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The Ferber vs. Weissbluth CIO Smackdown

April 19, 2012 |  by  |  1 YO, 9-12 Months, cry it out, parenting
Ferber or Weissbluth?

You’ve gotten your head around what sleep training means and then possibly came to the conclusion that CIO is the answer to your particular sleep issues. The next big hurdle is figuring out which method of CIO is right for you? And by “right for you” I mean that it:
A) Solves the problem of having your child fall asleep without you
B) Is something you and your partner can successfully execute (minimal user error)
C) Involves the least amount of crying possible

Luckily the list of CIO options is rather short. In fact there are really only 2, which you are probably familiar with from reading Ferber and Weissbluth.

The Ferber Method

Check and console comes in many varieties but probably the most well-known is outlined by Dr. Ferber and in case you aren’t familiar, I’m including it here. You put baby in the crib and leave the room. However you make brief consoling visits (~15 seconds, a few kind words, back rub, then leave) according to the schedule below.

From Solve Your Child’s Sleep Problems, Richard Ferber, MD. (p. 74)

Day At First Wait Second Wait Third Wait Subsequent Waits
1 3 5 10 10
2 5 10 12 12
3 10 12 15 15
4 12 15 17 17
5 15 17 20 20
6 17 20 25 25
7 20 25 30 30

Vanilla CIO

AKA Weissbluth method, where you kiss baby on the head, tell them you love them, put them gently in their crib, and walk out of the room.

CIO Comparison

Name Ferberizing Weissbluth/CIO
Also known as… Graduated Extinction, Check and Console, Controlled Crying Extinction, no-peek
How to: Return to child every X minutes to console for ~15 seconds then leave. Put baby in crib, walk out, close the door. The end.
 Pros: Parents feel less guilty because they are providing some degree of soothing.  Less likely to unintentionally reinforce crying with ongoing intervention.
Cons: Intervention may lead to longer crying by sending mixed signals  Parents feel generally crappy about it.

Which Method is Best

For situations where CIO is appropriate, I’ve long been a staunch proponent of Weissbluth/CIO method over “Ferberizing” because I’ve observed that Ferberizing has two significant downsides:

1

Prolonged Crying

Some (most?) babies tend to amp up when they see you. On a 10-point scale, if a baby is crying at level 7 and Mom walks in the door, that baby is often going to jump to level 11. So Mom’s well-meaning presence is often working against the goal of minimizing crying. Also going to your crying baby can also have the unintended consequence of reinforcing the crying. Psychology majors are probably familiar with the term intermittent reinforcement. The basic idea is that if you reinforce (by coming in to soothe) the negative behavior (crying) intermittently (every 5, 7, 10, 12 minutes) it will continue longer than if you never went back in to the room at all. Weissbluth also maintains that “full extinction” results in less crying overall.

2

User Error

The more times you go in to pick up your crying child the more opportunities for the dark well of parental guilt you are feeling to suck you in so that you go back to whatever soothing behavior (rocking, nursing, etc.) you were trying to get out of when you started down this path. And each time this happens you are vastly increasing the chance that the next time (and rest assured there WILL be a next time) you try CIO it will be a horrendous prolonged nightmare for all. When you see people on baby forums talking about how CIO for them was a total disaster, I can almost guarantee that the underlying issue was user error.

For these reasons, I’ve generally been an advocate for the Weissbluth/extinction method of CIO. So as with most things I went on the Internet to look for validation of my own personal brilliance which included reading the most current academic research on CIO (links at end of post). What I learned from the academic research is this…

Research on Cry it Out

1

You are in good company.

About 25-50% of babies over 6 months and 33% of toddlers/preschoolers have “sleep problems” (i.e. bedtime is a nightmare, they wake up repeatedly at night, or both).

2

It’s not about food.

Newborns ABSOLUTELY need to be and SHOULD be fed on demand, at night. But when your almost 1 year old is nursing all night long, you don’t have an unusually hungry kid. You have a sleep problem.

3

Thing generally don’t get better by themselves.

It would be awesome if kids would just outgrow the “terrible sleeper” phase all on their own. It would also be cool if they would make you a killer martini. However neither of these things is going to happen.

4

Your non-sleeping baby/toddler will grow into a non-sleeping kid.

You can deal with the issue now or three years from now because it’ll still be there.

5

Not sleeping is a big deal to your kid.

It impacts their mood, development, learning, performance and health. Seriously, it’s important.

6

When your kid sleeps everything get’s better

Kids who are sleeping are more secure, predictable, and less irritable. Also? Sleep training doesn’t impact consumption of breastmilk (yay!).

7

Cry It Out Works

Baby forums are bursting with CIO horror stories (was horrible! didn’t work! have to re-train every time the kid sneezes!). Which is a shame because the academic research on this sort of “behavioral modification treatment” shows that almost without exception, it does work.

What I DIDN’T find was any evidence that one method works better than the other. But there is ample evidence that either method works just fine.

Least Amount of Crying

Of course the single most important question is: does one method result in less crying than the other? Because while “solves the sleep problem” is our #1 goal, minimal crying is easily the #2. I could find nothing that answered this question so I asked Dr. Jodi Mindell, psychologist who specializes in pediatric sleep medicine and is the associate director of the Sleep Center at Children’s hospital in Philadelphia. Because she was the primary investigator on much of the cry it out research and is also the author of the popular book Sleeping Through the Night. Her response?


Unfortunately those studies comparing duration of crying have not been done, at least as far as I know. – Jodi

Bummer.

So while I’ve been vocally pro-no-peek for years, apparently both work fine and you can choose whichever method works for you and your kid. But here are a few parting thoughts that may help you figure out which method is best for you.

Which CIO Method is Right for You?

  • If you go to your child periodically will you be able to leave after JUST 15 seconds of soothing?
  • Does your baby cry more or less if you enter the room (and not pick them up, nurse, rock, etc.)?
  • Can you let your baby cry and resist the urge to peek/intervene?
  • Does not going in to your baby feel unimaginably wrong to you?
  • Have you dabbled with CIO before? (If yes then I strongly encourage you to go with the no-peek/intervention method).

Anybody have any thoughts on one method vs. another? Experiences or lessons learned you care to share?


270 Comments


  1. My current 5 month old has been a nightmare at night, sometimes waking every 45 minutes, and also sometimes just staying awake for an hour or so at night… Just babbling and cooing, not upset until she needs help getting back to sleep. She sleeps in a swing still and it works great for naps. There have been a handful of times where I put her in her crib when she’s awake at night and she’ll fall asleep on her own after 20 minutes of just talking to herself so I feel she might be ready for extinction. She won’t fall asleep in her crib at bedtime though… She needs to be rocked by me in her swing. My question is: if she’s used to falling asleep in her swing can I use extinction to get her used to sleeping in her crib at night? And can I use the swing for naps still? Also, does it make a difference that she is still in my room? We won’t be moving her to her own room until after we move cross country in a few weeks. Thanks!

    • You’ve probably figured it out now, but yes, you can use extinction to move your baby from sleeping in a swing to sleeping in a crib. For maximum effectiveness, you should not use the swing for naps and use the crib for all sleeping. Once sleeping in the crib is firmly established, you can use the swing again. The only difference having the crib in your room would make would be making it harder for you not to intervene.

  2. Hi I tried Ferber with my son when he was 8 months old and it worked really fast I achieved the 8 hour sleep stretch in two days!! Then he suffered from a cold in a months time and I started picking, rocking and nursing to sleep! Now he is 10 months old and wakes every 2 hours and nurse to sleep sometimes even refuses to sleep for an hour and half during the night, so I tried ferber’s method again but as soon as he see me he would just cry his head out and it melts me really down but today I started with extinction and guess what he is asleep in just 20 mins.. I k ow it’s too early to say anything but I’m just thinking if extinction was the answer all the way along!!

  3. We are attempting to sleep train our 4 month old based on his pediatrician’s recommendations. She said, “there’s no reason he shouldn’t be able to sleep through the night without needing your milk if he has full access to it throughout the day”.  The last two days have been insane, we’ve been using a mix between Ferber / Extinction simply because we’re too exhausted to check on him in those intervals. However every time I do check on him he gets louder, defeating the purpose, so I think extension might be the way to go.  I’m still nervous that he needs to eat in the middle of the night so I’ve been feeding him at 1 a.m. , but I think this might be sending him mixed messages also.  I definitely expected this but the days are even worse. It’s hard to keep on a nap schedule when he’s not sleeping throughout the night… here’s hoping the rest of the week goes a little smoother.

  4. Hi, My husband and I are expecting twins in a few months; they will be our first children. We are “older” parents, and I’ve had plenty of opportunity to watch my friends go through sleep training. In theory, I’ve always been a big supporter of CIO (I’ve seen both Ferber and extinction work well). My question though is how it all applies to twins. Are there books or articles you can recommend that apply CIO to twin babies?
    Thanks in advance for the assistance.
    Best,
    Daniela
    PS. I know none of this applies to the first few months. I just have the time and headspace now to read and learn, so I’m using it as best I can.

    • The short answer is that you don’t need to do anything differently. The long answer is – you may not NEED it. Independent sleep is a must. How you achieve it will depend on how you approach sleep with your kiddos, their temperaments, and what happens in the first 3-6 months. Independent sleep is something you chip away at and it may come easy or hard. If it’s not coming easy then sleep training is your fallback. And it’s 100% fine but generally a fallback people try to avoid if possible. Your focus could be on:
      a) Safety
      b) Soothing
      c) Sleep
      That’s the first 3 months. Newborns cry a lot and you’ll have TWO. When things start to calm down between 6-12 weeks see if you can get them to fall asleep alone. They may surprise you. good luck!

    • Weissbluth has a book on this exact topic!

    • Hi! I came here just reading up on CIO. I actually have 9 month old twins and have been using CIO for the past 3 days and progressing. My advice is, if they’re still newborn, to put them down as soon as they need to sleep so they can learn this at their own. I agree that sleep training is a last resource, but rest assured that it also applies to twins, at least in my experience. The first months I rocked any baby that stired so he wouldn’t wake the other and it was taxing to say the list. Now it’s been 3 days where I let them cry (one wakes the other) and console after 5 min, then 10, 15 etc but they’ve been both asleep by the 10 min check up. Twins are nooo joke but I’m sure you’ll do great! Congrats!

  5. Melissa schoelkopf

    My 8 month old daughter is very attached, only sleeping with me and nursing all night. I finally decided it was time to get this changed. The first night I tried to sit in the room and let her cry but she screamed for an hour even flipping out of the crib (i caught her) so I lowered the mattress and left watching her on the monitor. She then climbed the mesh bumper so I had to go in and remove that. The screaming continued. My daughter then started trying to climb the rails and kept getting her legs caught so after two times I again lowered the mattress to its lowest level and left. 3 hours in before and after I left the room my daughter finally fell asleep on her own until a 3am feeding at which point she finished the night with me. Night two she cried for 30 minutes at a much lower pitch and volume and put herself to sleep, sleeping in till 5 a.m. I feel like we’ve made huge progress but it was only night to so crossing my fingers today is shorter

    • Hey Melisa,

      I’m having the same problem with my daughter, I haven’t slept on my own for 8 months, my back is in agony from holding her all night long. How’s the sleeping going now? Any tips on how to start training her?

      • Honestly just realize you will feel like the worst mommy ever for a bit and do it sooner rather than later (this does not make you a bad mommy). My daughter still fusses for a few minutes when i lay her down but shes doing great and even after the awful crying at night she would wake up smiling. I had to ban my son and husband from rescuing her. She has music in her room that times out, but it comes on when she wakes up and cries. Im still fighting the middle of the night wake ups but I let her fuss for 10 minutes before I pick her up. Im also trying to get her to fuss through the 1A feeding which she does most nights. Now when she wakes up between 3 and 6 she comes into the bed so I havent beat the one yet. This isnt easy but both of us were sleeping so poorly the last few months she slept with me. Wherever you hold her before bed, just turn out the light, no playing and then place her in her bed. And leave quickly!! Then settle in because its going to suck at first but remember if you back down even once shell know youll come get her. My girl took a couple of weeks to stop the screaming fits but they reduced dramatically after the first few days. Stick with iit and dont back down. Yall will both sleep so much better in the end. Good luck!!!

        • I’m going through this right now with my 9 month old and your post is helping. Hardest thing I’ve done but I couldn’t stand being a human pacifier and like you said, my back was in so much pain. This website really helped me so much tonight. He screamed for the first hour. We did the Ferber for the first 45 minutes and then extinction for the rest of the night. He woke every 2-3 hours and cried for 30 min until 3:30am when he cried every 10 min for a short time. At 4:45am I gave him a bottle in his crib without picking him up and he’s back asleep. Fingers crossed tomorrow is a bit easier but this is definitely worth it for both him and me.

  6. Hello!

    My 3.5 month old son would only get quality naps if I’m holding or wearing him. If I put him down when he’s awake, he’ll fuss for 10 minutes, and starts crying intensely. If I put him down when he’s drowsy and he falls asleep, he’ll wake up within 5 minutes wide eyed and alert. If I put him down in deep sleep, maybe I’ll get 15 minutes to 30 minutes tops. At night, I have a bedtime routine (bath, bottle, book), and then I rock him to sleep. He’ll wake either every hour or 2 hours. Bottm line is, I’m at my wit’s end! I’m physically and mentally exhausted. I want to use extinction once he’s 4.5 months old. Should I work on naps first or bedtime first? Swaddle or no swaddle? Do I go by the clock or wake times? Please help!

    • Hi! I would recommend working on bedtime first. Keep the swaddle, as long as he’s not rolling over in it. Definitely go by wake times, not by the clock, at this age. But you can have a consistent bedtime. Also, it’s probably better if you change your bedtime routine a little bit- put the bottle as first part of the routine, so bottle, bath, book and no rocking, put down wide awake. Good luck!

      • Hello Sam,

        Thanks so much for your post! He’s starting to gnaw/suck on his fingers and is this a method of self-soothing? If so, should I still swaddle or should I give it a try without the swaddle and have him gnaw/suck on his fingers? He still has middle of the night feedings approximately every 3-4 hours. Should I go ahead and set a specific time to go at night? For instance, he goes to bed at 8pm, let him cry for ‘x’ amount of time without me stepping in, and only go in to feed him at 11pm or midnight? Thanks again!

        • I’m in the exact same situation as you. Sound like the same kid! What did you end up doing and did it work? Mine sucks his hands too so I want to leave them uncovered.

          • Hi Wendy,

            My little bub is 5.5 months now since I’ve posted and sleep is so much better now, for both baby and parents! I used Extinction for bedtime once he was a little over 4 months old. I didn’t work on naps because I wanted to make sure he gets the quality naps he needed during the daytime, which meant I had to put him in the carrier. It was so hard the first couple of nights, but now he goes to sleep within 5-10 minutes after laying him, no crying whatsoever. Let me tell you, it wasn’t an overnight success. My little bub took about a solid 3 weeks to solidify his bedtime sleep because he was waking up multiples times a night aside from the one middle of the night feeding so it was a long process. I started nap training about a week and half ago and it’s still a work in progress. We’ve cut down to 3 naps and early bedtime around 5:30pm-6:30pm, depending on how naps went. There were days where he even took 1-1.5 hour nap! It’s not consistent as I want it to be, but like I said, it’s still a work in progress!

            • Please tell me how you did it and what the nights were like. I’m in the verge of a mental breakdown.

  7. My LO is 10 months now and just began crawling 2 weeks ago. We CIO using the Ferber method and it worked great until she reached a leap. Now she goes down at bedtime with no problem but wakes after about 3 hours, screaming. She only stops when I rock her and as soon as I put her down it starts all over again. This has gone on most nights for the last 2 weeks. We are all exhausted and I’m so worried that something is wrong (teething, not feeling well) I don’t want to leave her to cry that long, especially in the middle of the night when I have to be at work at 7 am. I guess I am just looking for reassurance that the extinction method is most effective and I won’t screw up my kid and have her think I won’t be there for her if she needed me. I know there is also a regression that happens around now. I think I need someone to tell me what to do. Any advice from those that have come out on the other side of this?

  8. My sweet boy is 3 months old, and we’ve really been through the ringer with sleep. We started out with a great sleeper – by 2 weeks old, he was doing all of his sleeping in his crib, falling asleep on his own when put down drowsy, and sleeping been 4-5 hours for his first stretch at night. And then we were blind sided with silent reflux that was so bad it actually left ulcers in his throat.

    So from roughly 5 to 10 weeks, we went into survival mode and just did whatever we could to help him sleep while we worked with our pediatrician to find a solution that would help with his pain.

    After trying several different treatments, we finally found something that works, and his pain is now gone! But his sleep is still suffering because of the terrible habits he formed during our season of “do whatever it takes for him to sleep.”

    While we feel very fortunate to have gone from only sleeping upright on mom or dad to sleeping in the rocknplay to now sleeping in his crib, we also recognize that there is a lot of work to be done. He wakes 4-6 times at night, consoled only by nursing, his naps are all only 45 minutes long, and it takes a combination of bouncing and back patting for 15-30 minutes to get him to fall sleep, followed by an extra 10 minutes of holding him to make sure he stays asleep when we put him down. He will not sleep in a swing, nor will he sleep any longer if we hold him instead of putting him down.

    We tried pick up/put down, but he is REALLY resistant to going to sleep on his own, and patting him or picking him up just rile him up even more. The first night we tried, he screamed for 2 hours straight – held or not. If he’s going to do that much intense crying, I would rather we get faster results for his and our sake.

    At this point, he is often only getting 12-13 hours of sleep a day, which, based on his temperament by the end of the day, just isn’t enough for him. Obviously, I don’t want to leave my young baby to cry in his crib, but I’m becoming more and more concerned for the long term effects of his lack of sleep.

    So, at the risk of being crucified for even asking, I guess my basic question is whether or not 13 weeks is an appropriate time to sleep train under these circumstances?

    And if this isn’t the right time to start sleep training, what can we do in the meantime to get him more sleep?

  9. I’m planning on using the Ferber method for sleep training. Do we still do the check in if baby wakes up in the night and starts babbling or only when in distress (e.g. crying)?

  10. With my daughter (now 3.5) extinction was absolutely the only way. She woke up & ramped up whenever we went in, but without she was sorted in 2-3 days and only ever cried for max 45 mins, usually 20. Only did it twice – aged 4 months and again at 18months. My problem is my son. He’s now 16months, has self settled since the beginning and is an ok sleeper – sometimes sleeping through 7 till 6 but is currently doing this screaming thing every time we put him is his cot, and when he wakes at night. My OH is all for leaving him but I’m wide awake, listening to him properly howl 90 mins after he began. I guess I’m looking for reassurance (even having had such an amazing experience with my daughter) that Im not damaging him, going to make him terrified of bedtime etc etc etc….

  11. I’m sleep training my 10 month old, but she does not know how to lay down and stays sitting up crying the whole time. This is night 6 for us. I had to go in after 2 hours because she wouldnt settle and she was just there sitting up and I helped her lay down and went straight to sleep. Will she learn how to lay down? What should I do?

    • My baby “forgot” how to sit down the first night we were sleep training. He got stuck standing up the first night for two hours in the middle of the night. I finally went in and plucked him off the crib, laying him down. He was asleep in 2 mins. The next day we worked on sitting down on and off all day. I stuck him in the crib, put something he really liked nearby but out of reach (phone or food) and waited for him to sit. Did it over and over. He has never forgotten how to sit again.

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