Is the "cry it out" approach harmful?

Question

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.

Answer 1

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.

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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? :)}

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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.

Answer 2

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.

Answer 3

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.

Answer 4

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.

Answer 5

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.

Answer 6

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.

Answer 7

Short answer: if the child has a genuine need, crying should never be ignored. If the child is crying willfully or for a selfish reason, it should be ignored. Longer answer:

Sometimes a child will cry when it has a genuine problem or need, like being hungry or soiled. If you anticipate these needs by feeding on a set schedule and changing right away, you can eliminate or at least greatly reduce need-based crying. In any case, when the child has a genuine physical or emotional need, it should be answered.

Other times a child may cry for a wanton desire. For example, the child may want to eat, even though he is not really hungry. He just wants to put food in his mouth for the sake of it. Or he may want to play with something he is not allowed, and so on. It is very important to ignore such crying. If you react to wanton crying he will just do it more to get you to work for him unjustly.

Finally, a child may cry due to a complaint. For example, if you put a small child to bed and he is not tired, he may cry and complain. Or perhaps you confine him in a crib, and he cries because he does not want to be trapped in a crib. These are legitimate cries, because by doing such things you are answering your needs, not his. If a child is crying because you are imposing on him in some way, ask yourself, "does he really need this, or am I doing this for my convenience?"

When a child cries out of loneliness or isolation, it should always be answered and comforted. For this reason, it is wise to let the child sleep with you until it moves out on its own. Putting young children by themselves in empty rooms or remote cribs for long periods of time is traumatizing and should never be done.