Sleep Training

a baby sleeping in a crib in an article about the cry it out method of sleep training
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Cry-It-Out: The Popular Sleep Training Method, Explained

Because maybe it’s time to get some real sleep.

by Sarah Jaffe

When you have a newborn baby, you spend many hours in the day trying to prevent them from crying. Whether it’s popping pacifiers in their mouth, babywearing, or following a nursing schedule that ensures they’re never too full or too hungry, parents can run themselves ragged trying to avoid the dreaded newborn howl. It’s not hard to see why a sleep training approach known as the cry-it-out method might scare some people away. But, when you’re many months past exhausted, and the sleepless nights don’t seem to be getting any better, sleep training starts to sound pretty great. You probably have lots of questions: What exactly is cry-it-out? Does cry-it-out work? Is it safe? How long will it take, and how much crying is too much?

If you’ve ever wandered into a parenting Facebook group, you probably know that sleep training can be a highly charged topic, and that you can get strong opinions both celebrating the cry it out method as a gift to tired parents and those who are firmly against it. But getting straightforward answers to your questions can be another matter. Two experts who have worked in the field of infant sleep for years, and helped hundreds of families, have the answers to these questions, and more, so you can figure it out if the cry-it-out method is right for you.

What is the cry-it-out method of sleep training?

The cry-it-out method — which goes by many other unpleasant monikers as well, including “extinction sleep training” or “full-extinction sleep training” — is due for a rebrand, says Alexis Dubief, author of Precious Little Sleep. “I don’t use the term ‘cry it out’ ever—’cry it out’ is a pejorative, used by a school of parenting philosophy that determined that this is terrible for infants. What we’re doing is making a change at bedtime.”

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What change, exactly, does cry-it-out seek to bring about? With very young infants, it’s easy to get into a pattern of nursing, bouncing, or rocking them to sleep, then sneaking them, fully asleep, into their crib. The “change at bedtime” that you’re making with the cry-it-out method is to put your baby into their safe sleeping environment at bedtime when they’re drowsy but awake. This sounds intimidating to first time parents especially, but it allows baby to adjust to their surroundings before falling asleep so that they’re not frightened or surprised to find themselves in their crib as they go in and out of deep sleep during the night. But, if being put to bed awake is new to them — and it is new to most babies at some point — it often results in some crying or fussing as they figure out a new skill: How to self-soothe.

Cry-it-out versus Ferber Method: What’s the difference?

The cry-it-out method is similar to the “Ferber method” of sleep training, which is also known as graduated extinction (as opposed to full extinction). named for the pediatrician Richard Ferber, who coined it. With Ferber’s method, you check on your baby periodically, at increasing intervals, during the time that that they’re crying and not asleep. With the “full extinction” sleeping training method, you don’t do check-ins, and Dubief actually thinks that’s a good thing.

“After 15 years of working with families, check-ins don’t help, and make things worse,” Dubief tells Romper. When clients do check-ins, she sees that it can actually rev a baby up, rather than help them to sleep, and that the baby “gets more upset and more angry with them when they leave.” With the cry-it-out method, you can still look at your baby on the monitor and make sure they’re OK, but you trust them to be capable of falling asleep without your direct assistance.

At what age can you let a baby cry it out?

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This can vary a bit, and there is no hard and fast rule, but four months seems to be the earliest age that most pediatricians recommend sleep training. “Usually four months is the earliest I would try,” says Dr. Craig Canapari, director of the Yale Pediatric Sleep Clinic. How old your baby should be for the cry-it-out method will depend on many factors like whether they were premature and whether they have any health problems. That said, for most babies, sleep training — including the cry-it-out method — will get more difficult as they get closer to the one-year mark.

Signs your baby is ready to cry-it-out

In addition to being over 16 weeks of age (adjusted for prematurity, if needed) experts agree that to be ready to cry-it-out, your baby needs to be able to distinguish between their days and nights, and have a “bedtime” that coincides with their longest stretch of sleep before you try any kind of sleep training. Dubief tells families to look for three signs of sleep training readiness in particular:

  1. They’re falling asleep at the same time every night
  2. Bedtime is a somewhat known time
  3. Bedtime is preceded by the longest stretch of wake time

How should you do the cry-it-out method?

Sleep training a baby is intimidating, but the process typically only takes a few days and should result in much better sleep for everyone. It helps to feel confident in your plan, so Dubief has the following tips for parents doing the cry-it-out method:

  • Make sure you have the right sleep schedule for your child. Increasingly, she’s seen parents who are so concerned about “overtiredness” that their baby has an excessive amount of daytime sleep.
  • Avoid nursing or bottle feeding within 20 minutes of bedtime. If your routine used to be “bath, jammies, book, feed” Dubief suggests that you change it to something like “feed, bath, jammies, book” before you begin sleep training. That way, your baby isn’t falling asleep while feeding, which makes it difficult to put them down “drowsy but awake,” which is the key to successful sleep training.
  • Lay them down in the environment that they’ll be sleeping in for the night, when they’re still awake.
  • Leave the room.

How long should you let a baby cry-it-out for?

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Is there a number of minutes of crying that’s too long to let them cry? How long should you let your baby cry it out?Again, there’s not a magic number. A study by a team of sleep researchers found that the first night of sleep training tends to be the worst, with approximately 45 minutes of crying. “If the baby is crying for more than 90 minutes, or having extended crying for more than a few nights, I would press pause, check in with the pediatrician, and try again in a few week,” Dr. Canapari says.

How long does the cry-it-out method take?

It’s hard to listen to your baby cry — and of course, you want to get past the crying part to the sleeping part. If the method is working, you should be seeing rapid improvement within a few days, and certainly the first week. If you aren’t, it may be time to talk to your child’s pediatrician or to a sleep specialist. While the first night may involve crying and still a lot of night wakings, you should be seeing quick improvement. “You’re looking for rapid improvement within two days,” she says.

Does the cry-it-out method work for every baby?

You’re right to be dubious as a parent of anyone selling something that they insist works for every single child. “Nothing works for every child,” Dr. Canapari notes. “That being said, if the child is developing normally, and ready for this (which will typically happen before 4-6 months) with no underlying medical issues disrupting sleep, it is a highly researched method.” In other words, while cry-it-out may not work for some babies, it is tried-and-true for many families.

Can cry-it-out be used for naps?

Yes, the cry-it-out method can be used for naps, but it’s likely to be a harder road than bedtime. Some babies may not start consolidating their sleep cycles during naps until 7-8 months of age. “Longer naps may take time no matter what you do,” notes Dubief. “That said, you can still work to break the sleep associations that might be interfering with naps, and avoid rocking or nursing your child until they’re completely asleep. Helping them to learn to fall asleep in their crib is good practice, for both bedtime and naps.”

Is the cry-it-out method a harmful or safe way to sleep train your baby?

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Cry-it-out is not something that’s mandatory to do if you’re uncomfortable with it, but it is not harmful to babies. “Sleep training is safe and does not damage babies,” Canapari says. And the idea that you’re interfering with the bond that you and your child have by sleep training just isn’t rooted in fact. “Attachment science tells us that parent-child bonds are not balsa wood. They are titanium,” Dubief says. “When we are generally responsive and emotionally available to our children, these bonds form.”

Sleep deprivation, on the other hand, is dangerous. Dubief has worked with families where the parents have crashed their cars, fallen down the stairs, or whose mental health has seriously suffered because of a lack of sleep. The cry-it-out method of sleep training is safe for babies, and may be sanity-saving for your whole household.

How to decide if the cry-it-out method is right for your baby

No one is required to do this sleep training method. “Not everyone is up for this,” Canapari says. “Likewise, if you are happy with how your baby is sleeping, don’t let anyone convince you that you need to change anything.” Some questions to ask yourself before you embark on a sleep training journey include:

  • How old is your baby?
  • Was your baby premature? (If so, their “adjusted age” is more likely the more appropriate measure)
  • Does your baby have any health problems?
  • Is their growth on track?
  • Do they have the right sleep schedule for their age?
  • Do they distinguish between days and nights, and have an established circadian rhythm?
  • How is their current sleep schedule impacting you and your family?

No one likes to hear their baby cry, but, Dubief points out, being a parent often involves doing things your child doesn’t want you to do, be it preventing them from running into traffic as a toddler or helping them to learn to sleep on their own when they’re younger. “Sleep is a biological need,” she says. “If someone suggested to you to have children you should just give up drinking water—just a cup a day, just enough to stay alive—for 2 years, because your child needs it, we’d think that was absurd—but with sleep we act like it’s optional.”

Experts:

Craig Canapari, MD Director, Yale Pediatric Sleep Center

Alexis Dubief author of Precious Little Sleep.

Studies Cited:

Honaker SM, Schwichtenberg AJ, Kreps TA, Mindell JA. Real-World Implementation of Infant Behavioral Sleep Interventions: Results of a Parental Survey. J Pediatr. 2018 Aug;199:106-111.e2. doi: 10.1016/j.jpeds.2018.04.009. Epub 2018 May 9.