
The cry-it-out (CIO) method, also known as the extinction method, is a sleep training technique that involves putting your baby to bed while they're still awake and letting them cry until they fall asleep without any help from their parents. While the method is controversial, it has stuck around because it can be effective. Some experts view graduated extinction as a variation of CIO, while others consider it to be a different method of sleep training. The Ferber method, for example, is a type of graduated extinction that involves spending less and less time with your child each night so that they adapt to falling asleep without you being present.
| Characteristics | Values |
|---|---|
| Other Names | Cry It Out (CIO) Method, Unmodified Extinction, Ferber Method, Graduated Extinction, Controlled Crying |
| Description | A sleep-training technique that teaches babies to self-soothe and fall asleep independently |
| How It Works | Babies are put to bed while they're still awake and allowed to cry until they fall asleep without any help from their parents |
| Time Commitment | No time limit for crying, but some sources recommend trying for an hour for the first two naps of the day |
| Age Recommendation | Babies over 6 months old |
| Effectiveness | Works for some families but not for others |
| Benefits | Can help babies and parents get better sleep, can work quickly |
| Drawbacks | Stressful for parents, confusing for babies if the method is changed frequently, may increase a child's frustration if the parent is in the room without contact |
| Alternatives | Ferber/Graduated Extinction Method, The Wave Method |
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What You'll Learn

Graduated extinction vs. total extinction
The cry-it-out method of sleep training is also known as the "extinction method". This method involves putting your baby down to sleep while they are still awake and then leaving the room, not returning to soothe them. There are two types of extinction methods: graduated extinction and total extinction.
Graduated extinction, also known as the Ferber method, involves leaving your baby to cry for a certain amount of time before going in to soothe them. The first interval is usually around two to three minutes, and then the parent returns to comfort the baby for one to two minutes. The parent then leaves the room again, this time for a slightly longer interval, and so on, gradually increasing the length of time between visits. This method assumes that the baby will eventually learn to self-soothe and fall asleep independently. Studies have shown that this method is effective in reducing the time it takes for babies to fall asleep, decreasing the number of awakenings, and reducing maternal and infant stress. It is also worth noting that this method has been found to increase security and attachment in babies, with no adverse secondary effects identified.
On the other hand, total extinction, or the "cry-it-out" method, involves putting the baby down and not returning to soothe them at all. This method assumes that the baby will eventually fall asleep on their own without any parental intervention. While this method may appear harsher than graduated extinction, some believe that it results in less overall crying because the baby learns more quickly that no one will come to their aid. However, this method can be difficult for parents to implement due to the enduring crying, fear of repercussions, and incongruence with personal beliefs.
It is important to note that no single infant sleep method will work for all babies, and parents should trust their instincts and listen to their baby's needs. Sleep training is not recommended for babies under six months old, and it is always a good idea to consult with a pediatrician before starting any sleep training program.
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The Ferber method
To implement the Ferber method, parents should first establish a consistent bedtime routine. Then, after following this routine, they put their drowsy infant into their crib while they are still awake and leave the room. If the child cries, parents wait for a short period of time (starting with three minutes the first night) before returning to the room to briefly comfort them. Comforting can include patting the baby or speaking in a soothing voice. Over time, parents gradually increase the waiting period before returning to the room, teaching the child to self-soothe and fall asleep independently.
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The role of parents
Parents who choose this sleep training approach must be prepared for the emotional challenge of hearing their child cry. It can be distressing for parents to resist the urge to respond immediately to their child's cries, and it is essential that they monitor their child's safety and well-being during the process. Some parents may opt for a modified version of extinction sleep training, where they remain in the room or nearby to ensure the child's safety and provide a sense of reassurance.
The traditional or "pure" form of extinction sleep training involves putting the baby to bed while they are still awake and then leaving the room, without any interaction or check-ins. This method can be challenging for both parents and children, as it requires a significant amount of self-soothing on the part of the child. However, proponents of this technique argue that it can help the child develop essential self-soothing skills that will benefit them throughout their lives.
Some parents may prefer a more gradual approach, such as the Ferber method, which is a variation of extinction sleep training. This method involves putting the baby to bed while they are still awake and then gradually increasing the intervals between visits to reassure the child. This technique can be less stressful for parents who are uncomfortable with the idea of leaving their child alone for extended periods.
Ultimately, the decision to use extinction sleep training and the specific method chosen is a highly personal one. Parents should consider their child's needs, temperament, and development, as well as their own comfort level and parenting style. It is important to remember that sleep training is not a one-size-fits-all approach, and what works for one family may not work for another.
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Safety concerns
The "cry it out" (CIO) method of sleep training is controversial, with some parents, pediatricians, and sleep experts expressing concerns about letting a baby or toddler cry indefinitely. The CIO method involves putting a baby to bed while they are still awake and letting them cry until they fall asleep without any help. The same principle applies if the baby wakes up in the middle of the night; the goal is for them to be able to self-soothe. This method is sometimes called "extinction" sleep training, as it aims to eliminate crying at bedtime and during the night, rather than gradually reducing crying over time.
There are several safety concerns and potential risks associated with extinction sleep training:
- Intense or extended crying: Some researchers, clinicians, authors, and parenting organizations express concerns that intense or extended crying may be detrimental to a child's health and may create a poor attachment between the parent and child. They advocate against cry-intensive methods.
- Inconsistent carers: Inconsistent responses from different carers can compromise extinction interventions. For example, different carers may respond differently to a child's distress, potentially strengthening protesting behaviours.
- Practicalities: External factors and practicalities may prevent the uptake or continuation of extinction methods, such as crying disturbing other children or a spouse's need to work.
- Stress: Some people worry that the stress of extinction sleep training may be sufficient to cause harm and warrant its cessation. While studies have shown that babies who were sleep-trained with graduated extinction had lower stress levels overall than those in other groups, the debate around this issue continues.
- Poor attachment: There is a concern that extinction sleep training may lead to poor attachment between the parent and child.
- Other methods may be more effective: For some babies, other sleep training methods may be more effective and less stressful for both the child and the parent. For example, the 4 S's method is recommended as a low-stress and effective alternative to CIO.
It is important to note that sleep training methods should be tailored to the individual child and family, and no single method will work for all babies. Parents should be consistent with how they put their child to sleep at bedtime and naptime so that the child can develop a consistent sleep strategy. If there are safety concerns or a need to check on the baby, it is recommended to keep the interaction brief and mundane to avoid interfering with the sleep training process.
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Alternatives to extinction
The cry-it-out method (CIO) is a controversial sleep-training technique that can be stressful for parents and may not be suitable for all families. Several alternatives to CIO can be considered, including:
- Positive routines: This approach focuses on establishing consistent and calming bedtime routines to help children relax and prepare for sleep. It may include activities such as reading a story, listening to soothing music, or having a warm bath before bed.
- Faded bedtime: This method involves gradually reducing the amount of help or interaction a child receives at bedtime. For example, if a child is used to being rocked to sleep, parents can start by rocking with less intensity, then move on to holding the child without movement, and eventually decrease the amount of help until the child can fall asleep independently.
- Scheduled awakening: This technique involves waking a child up slightly before their usual wake-up time and helping them fall back asleep on their own. Over time, the child learns to self-soothe and fall back asleep independently.
- Gradual extinction or Ferber method: This is a variation of CIO, where parents put their child to bed while still awake and leave the room, but return for brief visits at gradually increasing intervals. This method offers reassurance to the child while still encouraging them to fall asleep independently.
- The Wave method: This method involves checking on the child every five minutes if they are crying. It provides an opportunity for health and safety checks while still allowing the child to self-soothe.
- Room-sharing: While it is not recommended to bed-share with infants, room-sharing can provide reassurance and a sense of security for both parents and children.
The choice of sleep-training method depends on various factors, including the age and development of the child, parental preferences, and the family's overall well-being. It is important for parents to be well-informed about the different techniques and make decisions that align with their values and the needs of their children.
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Frequently asked questions
The extinction method, also known as "cry it out" (CIO), is a sleep training technique that involves putting your baby to bed while they're still awake and letting them cry until they fall asleep without any help from you.
The idea behind the extinction method is that if you leave your baby in their room and don’t respond to their cries, they’ll eventually stop crying and fall asleep on their own.
The extinction method is controversial, and some parents and experts are concerned about letting a baby cry indefinitely. However, studies have shown that sleep training with graduated extinction in babies at least 6 months old is unlikely to cause damaging stress, long-term problems, or insecurities in your baby.
The extinction method can help babies (and their parents) sleep through the night and get the rest they need. It can also help babies learn the essential skill of falling asleep on their own and self-soothing.
The extinction method can be stressful for parents and may lead to doubts about their parenting abilities. It can also be confusing for babies if it is not applied consistently. Additionally, there are concerns about whether this method could lead to poor attachment or cause harm in some way.











































