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We have several questions on this site that deal with infants and toddlers who cry a lot, for various reasons. Here is an example question and example answer, another answer. The topic was raised on the Skeptics site but no answer was provided. Perhaps we can find a good answer on our site here.

There are two basic approaches:

  1. Leave the child completely alone until the crying stops. <-- This is what I want to address.
  2. Leave the child for only a short moment and then return. Repeat with increasing absences.

Is it likely to harm an infant/a toddler to let him intensively cry until he stops on his own?

To elaborate, I have some additional questions:

  • At what lower age/development limit would the practice be acceptable, and why?
  • What factors could help determine whether the practice would work on a specific child?

For the purpose of this topic, let me define "crying" as real, full-strength, all-out, non-verbal mommy-daddy-come-help-me crying, not just whining or whimpering. Every parent knows his child and will recognize when the child really cries -- that is what I mean here.

Also, let me define "harmful" as not just transitory sadness but rather something where one could expect negative mid-to-long-term effects such as trauma, separation anxiety, lack/loss of trust in parents and others.

The crying could be related to bedtime/sleep but also during daytime when the parents aren't near.

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Your question is extremely well thought out and complete. Therefore it requires a complete answer, which I will try to provide at a later date, when I have some time to flesh it out. Good job on a great question. –  morah hochman Dec 7 '11 at 0:01
    
Thank you @morah. I fear this might be a controversial topic, so I tried to make it as precise as possible. –  Torben Gundtofte-Bruun Dec 7 '11 at 5:39
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You may be interested in this article from Parenting Science which discusses some of the evidence surrounding the Ferber method: parentingscience.com/Ferber-method.html –  Doug T. Dec 7 '11 at 18:26
    
Anecdotal, but I know some parents who let their child 'cry it out' and discovered him the next morning lying in a pool of dried-out vomit... –  Benjol Dec 8 '11 at 5:45
    
Everey kid is different. I agree that it can't be a good thing to leave your child screaming. That doesn't mean that it is a bad thing, but it seems to me pretty obvious that any cry it out method is a last resort, when you just can't do anything else. –  Lennart Regebro Jan 10 '12 at 22:05

6 Answers 6

up vote 6 down vote accepted

Preface: If you are reading this page because you are trying to decide how to handle your child's sleeping, please go and read the link that Doug T provided in a comment on the question (http://www.parentingscience.com/Ferber-method.html), there is a lot of good advice and plenty of creative ideas on how to handle your children's (non)sleeping.


At the risk of getting shot down for being subjective (I can't see anyone doing clinical trials on this topic...), I'll have a go:

I'd say that mid-to-long-term effects are plausible if you consider that a person's psychological make-up is a continuum built from acquired experience. The child - and all their experiences - don't just cease to exist when they become an adult, even if they can't remember all those experiences.

The idea that kids are robust little critters who can bounce back from anything has been around for a long time, and it's definitely got history on its side. But then, not so long ago, babies were operated on without anaesthetic because they weren't considered 'conscious' enough to feel pain. (Like fish, or something! I can't find a source that I like for this, but there are a lot of references out there).

Obviously, it's easier for us as parents to believe that our kids are going to turn out ok no matter how much we screw up, but that doesn't make it true. And going to the other extreme is no good either.

I think kids can bounce back from isolated negative experiences - just like they can bounce back from a bad night, or a childhood illness. But the problem is with repeated negative experiences, which are far more likely to drill their own negative paths into the child's neurons...

Here's what I suspect might happen in the case you outlined:

What does it teach you when your mommy-daddy-come-help-me screams result in nothing happening? Well it could teach you that you are alone in life, and that the universe is a cold, dark, dangerous place*. I wouldn't expect that child to grow up into someone with a sunny and optimistic outlook.

*Obviously, you may actually believe that this is true, so the child has learnt a valuable lesson: did you by any chance cry yourself to sleep when you were a baby? :)


EDIT Found the book I was thinking of: "Why love matters, how affection shapes a baby's brain" by Sue Gerhardt. Note that it's too long since I read the book to assert that what she says supports what I wrote above. But it's definitely an interesting trip into the frontier between experience, emotion and brain chemistry.

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Actually, there has been research on the long-term effects of stress on the brain, I'll see if I can find the references... –  Benjol Dec 7 '11 at 15:00
    
I read the reference to the "mommy-daddy come help me" differently. I don't think it literally means the baby is saying the words, if so, in my opinion you have waited too long to teach your child to sleep. I thought more it was the crying that the parent is translating into meaning this, which might not be what it means at all. –  morah hochman Dec 7 '11 at 15:26
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Is crying itself a negative experience? If so, then all babies' lives are filled with negative experiences. Screaming "mommy-daddy-come-help-me" and not having your parents come would only teach that the "unvierse is a cold, dark, dangerous place" if the child actually needed help, and something bad happened because help did not arrive. Isn't it just as valid to say that that situation would teach a child that sometimes you're afraid when there's no reason to be, and that facing those fears alone can work out okay? –  Beofett Dec 7 '11 at 15:37
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@Beofett, I'm not sure that from a baby's perspective they ever 'cry for no reason'. In that situation, the only way in which I would expect a child to learn that there's no reason to be afraid is if someone comes and tells him so, which is the second case which Torben seems to have explicitly excluded in his question... –  Benjol Dec 7 '11 at 20:40
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There are clinical trials on the effects of stress on babies, and actually there ARE studies on CIO. See this link for a summary. –  justkt Jun 25 '12 at 14:54

You asked this question has it related to infants and toddlers, and I warn the two age groups are drastically different.

An infant has not yet developed emotional context. Therefore, their cries always mean something. It's a signal of distress and needs to be addressed by the caregiver. Where as, a toddler has emotional context and can cry for many different reasons.

I don't personally recommend letting an infant cry it out, unless it's required to allow the caregiver to rest, or the caregiver finds the crying will cause them to treat the infant in a harmful way. In which case, it's more important that the care giver step away from the situation.

Crying never harmed anything.

When an infant cries for a long period, they start to produce higher levels of the stress hormones Cortisol. Which I don't think is good for an infant.

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I found this interesting article about the topic: http://www.psychologytoday.com/blog/moral-landscapes/201112/dangers-crying-it-out. It essentially says, don't let your baby cry it out. Letting your baby cry it out undermines their development. The article says that the whole cry it out approach is based on outdated ways of thinking, such as that it is a bad idea to touch your baby because you could give him or her germs.

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There are actually more than 2 methods of teaching a child to sleep through the night. The 2 you mentioned are both considered CIO. There are several variations on this as well as gentler methods such as those based on behavioral fading (Kim West's Good Night Sleep Tight for example)

The fact is that some children are going to be easy to sleep train with any method. Others may have more challenging temperaments, sensory issues, inconsistent experiences or have another issue that can effect sleep such as allergies, apnea, low weight, feeding issue, reflux and asthma.

Sleep training should not be attempted before 4.5 months - 6 months + is preferable.

I am not comfortable with a child crying for more than 1 hour straight without being calmed and would not recommend leaving your child in a room alone to cry themselves to sleep.

We want children to learn sleep skills such as self-soothing, not to exhaust themselves to sleep or give up because no one is responding.

Whichever method you choose here are some key principles:

  • PLEASE keep in mind that if you do not see results in at least 5 days your plan is not working. Stop.

  • Bedtime, naps, environment, managing feeds, bedtime routine etc. are key components for success and to make the process easier.

  • Be consistent

It's a good idea to have a clear plan before starting and a clear idea of how you will respond if things don't go as planned.

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I think there's too many factors at play to determine the proper age to use cry it out. And since babies can't talk, I don't know if there are any factors that would say "this will definitely work" or definitely not work. As with any practice with children, you just have to try it and see. Does it work for the baby? Does it work for YOU?

Here's my experience:

My daughter is now 4, and we used the cry it out method. Turns out as an infant, she just needed more food throughout the night. Once we provided that, she cried at night less often. At around 2, she started in again, possibly due to night terrors (babycenter.com has some great articles on this), and we let her work it out herself to learn "self-soothing". This was not every night, just once in a while. Eventually the crying stopped altogether, at around 3 years.

I also agree that infants rarely cry for no reason. My answer would be "If it cries, feed it!"

Now my son, who is 2, has started waking up at midnight and 4am, and sometimes at 5 or 6am. Probably night terrors again.

And, sometimes I let him cry it out to have him learn self-soothing, but sometimes I bring him into my bed to sleep (this also helps his sister, who shares a room with him). This makes me feel better, even though I could pay for it later (some kids really like sleeping with parents).

Again, many factors play into the decision, which is re-decided each night. Do I let him cry each night to maintain consistency in how I handle it? Or is this crying time different from the rest so I should handle it differently?

So is it harmful to let them cry it out? Both my kids appear very happy and healthy. I think it's impossible to trace back the exact cause of any issues kids have when they get older. I wouldn't sweat it.

I also think that probably at around 3 the night terrors should be over, and the child is then crying for "legitimate" reasons, and should be checked on.

I would also check Baby Center to see what other parents have had to say. They have years' worth of data and postings about it.

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I know parents on both extremes of the spectrum, and if there are any long-term effects on their children, I honestly can't detect them. I think if one way was clearly better the topic wouldn't be so hotly debated.

In my experience, the harm is more short term due to the boy-who-cried-wolf effect. When you become accustomed to ignoring their cries, you don't know when they really need help.

However, I also think it's important to take the parents' mental health into account. Especially first-time parents have difficulty with the thought that their baby is uncomfortable, and usually only adopt the cry it out approach after they've exhausted everything else and are driving themselves crazy trying to function on 2 hours of sleep.

Therefore, my advice is to keep your baby from crying too long if you can help it, but don't condemn yourself as a horrible parent if every once in a while you need to let them cry it out.

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