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The Pediatrics Cry it Out Study

September 10, 2012 |  by  |  1 YO, 9-12 Months, cry it out
Pediatrics long-term effect of CIO study

Actual Academy of Pediatrics medical professionals older and less cheery than pictured here.

In an ideal world babies would never cry. We would all have tons of pre- and post-natal support and education. Nursing would be easy to figure out and nursing Moms would get free muffins at Starbucks. Our fabulous in-laws/parents would live next door and would be helping us with our children and making fresh apple pies. We would all have happy easy babies who nodded off to sleep in their cribs for 2 hour naps. And like the tooth fairy, baby fat fairies would come to our rooms while we slept and take it all far far away.

Alas this is not our world. In our world, some babies are really challenging. Their parents love them desperately and read every baby book in publication trying to figure out how to keep their fussy baby from crying, how to help their non-sleeper get some restorative sleep, and shuffling bleary-eyed through the first months or years of parenthood.

Sometimes these exhausted families turn to cry it out after all other options have been exhausted. They may even look on the Internet for advice or support about their situation. Which is a huge mistake because the Internet is filled with articles suggesting that anybody who uses sleep training is a terrible parent who is permanently damaging their children. That as miserable as the whole exhausted family is, chronic sleep deprivation for years would be far preferable to a few nights of crying. And that failing to agree with that perspective makes you a (insert: bad parent, anti-attachment parent, unloving, selfish, etc.)

Well the American Academy of Pediatrics has just published a study that I hope will go a long way towards dampening the yelling/judging about CIO and hopefully enable parents, under appropriate circumstances, to consider sleep training as a potential alternative to long-term severe sleep deprivation.

Pediatrics 5-Year Study on CIO

This study is the first long term study on sleep training. Parents of 8 month old babies who were struggling with sleep were split into two groups. The first group was told, “Good luck!” and sent on their merry way (OK I’m paraphrasing). The second group was given an individual sleep plan from a trained nurse that included either check-and-console/Ferberizing or what they call “camping out” (baby cries but parent hangs out in the room for increasingly shorter periods of time while this is going on). Then they compared the two groups (detailed parental surveys and cortisol stress tests) at 10 months, 12 months, 2 years, and 6 years.

Numerous studies have shown short-term benefits from sleep training a la improved sleep, greater parental health/well being, lower maternal depression, improved parent-child relationship, etc. This study focused on long-term outcomes, lasting 5 years, and came to this conclusion:


Behavioral sleep techniques did not cause long-lasting harms or benefits to child, child-parent, or maternal outcomes.

What they found was that by age 6, kids who did vs. didn’t do CIO were both doing just fine. Will this study help quiet the “you are an awful parent!” anti-CIO judgment on the internet? Judging from the early comments on articles, probably not.

In fact people are already up in arms about the “did not cause lasting benefit” statement from the quote above. Why let your child cry when, by age 6, it won’t make any difference?

I’ll tell you why. Because yes – by 6 years of age most kids HAVE figured out how to sleep without their Mom’s boob in their mouth all night. Because they’re SIX. So if the idea that your child will have sorted out these sleep issues by the time they are entering 2nd grade is evidence that you shouldn’t let your non-sleeping 1 YO cry then you are made of sterner stuff than I am. Because there are a lot of sleepless nights to be had between now and 2nd grade.
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101 Comments


  1. Ah, thank you for keeping us updated on the latest sleep research. It certainly reassures parents considering CIO that their child will pull through safe and sound!

    I have a random question, Alexis! (Sorry for the tangent.) My 4.5mo fights sleep and cries hard before every nap/bedtime, even though he’s tired. Why?? He also needs shushing, patting, swinging, and the pacifier to fall asleep. So if he cries this much anyways, would you still not recommend CIO at his age? It’s so stressful to hear, 4 times a day. Also, he’s oozing out of his swing, so I need to move him to his crib soon, but all “no-cry” solutions for our baby have failed. What can I do?

    Thank you for all your wonderful posts, by the way. They’ve been more helpful than you can imagine.

    • Are you keeping him awake too long? What if you try shortening the amount of time he is awake – what happens then? That’s my FIRST guess.

      The fact that he needs so much soothing makes me disinclined to suggest CIO right NOW. It just seems like he’s a really sensitive baby and I’m afraid that sensitive baby + young = ugly CIO scene. (I’ve been wrong often so don’t let this scare you because I don’t know you or your baby so really, I’m just making a big guess here.)

      But if he’s really sensitive I would work on:
      – shorter time awake
      – DARK room whenever he sleeps
      – LOUD white noise always
      – Swaddle (I know he’s 4.5 months and probably breaking out but find a way! try double swaddling!)
      – Then add on everything you’re already going – swinging, paci, etc. See if that doesn’t help make some improvement.

      If ALL of that gets you NOWHERE, it may be time to run the CIO plan by your pediatrician (just cuz he’s a bit young) and give it a try.
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

    • Hi Catherine, my 4.5 month is the same :) and yes I have now figured out that he was over tired as well as strong sleep associations to rocking/holding etc I have removed one thing at a time i.e I would hold him and sing but not rock for a couple of weeks then lay own in our bed and hold him and sing, then put him down in bed and just singing…we are now at singing until his eyes are heavy and he drifts of on his own, but yet to still make the transition back to his own bed. He cannot be awake more than 1.5 hours 2 tops (and I’m pushing it) I also got in contact with Nicole at the babysleepsite.com and they have done a plan that suit your parenting style. My son fussed (and yes cried) for 45 mins the first night, 20 min the second and 10 mins the 3rd that’s what we are up to now, but a HUGE improvement from crying for an hour every night we put him to sleep! Good Luck

  2. Alexis,
    First, the picture is too awesome with the caption. Love it.
    Second, the description of the perfect world with the free Starbucks’ muffin is lovely. Can I live there?
    Third, YAY and thank you for continuing to be a voice of reason on this topic. Perhaps the children did not fare any better or worse but I bet their parents got a little more sleep and were able to take a deep breadth once in a while. I know CIO worked for our little family. Tough at times and ultimately so worthwhile.
    Thanks for yet another illuminating post.
    Laura

    • The picture really made me laugh, that’s why I picked it. Look at the girl on the right. What is she…SIXTEEN? And their teeth match their coats. Which would never happen because actual doctors drink too much survival coffee to ever keep them neon white. But they threw on the “could actually be old enough to have medical degree” dude on the right. He’s the token old guy. Also I think they all just had a V8.

      Thank you for calling me the voice of reason. I wanted to just be called, “The Voice” but surprisingly it was already trademarked ;)
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  3. Excellent summary!

    What the study didn’t stress (and what some of the comments elsewhere completely ignore) is that there are real benefits to achieving independent sleep for babies– babies end up better-rested, and parents can maintain their adult relationships and not go insane with exhaustion. It probably helps prevent job loss, major depression, car accidents, and shaken-baby syndrome.

    Keep up the good work!

    • Hey everybody – did you see this? Check it out an actual DOCTOR gave ME props. Did everybody see this? I’m going to post on FB about this because I don’t want any of my readers to miss out on this.

      Seriously this is the most exciting thing that has happened all week (and it’s been an exciting week!).

      Thank you so much for your kind words. And in case you are curious, Dr. Benaroch also blogs about parenting stuff and you can check it out here:
      http://pediatricinsider.wordpress.com/
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  4. You emailed me awhile back b/c you noticed a ton of hits from my site (yes, my daughter and I are sleeping much better now, though not perfectly – it’s a work in progress)… and I wanted to say thanks for checking in. I also wanted to say thanks for you fair, unbiased, and ACCURATE reporting. NBC nighly news reported on this study last night (http://video.msnbc.msn.com/nightly-news/48978721) and the ENTIRE VIDEO features what looks like hours old babies crying in the background while they talk about hwo CIO is okay. Um, NO IT IS FUCKING NOT for a 2 day old. It just sucks that some misinformed person is going to watch that video and say “SEE – I told you to just let the baby cry.”

    Furious.

    • That’s how I got started on this whole CIO thing to start with. Initially I was chicken because I thought all the angry Internet Trolls would drown me in vitriol. But I was getting 10+ emails a day (not a joke) from people who want to know if it’s OK to let their 10 day old cry because everybody is soooo tired.

      (Note: 50% of my readers come from outside the US/Canada and not everybody has the same postnatal support or education so they’re not necessarily bad Moms or anything.)

      Anywhoo the whole thing was bumming the out so I figured it was easier just to talk publicly about it because:
      a) there IS so much angry/scary talk on the internet and
      b) I can handle the trolls

      (Note #2: I’ve never gotten a single troll nor have I ever deleted an angry comment which is AMAZING. Although now I’ve probably jinxed myself.)

      Anyhoo that was a long rant but anyway … Congratulations on your work in progress and I’m so happy to hear things are much better now!
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  5. I just read something recently that said although they didn’t see behavioral differences between cio and non-cio babies, they did find cio babies had higher levels of cortisol in their blood, which suggests they are more stressed out. I need to find the article again to get more details. Has anyone else read that? I just like to look at both sides. Luckily, our 1-year-old has gradually improved his sleep to either one wake up per night or sleeping through, and we never had to do cio (although we considered it numerous times).

    • If I’m reading it correctly the cortisol tests were taken at 6 years AND that any variation in answers between either group on any of the many things they were testing for were considered not statistically significant.

      (It’s hard for me to understand academic speak but that’s my read on it). Email me if you want to read the full copy yourself. Or you just want it for a sleep aid ;)
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  6. Hello,

    Our son goes down in his crib just fine, he never protests. He gets a bottle and is asleep by the time put him down BUT, he has recently, I’d say the past 2-3 weeks, been waking up after 2 or 3 hrs, crying and whining. Some nights he does great, other nights, not so great. He was breaking his top two teeth in around this time and I wondered too if separation anxiety was kicking in? Last night he slept great from 8pm-1:45am and then woke up crying, I tried giving him his binky, he didn’t want that. His top teeth have broken through so I didn’t think it was teething. I hate to hear him cry and I’m afraid to do CIO if he is in teething pain. Could it be the separation anxiety as well? He is going to be 8 months old on 9/21. THank you,

  7. Thanks for sharing this!

    Love, love, love this blog and will share it with everyone I know who says they are having sleep struggles. It has helped me not only get through the rough patches but made me feel like less of a failure for having to do some CIO with my son. (Who now goes down most nights without a peep!)

    • Aw man, thanks :)

      Also you should never feel like a failure, EVERYBODY is struggling, trying things out, seeing what works. That Mom who shows up at the new baby playgroup in spotless white pants with perfect hair and makeup? She’s crying at 2:00 AM too. Don’t be fooled – you aren’t alone :)
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  8. Thanks Alexis!

    I have mailed you almost 9 months back, when my baby was 5 months old. And couldn’t keep you updated after that, though i read your each new article, and modified what I was doing with each one.

    Well I tried swing with white noise, then ferberizing almost three times( and it was very difficult because he would cry for one hour or so to start with)and then learn to soothe himself..every time my son would do well with the routine for about a month or so but teething, fever etc would again disturb it. Finally, cry it out without a peek was the best solution( he never cried for more than 28 minutes with no peek method) even though after teething or fever it is disturb for a night or two..but then he easily ( sometimes crying for 45 seconds) catches up the rhythm. Thanks again. My life is so much easier now.

  9. Thanks for posting about this. I was also dismayed by the comments on the article. I really just don’t understand why the anti-CIO crowd loves to moralise so. My favourite comment on the article was the one likening CIO to infant heart surgery and infant circumcision without anesthesia on the basis that all of these are similarly cruel… really? How do you even begin to reason with someone like that?!

    • What frustrates me is the, “We never had to do this so YOU’RE a bad parent if YOU do.”

      Your baby is your baby. Their baby is not your baby. Keep having more babies, eventually you too will get one that is challenging. We’ll see how morally outraged you are when it’s your turn to not sleep for a few years. Or when your baby is so overtired that they cry all day long out of sheer exhaustion.

      If you have an easy baby instead of jumping on people that don’t, maybe you should just enjoy the day and be grateful that your baby is so easy. Maybe you can use the long happy naps your baby is taking to make muffins for the neighbor who DOES have a challenging baby. There’s an idea…
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  10. Fab-we are big endorsers of CIO, it worked GREAT for our son who went down for bed and naps w/o a pacifier but woke up some nights multiple times a night. The pediatrician suggested CIO, and after also reading your blog we tried it-it worked after 2 nights! However, he has begun sucking his thumb (ugh!) to self-soothe if he wakes up early (plus side, no crying!) and his naps have become crappier. Could you write a CIO nap edition? :)

    • It’s on the list but I will say this – nap CIO is a bit of a mixed bag. Where night issues are pretty much a lock to get resolved relatively quickly, naps can be much more challenging.

      Also if the thumb is the issue (is it?) for the crappy naps, it may be almost impossible to prevent him from using it. Unless you want to go back to swaddling or some such. I’m surprised though because generally the minute they figure out how soothing their fingers are naps get better not worse?
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

      • The thumb is only an issue because I know it’ll be harder to break later than the pacifier; but seriously if that’s his own sleep issue I’ll take it! Before we did CIO, his naps were awesome, 1 1/2-2 hours twice a day, sometimes needing a short catnap (20-30minutes) later in the day. Lately, he’s been waking himself up at times after his 45 minute sleep cycle and crying, screaming crying. I can tell he’s still tired but he just can’t get back to sleep. Sometimes I give in and give the pacifier back in these cases (sometimes it works, sometimes I make it worse!) Ugh!

        To top things off, he just learned how to roll over onto his tummy and thus has scared the ever-loving-&*#@ out of his mommy during a nap and middle of the night when I heard a cry, checked the monitor (just in case) and yup…on the tummy!

        • Ugh? Why ugh?

          I would certainly let him suck his thumb. It won’t be a problem until his permanent teeth are coming through, and by that time he may well have stopped of his own accord, and if not he’ll be old enough to get him on board with giving it up instead of trying to force him not to.
          CarrieVS recently posted..How the Lion Got his JobMy Profile

        • I would go get him when he wakes up. Generally once babies start really crying (not just a quiet grumble) AND they’ve slept for 45+ minutes, they won’t fall back asleep (even when it’s obvious that they’re still tired). Sad but true :(

          Also I’m assuming that you’re helping him fall asleep at naps (or using a pacifier, or both). Sadly this is also why he’s waking up screaming – it’s a bit of a shock to have things change from what he remembers from when he FELL asleep. I know I KNOW that getting him to fall asleep solo for naps is no easy task but that’s the solution to the “wakes up after 45 minutes screaming” dilemma.

          The upside of him learning to flip over (once your heart stopped pounding from the shock ;) is that almost all babies sleep better ON their tummies. Although sometimes there is a rocky transition period where they get stuck there and gripe about it. (Most things with babies involve a rocky transition but are better on the flip side).

          Good luck!
          Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  11. Hi Alexis,

    Thank you so much for posting this study. I currently have a love/hate relationship with CIO and am hoping you can guide me back to the side of love and away from the hate (and haters).

    We did the full blown method with our almost 8 month old daughter last Monday so about a week and a half ago, we followed your instructions word by word. We had already been woking for 2 weeks to slowly wean rocking her to sleep. The first night she cried 20 mins and the next night 5 mins and slept from 8:30 to 7:30 without waking up for 7 straight days. We thought our lives had changed! Prior to this she was waking twice a night and we were feeding her and rocking her back to sleep. Then she decided to throw us a curve ball.

    This week she has started screaming when we finish our bedtime routine ( very solid BTW- diaper, pj’s, books, song and no eating 20 mins before bed). She still falls asleep within about 7 mins but she is waking up once or last night twice a night and will not settle back down without me breastfeeding her. Typically 7 hours after she fell asleep but last night at 1:30 and 3:30. We let her cry for 10 mins then feed her, lay her down with no rocking and she immediately rolls over and goes back to sleep. She is waking up at 7:30 very unhappy and ready to go back to sleep again after eating. Yesterday she went back to sleep again for almost 3 hours! She typically takes a morning nap of almost 2 hours about 2 hours after waking up.

    Any ideas? It seems this pre-crib screaming is corresponding with the night waking. We also still swaddle her and rock her for naps, could that be working against us? I’m slowly trying less rocking and various states of unswaddling for naps but I also know she needs her day sleep.

    Please help before we give in and give up!

    • Well it sounds like your experience last week was fantastic – YAY!

      The question is – what’s happening now? I’m wondering if she’s not sick or going through a growth spurt. Here’s my thinking…

      If she sleeps 11 hours at night and then wakes up seemingly tired, it seems like something ELSE is up. We may not ever figure out what ELSE is going on, but most babies sleep ~11 hours a night so she shouldn’t be waking up so tired. The unusual 3 hour AM nap also suggests something ELSE.

      While the 7 minutes of complaining at bedtime could definitely be extinction burst/CIO stuff (ps. I’m not sweating 7 minutes – it’s not a big deal), the REST of what you describe feels like something ELSE.

      Also, the rocking, swaddling for naps wouldn’t explain your night-sleep problems.

      Assuming she might have a virus and/or going through a sleep regression/growth spurt, I would feed her at night when she wakes. Don’t let her cry 10 minutes as this doesn’t seem to be doing anything for you. I’m wondering if this isn’t a temporary blip. I know you want to find some causal relationship and the proximity to your CIO last week makes it sound like they’re related, but I’m not thinking that is so.

      If it IS a growth spurt she’ll eat/sleep more and then it’ll pass. So that’s my best guess.
      Alexis recently posted..Why CIO isn’t WorkingMy Profile

  12. You have 24 comments on this ALREADY????

    The only thing I wished this study had done was have a “Weisbluth” arm that did extinction. Because I think you’re right: periodic checking can be so hard on the parents it just winds up making things worse.

    I’d love to hear your thoughts on this.

    • I don’t know why the NIH isn’t seeking my input on these things (HA!) but I think what they REALLY need to do is the following:

      – A study that compares CIO to people who didn’t CIO. Technically this study compares CIO to “we don’t know what they did so it could have been CIO, or not, who knows?” (I think the results are still valid because across multiple measures, the kids were all happy and fine and such).

      – A study that looks at how LONG the crying takes (how many hours per night, how many nights, extinction bursts, etc.) so that somebody finally has some data that talks to which approach leads to less crying.

      – A study that looks at improvement in sleep. I see many MANY kids who end up increasing the amount of sleep throughout the day by ~20% and I think that whole aspect of sleep training would be interesting to have locked down in research.

      These are the things people are interested in and fundamentally, it IS our tax dollars that funds this stuff. So if anybody at the NIH is reading this – there’s my 2 cents :P
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  13. Hi Alexis,
    Your website has been a fantastic resource for me, and I’ve been very grateful for your compassionate and balanced approach.

    My son (breast-fed) is almost six months old, and we’re going through a difficult patch. He used to sleep for four hours at a time, and I didn’t mind getting up to feed him because he fell asleep so quickly.

    At four months, I stopped being able to “put him down drowsy” and I panicked and started a nurse-to-sleep habit. It wasn’t sustainable because no one else could put him to sleep, and he was bouncing back from naps, so we recovered using a short-and-sweet CIO (with checks.) We also darkened his room considerably, and now his daytime naps are fantastic. He’s not rubbing his eyes and yawning all day anymore. He gets four naps, lasting between 45 minutes and 90 minutes, averaging somewhere in the middle. He’s got an early bedtime, and wakes up for the day about 12 hours later, so I’d be surprised if over-tiredness is the problem.

    Maybe this is a coincidence, but since we fixed his daytime naps, his nights have been horrible. He started protesting at bedtime, but we used CIO with checks and now he’s back to going to sleep drowsy but awake (bath, boob, book, bed) and falls asleep without complaint. However, he has been waking every 10-90 minutes all night, regardless of whether his last nap is close to bedtime or not. I thought of your “object permanence” problem because he falls asleep with a pacifier, but sometimes he wakes up screaming with the pacifier still in his mouth, and nothing else seems to have changed (we don’t use a timed white noise/mobile/toy.)

    Because the wake-ups are so close together (often 10 minutes apart), I wonder whether this is due to teething pain (he just cut his first tooth, looks to be working on another one.) He’s been much crankier and clingier during the day, even without the visible signs of tiredness.

    We’ve been responding by giving him his pacifier back, which sometimes works, or giving him a minute of walking to calm him down, then putting him down awake. I try not to offer the breast unless it’s been four hours since the last feeding, but if he’s really worked up I sometimes crumble.

    I was pretty confident using CIO to help him fall asleep on his own, but I’m confused about what to do when he wakes up again, especially since he has not been weaned at night yet. Letting him yell at night is much harder on me, and I’m a behaviourist, so I understand the power of intermittent reinforcement.

    How can we take our nap success and translate it into better sleep at night? How can we tell the difference between teething pain and object permanence? Is there anything we should be doing differently?

    Thanks again!

    • *Update*
      Well, teething is over, and the stretches are getting a little longer (up to three hours.) I discovered what object permanence sounds like tonight!

      Screeeech! What the heck? Panicky noises were coming from the baby’s room, so I helped him calm down and put him back down. Fifteen minutes later, I heard the same screaming, so I turned on the light. He squirmed and looked toward the top of the crib.

      There’s usually a blanket hanging there to block the light, and he’s interested in looking at the polka dots. I moved it in the night, because he had grabbed the corner and it seemed unsafe. Somehow, even at 5 am, in his pitch-dark room, he realized it was gone, and was freaking out.

      It’s helpful to have heard that, and to know the difference between an object-permanence scream and the usual come-get-me-and-nurse-me-out-of-habit yelling. If I hadn’t read this, I would have been really worried!

    • To be honest nothing jumps out at me to explain why he is waking up every 10-90 minutes all night long. I can’t say that it WASN’T teething although generally a good stiff dose of Tylenol will fix it (and thus you would have had good information that the tooth pain WAS the root cause). Did you try some medication and if so, did nothing change?

      If so then presumably all is well now and YAY!

      And yep – kids freak out when things change in their environment. And really, who can blame them? If I woke up and found all my bedroom furniture missing I would be pretty chuffed about it too. (Of course the upside would be that, as none of my bedroom furniture is particularly nice, we would be forced to buy nice new bedroom furniture ;).
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  14. Hi Alexis. Your entire site is wonderful! I’ve read the No Cry Sleep Solution, CIO literature from the pediatrician, and countless online baby sleep advice but the advice on your site HANDS DOWN is the most informative and jives the most with my own intuition and experience. I was so excited to find it.

    We’ve been doing CIO with our 6 month old for the past week. It can still take him 30 and sometimes 45 minutes to fall asleep on his own and his bedtime is all over the place because his naps are so short that sometimes I have to give him four. However, I was encouraged because his nighttime waking had stopped completely once we incorporated white noise 3 nights ago.

    Sadly, he woke again at 11 last night and after 45 minutes of crying I broke down and nursed him. He was up on and off for half the night after that, so things seem a little bleak this morning. Why would he suddenly wake again when he had slept through the previous 2 nights?

    Prior to last week I had been nursing him in bed at least twice a night to get him to go to sleep, but I hadn’t nursed him during the night at all for this week of CIO, so silly-me thought he had been effectively night-weaned. Guess I was wrong!

    The game plan going forward is to nurse him for 5 minutes if he wakes during the night and then hope he goes back to sleep with minimal fuss. If not, the only thing I can think is to just let him cry. (Or should I assume 5 minutes of night nursing is not long enough and increase the amount?) He’s very stubborn and I think we’ve only ever gotten him to fall asleep using CIO in about 15 minutes ONCE.

    To top it off, the entire situation is complicated by the fact that we live in a one bedroom apartment so night waking is especially aggravating for my husband and I. For the next few nights I think we’ll be sleeping in the living room to make his night waking a little more bearable.

    Any thoughts or suggestions on our game plan would be welcome. Again, love your site! It’s been a really tremendous help to us.

    • Emily, I think the return of the wake-ups is considered normal, and part of the “extinction burst” that Alexis discussed in a previous post. I’m no expert (see previous panicked post) but it sounds like you’re doing great! Our kids are the same age and you’re much further down the path to rest.

    • I don’t have a solution but I do think I have an answer.

      I think that you’re probably looking at the 6 month growth spurt/sleep regression.
      http://www.troublesometots.com/the-thing-about-sleep-regressions/

      People think that once a baby is done eating at night that they should be DONE. This is one of many things about babies that would be simpler if true, but isn’t.

      Growth spurts exist! They will eat more than they were! So you’re trying to night wean at a time when his body is demanding MORE food. (I know it’s SUPER confusing).

      Look finding the ideal time is almost impossible. Travel, colds, ear infections, growth spurts, learning to flip over, teething, etc. ALL mess you up. So you look at all these things and try to figure out a sliver of time to work on sleep training. It’s hard for EVERYBODY.

      But my guess is that your baby actually does need more food right now for a while. As long as you aren’t nursing to sleep AND you aren’t still night nursing constantly for the long haul, it may just be a frustrating but temporary blip.

      On the other hand if you find yourself constantly night nursing 2 weeks from now then she’s developed a habit and you’ll have to start back at “gently wean off night feedings” to get back to where you were last week. I know it sucks. But there it is.

      Also I think at 6 months having an inconsistent bedtime is doing you more harm than good. And I think THAT probably is the root cause (mostly anyway) of her ongoing crying at bedtime. That and the extinction bursty stuff that Amelia is talking about (thanks for chiming in Amelia!).

      So if it were me I would pick what you think is the best bedtime in general (hopefully it’s in the ballpark of 7:00ish) and work naps to defend that bedtime. Basically if a 4th nap would blow the 7:00 bedtime, I would push to keep her awake and “defend” bedtime. If she’s absolutely miserable maybe you go for a brief stroller walk to let her get ~10 minutes of sleep (enough so she’s not exhausted but not so much that she isn’t ready to sleep at 7:00 yes?). But I would rather have her a tad overtired AND have a consistent bedtime, then have bedtime bounce due to late naps.

      A consistent bedtime will help a whole slew of chemical processes in her body get organized and THESE will make SURE she is ready to sleep at the same time every day.

      Hope that helps!
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

      • Thanks Amelia and Alexis. Things are slowly getting better with his sleeping (both at bedtime and through most of the night). With baby it always feels a bit like one step back, two steps forward, but I’m staying positive and hopeful! The comment about “defending” his bedtime makes a lot of sense. The more bedtime consistency he gets the easier it’s become. Thanks again guys.

  15. Love your site and love the fact that this article/study came out. If for no other reason than being able to have an educated answer when someone frowns at my having CIO-ed my baby.

    Question though…
    We did CIO with our 6 month old, and after a month of everyone getting used to it (we started with nights only and then did naps), he has started to cry when he realizes we are putting him down (either when we take him into his darkened room or when he hears the sound machine go on, etc). Seems that now his sleep association has turned into a bit of stress for him. He cries pretty consistently for about 5-10 mins when we put him down, then either falls right to sleep or plays, moves around, finds his comfy spot for another 5-20 mins. Is his crying him fighting sleep because he wants to continue playing? Is it because he is starting to have separation anxiety? I know that 5-10 mins isn’t all that terrible, but I guess I just feel uncomfortable at having him complain/cry the minute he knows he is going to be put down.

    Will he ever go down with just 1 minute of crying or a small whimper? Am I expecting too much?

    Love to hear your thoughts.
    Thanks!

    • Yes. To pretty much all of your questions the answer is yes.

      Yes this is separation anxiety. Yes he would rather stay with you then be alone in his bed. Yes he wants to play and is not keen to see you signaling that it’s time to sleep. Yes he wants to continue to play.

      There could be a tiny bit of nap timing in there (naps too early, too late – these things are always shifting so you never know). But my guess is that everything you suggest is exactly what is happening. He doesn’t want the party to end.

      This is REALLY normal stuff. I know it blows but I’m not at all worried about 5-10 minutes. Will he ever go down with barely a whimper? SURE!

      These things ebb and flow. There are times when your kids only want to be held. They’re times when the lights on the Christmas tree are so fascinating they forget you’re in the room. There are times when they will fight sleep so hard you’ll think they don’t need to nap anymore (they do!). As a general rule ALL kids would rather play with you then go in a dark room and sleep.

      But eventually they get used to the rhythm of the day and will go down with barely a whimper. My 3 YO told me today, “Mom I need sleep.” How freekin awesome is that?

      But that is not all days. And he’s 3.5 years old so he’s got a few miles on your baby. But your baby will get there too. And don’t feel bad about 5-10 minutes. It’s just his way of saying, “I would rather not nap.” But you are the Mom and you know that he needs that nap. And you tell him so with your consistent love and soothing nap routines. The rest just is what it is.
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

      • Thank you for your response! It makes me feel better that it’s normal, and that its not something that I’ve completely missed or done wrong in the sleep training/putting down awake method.

        In the end, that lasted about 2 weeks, and finally he would go down with nary a peep. We would go in, read, lights out, sound machine on and in his crib he would go wide awake. He would go right down without saying a word, or play with his little stuffed elephant if he needed time to settle.

        Then about a month later, he started with the serious complaints before bed again. And with his growing strength and personality, it wasn’t just crying, but blood curdling screams. It also coincided with separation anxiety during playtime, and we couldnt leave the room without him complaining or following us. That passed after about 2 weeks as well, and he went back to going down easy.

        Now, he is back to screaming again!!! What gives?! He is still rather clingy on most days, so I assume that its mostly due to separation anxiety, but why is it that he is fine with going to sleep alone one month and then HATES it all of a sudden, only to be fine with it again after a while?! Is it normal for the separation anxiety to come and go in waves? Is there a shift in sleep patterns at this age? That third nap is starting to get really hard, and he does not (I repeat NOT) want to go down, even though he looks and acts tired. Is this a sleep regression?

        (He is 10 months old, by the way)

        Thank you, thank you!!

  16. Hi, I’m a big fan of your site! I started CIO about 3 weeks ago and it was really helpful being able to read all your tips and experiences. Well the CIO at night seems to be going well (fingers crossed). The past 2 nights she didn’t even fuss when I put her in her crib. She usually only wakes up once in the night to feed, then falls straight back to sleep. If she wakes up more during the night, I’ll let her fuss/cry till she falls asleep on her own.

    But our bedtime routine has always been to feed her before putting her in her crib and she almost invariably falls asleep on my boob. Once I take her off, she cries in protest but at least she’s awake when I actually then put her down in her crib. My question is, is it a problem that I’m feeding her till she falls asleep?

    Thanks, Alexis!

    • It’s not a huge problem but it’s not really helping you.

      If she’s falling asleep on the boob I wonder if maybe her bedtime isn’t a little too late? What happens if you push it up a bit so she isn’t SOO tired at bedtime?

      Another option is to shift the feeding up in the routine (boob, bath, books, bed). That way she still gets the late feed in but she isn’t falling asleep on you.

      The only reason it’s REALLY a problem is that even though you are waking her up, you could still end up with a nurse=sleep association because the too activities are so closely related. You’ll hear some Moms complain that they put baby down awake but baby still wants to nurse all night? Well that’s why.

      It doesn’t sound like your baby is doing that which is why I’m not hugely concerned. But if she DOES seem like she wants to eat all night long all of a sudden it’s either a) growth spurt or b) nurse=sleep association biting you in the butt :P
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  17. Hi Alexis:

    My son is a month old. I read your post about babes being awake too long and I think that Is the case with him, but when I try to put him tO sleep he fights it. In fighting it he cries and whines. Meanwhile staying awake even longer while he does so. I try rocking him, shushing, pacifier, I even offer him my breast and nothing. I’ve true rocking him in his cradle and still nothing. I spent two hours yesterday trying to put him to sleep and he just wouldn’t fall asleep!! Any suggestions?? Please help! Thanks

    • Hi MickleyMom,
      Check out Alexis’ posts on swings. SUPER helpful! If you don’t have a swing, it’s worth looking into getting one. They don’t have to cost a lot if you buy used and are definitely worth the money if it means less sleep stress!

    • YES getting a newborn to sleep is really hard. He isn’t fighting sleep – he’s simply incapable of it. He hasn’t learned how yet and he needs you to give him SOOO MUCH soothing that it just happens.

      Do everything here:
      http://www.troublesometots.com/newborn-baby-sleep-survival-guide/

      ALL of it, not just one or two. Whenever it’s time for him to sleep you want to:
      – TIGHT swaddle
      – DARK room
      – LOUD white noise
      – Pacifier (if he’ll take it)
      – Nurse to sleep is OK at this age (if you can get him to fall asleep without nursing to sleep that’s better but if you’re struggling don’t NOT nurse to sleep!)

      And if none of that is getting you anywhere then the swing is a possibility you should definitely consider.

      He may only be able to be awake for 45 minutes at his age so he’s likely awake too long (it’s REALLY common for newborns to be awake too long so don’t feel bad about this!). So you’re whole “awake” time might be – baby wakes up, change diaper, nurse, change PJ, soothe to sleep. Repeat this all day long (don’t worry it gets better).

      Good luck!
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

  18. Hi Alexis,
    Thanks for posting about this study – its helping to relieve my mom guilt about our current CIO endeavor. We are working to correct a nursing to sleep habit.

    Your site has been so helpful. But I’m still feeling like we might be doing something wrong. We are on night 13, and our 6 month old daughter still gets real upset when I set her down. We’ve had some good nights with very minimal or no fussing, but we aren’t seeing a trend toward less crying, more like one good night, followed by worse nights.

    Thirteen nights seems so long!

    Our bedtime routine starts between 6:30 and 7. I nurse her, then put on sleep sack, read two short books, then a song, then crib. We have white noise and blackout shades.

    She usually starts falling asleep at the boob, but gets a second wind during the books.

    Once she is down, she sleeps until 3:30/4, then I nurse her and she goes back down until 6:30/7. On the mornings she wakes closer to six, she still seems really tired, so I nurse her again and put her back in the crib. This can get another 30-40 mins. This is all fine with me, it’s the crying to sleep the first time that bothers me.

    Naps are a mess. Still only able to get her to stay asleep by nursing her to sleep and keeping her in my arms with a pacifier. She does one short nap about an hour after she’s up, then another around 11, then another around 3 (sometimes even as late as 4).

    I can’t seem to get the naps any better right now, but have been focusing on the nights as you suggest.

    I guess my questions are – do you see anything wrong with what we are doing now?

    Is the pattern of crying at night showing that this isn’t working for her? Shouldn’t it be better by now? How do we know it’s working?

    Here’s the minutes she’s cried over the past thirteen nights:
    40,25,28,23,0,35,15,18,2,35,3,8,8,10

    Thank you!
    Nicole

    • Nicole,

      Everything you say here sounds really great. I know it doesn’t FEEL great and I totally get it. But what I see is actually a few days of crying, a little extinction burst stuff, and really what amounts to 7 days of crying, not 13.

      See you see the nights of 3, 8, 8, 10 as “continued crying” where I see that as “she’s done but is complaining because she doesn’t want to go to sleep.”

      If I were the sleep fairy I would sprinkle some fairy dust on babies so that when placed in their cribs they would smile and look adoringly at you as you mummer soft words of love and close the door. Sadly I am NOT the sleep fairy so what you get is kids who are complaining because they don’t want to sleep, they want to play and stay with you. Given that she is 6 months old she doesn’t have the words to express this so she cries. When she is 1.5 years old this will sound more like, “No sleep Mama! No sleep!”

      I know you’re looking for a “fix” and probably don’t want to hear “you don’t have a problem.” But I really don’t think you do. I think you’ve actually been done with CIO for a few nights now.

      I WILL say that you want to defend bedtime and make it a bit more consistent. That may mean blowing off the late nap (or keeping it super short). You probably don’t want her sleeping past 4:00 so if it’s 4:00 and she’s READY to sleep, make it a short 10 minute cat nap so that your ~7:30 bedtime isn’t thrown off. Consistency of bedtime will help her chemical processes minimize complaining.

      So in general I might think about not putting her down for a nap any later than 3:30 (at the latest). If this results in her being a total MESS at bedtime then perhaps I’m wrong. But I DO think that having a consistent bedtime will help and if she’s napped TOO recently you may get more complaining because she’s not quite tired enough yet. Does that make sense?

      Hope that helps – good luck!
      Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

      • Hi Alexis,
        Thanks for weighing in so quickly. It is nice to hear I’m not messing this up royally. Of course a quick fix would be great. :)

        Last night she cried really hard for 11 minutes, slept for 30, then woke up crying really hard for 15, before I gave up and checked. She had a really gross diaper, so I felt terrible.

        I will take your advice about the late nap and try to have her up by 4. Her naps today again have only been 35-40 minutes. I can’t figure out if she isn’t tired enough or too tired. She could be teething and also seems to be starting with some separation anxiety.

        So much to try and figure out, I feel like I’m losing my mind!

        Thanks again for your input, I didn’t get any good feedback from the pediatrician. He just said if it doesn’t get better try again in a couple weeks.

        – Nicole

        • I hate to disagree with pediatricians as by all measure they should know way more about these things than I do.

          But I think I have to disagree with the whole, “try again in a few weeks” thing. Because what happens if you go back to nursing to sleep and then restart the whole crying process 3 weeks from now? WAY MORE CRYING! Because you would have effectively taught her that if she keeps it up all but eternally, you’ll come nurse her to sleep yet again.

          So I think that is actually horrible advice that would actually have the opposite effect of what you are trying to achieve.

          I know YOU know that. I just wanted to make sure it was clear in case somebody else was reading that and thought that your pediatrician’s advice sounded like a good plan.
          Alexis recently posted..30 Practical Parenting Tips You Will Never Learn from the MoviesMy Profile

      • Hi Alexis,

        Me again. Sigh.

        We’re on week 3 and still getting a lot of crying at bedtime. Tonight she didn’t settle for 40 minutes (crying off and on).

        I don’t get it. She was in bed just before 7 and seemed nice and tired. I can’t figure out what we are doing wrong.

        Once she’s asleep, she sleeps for 8-9 hours, nurses and goes back to sleep for 2-3. That is wonderful.

        But I don’t think I can take the bedtime crying much longer. I feel awful for her – she seems genuinely upset. Im worried its separation anxiety and she feels abandoned. Is there any way to back off a bit on sleep training?

        Could we go start over with the checks? Back to 3, 5, 7?

        I don’t want to undo all the progress, but it doesn’t seem right.

        Sadly,
        Nicole

        • Hey Nicole,
          Sorry to hear that :(

          If she seems nice and tired could she be OVER tired? Should bedtime be 6:30? I don’t know that’s the answer but it definitely would explain the prolonged crying.

          Also are you giving all the soothing possible? Using a lovey? Loud white noise?

          What I WOULDN’T do is go back to checks. Because my strong fear is that it would reward the crying and just lead to MORE crying.

          In fact often the “off and on” crying is complaining. They sort of get bored/tired and stop for a while. Then they realize they’re still in their bed where they don’t want to be and get worked up again.

          This probably doesn’t help you at all but I had an adorable 10 month old baby (and her parents) visiting this weekend. They ended up doing CIO a few weeks ago but this strong willed baby didn’t want to let go of those night feeds despite all their best efforts, thus the CIO.

          So she woke up at 11:00 PM while here and cried for 45 minutes. Her parents felt terrible, felt they were keeping us up, felt that she was sad and feeling unloved, etc.

          Of course she’s not my baby so I could hear things a little more objectively. And what I heard was a REALLY PISSED OFF BABY. Not an unloved baby. Not a starving baby. An ANGRY baby who was NOT happy about the change in plans. AT ALL.

          She did the “on and off” thing too.

          I’m not sure if this helps you feel any better. Want me to come to your house and tell you how pissed YOUR baby is? ;)

          I have no easy answers. I can’t fix it. But on and off doesn’t worry me as much as prolonged screaming. And I DO believe that checks will mess you up. That way lies madness.

          I might tweak bedtime a bit (too early? too late? too tired?). But I’m guessing you have a strong willed angry baby too. And if I’m right, there is no quick fix. Sadly :(
          Alexis recently posted..The Pediatrics Cry it Out StudyMy Profile

          • Thanks. It’s much easier for me to think of her as being pissed off rather than sad, scared, and lonely.

            I was thinking about a lovey of some sort, but then I get nervous about having something in the crib with her. She sleeps on her stomach, so I’m worried she’ll wedge whatever we put in thee between her face and the mattress.

            Last night we tried putting her in a tad earlier, and that was the worst night we’ve had in a while. So I think we might go a bit later.

            Thanks for the feedback and support!

            Nicole

  19. Hi there. It is 11:15pm and I have already been up once with my 3 month old who went to bed at 7 and woke at 10pm for her first of what is usually many crying spells. I discovered your site this summer when I did a google search for help in the sleep department. I filed it away in my brain because I just knew I would need you. This is my 3rd child (I also have a 6 and 4 yo who sleep very well now but did not as babies). My recent story goes like this…

    After the first few weeks of honeymoon sleep, Stella became a pretty short napper. She would take ONE good nap a day (1-2 hours) in her swing. She was soothed by a swaddle, swing, white noise, and paci. We often had to put her down 45 min after she woke to avoid the overtired state (learned this thanks to your great info). As the day went on, it became more difficult to get her to sleep. I resulted to rocking and then slipping her in the swing to finish it off. Around 6 weeks, ALL naps became short at 30-40 minutes. There was NO long ones. She was taking about 4 short naps a day. By 5pm, she was a mess. She would take a 10 min cat nap in her bouncy seat while we bounced it through dinner.

    On the flip side, she was an awesome night sleeper! She starting sleeping a huge stretch around 6 weeks of age. She went down between 8-9 and slept til 3, woke to nurse, and slept until 6, woke to nurse and slept til 8ish. Around 10 weeks, she was sleeping 10-12 hours. Sounds amazing, right? It all came crashing to an end 3 weeks ago.

    It started with one night waking, then two, now she wakes 3 hours after being put down to continue to wake every 2-3 hours. Sometimes the paci soothes her back to sleep when she wakes before 1, but tonight that did not work. I had to nurse her at 10 because I didn’t think she got enough before bed. My mind starts to play tricks on me. I come up with several different reasons why she is waking and end up thinking she is hungry. BUT she was able to sleep all night 3 weeks ago without waking up starving!!! What happened?

    Did I mention how tired I am?

    When this all broke down, I decided to wean her from the swing for naps. My plan was to do that around the 3 month mark anyway. I figured she was already taking short naps and now this night stuff was going on, I might as well do it. The swing obviously wasn’t getting us far. Now we rock her until she is drowsy and then put her down. It takes a little fussing and several paci put-ins, but she gets to sleep. Then she is up 30-40 minutes like clockwork. I watch her on the monitor and she just kind shakes awake. I realize that it is a sleep cycle thing so I even try to be there to stick the paci in at the 30 minute mark, but it hasn’t helped.

    At night she HAD been sleeping in a rock ‘n play (this little hammock/basinet thing). So we went cold turkey with all of it at the same time and now she is in the crib at night too. (We did this about a weekAFTER the night wakings started so I don’t think the crib is contributing to it). A few nights ago, she did make it all night (til 5ish), but that happens about once a week.

    Bedtime routine is bath around 6:45, a place where she is very happy. Then she slowly loses her mind when I am putting her sleeper on! Like crazy tired crying! So by the time I nurse her, she is already falling asleep. I keep trying to jostle her awake, but I end up putting her in the crib with her paci, where she looks like she is so content to sleep all night. Not so…10 o clock hour is when it all begins.

    I’m tired and just not sure where to go from here. My pediatrician told me to let her cry last week. I just feel like she is so young. I’m lost. I know this comment is all over the place, but I hope I gave you enough info to help me out or to offer suggestions.

    Thanks. **As I was proofreading this (midnight), she woke! So about 2 hours after I nursed at the first waking. I just put her paci in and she is still not settling. Here we go!!!! HELP!!!!!!!!!!!!!!!!!**

    • Dawn,

      You are realizing the undeniable truth that being up all night while parenting 2 little kids is just. too. much. So of course you are exhausted!

      First the good news: everything you describe in the first few paragraphs is absolutely normal! Naps harder to come by as the day goes on, fussy and miserable around dinner time. Check and check. Normal newborn stuff.

      Then around 3 months things go off the rails. I can’t easily tell you what magical transformation happened at 3 months (usually things go off the rails at the dreaded 4 month sleep regression but whatev) but there are a few things jumping out at me:

      – She’s melting down when you try to put her to sleep at 6:45. So believe it or not perhaps for right now, her bedtime is too late. Also if she’s falling asleep while you try to nurse her she’s probably not really eating. Thus she’s using you to soothe to sleep (clearly you have a really strong suck=sleep association here) but probably not getting much nutrition. This is the first thing that is leading you down the path of eating multiple times a night.

      If she’s barely eating at 6:45 it could very well be that her last real “meal” was 4:30ish. By which measure it’s totally reasonable that she’s waking up at 10:00 PM hungry, yes?

      Solution? Feed her earlier in the bedtime routine and possibly push bedtime up. Some newborns go to bed at 6:00 pm. I would play around with that and see if things don’t improve.

      – On the same note, babies have growth spurts where they legitimately DO need more food. Was she sleeping through the night weeks ago? YES! Could she legitimately need more food now? YES! This fact trips up so many tired parents. Sadly babies do not improve in a linear method :(

      – She is only 3 months old and yet you are weaning off the soothing. I get it – everybody is keen to get baby sleeping in the crib. But I think you’ve weaned of the WRONG soothing. Here me out.

      Your baby has a strong suck=sleep association. This is why she is waking up all night long demanding to nurse and/or have the paci reinserted. It’s pretty normal for babies to have a strong suck=sleep association but even though she’s only 3 months, it’s tripping you up.

      (I’m pretty sure that if you parked her on your boob all night she would sleep just fine. Not a good solution, just an observation).

      Ideally you are creating multiple sleep associations. At 3 months I would be a strong proponent of swaddling (yes even if you think she’s done), loud white noise, and going back to the swing (at least for naps if not for nights also).

      You’ve been working on “put down awake” but honestly? You haven’t really been. You’re putting her down awake but then letting the paci do the “soothe to sleep” part. And the paci isn’t working anymore. And I think if you try to put her down awake without the paci you’ll see that you haven’t really been putting her down awake at all (follow me?).

      The Solution?
      – Ditch the paci
      – Don’t let her cry (sadly if I keep disagreeing with pediatricians like this the AAP is going to release a statement condemning me)
      – Give her lots of OTHER great soothing sleep aids that are more consistent than the paci (ie don’t fall out) – loud white noise, swaddle, possibly swing (naps and/or night)
      – Work on really putting down awake (no paci)
      – Try to separate nursing from bedtime by at least 20 minutes
      – Push bedtime up earlier

      Let me know what you decide to do and how it goes, OK?
      Alexis recently posted..Baby Sleep: What is Normal?My Profile

  20. Thanks for your great blog! After reading through the posts where everyone has younger babies, I feel a little silly asking about my 13 month old. We are just now starting to try some “mild” CIO because I am to the point where, after a year of being “super mama” who couldn’t do CIO, I am beyond exhausted. Sure, some nights/weeks/months have been better than others but the truth is I end up nursing her at least once in the middle of every night. Actually, sometimes it is only once at 4:30 or 5:00 in the morning because I cannot bear to wake up even earier than usual. No more nursing to sleep initially, though my husband rocks her to sleep. Now she hates her crib because we have done some CIO recently and she is PISSED just at the mention of bedtime or crib. Our secret nickname for her is Princess Protest. She has always had very strong opinions. But now it is a little less cute and a lot more tiresome. How in the world do we put her to bed without rocking, etc? She has amazing stamina. And I have much less emotional stamina. Do I just leave the house for a night and let my husband do the CIO since he can handle it; sometimes even sleep right through it! I need advice and encouragement. She has just started to resist naps too, with her new crib hatred. But I can almost always get her down for at least one nap a day (nursing to sleep).

    • Hey Andrea,

      You are not the first person who has tried to be a super mama and then gotten ground into an exhausted pulp. Good for you to recognize that this isn’t getting you anywhere and that the whole family needs to be strong and healthy. Seriously, this is a pretty major insight!

      My advice is to not be “mild” about it. Come up with a plan, commit, execute. I don’t know what you mean by “mild” but I do know that dabbling/not really committing/backsliding when it comes to CIO is the absolute worst case scenario. Which is why when it comes to CIO I quote Yoda:

      Do or not do. There is no try.

      Also she may be pissed because babies do not want to sleep! Who wants to miss out on the party when there are all sorts of exciting things going on! Playdates, solid food, toys, crawling. The crib is dull and lonely. Of course she’s pissed when you talk about leaving the party. C’est la vie.

      Check my post below for pretty much my whole take on CIO. Come up with a plan. Commit. Execute.

      If it helps I can tell you where the “rock to sleep” road leads and you don’t want to go there. It HAS to stop. She’s not a newborn anymore. She’s absolutely capable of this. When she cries I know you feel terrible. But I can guarantee you that she’s more pissed than anything. She is YELLING at you because she doesn’t like the change of plan. This is not the last time she will yell at you.

      Absolutely you should leave the house. I fully support that plan.

      The nap resistance is probably coincidental. It goes back to the missing the party thing.

      You can do this. You need to do something. Commit. Plan. Execute.

      Also? Princess Protest is priceless (don’t be surprised if I steal that & use it somewhere ;).
      Alexis recently posted..How to Cry it Out: The Bedtime EditionMy Profile

  21. I am using Sleep Bug on my iPhone to get my son to sleep. He really loves it. I just set it to run for 30 mins and it works.
    Earlier I had a sound machine above his bed but it broke. So instad of buying a new one I got this app. I recommend it!

  22. We have a very strong willed 5-month-old girl. We’ve decided to go the CIO route with her when, last week, she started rejecting all forms of soothing to sleep besides nursing. :( We had been working on putting her down awake but between the four-month Hell Week thing, growth spurt, and travelling out of and back into this time zone, she completely stopped wanting to sleep and would rather play.

    She only naps 45 minutes at a time and has only had nights of 1-2 feedings a handful of times. Most nights, she wakes every 2-3 hours and the only way to get her back down is to nurse her.

    She’s a very happy, alert baby during the day, but I dread every nap and every bedtime. I’ve resorted to waiting till she’s extra tired and fussy before nursing her down for naps. But that means she’s awake for 2.5-3.5 hours before naps. Yesterday she only took two! But I know that can’t be right… Can it?

    Anyway, my husband and I are exhausted and I would seriously consider killing a lot of cute, furry animals in cold blood if I could get at least four consecutive hours of sleep. You know, if somehow that would make it happen. Night 1, she cried on and off for an hour and a half but still woke up every 2-3 hours. Night 2, she cries on and off for an hour with the same night habit. Any suggestions would be appreciated!!

    • Sometimes killing lots of cute furry animals helps. But don’t let the neighbors catch you.

      I have no easy answer for you but I do see a lot of probably causes for why she is eating so much.

      1) She’s waaay overtired. She’s awake too long between naps (not judging, I get it) and then takes short non-restorative naps which means her cortisol levels are probably high going into bedtime. Cortisol is a stimulant which is going to make it harder for her to fall asleep.

      I would actually try to shrink this to have smaller windows and more naps during the day. I know nap battles blow, but it is what I would do. At 5 months I would strongly consider swaddling for naps, white noise, and possibly the swing. If you’re having NO luck with naps, maybe a car ride?

      Basically whatever you have to do so that she’s not exhausted heading into bedtime. Even if she hides it well, her body produces chemical stimulants when she’s really tired. And that works against a smooth bedtime.

      2) Soothing at bedtime? At 5 months definitely white noise and possibly a swaddle too. I know you’re probably thinking “she’s too old!” but I promise, she probably isn’t.

      3) How is she eating during the day? She’s nursing a ton at night. This could be due to a number of things:
      – STRONG nurse=sleep association. She’s not really hungry she’s just requiring you to recreate her association all night long.
      – Night feeding habit. She’s USED to eating constantly at night, so she’s legitimately hungry at night. Do you think she’s really chowing down during those night feedings or is it comfort suckling?
      – Nursing issues (this is pretty rare and least likely scenario). Low supply or fast letdown will result in a growing baby who eats all the time regardless of what you do. If you suspect this is an issue it’s time to find a good IBCLC to work with.

      So you do what you need to to get as much food in her during the day and start gradually reducing the amount of time she gets to feed at night. That’s the general advice about that. It takes a while – not an overnight fix. Personally I would start with the middle of the night feed because if she’s eating 2 hours after bedtime you’re probably still awake for that one.

      Also if she has a big sleep=nurse association, have Dad put her to bed. And make SURE you’re separating nursing from bedtime by at least 20 minutes. Basically you want to get YOU out of the bedtime scene as much as possible.

      Hope that helps…PS. Stay away from my cats, OK?

      • Your cats are safe. :) Check on the swaddle and white noise. Working on naps and separating boob from bed. I’m kicking myself because we were doing decently well with putting down awake until we travelled across the country and I reverted to nursing her down just to deal with the jet lag. :( Thank you so much for the info!!

  23. Oh, so my question is: What should I do about all those night feedings? That’s the big one right now. We’ve got like 42 other things, but I don’t care about them nearly as much.

  24. I firmly believe that prior to starting any type of sleep “training”, an assessment by a knowledgeable specialist to rule out other causes of interrupted sleep would be invaluable. Many babies with sleep “problems” are actually babies with feeding difficulties. Be aware of your baby’s behaviour at the breast – does he pull? bite down? become antsy? pull off? Is the milk transfer (breast and bottle) poor? Has you baby a tongue tie? GERD? Sleep apnea?
    Please look into all causes of sleep disturbance before subjecting your baby and yourself to sleep “training”.
    LK
    RN,IBCLC

    • I do talk about reflux and sleep apnea, while possible, is quite rare for kids under 2.

      If you look at CIO as a tool to solve the “put down awake” problem then nursing difficulties aren’t technically related. And I DO advocate for gentle night weaning which often works great. But you’re right, nursing issues can make gentle night weaning a slog and it can be really hard to know if baby is nursing all night out of habit/association vs. some subtle nursing problem.

      Is there a good directory online for people to find local IBCLCs to work with? I only found one and it was a bit of a mess.
      Alexis recently posted..How and Why to Use and Lose the PacifierMy Profile

  25. I have a sad tale to tell. My exclusively breast fed baby girl started sleeping through the night at about 2 months. She would clustered feed during the day, have decent naps and sleep until between 7-8am. Being a first time mom I knew this wasn’t the norm and was very grateful for the fantastic sleeper God had sent me. My two month old was also a belly sleeper as she would not sleep longer than an hour on her back. Because she had abnormally great control of her head and could move it from side to side when on her belly our family doc said the belly sleeping was fine. At 3 months my babe rolled from her belly to her back one night. She then began to wake once a night when she rolled and would cry because she cannot roll back. Since she has turned 4 months she now often wakes twice a night. I find her on her back unable to return to her preferred tummy position. She has also stopped taking good naps during the day as well. It is rare for her to sleep more than 45min-1 hour at a time. After being awake for about 1hour 15min to 1hour 30min she yawns and rubs her eyes so I put her down in her crib. It often takes her 30min-1hour to go to sleep in her crib (I used to nurse her to sleep but gave it up around 2.5months)and she will then wake about 45 min later, sometimes sooner! I know she is still tired because she is fussy when she gets up but I try very hard to resettle her (back patting and shhhing, I only pick her up when she is very irate)but most times she will not settle. So now I have a baby who sleeps very little during the day and is up at twice a night! I do feed her when she wakes at night because I know breast milk digests quickly and I worry she might be hungry, but I put her back down awake but drowsy. She would nap in her swing when she was younger but rarely will now. Any insights on our sleep issues would be appreciated. FYI I am firm about a sleeping routine (feed, bath, story, snuggle, crib)and have been for a while. I feel like I’m doing all the suggested tips but her sleep (and mine!)is deteriorating!

    • Hey Dawn,
      Well I’m sorry about your tale is so sad. But honestly this doesn’t sound THAT bad (I’ve definitely heard worse!).

      A baby needing to eat 2X a night at 4 months is actually far more typical than not needing to eat at night at 2 months. So I get while you feel this is a major step back, in the broader scheme of things, it’s actually pretty normal. Also she’s probably going through the 4 month sleep regression/growth spurt and genuinely NEEDS more food:
      http://www.troublesometots.com/the-thing-about-sleep-regressions/

      This would also explain the naps going south on you. If it’s taking her 1 hour to fall asleep in her crib AND she’s happily hanging out in there, then cool. However if she’s crying for 1 hour at each nap I would reconsider your nap approach. She’s only 4 months old so crying for hours each day has got to be stressing you and her out quite a bit no?

      I would go back to more soothing for naps. Swaddle, loud white noise, swing. Even if you want to continue in the crib, try working with swaddle + white noise. Even if the naps don’t get any longer, reducing the amount of time it takes her to fall asleep would be great.

      If she’s really sleepy from lack of sleep during the day, you may need to move bedtime up a bit to help her catch up. This won’t likely fix the night feedings but may help with her overall sleep debt.

      I’m guessing this is a temporary setback. Lots of soothing, and consistency of sleep will help you get through it. Good luck!
      Alexis recently posted..How and Why to Use and Lose the PacifierMy Profile

  26. I am at a loss. My son is 5 1/2 months and 17.5 lbs has some sleep issues. he goes to daycare 3 days a week and the room is very bright and loud. he fights naps and when he does nap he only sleeps about a half hour at a time. I believe his bad nap habits at daycare have continued at home, by the time 5 oclock comes along he is so overtired and fussy that i have to put him to asleep at 6pm. He doesn’t have a hard time going to sleep at this hour but he does wake up a few times at night which i believe are the result of his infrequent naps during the day. He wakes up a few times a night but i feed him once. I use the binky the other times but sometimes that can be an issue because he will spit it out and i have to keep going in a number of times. What would you recommend. i have thought about swithing daycares but my 3 year old daughter also goes to the same daycare and she loves it. Life is hard enough in the morning without having to do multiple drop offs. Please let me know your thoughts or suggestions. I am very stressed out over this. HELP!! should i do the CIO method and hope this will help with his naps at school?

    Thank you!
    Tricia
    Tricia recently posted..How and Why to Use and Lose the PacifierMy Profile

    • Hey Tricia,

      Lots of babies sleep poorly at daycare. I am however surprised that they don’t have a “sleep space” that is darker includes loud white noise to at least create the opportunity for longer naps. Is there any way you could talk to them about creating one?

      Sadly CIO won’t solve your problem. If he’s waking up because he’s OVER tired then the solution is to help him sleep better. I’m also assuming that he doesn’t typically go to bed at 6:00 pm so then you’re also likely to run into issues by being inconsistent about bedtime :(

      You’ve got two small children and you work. This is really hard under the BEST of circumstances. Two dropoffs is totally a hassle. Is it a worse hassle then getting up repeatedly during the night? That’s your call. But I would say that if the room is bright and loud and no accommodation can be made to encourage better naps, I would be inclined to look at options. Because he’ll be napping there (or not) for the next 3 years. So this isn’t going to go away soon….

      Good luck!
      Alexis recently posted..How and Why to Use and Lose the PacifierMy Profile

      • Hi Alexis,

        Just thought I would update you on how my son is doing. I took your advice and switched my son’s daycare. I think i needed the wake up call that his naps may never improve at that particular daycare with all that stimulation. He is doing so much better at the home daycare and what do you know, he actually sleeps. Yay! He is 8 months now and i have had to let him CIO at night a few times due to extinction bursts. he is getting better slowly but surely. He was waking up between 4 and 4:30 some mornings and fought going back down but the past few days have been about 5:00 or 5:30 and will go back down after a bottle. Any way i am hoping for a consistent 12 hours a night soon. that would be a beautiful thing! :) Do you think it will happen for me?
        Tricia recently posted..Much to be Grateful ForMy Profile

  27. Alexis I could kiss you! my baby changed his sleeping habits at 6 months old. Pervious to this he slept through the night from 2 months old. Then at 6 months was waking through the night. I stumbled on your website and I followed your CIO method. I saw the mistakes I was making which made total sense and he is back to sleeping 12 -13 hours EVERY night!. As for CIO being cruel and bad for your baby I say rubbish!! my little one is a very happy healthy little boy always smiling and bubbly. The fact that his mum gets a whole nights sleep makes all the difference. I am a nightmare without my sleep grumpy and no fun and that can not be good for baby if I’m tired too, so to all you mums who say CIO doesn’t work, is cruel and damages your baby I will leave you to getting up 3-4 times a night being tired all day and having to deal with a grumpy baby because they have not had a good nights sleep either. As for the mums who have not tried CIO keep to the rules it DOES work!!

    • You and me both sister. I think too many people overlook the “when you are massively and chronically sleep deprived you are not the parent you want to be” part of the equation.

      I always think it would be fun to be on Survivor. I could live on rice. I think I would be good at challenges. I could make shelter, fire, it would be exciting! Except that everybody is existing on 2 hours of sleep due to (rain, sand lice, hunger, etc.). And I know that when I’m exhausted I morph into a snarling wildebeest. I would be so rude and obnoxious the tribe would be quick to vote me off the island so my tenure on Survivor would barely last a day.

      The same holds true for my ability to be a calm, nurturing, emotionally available parent.

      And thanks for giving the rules a shoutout :)
      Alexis recently posted..Weaning Baby Off the SwingMy Profile

  28. Hello, Alexis!

    I always wonder, How do YOU get any sleep answering every question from us sleep-deprived parents? So we did CIO with GREAT success on my 5-month old. A month of blissful, 12-hr night sleeps later, and she started waking up at 4 a.m. (One night it was at 5 and the other night it was at 6:30, but so far it’s been consistently 4 a.m.) We’re going on 10 days of this now and are at a loss.

    We hadn’t changed anything in the bedtime routine–she goes to bed at 7 p.m., her last meal of solids (I always give her a cereal for her last solids meal) is between 3:30 and 4 p.m., she almost finishes an 8 oz.-bottle about a half hour before bed and then has a quiet chat with her daddy (who does bedtime and all night feedings) until she’s drowsy.

    She doesn’t wake up crying; she wakes up AWAKE. Bright-eyed and bushy-tailed, babbling happily for 15 minutes until she starts screaming. My husband started diluting the milk several days ago and we’re down to 25%, but I wonder if there’s anything else we could do and also what you think is going on. When she had two teeth erupt several weeks ago, she had trouble falling asleep but still didn’t wake up in the night, and the fact that she doesn’t wake up crying from pain makes me disinclined to think this is teething. Oh, and she still did this the few nights I gave her Tylenol for teething pain just before bed.

    Thank you for your insight!

    • Patricia,
      I know what it’s like to feel lost and have nowhere to turn. So I try really hard to respond. But I don’t always catch them all (or I’m weeks nay months behind in some cases). So there are probably plenty of people saying, “Alexis never answered my #@$( question!!!”

      C’est la vies.

      As for the early wake up – if you give her a bottle she settles back down and sleeps for a few more hours? Or even WITH the bottle she’s up for the day?

      If she needs the bottle to sleep for a few more hours I would give it to her. It could be a lot of things – teething, 6 month growth spurt (very likely), a passing phase, she’s excited for Halloween, who knows. Sometimes babies need extra food and if a 10 minute feeding buys you 2 extra hours of sleep, it’s a worthy trade off. Wait a few weeks and then try diluting the formula again.

      The early wake up is REALLY common with babies and comes and goes often throughout the first 2 years. “Will only go back down with food” is a far easier problem to deal with than “won’t go back to sleep regardless and now whole day is messed up because she woke up at 4:00 am.”

      Sorry no great fix :(
      Alexis recently posted..Weaning Baby Off the SwingMy Profile

      • Thank you! Just hearing that this is normal makes it easier to handle. It’s particularly helpful to hear that the early wake-up will be coming and going for the next few years. I think that’s what was driving us crazy, knowing that she had slept through the night for many nights and wondering why she couldn’t do it anymore. I hope she remembers soon that she’s done it before.

        Oh, and yes, she does go back down. Sometimes right after the bottle, and sometimes she’ll stay up for more than an hour but when she goes back down she’ll sleep for several hours. It screws up the day, but this is Baby World, which is like The Twilight Zone in a funhouse in Alice’s Wonderland. We’re used to screwed-up days.

  29. Can you send me the AAP article on CIO? I’m very curious about it – thanks!

  30. Hi Alexis

    As I understand it, the study is astoundingly flawed: they didn’t actually follow up on whether the parents even used CIO (or some other method). And surely it can’t be expected that all the parents in the control group (who already admited that they were having “sleep troubles”) DIDN’T do CIO? (ie, they were having troubles, so they want to do something – even if their health care professionals don’t tell them to do CIO, doesn’t mean that everyone else isn’t?)

    This article explains it better than I can…
    http://www.phdinparenting.com/2012/09/18/the-infant-sleep-and-cry-it-out-study-that-proved-nothing/

    Katrina

    • Hey Katrina,
      I don’t think “astoundingly flawed” is even close to fair. People like to poop all over the AAP (they get a ton of flack for their position on co-sleeping too) like they’re a bunch of boobs who are funded in secret by the crib manufacturing coalition or something. But honestly – the AAP is the largest, most respected pediatric scientific peer-reviewed journal. It is IMMENSELY difficult to get research funded at all much less actually PUBLISHED in such a journal. So anytime somebody says, “Man those AAP guys are a bunch of boobs.” my first response is, hold the phone peeps. When in doubt give the AAP the benefit of the doubt, OK?

      Secondly part of the challenge of studies like this is that CIO means different things to different people (something I see CONSTANTLY). So you can’t just ask somebody, “Did you do CIO?” Because one person will say YES when they let their 5 month old fuss for 5 minutes while they were in the toilet, and another person will say no when their 3 month old cried for 30 minutes while they finished a phone call.

      And nobody has enough money to do a study where scientists come to your home and actually monitor what you do and code activities with any rigor because it would cost a billion dollars and the NIH is underfunded as it is. So if you want THAT study you need to start writing your congresspeople to give the NIH a ton more money.

      But enough of my rant on research methods and limitations…

      Anyhoo they know that the two groups DID have statistically different behaviors in managing their children and sleep because the focus group had far better sleep outcomes at 10 months, 12 months, and 2 years. Did they do CIO after

      This study is actually the continuation of ANOTHER previous study that was ALSO published in the AAP a few years ago and the primary group definitely was coached specifically with techniques that would involve some crying:
      http://pediatrics.aappublications.org/content/122/3/e621.full

      You are correct in that we don’t really know what the control group did however the assumption is, “they didn’t solve the problem” because they had much higher rates of depression and self-reported ongoing sleep issues.

      But lets say you’re in no way convinced that any of this matters. Fair enough. The big picture part of this study is that the primary group definitely employed tactics that involved crying to solve their sleep problems. And by every possible measure (surveys, physical examinations, cortisol tests) these kids are doing JUST FINE. So even if you remove the comparison part and just look at the group who DID use some variety of CIO, their kids, at 6, are doing great!

      In closing (dear God this is long) I’m not trying to sell you on anything. If CIO isn’t for you and you’ve found another way – AWESOME! My hope would be that everybody would find a tear-free way to get sleep stuff sorted out for their family. But I’m not about to sign up for the idea that the AAP or this study is astoundingly flawed. Because what we wanted to know was that kids who DID undergo CIO are just fine at age 6. And now we know.
      Alexis recently posted..Weaning Baby Off the SwingMy Profile

  31. We attempted the cry it out method after two months of waking up 4+ times a night after the 4 Month sleep regression hit us hard.

    The day we began the sleep training, the maximum our daughter cried for was 30 mins, and woke up once that night. Every night since she has slept twelve hours straight. Naps are still not perfect, I can only manage to get her down for 30 min at a time. But considering what we were somewhat getting used to before we attempted the sleep training, this is more than we could of hoped for. Not only are we well rested, my daughter is a happier baby.

    If a child isn’t sleeping well, an educated mind would assume it would have a negative effect on their development in the long run.

    Cheers,
    Pro-CIO.

  32. This is good to read, It is nice to read something that isn’t making me feel like I am putting my baby in the basement to go to bed by letting him CIO.

    I do have a question though. My son (almost 10 months) has never been a good sleeper/slept through the night. Partially my fault since I can never stick to the crying… I am really trying tonight!! He is also a strong willed baby and can honestly cry for an hour plus! Is this horrible, to let him this long??? Will it get shorter? Any advice?

    Also he wakes up SUPER early, 3am… ready to go. Does this mean I need to be ready to go too… and just deal with it?

    • Megan,
      To do CIO properly one should, if possible, put baby in a shed. Ideally one located in snow-filled woods, possibly with packs of rabid wolves nearby. ;)

      My advice is really summed up in the article linked below. Will it get shorter? yes. Will he cry over an hour? Probably.

      So my only advice is that if you’re going to do it – DO IT. No dabbling. Come up with a plan you think is best. Commit to that plan. Execute. Dabbling is to be avoided because it really just leads to…..more crying.

      Also 3:00 AM is too early. Which makes me believe he either has a bedtime that is WAY too late, or he’s really overtired (possibly from little to no naps?). He’s a bit old for the swing but his night sleep must be super short if he’s starting the day at 3:00 AM. Not to mention that suggests that his naps are a bit off target too – he’s probably ready for his first nap at 6:00 AM no?

      What does your pediatrician think about the 3:00 am business?

      You have my sympathies – you must be EXHAUSTED. Let me know how things work out, OK?
      Alexis recently posted..How to Cry it Out: The Bedtime EditionMy Profile

  33. Hi,

    My son just turned 10 months and is breastfed. The majority of his life ws didn’t cosleeping with us either in his playpen next to our bed or in our bed nursing and falling asleep on the boob. A few months ago we moved into a house with his own room that he’s now used to. I began by letting him take naps in there(nursed to sleep) and at night nursed him to sleep in the chair next to his bed then placed him in his crib. But when he’d wake up later in the night I’d bring him back to the bed with us til morning. Now I’ve started using the cio method which is working great getting him to fall asleep on his own without nursing to sleep (nurse til full and drousy then put in crib to fall asleep on own)…the problem is when he wakes up he’s always crying and upset like in there’s morning and after naps when usually if sleeping with me he wakes up happy. Is this something he’ll grow out of and eventually wake up happy since this is still new to him? Also if he wakes up in the middle of the night like 2 or 3 or super early like 5 am does he need to nurse or should I just let him keep crying back to sleep. I’ve heard by now they don’t need to nurse at night and its just a habit of comfort since I used to cosleep. He uses a pacifier that’s clipped to his shirt that I’m sure he finds on his own when he wakes up but maybe not. He eats and sleeps a lot during the day but doesn’t go to sleep til 9 or 10 cuz daddy likes to see him when he gets home from work. also one day he took one nap for 2.5hrs and another for then 3hrs then I eventually just woke him up cuz it seemed too long. Sorry im a mess. Any help would be greatly appreciated.
    alana m. recently posted..Much to be Grateful ForMy Profile

  34. Hi Alexis,

    My daughter is almost 9 months old. We co slept until just under 8 months. She is now in her crib but wakes up every 45 minutes – 2 hours (if we are lucky) we tried CIO, she cried and couldn’t calm herself down. Cried for 2 hours (periodically checking in on her 5, 10, 15 minutes) and ended up getting so worked up she throws up, did this every single night we tried. Do you have any suggestions??? We are desperate & exhausted.

    Thank you!!!

  35. Sarah Margulies

    Alexis,
    Your articles are SO HELPFUL.
    I’m a single mom and I have 4 month b/g twins who sleep in their rock n plays with their pacifiers. They go to sleep pretty easily drowsy but awake, and only wake once at night around 3am to feed. Their bodies are positioned in such a way that if the pacifiers fall out, they can be sucked right back in.
    I’m thinking about transitioning to the crib in a few days when my nanny has five days off and it will be just me and the kids. My problem is, if I let them cry it out while transitioning, is it (a) too early since they’re young and (b) mean to change their sleep location AND deprive them of their pacifiers, as once they’re in the cribs and crying, the pacifiers fall out and can’t be put back in unless I’m standing there to do it for them?

  36. This article totally sucks.
    There is PROOF that CIO is detrimental to a child’s health. Psychologists study to learn how to treat the negative effects on a child from CIO and detachment parenting.

    This is just wrong. There are times when mommy needs a break and baby won’t stop crying so mommy takes 2 minutes to herself and lets baby cry, that is one thing. But letting baby cry sometimes for hours on end to ‘train them to sleep’ is just wrong wrong wrong and against all mothers instincts. I can’t believe you would post something like this :(
    Heather M recently posted..Summer Cloth Diaper Giveaway Hop ENDS 7/1My Profile

    • Hey Heather,
      It’s cool that you’ve found another way to make things work for you. And really that’s the goal for EVERYBODY. But I can’t believe you can’t believe I would post something like this. I definitely have much to say on the subject. If you want the whole story you should check this out:
      http://www.troublesometots.com/cry-it-out/

      To address your first point – the research about children who have been harmed by detachment parenting is based on cases of EXTREME AND HORRIFYING neglect. That is not what we’re talking about here.

      Again, I’m not trying to sell you on anything. But I am trying to open the dialogue about something that sometimes, is the right answer for other families.
      Alexis Dubief recently posted..Is Your Crib as Safe as You Think?My Profile

  37. I love this article. Thank you so much for posting. We just started CIO with our 5.5 month old infant out of necessity. She was becoming so chronically overtired that we had no choice. Nothing was working. She slept in bed with me for the first 3 months then went to her crib. She did ok for awhile but then the dreaded 4 month sleep regression began. We stuck it out for a month and a half hoping, it would get better but it has just gotten worse and worse. We believe it is due to chronic sleep deprivation. On ALL our parts! I was becoming depressed, my husband was becoming hopeless and my baby was becoming fussier by the day. I NEVER thought I would become a CIO parent. My son was probably the best baby I’ve ever heard of. Slept all the time and took naps like a dream. Happy, well behaved. Slept in our bed til 3 months and went to his crib no problem. My daughter is the exact opposite. I’m convinced that these “attachment” parents are the way they are because their babies are just natural sleepers. They have never experienced the extreme sleep deprivation that those of us who resort to CIO have. It’s so easy to sit on your high horse and criticize other parents because it’s so easy for you! These people are incapable of putting themselves in our shoes for even one moment because they already feel they are better than us because of their well behaved infants. I also feel that this study will change nothing in their minds. As proven by the above poster.

    I find it hilarious that “attachment” parents will site the AAP so often. But only when it suits their needs. The minute they do a real and accurate study on something they don’t agree with, they are now quacks! Why is they wait for 6 months to feed their baby solids? Because AAP said too. Why is it they put their babies on their backs to sleep? Because AAP said too! Why do they not let their children watch TV until they are 2 years old? Because the AAP said too! But now that the AAP says its ok to use CIO, it’s pure quackery! Will they change any of their other points of views? NOPE!

    Anyhow, I’ve been doing CIO with my baby for 2 days now and I already see a massive improvement in her mood and sleeping habits. She slept 7 hours last night and woke up to eat, then slept 3 more. I almost cried in the morning out of happiness. On top of this she only seems to cry for 10 minutes tops.

    To the parents who disagree with this study because it causes long term damage, just know that there are a million studies out there that will contradict anything you think and feel about how you parent. Relying on studies alone is unreliable and judgmental. Give me any parenting topic you want and I will find you a study that contradicts either side of the argument.

    We as parents must do what we feel is best for our own children. mothers using CIO simply don’t criticize the attachment parents because we all feel “to each his own”. If that’s the way you feel is best, then go for it! But don’t sit on your high horse and tell me I’m a bad parent for doing what I feel is best.

    Good luck to ALL mommies, detachment (which I hate that term) and attachment alike. Motherhood is hard enough without us moms making it into a constant competition.

  38. My dd just turned 9 weeks n I started sleep training about 2 weeks ago, it worked after 2 nights but she regressed and now I’m retraining her. Otherwise I will be rocking her and trotting round the house for 1-2 hours each nap n bedtime while she is swaddled n pacified. It got too much out of hand; I nearly dropped her sleeping on my feet. Sometimes it wasn’t enough n the moment her head hit the sheets she awoke n it would start all over again . I am encouraged to use CIO because it works; sleeping with rocking n pacifiers are all learned behaviors they picked up as newborns because we didn’t know better. Now they are so used to it weaning is a painful process. Sleeping on their own has to be learned n I believe the earlier the easier it is. Babies may not manipulate but they learn and know what they like n what they don’t , so they will cry when they don’t like smthg but if you keep giving in, you will know no end. As they get older, that’s when you have a spoilt brat.

  39. CIO doesn’t cause problems in 6 year olds. CIO problems manifest as teenagers/adults. The USA is the only country in the world where there is prevalence of children under 1 years of age sleeping separately from the parents. In every other country in the world, parents sleep with their children that are under 1 year of age. This trend continues, less and less children sleep with the parents in other countries as the child grows older, but the prevalence never comes close to US. The amount of parents that sleep train their babies in the US is unmatched by any country. This brings me to my point, the USA’s prevalence of anxiety, sleep disorders, depression, etc. but especially insomnia is unbelievably high when compared to other countries. Let’s take China, specifically Hong Kong, similar to the USA, industrialized, hustle bustle life. There are many studies, different methods, different end results. But no matter which one you consider, Hong Kong’s prevalence of insomnia is 10% and Americans prevalence at a staggering 33%. THREE TIMES!!! So when the author posts articles stating there are no longer term effects for crying it out. Please, please consider that these were 6 year olds! The prevalence of insomnia in 6 year olds is low regardless, yet where do our 33% insomniacs come from?

    • 57% of statistics are made up on the spot.

      Your reasoning is specious, you ignore confounding variables, you compare a city with an extremely high population density to the entire US, in which there are dense cities, suburbs, countryside, and everything in between. You falsely equivocate sleep training with separate sleeping spaces.. You ignore cultures in which sleep space is shared out of necessity yet child-rearing practices are quite harsh compared to what most readers of this blog likely practice. You imply that anxiety and depression can also be traced to sleep-training, when there are hundreds, nay, thousands of other variables in a person’s life contribute to their personality. You appeal to sleep practices done largely out of necessity. You appeal to the majority. You seem unable to conceive of any other factor besides sleep-training that could contribute to insomnia.
      Ashby recently posted..Student-designed Heart Monitors Bring the Excitement of Engineering to KidsMy Profile

      • Ashby, making up a statistic about making up statistic is humorous but it devalues the credibility of your post that follows.
        Also having a spelling mistake, on the opening sentence of your rebuttal to my perspective, seriously damages your credibility further. Especially in this case, “suspicious” was spelt “specious”, which may be a simple typo, but your use of a “e” rather than an “i” may indicate that the word was written intentionally.
        I will address your comments later. I currently do not have time to sufficiently address your concerns adequately. I do not care about being right or wrong, I simply state my opinion on sleep training to, as I believe, protect the babies and families of parents considering sleep training. I have no issue with the fundamentals of the rebuttals you bring. But I worry other parents may perceive these rebuttals as legitimate arguements that would convince them that my perspective has no merit and therefore sleep train their babies.
        However, because time is important, I would recommend any reader to refer their questions to this website. http://www.parentingscience.com/infant-sleep-training.html
        This site draws conclusions on multiple studies. It actually bothers me to some extent that this article we are commenting about has drawn the conclusion that sleep training 8 month olds is perfectly okay when the link I provided clearly states the opposite.
        So thank you Ashby for bringing up your questions as many parents most likely would ask the same. I hope you look forward to my in-depth response to your post. I feel it is important to refute your comments and reveal them to be irrelevant towards an attempt to prove my opinion as completely misguided.

      • Also, I would not intent to criticize your spelling as a personal attack. Please feel free to edit mine. I did not put an effort to proof read and correct for grammar or spelling.

      • Hey Guys,

        Great discussion here and I just wanted to chime in and say that there is a 99% chance Ashby is entirely right :)

        Asian countries in general (yes I’m generalizing) co-sleep for a variety of logistical and cultural reasons. They also have the highest level of dissatisfaction with the quantity of sleep and their babies get, on average, 2 hours less sleep a day than babies in the US. Now you could argue that there is a lack of conclusive data about how much sleep babies actually need. But by most measures, these parents are exhausted and their babies get substantially less sleep then their counterparts so it’s hard to argue that “they’ve figured out the best way” to crack this nut.

        As for the parenting science article, yes I’ve seen it before. Here’s the issue with all scientific research – you need to take a good hard look at it. The research cited draws from extreme neglect and does not represent healthy or normal parenting practices. The truth is that there has been an enormous amount of research that supports sleep training, but the “CIO = evil” pedagogy has become so strong in our culture that you can’t even talk about it without getting screamed at.

        Trust me, I know.

        If it’s not the right thing for you, that’s totally OK and entirely your own choice. But it’s neither fair nor reasonable to draw the conclusion that sleep training in infancy leads to chronic sleep challenges as an adult. Especially in light of the fact that there’s a huge amount of data suggesting the opposite.
        Alexis Dubief recently posted..Pediatrics Study on White Noise: Sounding Off on Sound MachinesMy Profile

  40. Hi Alexis, i need help with some trouble we are running into as we Ferberize our 7 month old.
    A bit of background first. Prior to us starting sleep-training, we were rocking our baby to sleep at night, he’d normally fall asleep as we fed him (either bottle or me nursing) and then we would transfer him to his crib, where he would stay until waking up again, 3-4 hours later, when we’d had to get up and do it all over again.
    But as he leaned to sit up and stand on his crib, we had to lower the mattress all the way down, and this is when things got problematic. The lower level of the mattress, apparently, made a difference for him (or maybe it was just a coincidence?) but whenever he fell asleep and we tried to transfer him to the crib, he would wake up crying and we’d had to start the process all over again.
    So what’s been happening in the last couple of weeks (and the main reason we are sleep-training now) is that I was co-sleeping with the baby in our guest room. He’d wake up a few times in the middle of the night and would use my boobies as pacifiers, to soothe himself back to sleep.
    After a few weeks of this, we said, enough. I want to sleep in my bed, get a good night’s sleep to better care for him, and not be just his walking, and very cranky, pacifier.
    As you can see, our son wasn’t used to soothing himself and didn’t know how to fall asleep on his own, alone in the crib.
    Tonight will be night 4 of the Ferber Method training, and while the length of the crying episodes are shortening (giving us hope) we are running into trouble with the baby, who doesn’t want to stay down and is falling asleep pretty much sitting on the crib.
    Last night, after his dinner-bath-book routine, we put him on his back on the crib, awake, and he immediately sat up and started to cry. He did this for only the first 15 minutes and after the first check-in, he just sat on his crib, and whimpered for 30 minutes or so as he struggled to keep his eyes open. He eventually fell asleep, sitting on the crib, slumped over (so sad!). We eased him down on his back, and he stayed there until 1:20 AM, that he woke up. And from then on, he spent the rest of the night sitting on the crib, bobbing his head as he was falling asleep, and jerking/jolting himself awake. Didn’t cry a lot, but I heard him whimpering for hours (heartbreaking and also maddening that he was so stubborn(?) and didn’t want to be on his back. Every time he fell asleep sitting (we have a night vision monitor, and can see him there, slumped over) we’d go in and put him back on his back, but before we could leave the room he’d wake up and sit up again and start the process all over again. At almost 4 AM we stopped going into his room, and just let him fall asleep sitting up (poor thing) and at about 6;30 he woke up crying.
    I’m really sorry for the super long and rambling message. I barely slept last night (and nothing so far today) – and I’m exhausted beyond words but determined to find a solution. By the way, it is the same story during nap time. This morning i “caved” and just laid him down next to me on the couch and swaddle him with a blanket to avoid the jerking that kept waking him up. He’s been napping for over 2 and a half hours (i should probably wake him up, but it is nice to see him sleep so peacefully :) So, if i didn’t completely confused you with my rambling, can you share so word of wisdom with us? about the falling asleep sitting problem? Million thanks in advance!

    • Hey Maggie,

      Quick advice – DON’T let him nap more than normal during the day. You don’t want him sleeping more than normal and thus being well rested to fight sleep again tonight!

      It is hard when babies sit up and refuse to lie down. You don’t want them sleeping sitting up but sometimes your efforts to gently lie them down go south on you. Few things to consider:

      1) Tonight will be far better (don’t let him nap too much though!).
      2) Is swaddling an option? Swaddled babies often stay lying better and are more comforted by being swaddled.

      Transitioning out of co-sleeping is a huge transition for EVERYBODY so it’s not entirely surprising that he’s having a rough go. It’s like when I go camping and I sleep like crap – the tent and sleeping bad is too foreign to me. (And also – spiders).

      Anyhoo at 7 months I would consider swaddling as your best easy bet at this point. Let me know how things develop – OK?
      Alexis Dubief recently posted..7 Sleep Lessons from a Stanford Pediatric Sleep SpecialistMy Profile

      • Thanks for the reply and advice, Alexis.

        Yes, last night was better (WAY BETTER) – we followed the routine and put him down to bed at 8:30. Cried hard for the first 5 minutes (and then cried a bit then stopped, then again, for the following 10 minutes.) My husband went to check-in on him (we noticed the baby relaxes better with him, I wonder if he can smell my milk or somehting?) but, anyhow, my husband eased him down on his back and down he stayed until 6:30 AM!!!!

        When we woke up this morning, my husband and I looked at each other and asked, Did you get up last night? – when we realized neither one of us had, of course our first thought was “is the baby ok?” – first time parents, what can i tell you!

        We are not taking a victory lap yet, but it is very encouraging!

        I am so rested, watching my very rested baby happily playing on his mat. I know sleep training is controversial, but, just seeing us all so happy and stress-free this morning, makes it worth the 3 nights of struggle we had.

        Thanks for the advice on the swaddle. I’d keep it in mind if we run into trouble again with the sitting on the crib situation.

        Thanks again!

        PS: i hear ya about the spiders ;)

  41. Alexis,
    I know you wrote this two years ago but I just saw this and we are at our wits end. Our child is seven months old and unfortunately we are still swaddling. We have tried sleep sacks, Woombies, etc but nothing works and it is taking longer and longer for some reason to get him to go to sleep. We rock, pat, feed him to sleep. Our doc has told us to try the CIO method. I started with the check and console but it made it worse when I would come in so I tried just doing our bedtime routine and he cried for two hours and 45 mins and I couldn’t take it anymore. How long do I leave him? Our marriage is suffering and I’m about to lose my mind from exhaustion. Any help would be much appreciated!

  42. Hi! My son is almost 4 months and constantly needs us to walk, rock or nurse to sleep. We tried letting him cry, but always go in after 10 min. I feel he is too young for full blown CIO, or maybe it’s just too sad to hear. But then it takes him forever to calm down, even while we are rocking him. He has never taken to a pacifier, we tried them all, but likes to suck on his fist. He stinks at naps as well. He usually falls asleep after a feeding and I put him down asleep, but he will only sleep for 30-45 min. Also, I’ve read that I could be keeping him awake too long, but how do you get them to sleep if they are awake? Help!

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