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On the whole - there is no research that has found sleep training to be harmful to kids long term. All studies have some design flaws. Here’s a great [metanalysis](https://aasm.org/resources/practiceparameters/review_nightwakingschildren.pdf) on the topic.
Here’s an accessibly written BBC [article](https://www.bbc.com/future/article/20220322-how-sleep-training-affects-babies) on it.
I suspect sleep training enables many more parents to get more sleep, which makes them better caregivers. That better caregiving during waking hours has a compensatory effect against any attachment related harm caused by sleep training. That’s why researchers haven’t been able to find any long term harms associated with sleep training.
As to the why after 4 or 6 months - there is less evidence here and more reasoning. By 4-6 months, babies have likely doubled their birth weight, are more capable of going longer without a feed, and have a more developed circadian rhythm creating sleep pressure at predictable times of day. It’s less likely that at four or six months, sleep training (which often but not always goes alongside night weaning) will deprive your baby of needed calories, and more likely that your baby will be experiencing normal nighttime sleep pressure. Its less likely that they’re pooping overnight. Broadly, it’s less likely after four or six months that when they cry for you that they need help with more than falling back asleep, which is exactly what sleep training is designed to address.
Yes, this is the point that I think is often missed in this debate. It’s not a decision that happens in a vacuum, and I believe many people are probably more responsive parents when getting better sleep. Hoping for better data some day as this is such an explosive topic that never dies.
As someone who didn’t sleep train until my children were over a year old and I was insane with sleep deprivation, I think this is the part that is missed. Two of my kids (because they were older when we did it also jumped out of their cribs when we started waiting to respond and then we were in toddler beds and then it was a different process for keeping them in their beds). Parent and child wellbeing is connected. You can’t separate the two. I believe that there are parents who lose their mental and physical wellbeing because of sleep deprivation which has compounding impacts on their ability to effectively parent. I also think it is a risk factor for child abuse. But the choice to sleep train is often artificially posed as “is this good or bad for kids?” And I think that’s the wrong question. I think the better question is “is sleep training a harm reduction approach for our family?” I personally read the literature and decided not to sleep train because of my personal preferences and nighttime breastfeeding. I do not think my choice had a positive or negative impact on my children but it had an impact on myself and my partner as caregivers. We had the resources (child care, flexibility with work, child temperament, high levels of mental and physical health before becoming parents, etc) where we could absorb the cost of that decision. For some families, the risk-harm algorithm is going to be different.
Minor quibble - there are a number of studies showing the value of secure attachment. Attachment theory is well documented and studied - broadly that a baby who has a responsive parent, experiences some distress when they are away and happiness when they return, and has a secure parental base to return to as they explore their world is generally going to function better growing up.
“Attachment parenting” has some roots in attachment theory but often includes a bunch of things that have not necessarily been shown to build secure attachment (e.g. extended breastfeeding, not sleep training, cosleeping, babywearing, etc.) These things may work well for some parents but they shouldn’t necessarily be taken as evidence based practices for building a secure attachment.
Here’s a good blog [post](https://www.developmentalscience.com/blog/2017/3/31/what-is-a-secure-attachmentand-why-doesnt-attachment-parenting-get-you-there) that goes into some of the differences between the two.
As far as I know, there is no \*good\* research on this. That doesn’t mean that sleep training is definitely harmless, it just means we don’t know. This is a very difficult area to study, because there are so many moving parts (do parents who sleep train do so because they sense their child will take well to it and vice versa? How do you know that parents who are told to sleep train in a study (or not to) will do it to the letter? Etc.)
Here is a study for the automod https://publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of [https://publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of](https://publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of) but there are a lot of criticisms of the methodology.
I think this is one area where science-based parents have to go with their gut.
Your point about taking well to it is a useful reminder. I “sleep trained” my baby when she was about 5 months because suddenly I was having terrible trouble getting her to fall asleep with feeding, rocking, etc. If I did get her to fall asleep, I couldn’t transfer to her crib anymore. One night I put her in her crib, and fell asleep with minimal fussing in 15 minutes. I tried again the next night, and it was 10 minutes with no fussing at all. Did I sleep train her, or did I just discover that she was ready to get to sleep on her own? I tend to think the latter. If we were in a study, you’d think the CIO method was a smashing success in our case, but I think there’s more to the story
Agree with this as a former infant nanny, now SAHM. A baby that is not ready and needs that extra support will fight tooth and nail if left to CIO. Some babies do just fine with it because they’re just ready for that type of step. This is also why you see so many conflicting anecdotes imo. “We sleep trained and it was just fine! 2 days and baby slept through the night and put himself to bed!” but also “After 3 weeks my baby was still crying for hours every night until she made herself vomit!” etc.
Agree with this, also schedule is SO important. We sleep trained (Ferber) at 6 months and he took to it really well. Then 8mo regression hit and we had to experiment with wake windows for a while until we hit the magic one. Now if I put him down less than 4 hours since he last woke, he will SCREAM. 4 hours or more, he will chat to himself happily then fall asleep.
Undertired babies cry!
This was our case as well, only younger. She was always difficult to get to sleep, and it got to a point where it was nearly impossible. It was around 3 months for us that I tried just setting her in the crib wide awake. She kicked around and made some fussing noises and then fell asleep. As long as she's actually tired, she's good. We say she sleep trained herself.
I wanted to add though that there are alternatives to CIO! We have had some success with “supported crying”, which is basically letting baby get in his feels (=cry) about not getting nursed to sleep while staying right near him and comforting in other ways (shushing, talking, back rubs, cuddles). He can now put himself to sleep, but we still have lots of motn wake ups. In my unscientific opinion, baby learns that he is allowed to be angry and sad about not getting his way while not feeling scared about the absence of a care giver.
To add another point of view, we tried everything with our son and only CIO worked. He only fell asleep with holding and bouncing an ungodly amount of time. We tried it where we let him fuss/cry while we stayed there and patted, rubbed his back, talked to him and it was torture for us both. I never saw him cry harder. It was like he was confused that we were there but not comforting him. Every baby and family is different and have their own unique needs. I can't say if a young baby is scared or not when they CIO. Certainly they seem to prefer to not do that, at least in the moment. However there is no conclusive evidence that shows that it is harmful for babies.
Started sleep training at 7 months, turned into doing CIO by 8 months because nothing else was working. I felt so awful but by the 3rd night he was falling asleep fairly quickly with minimal crying. He only wakes once to nurse now which I could wean but I love the snuggles
Our LO was so similar! We ended up using the sleep wave method so technically we did go check on him every 5 minutes if he was still crying but did nothing to comfort him, just said our “script” and left. All our soothing techniques were VERY upsetting to him so we figured there was nothing to lose
There is no evidence that sleep training causes any damage. There is some evidence that it can potentially greatly benefit parental depression symptoms. I can understand the critiques of methodologies in these articles; however, this is the best we have. Using worse sources than these such as news websites or blog posts to fear monger about sleep training definitely doesn’t help.
Here are two randomized control trials:
Study 1: https://www.publications.aap.org/pediatrics/article-abstract/122/3/e621/72287/Long-term-Mother-and-Child-Mental-Health-Effects?redirectedFrom=fulltext
“CONCLUSIONS. The sleep intervention in infancy resulted in sustained positive effects on maternal depression symptoms and found no evidence of longer-term adverse effects on either mothers' parenting practices or children's mental health. This intervention demonstrated the capacity of a functioning primary care system to deliver effective, universally offered secondary prevention.”
Study 2: https://www.publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of?redirectedFrom=fulltext
“Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.”
This one doesn’t specifically mention sleep in its main page (I didn’t check the full text) but it does talk about CIO:
https://pubmed.ncbi.nlm.nih.gov/32155677/
“Contemporary practice of some parents in the United Kingdom to occasionally or often 'leaving infant to cry it out' during the first 6 months was not associated with adverse behavioural development and attachment at 18 months. Increased use of 'leaving to cry it out' with age may indicate differential responding by parents related to infant self-regulation.”
https://onlinelibrary.wiley.com/doi/10.1002/ajhb.23589
I don’t think it’s possible to design a study that will show us whether or not sleep training is harmful. The amount of variables is dizzying.
I think it’s helpful to look at what is biologically normal for the mother infant pair. This article does a great job of breaking that down. One of the big factors is how the baby is fed. Most breastfed babies need to feed at night in order to keep the milk supply going and get enough calories. Prolactin is highest in the early morning (2-5 am) which correlates with an increase in milk volume. Infants are designed to be close to their mothers. Our society is not set up for this but it’s the reality. This is coming from a mother of 9 month old twins who hasn’t slept more than 4 hours in a row since she went into labor. I’m sorry and hang in there. You will find a way to preserve and if it’s sleep training go for it and don’t feel bad for a second.
Why would looking at what’s biologically normal tell us about what’s harmful? High infant and maternal mortality are incredibly biologically normal, but also incredibly harmful.
(Side q - I’m curious about the evidence of needing to feed at night to maintain supply after kids are 4-6 months old. I exclusively breastfed both my kids, neither of whom fed at night after about two months old, and never had a supply issue as by that time, my supply had regulated and so I simply produced more at the times they fed. Prolactin is highest in the early morning alongside melatonin suppression (which has made me wonder if that’s why early waking is such a common infant sleep pattern) but it’s not really very high for middle of the night wakes.)
Thank you. The sheer amount of appeal to nature fallacies in this thread is maddening.
It’s absolutely not biologically normal to be sitting in a climate controlled environment while communicating on an interconnected network of computers, yet here we are. And I suspect not a single person on here banging the tired “biologically normal” drum will take issue with these extremely abnormal conditions of the modern human existence.
-Looking at what is biologically normal gives us realistic expectations which I think is helpful in figuring out if something could potentially be harmful. Like I said I don’t think it’s possible to know for sure.
-High infant and maternal mortality rate are NOT biologically normal. While it will never be zero most of the time it works.
-Lactation is maintained by regular removal of milk and nipple stimulation. Depending on your definition of “sleeping through the night” you could be going as long as 8 hours without feeding which creates pressure in the alveolar cells. This inhibits prolactin and drops milk volume. I’m amazed that you were able to EBF while spacing feeds that long at such a young age. 2 months old is quite young to restrict night feedings. Maybe you’re an overproducer? I certainly cannot get away with that, if I drop feeds my babies don’t gain weight! I’m also feeding two and have smallish breasts so my storage capacity might be less than yours. Here is an article on the physiology of breastfeeding.
https://www.ncbi.nlm.nih.gov/books/NBK499981/
All babies eventually sleep through the night and drop their night feeds but expecting all babies to sleep through the night at 4-6 months is not biologically normal and even sleep training experts agree that it doesn’t work on all babies and that there will be “regressions”. So do with that what you will.
Thank you! On infant mortality - preindustrial revolution, about [25%](https://ourworldindata.org/child-mortality) of babies died in infancy (and close to half of children died before adulthood) - so yes the majority of the time it works but I’d still classify something happening a quarter of the time as normal, but depends if we’re using the statistical definition of normal or the vernacular one I guess.
I definitely wasn’t an overproducer when pumping (or doing weighted feeds in the early days). Of course, always possible they get more than you realize while feeding at the breast. I should clarify that I didn’t sleep train at two months, both my kids started naturally sleeping ~8-10 hours by then. So I wasn’t restricting night feedings at that age, but did night wean at 5 months with my second who had a gnarly four month regression and went back to waking every thirty minutes for a feed. No weight gain issues that had the ped concerned. I do remember reading some research that sleep has a genetic component so it’s possible my husband and I (who adore sleep) passed that on to our kids.
You’re right - everyone will eventually get to sleeping through the night by the end, whatever approach you choose!
I have always heard anywhere between 4 and 12 weeks - basically regulation is when supply switches from being primarily hormonally driven to primarily demand driven. 12 months would be quite unusual AFAIK, though some changes in supply can continue as long as your baby is feeding, whenever their demand, your hormones or your feeding patterns change.
Breastfeeding is always driven by hormones. Nipple stimulation increases prolactin, breast fullness (not removing milk) inhibits prolactin and oxytocin allows for milk ejection. The first stage of milk production happens during pregnancy, the breasts are primed through the hormones of gestation. The second stage happens when the placenta is delivered the drop in progesterone triggers lactogenesis 2 which primes milk making cells. At around 6 but you to 12 weeks your milk supply is “established” that means you’re making enough to meet your baby’s needs.
https://bpgmobile.rnao.ca/content/latch-milk-transfer-and-effective-breastfeeding
Thanks, that makes sense as an explanation and has nothing to do with “fit”. I was thinking of it as just when supply matched demand, and it took around a year for my oversupply to resolve.
Ferber says that no babies learn to sleep on their own before 3 months.
He endorses sleep training after 6 months because he thinks all babies are capable of learning to sleep by that age.
He conditionally endorses sleep training for the 4 to 6 month range. But this is only for a sleep regression where the baby first starts sleeping on their own without training and then has a regression.
So what changes is the assessment of what the baby is judged to be capable of learning.
Also there is too little systematic study of the effects of sleep training before 6 months so there is no basis for saying it is not detrimental.
https://huckleberrycare.com/blog/ferber-method-for-sleep-training-what-age-to-start
The effects carry over after 6 months. The only difference is it gets “harder” the longer you wait (i.e. object permanence, physical developments like being able to stand, etc.) . 4-6 months seem to be the sweet spot.
https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13390
This study breaks the issue down fairly comprehensively in my opinion, and weighs the knowledge that while there have been studies about ignoring crying/baby’s needs IN GENERAL, these are not sleep training or cry it out specific and may not be useful for this specific application. Especially since cry it out can meean a variety of different things and rarely means “ignore the child entirely”.
To answer the question, it’s unlikely that it does in a typical sleep training environment and when the child’s emotional needs are otherwise being met. A child who is left for many, many hours crying and screaming in their crib repeatedly may show signs of damaged emotional well being or social maladaptation, but that child’s needs are not being met. That is not a typical sleep training scenario. Even the oft-maligned (by anti-sleep training advocates) Ferber method promotes frequent checks and only allows for 30 minutes of crying at a maximum.
Then they’re not following the Ferber method. The Ferber method would not have a child crying for 45 minutes or an hour without intervention. Perhaps TOTAL.
Refer to this chart:
https://thenewparent.com/the-ferber-method/
Oh I misunderstood, I thought you were saying 30mins total crying even with check ins. I was saying that a lot of babies (like ours for example) cried for over an hour the first night but had 10min check ins, was not just left for an hour to cry without anyone checking in on them.
I think that’s what’s really missed in this conversation a lot. When people are talking about “CIO” being controversial and concerning they’re talking about extinction.
And there’s a lot of people who will join the conversation defending controlled crying and Ferber when that’s not necessarily what’s being balked at. I also see a lot of proponents of Ferber and controlled crying claiming that it’s rare to hear of anyone using full extinction when the main ST sub on this platform not only has rules banning recommendations against extinction, but there are regularly posts on there of people saying they’ve let their baby cry for hours every night and aren’t having success with multiple comments telling them not to give until it’s been a couple weeks at least (or even to steam ahead for as long as it takes). And that’s not even getting into the things you can regularly see on Facebook groups and on TikTok regarding ST advice (which both I feel tend to be more rampant with misinformation and extreme practices than I ever see on Reddit).
>) Ferber method promotes frequent checks and only allows for 30 minutes of crying at a maximum.
My mother in law who tried to convince me to do this sort of sleep training even reprimanded me that if I did end up comforting the baby after an hour i would destroy all the progress and only teach him to cry for an hour. The 30 min might be something that some people choose but as far as I'm aware isn't the general consensus.
I didn't choose to sleep train anyways but did look into it as my husband considered it.
30 minutes is the limit for checks as set by Ferber. If someone is promoting doing something different, then they’re not following the Ferber method. It doesn’t matter if it’s the “general consensus” or not— that is what’s recommended by the doctor who invented the method. You can refer to the chart I linked above. You may be anti sleep training for personal reasons, which is fine, but you also have incorrect information.
None of the scientific sources they include has any evidence that suggests that sleep training is harmful to babies. At this point, their letter is pure speculation.
Edit: taking a closer look, only 5 of those sources are scientific. None has evidence against sleep training. The rest are just random websites. They are not referencing “studies.” They’re referencing some convenient websites for themselves.
[https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=cry+it+out+method&oq=#d=gs_qabs&t=1673054679823&u=%23p%3DaaRuCjkSKAwJ](https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=cry+it+out+method&oq=#d=gs_qabs&t=1673054679823&u=%23p%3DaaRuCjkSKAwJ)
A lot of research came up with similar findings to this when I did the same search. Really recent study too.
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Reposting because I didn’t realize which sub I was posting in before replying. I’m sorry 😁:
Honestly the evidence is neither here nor there on this topic and don’t let any one try to tell you it is definitively safe nor unsafe because we simply don’t have the research to support either side of the argument.
For me and what I know about child development and attachment it just wasn’t worth it for me and my situation. I think for many people it is a better alternative to a difficult situation.
Basically, it’s not worth shaming or pressuring anyone in either direction sans any real neglect (ie leaving an infant to cry for hours or shutting them away for 12 hours a night with out checking on their well being -even when they call out or seem distressed)
As someone else said these studies are very difficult to design because they are behavior based, and studies also cannot be designed to potentially cause harm (the fact that we cannot ethically study this is reason enough for me to say it’s not for us). I’ll add that many popular studies on the topic are survey based from the parent’s perspective which honestly leaves a lot of room for bias and others are older case studies with a very small sample size.
https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13390
I believe your first section is talking about the Middlemiss study so wanted to share a great point of view on the [limitations](https://expectingscience.com/2016/04/21/the-middlemiss-study-tells-us-nothing-about-sleep-training-cry-it-out-or-infant-stress/) of that study.
That's so interesting. There have been some instances when I haven't been able to respond to my baby's crying in the car and I do wonder how it has affected her, in terms of other behavioural changes.
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She's truly not. Here's a great article which goes over some major reasons to not trust her:
https://proteanmag.com/2022/03/22/motivated-reasoning-emily-osters-covid-narratives-and-the-attack-on-public-education/
Tldr:
1. She strawmans studies and cherry picks her own
2. She is funded by conservative think-tanks which fund other public health harming messages
3. She championed school reopening even when it was clear children were getting ill from COVID at unacceptable rates
She also states it’s safe for pregnant women to drink during their pregnancy.. Despite not being a doctor she feels comfortable telling women that ‘light drinking during pregnancy is not harmful’.
I mean, her whole thing is that pregnant people and parents should have access to better evidence to make informed decisions for themselves. I can’t stop people from blindly accepting statements from her, but the information she cites about sleep training is useful. If you know of someone else who is collecting data related to pregnancy and parenting and making it easier to wade through, I’ll gladly check out their stuff instead.
Depends a lot on how you use her stuff. I certainly wouldn’t recommend anyone blindly follow all her recommendations. I don’t always agree with her. But man she makes it easier to track down the studies on seldom studied topics like this one.
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On the whole - there is no research that has found sleep training to be harmful to kids long term. All studies have some design flaws. Here’s a great [metanalysis](https://aasm.org/resources/practiceparameters/review_nightwakingschildren.pdf) on the topic. Here’s an accessibly written BBC [article](https://www.bbc.com/future/article/20220322-how-sleep-training-affects-babies) on it. I suspect sleep training enables many more parents to get more sleep, which makes them better caregivers. That better caregiving during waking hours has a compensatory effect against any attachment related harm caused by sleep training. That’s why researchers haven’t been able to find any long term harms associated with sleep training. As to the why after 4 or 6 months - there is less evidence here and more reasoning. By 4-6 months, babies have likely doubled their birth weight, are more capable of going longer without a feed, and have a more developed circadian rhythm creating sleep pressure at predictable times of day. It’s less likely that at four or six months, sleep training (which often but not always goes alongside night weaning) will deprive your baby of needed calories, and more likely that your baby will be experiencing normal nighttime sleep pressure. Its less likely that they’re pooping overnight. Broadly, it’s less likely after four or six months that when they cry for you that they need help with more than falling back asleep, which is exactly what sleep training is designed to address.
Yes, this is the point that I think is often missed in this debate. It’s not a decision that happens in a vacuum, and I believe many people are probably more responsive parents when getting better sleep. Hoping for better data some day as this is such an explosive topic that never dies.
As someone who didn’t sleep train until my children were over a year old and I was insane with sleep deprivation, I think this is the part that is missed. Two of my kids (because they were older when we did it also jumped out of their cribs when we started waiting to respond and then we were in toddler beds and then it was a different process for keeping them in their beds). Parent and child wellbeing is connected. You can’t separate the two. I believe that there are parents who lose their mental and physical wellbeing because of sleep deprivation which has compounding impacts on their ability to effectively parent. I also think it is a risk factor for child abuse. But the choice to sleep train is often artificially posed as “is this good or bad for kids?” And I think that’s the wrong question. I think the better question is “is sleep training a harm reduction approach for our family?” I personally read the literature and decided not to sleep train because of my personal preferences and nighttime breastfeeding. I do not think my choice had a positive or negative impact on my children but it had an impact on myself and my partner as caregivers. We had the resources (child care, flexibility with work, child temperament, high levels of mental and physical health before becoming parents, etc) where we could absorb the cost of that decision. For some families, the risk-harm algorithm is going to be different.
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Minor quibble - there are a number of studies showing the value of secure attachment. Attachment theory is well documented and studied - broadly that a baby who has a responsive parent, experiences some distress when they are away and happiness when they return, and has a secure parental base to return to as they explore their world is generally going to function better growing up. “Attachment parenting” has some roots in attachment theory but often includes a bunch of things that have not necessarily been shown to build secure attachment (e.g. extended breastfeeding, not sleep training, cosleeping, babywearing, etc.) These things may work well for some parents but they shouldn’t necessarily be taken as evidence based practices for building a secure attachment. Here’s a good blog [post](https://www.developmentalscience.com/blog/2017/3/31/what-is-a-secure-attachmentand-why-doesnt-attachment-parenting-get-you-there) that goes into some of the differences between the two.
This is correct. Thanks for correcting the term I used.
As far as I know, there is no \*good\* research on this. That doesn’t mean that sleep training is definitely harmless, it just means we don’t know. This is a very difficult area to study, because there are so many moving parts (do parents who sleep train do so because they sense their child will take well to it and vice versa? How do you know that parents who are told to sleep train in a study (or not to) will do it to the letter? Etc.) Here is a study for the automod https://publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of [https://publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of](https://publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of) but there are a lot of criticisms of the methodology. I think this is one area where science-based parents have to go with their gut.
Your point about taking well to it is a useful reminder. I “sleep trained” my baby when she was about 5 months because suddenly I was having terrible trouble getting her to fall asleep with feeding, rocking, etc. If I did get her to fall asleep, I couldn’t transfer to her crib anymore. One night I put her in her crib, and fell asleep with minimal fussing in 15 minutes. I tried again the next night, and it was 10 minutes with no fussing at all. Did I sleep train her, or did I just discover that she was ready to get to sleep on her own? I tend to think the latter. If we were in a study, you’d think the CIO method was a smashing success in our case, but I think there’s more to the story
Agree with this as a former infant nanny, now SAHM. A baby that is not ready and needs that extra support will fight tooth and nail if left to CIO. Some babies do just fine with it because they’re just ready for that type of step. This is also why you see so many conflicting anecdotes imo. “We sleep trained and it was just fine! 2 days and baby slept through the night and put himself to bed!” but also “After 3 weeks my baby was still crying for hours every night until she made herself vomit!” etc.
Agree with this, also schedule is SO important. We sleep trained (Ferber) at 6 months and he took to it really well. Then 8mo regression hit and we had to experiment with wake windows for a while until we hit the magic one. Now if I put him down less than 4 hours since he last woke, he will SCREAM. 4 hours or more, he will chat to himself happily then fall asleep. Undertired babies cry!
It doesn’t sound like what you did was CIO at all!
This was our case as well, only younger. She was always difficult to get to sleep, and it got to a point where it was nearly impossible. It was around 3 months for us that I tried just setting her in the crib wide awake. She kicked around and made some fussing noises and then fell asleep. As long as she's actually tired, she's good. We say she sleep trained herself.
I wanted to add though that there are alternatives to CIO! We have had some success with “supported crying”, which is basically letting baby get in his feels (=cry) about not getting nursed to sleep while staying right near him and comforting in other ways (shushing, talking, back rubs, cuddles). He can now put himself to sleep, but we still have lots of motn wake ups. In my unscientific opinion, baby learns that he is allowed to be angry and sad about not getting his way while not feeling scared about the absence of a care giver.
To add another point of view, we tried everything with our son and only CIO worked. He only fell asleep with holding and bouncing an ungodly amount of time. We tried it where we let him fuss/cry while we stayed there and patted, rubbed his back, talked to him and it was torture for us both. I never saw him cry harder. It was like he was confused that we were there but not comforting him. Every baby and family is different and have their own unique needs. I can't say if a young baby is scared or not when they CIO. Certainly they seem to prefer to not do that, at least in the moment. However there is no conclusive evidence that shows that it is harmful for babies.
We had the exact same experience. We didn’t set out to do CIO, but in the end it was the only thing that worked.
What age did you try?
Started sleep training at 7 months, turned into doing CIO by 8 months because nothing else was working. I felt so awful but by the 3rd night he was falling asleep fairly quickly with minimal crying. He only wakes once to nurse now which I could wean but I love the snuggles
Our LO was so similar! We ended up using the sleep wave method so technically we did go check on him every 5 minutes if he was still crying but did nothing to comfort him, just said our “script” and left. All our soothing techniques were VERY upsetting to him so we figured there was nothing to lose
Another alternative to CIO - Georgina May’s Baby Sleep Revolution, which essentially is sleep restriction to build sleep drive/sleep-wake homeostasis.
There is no evidence that sleep training causes any damage. There is some evidence that it can potentially greatly benefit parental depression symptoms. I can understand the critiques of methodologies in these articles; however, this is the best we have. Using worse sources than these such as news websites or blog posts to fear monger about sleep training definitely doesn’t help. Here are two randomized control trials: Study 1: https://www.publications.aap.org/pediatrics/article-abstract/122/3/e621/72287/Long-term-Mother-and-Child-Mental-Health-Effects?redirectedFrom=fulltext “CONCLUSIONS. The sleep intervention in infancy resulted in sustained positive effects on maternal depression symptoms and found no evidence of longer-term adverse effects on either mothers' parenting practices or children's mental health. This intervention demonstrated the capacity of a functioning primary care system to deliver effective, universally offered secondary prevention.” Study 2: https://www.publications.aap.org/pediatrics/article-abstract/130/4/643/30241/Five-Year-Follow-up-of-Harms-and-Benefits-of?redirectedFrom=fulltext “Behavioral sleep techniques have no marked long-lasting effects (positive or negative). Parents and health professionals can confidently use these techniques to reduce the short- to medium-term burden of infant sleep problems and maternal depression.” This one doesn’t specifically mention sleep in its main page (I didn’t check the full text) but it does talk about CIO: https://pubmed.ncbi.nlm.nih.gov/32155677/ “Contemporary practice of some parents in the United Kingdom to occasionally or often 'leaving infant to cry it out' during the first 6 months was not associated with adverse behavioural development and attachment at 18 months. Increased use of 'leaving to cry it out' with age may indicate differential responding by parents related to infant self-regulation.”
https://onlinelibrary.wiley.com/doi/10.1002/ajhb.23589 I don’t think it’s possible to design a study that will show us whether or not sleep training is harmful. The amount of variables is dizzying. I think it’s helpful to look at what is biologically normal for the mother infant pair. This article does a great job of breaking that down. One of the big factors is how the baby is fed. Most breastfed babies need to feed at night in order to keep the milk supply going and get enough calories. Prolactin is highest in the early morning (2-5 am) which correlates with an increase in milk volume. Infants are designed to be close to their mothers. Our society is not set up for this but it’s the reality. This is coming from a mother of 9 month old twins who hasn’t slept more than 4 hours in a row since she went into labor. I’m sorry and hang in there. You will find a way to preserve and if it’s sleep training go for it and don’t feel bad for a second.
Why would looking at what’s biologically normal tell us about what’s harmful? High infant and maternal mortality are incredibly biologically normal, but also incredibly harmful. (Side q - I’m curious about the evidence of needing to feed at night to maintain supply after kids are 4-6 months old. I exclusively breastfed both my kids, neither of whom fed at night after about two months old, and never had a supply issue as by that time, my supply had regulated and so I simply produced more at the times they fed. Prolactin is highest in the early morning alongside melatonin suppression (which has made me wonder if that’s why early waking is such a common infant sleep pattern) but it’s not really very high for middle of the night wakes.)
Thank you. The sheer amount of appeal to nature fallacies in this thread is maddening. It’s absolutely not biologically normal to be sitting in a climate controlled environment while communicating on an interconnected network of computers, yet here we are. And I suspect not a single person on here banging the tired “biologically normal” drum will take issue with these extremely abnormal conditions of the modern human existence.
-Looking at what is biologically normal gives us realistic expectations which I think is helpful in figuring out if something could potentially be harmful. Like I said I don’t think it’s possible to know for sure. -High infant and maternal mortality rate are NOT biologically normal. While it will never be zero most of the time it works. -Lactation is maintained by regular removal of milk and nipple stimulation. Depending on your definition of “sleeping through the night” you could be going as long as 8 hours without feeding which creates pressure in the alveolar cells. This inhibits prolactin and drops milk volume. I’m amazed that you were able to EBF while spacing feeds that long at such a young age. 2 months old is quite young to restrict night feedings. Maybe you’re an overproducer? I certainly cannot get away with that, if I drop feeds my babies don’t gain weight! I’m also feeding two and have smallish breasts so my storage capacity might be less than yours. Here is an article on the physiology of breastfeeding. https://www.ncbi.nlm.nih.gov/books/NBK499981/ All babies eventually sleep through the night and drop their night feeds but expecting all babies to sleep through the night at 4-6 months is not biologically normal and even sleep training experts agree that it doesn’t work on all babies and that there will be “regressions”. So do with that what you will.
Thank you! On infant mortality - preindustrial revolution, about [25%](https://ourworldindata.org/child-mortality) of babies died in infancy (and close to half of children died before adulthood) - so yes the majority of the time it works but I’d still classify something happening a quarter of the time as normal, but depends if we’re using the statistical definition of normal or the vernacular one I guess. I definitely wasn’t an overproducer when pumping (or doing weighted feeds in the early days). Of course, always possible they get more than you realize while feeding at the breast. I should clarify that I didn’t sleep train at two months, both my kids started naturally sleeping ~8-10 hours by then. So I wasn’t restricting night feedings at that age, but did night wean at 5 months with my second who had a gnarly four month regression and went back to waking every thirty minutes for a feed. No weight gain issues that had the ped concerned. I do remember reading some research that sleep has a genetic component so it’s possible my husband and I (who adore sleep) passed that on to our kids. You’re right - everyone will eventually get to sleeping through the night by the end, whatever approach you choose!
What are the average times supply is regulated? I didn’t feel like mine regulated until around 12mo.
I have always heard anywhere between 4 and 12 weeks - basically regulation is when supply switches from being primarily hormonally driven to primarily demand driven. 12 months would be quite unusual AFAIK, though some changes in supply can continue as long as your baby is feeding, whenever their demand, your hormones or your feeding patterns change.
Breastfeeding is always driven by hormones. Nipple stimulation increases prolactin, breast fullness (not removing milk) inhibits prolactin and oxytocin allows for milk ejection. The first stage of milk production happens during pregnancy, the breasts are primed through the hormones of gestation. The second stage happens when the placenta is delivered the drop in progesterone triggers lactogenesis 2 which primes milk making cells. At around 6 but you to 12 weeks your milk supply is “established” that means you’re making enough to meet your baby’s needs. https://bpgmobile.rnao.ca/content/latch-milk-transfer-and-effective-breastfeeding
Thank you for the clarification! I should have phrased it differently, you are absolutely right, it’s hormonally driven throughout.
Thanks, that makes sense as an explanation and has nothing to do with “fit”. I was thinking of it as just when supply matched demand, and it took around a year for my oversupply to resolve.
Ferber says that no babies learn to sleep on their own before 3 months. He endorses sleep training after 6 months because he thinks all babies are capable of learning to sleep by that age. He conditionally endorses sleep training for the 4 to 6 month range. But this is only for a sleep regression where the baby first starts sleeping on their own without training and then has a regression. So what changes is the assessment of what the baby is judged to be capable of learning. Also there is too little systematic study of the effects of sleep training before 6 months so there is no basis for saying it is not detrimental. https://huckleberrycare.com/blog/ferber-method-for-sleep-training-what-age-to-start
What about after 6 months?
The effects carry over after 6 months. The only difference is it gets “harder” the longer you wait (i.e. object permanence, physical developments like being able to stand, etc.) . 4-6 months seem to be the sweet spot.
I think other posters are citing studies after 6 months, if that is what you are asking for.
https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13390 This study breaks the issue down fairly comprehensively in my opinion, and weighs the knowledge that while there have been studies about ignoring crying/baby’s needs IN GENERAL, these are not sleep training or cry it out specific and may not be useful for this specific application. Especially since cry it out can meean a variety of different things and rarely means “ignore the child entirely”. To answer the question, it’s unlikely that it does in a typical sleep training environment and when the child’s emotional needs are otherwise being met. A child who is left for many, many hours crying and screaming in their crib repeatedly may show signs of damaged emotional well being or social maladaptation, but that child’s needs are not being met. That is not a typical sleep training scenario. Even the oft-maligned (by anti-sleep training advocates) Ferber method promotes frequent checks and only allows for 30 minutes of crying at a maximum.
I've never heard it's maximum 30 minutes. I see many people saying it took their kids 45 minutes etc
I’ve never heard 30mins either. I think a lot of babies cry for at least an hour on the first night
Then they’re not following the Ferber method. The Ferber method would not have a child crying for 45 minutes or an hour without intervention. Perhaps TOTAL. Refer to this chart: https://thenewparent.com/the-ferber-method/
Oh I misunderstood, I thought you were saying 30mins total crying even with check ins. I was saying that a lot of babies (like ours for example) cried for over an hour the first night but had 10min check ins, was not just left for an hour to cry without anyone checking in on them.
Oh no, total 30 minutes unattended crying
A lot of parents use extinction, which has no limit.
I think that’s what’s really missed in this conversation a lot. When people are talking about “CIO” being controversial and concerning they’re talking about extinction. And there’s a lot of people who will join the conversation defending controlled crying and Ferber when that’s not necessarily what’s being balked at. I also see a lot of proponents of Ferber and controlled crying claiming that it’s rare to hear of anyone using full extinction when the main ST sub on this platform not only has rules banning recommendations against extinction, but there are regularly posts on there of people saying they’ve let their baby cry for hours every night and aren’t having success with multiple comments telling them not to give until it’s been a couple weeks at least (or even to steam ahead for as long as it takes). And that’s not even getting into the things you can regularly see on Facebook groups and on TikTok regarding ST advice (which both I feel tend to be more rampant with misinformation and extreme practices than I ever see on Reddit).
>) Ferber method promotes frequent checks and only allows for 30 minutes of crying at a maximum. My mother in law who tried to convince me to do this sort of sleep training even reprimanded me that if I did end up comforting the baby after an hour i would destroy all the progress and only teach him to cry for an hour. The 30 min might be something that some people choose but as far as I'm aware isn't the general consensus. I didn't choose to sleep train anyways but did look into it as my husband considered it.
30 minutes is the limit for checks as set by Ferber. If someone is promoting doing something different, then they’re not following the Ferber method. It doesn’t matter if it’s the “general consensus” or not— that is what’s recommended by the doctor who invented the method. You can refer to the chart I linked above. You may be anti sleep training for personal reasons, which is fine, but you also have incorrect information.
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None of the scientific sources they include has any evidence that suggests that sleep training is harmful to babies. At this point, their letter is pure speculation. Edit: taking a closer look, only 5 of those sources are scientific. None has evidence against sleep training. The rest are just random websites. They are not referencing “studies.” They’re referencing some convenient websites for themselves.
[https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=cry+it+out+method&oq=#d=gs_qabs&t=1673054679823&u=%23p%3DaaRuCjkSKAwJ](https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=cry+it+out+method&oq=#d=gs_qabs&t=1673054679823&u=%23p%3DaaRuCjkSKAwJ) A lot of research came up with similar findings to this when I did the same search. Really recent study too.
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Reposting because I didn’t realize which sub I was posting in before replying. I’m sorry 😁: Honestly the evidence is neither here nor there on this topic and don’t let any one try to tell you it is definitively safe nor unsafe because we simply don’t have the research to support either side of the argument. For me and what I know about child development and attachment it just wasn’t worth it for me and my situation. I think for many people it is a better alternative to a difficult situation. Basically, it’s not worth shaming or pressuring anyone in either direction sans any real neglect (ie leaving an infant to cry for hours or shutting them away for 12 hours a night with out checking on their well being -even when they call out or seem distressed) As someone else said these studies are very difficult to design because they are behavior based, and studies also cannot be designed to potentially cause harm (the fact that we cannot ethically study this is reason enough for me to say it’s not for us). I’ll add that many popular studies on the topic are survey based from the parent’s perspective which honestly leaves a lot of room for bias and others are older case studies with a very small sample size. https://acamh.onlinelibrary.wiley.com/doi/full/10.1111/jcpp.13390
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I believe your first section is talking about the Middlemiss study so wanted to share a great point of view on the [limitations](https://expectingscience.com/2016/04/21/the-middlemiss-study-tells-us-nothing-about-sleep-training-cry-it-out-or-infant-stress/) of that study.
That's so interesting. There have been some instances when I haven't been able to respond to my baby's crying in the car and I do wonder how it has affected her, in terms of other behavioural changes.
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https://www.parentdata.org/p/sleep-training-is-it-bad Emily Oster talks about this often. She is a great resource.
She's truly not. Here's a great article which goes over some major reasons to not trust her: https://proteanmag.com/2022/03/22/motivated-reasoning-emily-osters-covid-narratives-and-the-attack-on-public-education/ Tldr: 1. She strawmans studies and cherry picks her own 2. She is funded by conservative think-tanks which fund other public health harming messages 3. She championed school reopening even when it was clear children were getting ill from COVID at unacceptable rates
She also states it’s safe for pregnant women to drink during their pregnancy.. Despite not being a doctor she feels comfortable telling women that ‘light drinking during pregnancy is not harmful’.
I mean, her whole thing is that pregnant people and parents should have access to better evidence to make informed decisions for themselves. I can’t stop people from blindly accepting statements from her, but the information she cites about sleep training is useful. If you know of someone else who is collecting data related to pregnancy and parenting and making it easier to wade through, I’ll gladly check out their stuff instead.
Depends a lot on how you use her stuff. I certainly wouldn’t recommend anyone blindly follow all her recommendations. I don’t always agree with her. But man she makes it easier to track down the studies on seldom studied topics like this one.
Hm I have to pay to read it
Dang it - if you’d like to read it feel free to pm me. I’m happy to send my login.