many children with sleep disorders don't snore, just as my child never did.
If you would like to know more about this widespread problem, please check out my ebook which can be bought on payloadz.
Good luck to all of you struggling to get help. Don't blame yourself when CIO doesn't work. It is most likely because it is the wrong treatment, and continuing to use it will delay appropriate diagnosis and harm your child.

February 2, 2009 | Unregistered CommenterMary Fay, M.D.

[...] sleep deprived parents that want their babies to sleep better and, like me, do not want to use the cry it out approach. Some of these things I have learned through experience and others I’ve learned [...]

[...] sleep deprived parents that want their babies to sleep better and, like me, do not want to use the cry it out approach. Some of these things I have learned through experience and others I’ve learned [...]

[...] so well worth it in the end, particularly when you think about the stress and anxiety that too much crying can cause on the child AND the [...]

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