Update: It’s been ~5 years since I wrote this. It’s mostly still accurate. However during this time I’ve vastly expanded my knowledge about kids, sleep, schedules, and sleep training. The sum total of that knowledge can be found in my book, which is a comprehensive resource on sleep training. If you’re serious about successfully fostering independent sleep for your child, this is your guide. 

Additionally I no longer use the term “CIO” for a variety of reasons. I would strip it’s use from my website but I can’t. Most people find my site through Google and the term they are often searching for is “how to Cry it Out”. So I will leave it here, largely unchanged, for that reason. Thanks for understanding.

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Well little baby, here we are. Mommy and Daddy have read every book, tried every technique, bought every sleep aid they could find. The months have slogged by and nobody is sleeping. Daddy is staring stoically out the window. Mommy is curled up on the couch wearing coffee-stained yoga pants and feeling like a giant failure. Everybody feels cranky and sad. And defeated. And the only way out of this pitt of sleep deprivation is to let you cry. They adore you beyond words, but baby, this is happening. It’s going to suck for a few days. But it really is for the best.

If you’ve come to the conclusion that cry it out is the answer this is a great overview.

1) To break out of the desperate pattern of bedtime battles and frequent night wakings and get everybody sleeping a civilized amount during the night.
2) To achieve goal #1 with the minimal amount of crying.

The best way to meet your CIO goals is to embrace the 14 point CIO plan I’ve put together here.

How to do Cry it Out?

1) Buy a night vision monitor.

They’re expensive and not particularly reliable (you may have to buy a new one for each new baby). But I think it’s a worthy investment for piece of mind and would recommend purchasing one prior to CIO. It will give you a safe window onto your baby all night long.

2) Make naps happen

You want your baby well rested going into bedtime because tired babies sleep poorly. So you’re investing in day sleep to help minimize the amount of bedtime crying. Does your baby take great naps in the car? In your lap? While co-sleeping? Great! For the next few days do what you need to to get those naps to happen. By any means necessary.

3) Avoid cat naps.

Your goal is longer naps. So don’t drive to the grocery store at naptime because that 5-minute car nap is working against step #2 (above). For the next few days you are going to be the Nap Master, to the exclusion of all else.

4) Use a solid bedtime routine.

What is a SOLID bedtime routine?

• Takes 20-30 minutes to complete.
• Involves decreasing levels of activity and light. (No TV time, no dance parties, activities should be moving towards the bedroom).
• Everybody should enjoy the activities.
• Final activities take place in the location your child will be sleeping.
• Ends BEFORE baby is asleep!

What are you trying to wean your baby off of? Rocking to sleep, co-sleeping, nursing to sleep, pacifier, etc? Whatever it is DO NOT include this as part of your bedtime routine! If it must be part of the routine (ex. food) then make sure there is at least a 20 minute gap between baby’s last meal and bedtime.

Sample Bedtime Routine – Bottle/Boob, Bath (no soap), Massage, Jammies, Book, Song, Bed.

5) Ensure that baby’s sleep location is ABSOLUTELY safe.

Dangling cords within reach of the crib? Unprotected outlets? The crib should be clear of any possible entrapment hazards (no stuffed animals, blankets or pillows!). The only thing in there, other than your baby, is potentially a small lovey. If your child is old enough enough to be out of a crib, put on your anal retentive hat and look at your child’s room. Does the furniture present tipover hazards? Are there toys which could break into sharp pieces? Choking hazards?

Special Case: What about Co-Sleeping?

Yes you can use CIO for a co-sleeping baby if you intend to continue co-sleeping. Most often this is used in the case where Mom wants to stop being used as a human pacifier but is happy to continue co-sleeping. This can be done but it’s challenging. You can’t leave an angry crying baby alone in an adult bed. Even if that “bed” is nothing more than a mattress on the floor. It is simply not safe and shouldn’t be done under ANY circumstance. So, where does that leave you?

If this is your goal, it leaves you IN the room with your angry crying baby. I realize this may sound like I’m joking but I assure you, I’m not. You put your child on your bed, preferably between you and the wall. Then you lie down on the bed facing away from your child. Then you bite your knuckles hard enough to keep from flipping over and nursing your crying child to sleep.

6) Use your words.

Your baby’s receptive language develops far earlier than their expressive language. This means they understand what you are saying long before they can speak themselves. “It’s time for you to sleep buddy. Mommy and Daddy love you. We’re right next door. We’ll see you with big hugs and kisses in the morning. But for now we’re going to leave so your body can get the sleep it needs to be strong and healthy. I love you little baby!” Use the same words every night as part of your bedtime routine.

7) Give baby as much soothing as possible!

For older babies (6+ months) your options are generally limited to loud white noise, block out blinds, and a small lovey. It’s sometimes helpful to have Mom stuff the lovey in her bra and wear it there all day so that it smells like Mom. If your baby is still swaddled that is also really helpful. DON’T use any sleep aids which will feed into your object permanence problem. So pacifiers, timed music, etc. are all forboden.

8) Leave the room.

There are some books that suggest that it is more gentle to stay in the room so that your loving presence can help provide helpful soothing. In my experience staying in the room has the opposite effect, making your baby more upset, “WHY AREN’T YOU PICKING ME UP! HELLO?!? I can SEE you sitting RIGHT THERE!” It also has the unintended consequence of potentially creating a new object permanence problem for you in that they will expect to see you sitting there when they wake up throughout the night. For these two reasons I suggest that once you put your baby down, you get out.

9) Mom or primary care giver should leave the house.

Decide which parent (if there are 2) is the most likely to turn into emotional jelly at the sound of their baby crying (generally this is Mom). The emotional jelly parent should get out of the house and leave things to their more stalwart counterpart. Lots of parents feel that they need to sit in the hallway, curled into a fetal position, crying tear-for-tear with their baby as some sort of penance for their failure to teach baby to fall asleep. Crying in the hallway serves no purpose other than to make you miserable. Worse, it creates the opportunity for the dark strains of guilt to muddle your thinking. “I feel horrible! Maybe I’ll just nurse him to sleep one last time?” Backsliding won’t solve any problems and even worse, guarantees you even more crying in the future. A good way to avoid backsliding is to simply leave it to your partner and get out.

10) Commit to Check and Console or Full Extinction.

Personally I recommend the Full Extinction or Weissbluth method. However as I was unable to find any research that backed up my theory that this method results in less crying, you’re welcome to consider both and determine which works best for you.

If you start the CIO process planning to Ferberize or check and console and THEN determine that your visits are making things worse, you CAN switch methods to the Weissbluth full extension method. However DO NOT switch from the Weissbluth full extension method TO Ferber or check and console as this generally leads to LOTS OF CRYING!

11) Cry it out does not mean night weaning.

IF your baby has been eating/nursing at night then you will need to feed/nurse your baby when they wake up. CIO is not a good way to cut out night feedings as hungry babies will cry A TON. If your baby had been eating at predictable times then feed your baby when they “regularly” would be eating. If your baby wakes up crying at a time other than when they would regularly eat, then I recommend you don’t go to them.

If your baby was previously sleeping glued to your boob (don’t laugh, this is a REALLY common problem) then sorting out what is a cry for attention vs. a cry for food will be challenging. You’ll need to listen to your baby and your gut and make the best determination you can. I would suggest you try to space out the feedings as best as you can. For example if you nursed your baby at 6:30 PM then I would be reluctant to offer more food before, say, 11:00 PM. If you nursed again at 11:00 PM, then potentially the next feeding could reasonably be expected to happen at 3:00 AM. However these are not hard and fast rules, listen to your gut. It’s almost always giving you good advice.

12) Put baby back down awake. Or don’t.

In my experience the key with sleep training is to put baby down awake at BEDTIME. If you feed your baby during the night AFTER that point, it is generally OK if they fall asleep in your arms and then go back into their bed. I have not found that it is critical to wake baby up enough to “put baby down awake” at 2:00 AM. However if they do not organically fall asleep during the feeding I would not encourage you to rock them to sleep in your arms intentionally and THEN put them down asleep.

13) When baby wakes up early?

CIO is very effective at bedtime because there are a number of biological factors that make it very difficult for your child to stay awake at that time. However if your baby wakes up very early in the morning (4:00 AM or 5:00 AM) letting them cry will almost never result in them falling back to sleep. If your baby wakes up very early and doesn’t seem to be falling back to sleep (it’s been longer than ~20 minutes) then it’s morning time for you. This is horrible but generally temporary. You may want to consider offering baby a quick snack, putting baby in the swing, or bringing baby back into your bed. Sometimes these options will buy everybody a few more hours or sleep. But crying is unlikely to do anything productive.

14)

If you’ve started down this path then in almost all cases the worst thing you can do is to cave in halfway through. Night #1 will be stressful for everybody. But what happens if you go to your baby to rock/nurse them after 45 minutes of crying? You’ve failed to let them figure out how to fall asleep without rocking or nursing. But you have taught them that if they cry for 45 minutes, you will come and rock or nurse the to sleep. Which means that the next time you have a go at cry it out (and trust me, there is ALMOST ALWAYS a next time) it will be longer and rougher than it is right now.

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The truth is that there are a thousand frequently asked questions about CIO but I’ve narrowed it down to a few hot button questions which I’ve answered below:

Cry it Out FAQ

1. How long will the crying last?

   I suppose “it depends” is not a particularly useful answer. If you follow all my advice then you’ll generally find that kids will cry ~1 hour at bedtime on night #1, ~20 minutes on night #2, and 10 minutes on night #3. They may continue to grumble at bedtime going forward but it will generally be only for a few minutes. Some babies will only cry at bedtime. Some will wake up periodically and cry for 20-30 minutes throughout the night. As long as you aren’t trying to night wean via CIO, the middle-of-the-night crying generally stops after night #1.

2. When will I be able to put my smiling baby down for sleep at bedtime?

   When do you smile when scrubbing toilets? Never? Well there’s your answer. Most kids will not enjoy bedtime until they are old enough to have their OWN kids at which point it will quickly become the favorite part of their day.

3. Am I a bad parent?

   I don’t know, are you? I don’t believe that CIO makes you a bad parent. I do believe that you have tried everything you can to avoid letting your baby cry. And that nothing worked. And nobody is sleeping. I also believe that your whole family will be happier and healthier when you are all able to get the sleep you need at night. Cry it out is a bummer and nobody likes to do it. But 3 nights of unhappy baby are a worthy tradeoff.

4. Can I use CIO for naps too?

   That is a whole separate topic which I’ll write about in the future. I don’t recommend tackling naps until AFTER night sleep is well established. So for now, focus on getting night sleep sorted out and let things settle into a positive and predictable sleep routine before you start mucking about with naps.

5. Won’t they get confused if I keep (rocking, nursing, pacifier) for naps but not bedtime?

   Different parts of the brain regulate day vs. night sleep so you aren’t mucking things up by rocking to sleep at naptime then using CIO at bedtime. Many people feel they need to tackle the whole day at once but I don’t recommend it. Sorting out naps tends to take a while and involve quite a bit of crying and not napping. Babies who don’t nap become overtired. Overtired babies cry at bedtime. A lot. So with the goal of minimizing crying you would work on having GREAT naps (by any means necessary) so your baby is well-rested coming into CIO bedtime. Once night sleep is well established sorting out naps becomes easier (because well-rested babies sleep better), which is why I recommend focusing on night sleep FIRST before moving on to nap battles.

6. If I can’t use CIO to night wean, how DO I get out of night feedings?

   Once you are done with crying at bedtime and things have become a bit more predictable, you can use these gentle night weaning techniques to gradually get out of night feedings. The bad news is that depending on the age of your child and the # of feedings this may take 1-3 weeks. The good news is that it’s surprisingly effective and tear-free.

7. What if my baby throws up?

   Some kids can get themselves so worked up they throw up. It sucks when this happens. You’ll need to quietly go to them, clean them up and get them fresh jammies/bedding, ideally with as little light and fuss as is possible. Put them back in their bed, use your words, and leave.

Anybody have any experience they would like to share? Words of wisdom, kind advice, and lessons learned are very welcome!