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Of sources and straw houses: The Annotated Dr. Sears Handout on CIO

I am increasingly seeing the use of this Dr. Sears handout by AP/NPers as “proof” that CIO causes all sorts of harm – implying that if you CIO, your child is in danger of developing ADHD, losing precious IQ points, and becoming an ax-murdering psychopath. Examples can be seen in the comments here and here (note the poster of this link also previously invoked the notorious “Harvard Study”). Like my analysis of the aforementioned “Harvard Study” and the scientific rationale underlying the practice of CIO, I hope this will be of help to mainstream parents who feel overwhelmed by the list of sources (which, I promise you, none of the quoters have actually ever read) Doc Sears supposedly provides to support his position. I’ve found most of the sources on the ‘net, so you can peruse them yourselves and decide whether they actually say what Sears claims they do.

Let’s start with his opening paragraph (emphases mine):

Science tells us that when babies cry alone and unattended, they experience panic and anxiety. Their bodies and brains are flooded with adrenaline and cortisol stress hormones. Science has also found that when developing brain tissue is exposed to these hormones for prolonged periods these nerves won’t form connections to other nerves and will degenerate. Is it therefore possible that infants who endure many nights or weeks of crying-it-out alone are actually suffering harmful neurologic effects that may have permanent implications on the development of sections of their brain?

Since CIO (as in the Ferber method) does not typically last “many nights or weeks” nor do babies typically lie crying for “prolonged periods” (no, 5-15 minute stretches, though they may seem endless to anxious parents, do not qualify), this question is really moot. Sears would like to pretend that CIO involves months of endless crying, but the reality for most parents is a few nights of crying episodes which get shorter and shorter until the baby realizes that being put in bed means they need to sleep, which is, generally speaking, a week or two at most (if it doesn’t work by then, it’s probably time to try something else).

Quoth Sears:

Chemical and hormonal imbalances in the brain
Research has shown that infants who are routinely separated from parents in a stressful way have abnormally high levels of the stress hormone cortisol, as well as lower growth hormone levels. These imbalances inhibit the development of nerve tissue in the brain, suppress growth, and depress the immune system. 5, 9, 11, 16

The first two references (5 and 9, respectively Butler et al and Kuhn et al) deal with rats of indeterminate age, whose endocrinology may or may not mimic those of human infants at 6+ months old. There is no report of any lasting damage, and the rat pups’ hormones restabilize once they’re returned to Mom – as would presumably happen with any separation for purposes of sleep in human babies.

Reference 11′s title is “Endocrine and Immune Responses to Separation and Maternal Loss in Non-Human Primates.”. I couldn’t find the book, but the title implies we’re talking about separations much longer (even as far as permanent separation) than human infants normally undergo when falling asleep.

Reference 16, Transition to child care: Associations with infant-mother attachment, infant negative emotion, and cortisol elevations, discusses elevation of stress hormone levels seen in 15-month-olds as a result of daycare attendance. As they point out, this is decidedly less stressful an event if the children are securely attached – which, to remind you, some 65% of American children are. Mind you, Young children adapt to repeated separations from their mothers, even of longer duration than a nights’ sleep. Mild, short stresses are not necessarily a bad thing.

Back to Doc Sears:

Researchers at Yale University and Harvard Medical School found that intense stress early in life can alter the brain’s neurotransmitter systems and cause structural and functional changes in regions of the brain similar to those seen in adults with depression. 17

Ref #17, “Effects of early stress on brain structure and function: implications for understanding the relationship between child maltreatment and depression, quite clearly deals with children who have been severely and consistently maltreated in early life, to the point where Social Services have to be involved. While some anti-CIO types would like to categorize the practice within the realm of child abuse/neglect, there is no evidence CIO in and of itself has any such effects – though Sears is desperately trying to conflate the two.

One study showed infants who experienced persistent crying episodes were 10 times more likely to have ADHD as a child, along with poor school performance and antisocial behavior. The researchers concluded these findings may be due to the lack of responsive attitude of the parents toward their babies. 14.

Actually, the study (which can be viewed full-text here) says nothing of the sort. The researchers looked at children who cried excessively at an average of 3 months (beyond the normal realm of colicky crying, and of course, having nothing to do with CIO nor, necessarily, maternal response to the crying); when they compared them to children who didn’t cry excessively at 8 and 10 years of age, they found 10/53 children in the persistent crying group had ADHD, vs. 1/62 control children. Their main hypothesis (supported by other studies they reference) is that persistent crying (and also sleeping and eating problems) may be an early sign of problems with emotional regulation, which may later manifest themselves as ADHD or school problems. This is emphatically NOT “CIO causes ADHD”, which is what Sears is implying. There is also no mention the researchers concluded that this was due to the lack of parental reponse to the persistently crying babies.

This is blatant misuse of a scientific source; though Sears is smart enough not to say outright that he thinks CIO causes ADHD, he leaves his foolish devotees to draw the “obvious” conclusion by the context.

Dr. Bruce Perry’s research at Baylor University may explain this finding. He found when chronic stress over-stimulates an infant’s brain stem (the part of the brain that controls adrenaline release), and the portions of the brain that thrive on physical and emotional input are neglected (such as when a baby is repeatedly left to cry alone), the child will grow up with an over-active adrenaline system. Such a child will display increased aggression, impulsivity, and violence later in life because the brainstem floods the body with adrenaline and other stress hormones at inappropriate and frequent times. 6

Refrence #6 can be found in its entirety here. I really shouldn’t have to say this, but it quite obviously doesn’t discuss CIO – rather cases of severe abuse, neglect and regular battery of infants which bring about the “chronic stress” and the subsequent adverse events described.

Dr. Allan Schore of the UCLA School of Medicine has demonstrated that the stress hormone cortisol (which floods the brain during intense crying and other stressful events) actually destroys nerve connections in critical portions of an infant’s developing brain. In addition, when the portions of the brain responsible for attachment and emotional control are not stimulated during infancy (as may occur when a baby is repeatedly neglected) these sections of the brain will not develop. The result – a violent, impulsive, emotionally unattached child. He concludes that the sensitivity and responsiveness of a parent stimulates and shapes the nerve connections in key sections of the brain responsible for attachment and emotional well-being. 7, 8

The interview with Dr. Schore (which can be found here) does say, “The baby left alone to cry or whose cries result in unpredictable or abusive responses may never learn what it feels like to maintain or regain balance through thoughtfully timed external soothing.” . However, the context is about children who are regularly shamed or ignored (day and night), and thus experience dampening of the neural pathways for expressing emotion and empathy. There is no evidence presented that normal, otherwise securely attached children undergo this simply as a result of CIO. In fact, the example given in the previous chapter (Rachel) is clearly a little girl who has been badly abused and neglected.

Decreased intellectual, emotional, and social development
Infant developmental specialist Dr. Michael Lewis presented research findings at an American Academy of Pediatrics meeting, concluding that “the single most important influence of a child’s intellectual development is the responsiveness of the mother to the cues of her baby.”

Researchers have found babies whose cries are usually ignored will not develop healthy intellectual and social skills. 19

Another reference I can’t access online, but since Dr. Zeanah is an expert on attachment-disordered children, I would guess this does not refer to children who are merely CIO’ed – whose cries are not “usually ignored”, or even ignored at all (as per the Ferber method).

Dr. Rao and colleagues at the National Institutes of Health showed that infants with prolonged crying (but not due to colic) in the first 3 months of life had an average IQ 9 points lower at 5 years of age. They also showed poor fine motor development. (2)

*Sigh* Here’s Rao et al. This is the same sort of inference Sears is trying to push on his groupies as the “CIO causes ADHD study”. In fact, Rao states rather clearly:”We speculate that irritability caused by subtle underlying neurological problems may be the cause of prolonged crying, despite the fact that most common neurological problems were ruled out in our population. Alternatively, children normally cry less as they mature developmentally; thus prolonged crying may be a sign of
delayed maturation.”. Ergo, the persistent crying (not CIO) may be an early sign the child may have congenital neurological issues which may manifest themselves later. So no, CIO doesn’t cause your child’s IQ to drop.

Researchers at Pennsylvania State and Arizona State Universities found that infants with excessive crying during the early months showed more difficulty controlling their emotions and became even fussier when parents tried to consol [sic] them at 10 months. 15

Ditto. In fact, according to the abstract of Ref #15, the mothers’ behavior had nothing to do with the children’s emotional state: “Maternal behavior and ratings of temperament at 5 and 10 months failed to distinguish the 2 cry groups.”

Other research has shown that these babies have a more annoying quality to their cry, are more clingy during the day, and take longer to become independent as children 1.

Said “other research” is a non-peer reviewed, unpublished Master’s thesis. Can we say “grasping at straws”?

Harmful physiologic changes
Animal and human research has shown when separated from parents, infants and children show unstable temperatures, heart arrhythmias, and decreased REM sleep (the stage of sleep that promotes brain development). 10 12, 13

As far as I can tell, all of the studies referenced deal with animals (I suspect Sears didn’t actually read them, because the author of ref #12 is also the author of #13, and the source is misquoted). Is he seriously contending human babies “show unstable temperatures, heart arrhythmias, and decreased REM sleep” whenever they’re away from their parents? Babies should be dropping like files if this were happening.

Dr. Brazy at Duke University and Ludington-Hoe and colleagues at Case Western University showed in 2 separate studies how prolonged crying in infants causes increased blood pressure in the brain, elevates stress hormones, obstructs blood from draining out of the brain, and decreases oxygenation to the brain. They concluded that caregivers should answer cries swiftly, consistently, and comprehensively. (3) and (4)

Both articles (only Brazy – ref #3 – is a study; Ludington-Hoe – ref #4 – is a review) deal with newborn babies. So just for the record, you heard it from me first, folks: DO NOT CIO YOUR NEWBORNS. ‘Kay?

I will point out that crying only decreased cerebral oxygenation (to a dangerous level? We don’t know) in infants with respiratory problems, not in normal newborns. That’s a fact not revealed to us by Sears.

However, as Ludington-Hoe states, there’s the fact that crying is “a series of four movements that basically resembles a Valsalva maneuver”. The Valsalva Maneuver is described as “A maneuver in which a person tries to exhale forcibly with a closed glottis (the windpipe) so that no air exits through the mouth or nose as, for example, in strenuous coughing, straining during a bowel movement, or lifting a heavy weight.”. The pressures are expected to be lower in crying than in a true Valsalva, as the glottis is not fully closed – evidenced by the piercing wails emerging from it. I can find no evidence of crying-induced cerebral hemorrhages in infants, which would indicate that the cerebral blood pressure during crying does not climb to dangerous levels. In any case, the infant’s flexible skull sutures apparently help prevent dangerous rises in cerebral pressure by stretching and releasing the pressure.

Either way, we don’t try to stop all coughing and defecation in infants with this rationale; there’s no reason to invoke it to stop all crying, either (I’m sure parents of colicky infants will be much reassured now).

There is an unused reference (#18) in the list. I’m sure you can figure out why it, too, does not prove CIO can harm babies. ;)

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30 Responses

  1. Thank you so much for the informative post!

    I have been reading quite a bit lately about the dangers of sleep deprivation (even in small amounts) for kids and adults.

    I find many of Sears’ advocates look at CIO as a danger to children at any age – clearly it is not. Most responsbile pediatricians will agree newborns are not ready for a full night of sleep and CIO. These Sears’ advocates do not take into consideration the harmful effects and possibly long term detrimental effects of sleep deprivation for the entire family when discussing CIO and I believe it is essential to the conversation.

    Thanks again!

  2. Excellent post – I hadn’t run across that particular Sears fact sheet before (probably because my sleep trained kid is now a 3 year old who sleeps wonderfully and I no longer frequent sleep problem forums!).

    And KEC definitely hits on what I think is a key point – why, in all of this OMG CIO is the EVIL! stuff, is there never any acknowledgment of the harm that sleep deprivation can do? Even if someday someone manages to show harm from CIO, that harm would have to be balanced against the harm from chronic sleep deprivation (to parent AND baby), which can be pretty severe.

  3. Well, I think the idea is that Mommy needs to suck up for the baby’s good, the baby “instinctively” knows how much sleep she needs, and she’s probably not tired but merely “high needs” anyway, and if you were cosleeping, you’d both be well-rested anyway (even though cosleeping babies have more nighttime awakenings), so if you choose to ‘deny your instincts’ and not cosleep, you deserve what you get in terms of sleep deprivation.

    this press release seems quite on topic; it was presented at the American Academy of Sleep Medicine’s 2008 SLEEP meeting earlier this month. It’s not yet published or peer-reviewed, and I am not entirely clear on whether all the study subjects were reactive cosleepers or some were also ideological ones, so take it with a grain of salt for now:

    Parents spending part of night with infants report poor sleep
    Tuesday, June 10, 2008

    Parental adaptation to infant sleep was poorer when infants spent any part of the night with their parents, even when parents endorsed bedsharing, according to a Penn State study presented at tthe 22nd annual meeting of Associated Professional Sleep Societies.

    Penn State researcher Molly Coutermine studied 45 families with infants between 1 and 24 months. Parents completed measures of parental cognitions about infant sleep and attitudes and practices regarding sleep arrangements. A measure of adaptation to infant sleep was derived from five items that inquired about parents’ satisfaction with infants’ sleep location, and bedtime and nighttime behavior.

    The results showed that the adaptation scores of both fathers and mothers were highly correlated. Parents whose infants spent any time with them at night had poorer adaptation scores that did parents who slept separately from their infants. Parents with more lenient attitudes toward bedsharing spent more time with their infants at night than did parents with less lenient attitudes. Interestingly, however, more lenient attitudes toward bedsharing were associated with poorer adaptation in both mothers and fathers.

    “In a culture that is typically not accustomed to co-sleeping, parents who choose to co-sleep for their child’s well-being may be doing so at their own expense,” said Countermine, who is a graduate student in human development and family studies.

    • You’ve got to be kidding me. I am all for cosleeping but my child does not like it unless it’s cold out. We nurse and I bring her to bed, but after that, she fusses. So to assume cosleeping works for everyone is a bit ignorant.

      .. and I am stumped as to how you are using that article in support of cosleeping? Did you not actually READ it?

  4. In fact many non-reactive colseepers do argue that families would sleep better in general if they adopted the family bed. I do not believe research has supported this claim. I’ll come back and post a link to some studies I have read on this.

    In my personal experience, refusal to CIO and co-sleeping led to a 10 year old who did not sleep through the night until at 10 1/2 he was allowed to CIO. He has slept through the night since. In the meantime the entire family suffered sleep deprivation.

  5. I wish I had found this blog or something like it two years ago and saved myself a lot of sleep deprivation. Sigh. I really believed this stuff, and I consider myself a critical thinker. Somehow because the A.P. stuff *sounded* plausible I didn’t bother with the due diligence like actually reading the research.

    My daughter is now 3 and still a poor sleeper. However, we have at least established some boundaries and I certainly get a lot more sleep now than when she was co-sleeping and nursing all night long. I will not be co-sleeping with any future children. I wanted it to work SO BAD. But it is just not right for our family. I hate that I felt so guilty about finally putting my daughter in a crib.

    I never have let her CIO, it rips my heart out even now to hear her cry. That’s the part of sleep training I still don’t understand.

  6. Elizabeth,

    I’m writing this blog because I couldn’t find anything similar when my children were babies – only messageboards (even supposedly “mainstream” ones) where APers ruled the roost, and pointing out their views were unsupported by the evidence earned one only flames. I hope you find the info here useful and welcome :) .

    I don’t presume to tell you what to do – CIO or not – but children crying is a fact of nature. We simply can’t meet kids’ wants all of the time, nor should we. I didn;t enjoy CIO any more than I enjoyed their cries of pain when they were vaccinated, but since I felt it necessary I grinned (OK, grimaced) and bore it, knowing it was temporary and would ultimately be for my child’s benefit. Not that this is an exact parallel, but when they were little and they whined for a second treat (they usually got one if they behaved), it was hard to resist as well…but it would have been very unhealthy if I’d just decided I can’t listen to their crying anymore and given in.

  7. James McKenna, an advocate of co-sleeping, has claimed that both mother and infant have less deep sleep and more night awakenings.

    http://pediatrics.aappublications.org/cgi/content/abstract/100/5/841

    Of course, he wrote this paper in defense of co-sleeping as a preventative measure for SIDS due to the lack of deep sleep and sensitivity of mother and child to each other’s movements during the night.

  8. An interesting article on children’s sleep.

    What is interesting is there is little mention of children who are sleep-deprived due to “child-led” parenting but the consequences are the same as a child who is over-scheduled and unable to get enough sleep:

    http://nymag.com/news/features/38951/

  9. 60 Minutes show discussing some of the latest research on sleep. There is a transcript as well as a video link to the show:
    http://www.cbsnews.com/stories/2008/03/14/60minutes/main3939721.shtml

  10. I think it might make sense to be in close proximity to a newborn in order to prevent the kind of deep sleep that is a possible risk factor for SIDS. However once a baby is out of the SIDS danger zone it is pretty exhausting to feel like neither you nor the baby are getting into a deep sleep because of being too close. The McKenna research makes sense to me but for me it is not an argument to co-sleep, especially not past the sensitive first months.

  11. Close proximity need not be in the same bed, however, which can be risky in and of itself. There is no conclusive evidence sharing a bed (as opposed to sharing a room) reduces SIDS/SUDI, and is probably a risk factor for it in the early months.

  12. I like something like the Arm’s Reach Co-Sleeper. It’s called a “Co-Sleeper” but it’s really just a side-carred bassinet. The mattress is not flush with the adult bed, either, so there is little danger the infant will roll onto the adult bed.

  13. I completely agree, and have said as much in one of my post regarding cosleeping. But many cosleepers (the people, not the items), instead of acknowledging this to be the perfect method of having your cake and eating it too, tend to get all defensive when confronted with the fact that bedsharing can be risky.

  14. I co-slept (we had a co-sleeper, but in reality I literally held my son all night) until he was 6 months old.

    My son was very premature, and even though he was on an apnea monitor, I was incredibly nervous about letting him sleep more than a foot from my bed.

    Anyways, he did very well with this until about 6 months when he started getting very wiggly and we started having issues with him wanting to be held, yet also wanting space.

    We tried to simply move him to the co-sleeper in bassinet mode, but he just couldn’t sleep with us in the room with him yet not physically holding him.

    We moved him out of our room and into his own and used the Ferber method. Within days he was falling asleep on his own and sleeping through the night.

    He is now a wonderful sleeper at 3 years old. We put him to sleep at night, and unless he has a true need, he stays in his room and falls asleep.

    I’m currantly pregnant with number 2 and the plan is to keep the baby in a free standing bassinet beside our bed so we don’t fall into the “holding the baby all night long” routine. I don’t doubt that the co-sleeper is good for some people, but our son was never content in it, and I think it was counterproductive to establishing good sleep. We’ll see how it goes this time around.

  15. Best of luck, Lauren :) . We used a bassinet with mesh sides – the better to see the baby when you’re lying in bed, and if baby wedges against the side of this kind of bassinet – no harm done.

  16. I’ve found that co-sleepers always talk about how wonderful it is and how they and their babies get so much more sleep because they co-sleep, which is really funny because my daughter has been sleeping through the night since she was 2 months old (except for the occasional wakening, but that happens less than once a week.)

    AP preach that breastfed babies have to wake up multiple times per night, so co-sleeping is the best option. However, I think in most cases the multiple wakings are caused by the co-sleeping rather than mitigated by it.

    I personally am not a fan of CIO, but I don’t consider it abuse nor do I think it causes deep-seated emotional problems that will haunt children for the rest of their lives.

  17. Esther, I’m not sure how much of the increase in night wakenings is real, and how much is simply the fact that the co-sleeping parent is aware of it. I’ve done both, and had insomnia to boot. When my daughter slept in another room, she still woke up. I know, because I was in the next room reading or using the laptop and heard her. The difference is that she roused briefly, turned over, and usually went back to sleep.

    Many co-sleeping parents have little confidence in babies’ ability to do this, and treat every waking as a “he’s hungry”. They end up trapped in a cycle of night feedings, exacerbated by the fact that baby can smell the milk and knows how to get it. I know co-sleeping, BF’ing parents who are still night feeding at 2 and treat this as normal–and even say night weaning is cruel. I had to formula feed, and while I know that formula means longer sleeps, it was beneficial in that I had to learn more about how to soothe her.

    I don’t think Ferber is as bad as some other methods (Weissbluth seemed absolutely cruel from what I read) but it gets an awful name because of 1) parents who try it too early and 2) parents who persist with CIO when it clearly is not working. The stories about parents who persisted till the baby was sick can provoke a visceral reaction in many people.

    I freely admit that I didn’t CIO because 1) my child is a stubborn creature who WILL cry for an hour and 2) I am a softy. But I don’t think controlled crying is equal to just leaving baby to cry for hours.

  18. IIRC, the greater amount of night wakings for cosleepers was determined by video or polysomnographic data, not parental reporting.

    And I am certainly not promoting old-style, til-you-throw-up, hours long CIO, though it is, technically, an effective way to sleep train. Nor do I think CIO works with every single baby (nor does Ferber, as far as I can tell). I do think it’s a very effective tool for many babies, and it shouldn’t be dismissed on shoddy evidence of harm as presented by Dr. Sears.

  19. The problem with this post, as I see it, is that CIO is defined as this anodine little 5 to 15 minute foray into crying. Unfortunately, I know many, many, many people who let their babies cry much, much, much longer than that. On person I know was letting her baby cry for 4 hours…that’s right, 4 hours, and still the baby was not going to sleep. The problem with CIO is that people don’t just do 5 to 15 minutes, and it encourages a sort of us (parents) vs them (babies) approach. I know many families deeply entrenched in this battle, and the babies are “winning”, crying for hours on end every night. Extreme, you say. But happening all the time.
    And BTW, co-sleeping children generally learn to sleep through the night just fine. If they don’t, there must be some other issue going on.

    • If you’d read my comment above yours, you’d know I don’t see CIO as a panacea, nor do I recommend letting babies cry for 4 hours non-stop. I don’t think that even then, though, the harm threatened by Dr. Sears will ensue.

      And co-sleeping children often don’t learn how to sleep through the night as fast as solitary sleepers. Look at AP-friendly websites that are populated by mothers still nursing their cosleeping 2yos every 2 hours and tell me it’s just as sleep-friendly to exhausted parents. Extreme, you say. But happening all the time. ;)

  20. I think ehaugsjaa sets up a straw man (wow what a surprise) by discussing this extended period of crying. How do you know all these people? Are you at their houses? What sort of place do you live? I am really sick of this 4 hours of crying junk. It’s imagined and, people, needs to stop. If you’re aren’t happy with your way of doing things without imagining stuff that horrible other people are doing then why is it so great.

    Normal people are just fine with the way they do things and don’t have to dream up weirdo torture dungeon scenarios. Your pathetic.

  21. You’re pathetic, that is.

  22. Hi. I don’t have a strong opinion about CIO as a practice in general – in fact I was pointed at this site by a comment on a post I just wrote asking parents to chill out over the whole Baby Sleep Wars.

    But.

    You seem to be making some of the same kinds of rhetorical moves your criticizing Dr. Sears for, in this post. For example, your argument that infants don’t cry for prolonged periods during sleep training is…well, far from universally accurate. CIO sleep training works well for some babies and not for others. Sears is taking the worst case scenario, you’re taking the best. Both without data to back it up.

    • Let me quote myself :

      Sears would like to pretend that CIO involves months of endless crying, but the reality for most parents is a few nights of crying episodes which get shorter and shorter until the baby realizes that being put in bed means they need to sleep, which is, generally speaking, a week or two at most (if it doesn’t work by then, it’s probably time to try something else).

      In which I state the typical scenario (not the extremes – sure, there are infants who CIO for 1-2 nights as well, but that’s not the usual experience), that it may not work in that time frame and if not – try some other method.

      How is that ‘taking the best case scenario’ or indulging in the type of outright trickery Sears does?

      • A vast (VAST) number of parents who use CIO techniques leave their infants crying for several hours on end (we’re talking 2 – 6+ hours, non stop). If your own defensiveness about techniques that you’ve used yourself means that you refuse to acknowledge this fact, then this entire resource is far too biased to ever be taken seriously. You ARE indulging in trickery, by claiming that practicioners of CIO only let their babies cry for short bursts, over a small number of nights. Maybe that’s true of how YOU did it, and maybe it isn’t, but I can tell you for CERTAIN it’s not how all CIO parents do it – or even the majority of them. It’s a lie.

        To be frank, some of what you’re saying is absolute nonsense. “The baby realises that being put to bed means they need to sleep”? A young infant is not by any stretch of the imagination capable of such complex thought. They don’t know what “going to sleep” entails, it’s just something that happens. They don’t know what “bed” is, it’s just another place to lie down. They DO know what crying is for: that’s instinct. Crying is how they let their parents know that they need them. They also know what those cries being ignored means. They can learn that no one is coming, and that there’s no point crying, no matter how much they NEED their parents. Instinctually, continuing to cry is dangerous, so they stop. They give up. They lie still, quiet, alone and broken. Trying to argue this as a positive is ridiculous: “giving up” is something that is thought of as a negative in pretty much every aspect of a person’s life. We don’t want our children to be the type of people who give up hope… except when it comes to sleep training? How does that make ANY sense? Parents talk about “winning the battle” when it comes to their babies and sleep. It’s twisted. But then, some parents love nothing more than “winning battles” against their children throughout their entire lives. Such is our selfish western mess of a society.

        You are so aggressively PRO cry it out that I can only possibly attribute it to defensiveness. People are telling you that something you did with your kids isn’t the right way: and you don’t like that one little bit. I say tough. I say suck it up and accept that a lot of parents will never leave their children to cry themselves to sleep, and a lot of people don’t like that anyone does it. THAT fact is something that gives me a tiny glimmer of hope for this self-centered mememememe world.

        • Oh my, so full of righteous anger, aren’t we?

          I don’t think you have any idea what the VAST majority of parents are doing WRT getting their children to sleep. And even if what you said were true (and I don’t personally approve of it), there is still no evidence of any harm coming about from cold-turkey CIO.

          And yes, I know Sears makes that stupid claim about how babies just give up and become a mass of abjectly miserable protoplasm as a result of CIO. He has about as much evidence for that claim as for anything else he claims in this handout I analyzed above. Just because it reeks of ‘truthiness’ to you doesn’t make it true, you know. The very fact that most CIO’ed babies wake up the next morning well-rested and cheerful would tend to belie your pet theory. But hey, why look at facts when you have drama?

          And the last paragraph is just hilarious. I’m not “aggressively pro-CIO” – if you don’t want to do it, then don’t. I’m very aggressively anti-misinformation, however, which is what you and Sears are attempting by guilting parents out of an effective method of getting your child to sleep based upon nothing more than your personal prejudice and projection of YOUR hangups onto a baby. Well, you and your ilk have had the run of the Internet long enough, and it’s about time for a change. Good thing I’m no longer the only one to call your type on their BS anymore!

  23. So it seems then the author of this article is supporting a controlled crying method as oppose to actual CIO. Going in and checking on the baby every 10-15mins or so is what they call “controlled crying”.

    Yes people really truly do and will let a baby CIO for hours and hours with no comfort or even checking on them but then are “attached” during the day…it does happen. My sister let my nephew CIO for 6hrs b/c CIO “as best for him” I think people can totally take it to the extreme.

  24. Great article! I will be cross linking this on my blog if that is ok. (www.mybabysleepguide.com)

    Here is another great post about the truth of research and cio:
    http://www.mybabysleepguide.com/search/label/cry%20it%20out

    original post here
    http://bedtiming.typepad.com/bed-timing/2009/06/what-are-the-longterm-outcomes-of-letting-your-baby-cry-while-sleeptraining.html

  25. I know this blog is a few years old but it is still relevant and helpful so I thank you. I find that it is becoming increasingly frustrating to defend oneself from the ever increasing and aggressive Dr. Sears Fundamentalist! Being an academic I get very annoyed by the manipulation and misrepresentation of academic work. Most people see the ‘Dr’ and assume what is being said is correct.
    I personally used CIO to great effect; granted I was very lucky from the off with my son, who even though was breast fed never woke during the night. From the moment of birth I got a minimum of 7 hours sleep out of him. Where I found CIO to really help was at around 14 months I transferred my son into a toddler bed, I know that seems young but it was a lesser of two evils. In the morning instead of crying to be lifted out of his cot he would climb out himself, my fear was that he would fall from the height of the cot sides. That was when the going to bed issues started. In the cot with means to escape he was quite happy to lie down and sleep but once in the toddler bed he would run around the room and cry. Obviously he wasn’t happy with the new sleeping arrangement and so we would stay in the room with him, reading him stories, talking and telling him that it was time to sleep. We would do this for around 15mins ending with a night night kiss and telling him he was loved. For the first night he cried and cried felt like forever and broke our hearts (it was actually about an hour). We would go in and lift him hug and kiss put back in his bed and leave every 10 mins or so, by the end of a week he was happy to have his story and night night kiss and cuddle and sleep. Still at 2years and 8months he has his story and sleeps without issue. So in our context CIO worked very quickly and effectively.

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