Is Cry It Out Safe for My Baby?
The short answer
Research consistently shows that extinction-based sleep training (cry it out) does not cause long-term harm to babies, attachment, stress levels, or development. A landmark 5-year follow-up study found no differences in emotional health, behavior, or parent-child attachment between sleep-trained and non-sleep-trained children. However, this method is not right for every family, and that is okay.
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By Age
What to expect by age
Cry it out is not appropriate for babies under 4 months. Young babies cry to communicate needs including hunger, discomfort, and the need for closeness. Their nervous system is not mature enough for self-regulation. Always respond to your newborn's cries.
Some families choose full extinction at this age, though many experts suggest starting with gentler approaches first. If you use CIO, ensure your baby is fed, dry, safe, and healthy before starting. Most babies using this method show significant improvement within 3-5 nights, with the first night typically being the hardest.
This is a common age for CIO implementation. Your baby has the developmental capacity to self-soothe. The method involves putting your baby down awake, saying goodnight, and not returning until morning (or a predetermined feed time). Crying typically peaks on nights 1-2 and decreases rapidly. Research shows cortisol levels normalize quickly and are not elevated in follow-up studies.
CIO can work for toddlers but crying may be more intense and prolonged because toddlers can protest more vigorously. Some parents find graduated methods more manageable at this age. If you choose full extinction, be prepared for 2-3 tough nights. Consistency is critical - going in after extended crying teaches your child that enough crying will bring you, which can worsen the process.
What Should You Do?
When to take action
- Your baby cries intensely the first night and less each subsequent night
- The first night is the hardest with 30-60 minutes of crying for some babies
- Your baby seems perfectly happy and normal during the day after sleep training
- Sleep improves significantly within 3-7 nights
- Your baby cries for more than 90 minutes on the first few nights and you are concerned
- Sleep training has not improved after 7 consistent nights
- You have specific concerns about your baby's health that may affect sleep training suitability
- Your baby is vomiting from crying - check on them, clean up, and restart if you choose
- Your baby sounds like they are in pain rather than protesting
- You are unable to cope with the crying and feel you may act unsafely
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Sleep Concerns
Sleep Training Methods Compared
There are several evidence-based sleep training approaches, ranging from gradual methods with lots of parental presence to more direct methods with less intervention. No single method is best for all families. Research shows that multiple approaches are effective and safe. The best method is one that you can implement consistently and that aligns with your parenting values.
Ferber Method: What to Know and Common Worries
The Ferber method (graduated extinction) involves putting your baby down awake and doing brief check-ins at increasing intervals without picking them up. It is one of the most researched sleep training methods and has been shown to be safe and effective. Check-ins reassure both parent and baby, though some babies find them more stimulating than helpful.
Gentle and No-Cry Sleep Training Methods
Gentle sleep training methods minimize or avoid extended crying by using gradual approaches with ongoing parental presence. Methods include the chair method, gradual retreat, pick-up-put-down, and fading. These tend to take longer than extinction methods (2-4 weeks vs. 3-7 days) but may feel more comfortable for some families. Research supports their effectiveness.
Sleep Training Guilt and Methods
Multiple large-scale studies have found no evidence that sleep training causes long-term emotional, behavioral, or attachment harm to children. Both graduated extinction (Ferber) and bedtime fading methods have been shown to be effective and safe. Parental guilt about sleep training is extremely common but is not supported by the research evidence. The AAP acknowledges that various sleep training approaches can be appropriate starting around 4-6 months of age.
How Long Should Baby Be Awake Between Naps?
The ideal awake time between naps (called a "wake window") increases as your baby grows. Newborns may only handle 45-90 minutes awake, while toddlers can manage 4-6 hours. Getting wake windows right is one of the most effective ways to improve nap quality, because both too-short and too-long wake times lead to poor sleep.
Is a Bath Before Bed Really Necessary?
A nightly bath is not medically necessary and some babies with sensitive skin do better with less frequent bathing. However, a warm bath can be a powerful sleep cue because the subsequent body temperature drop triggers melatonin production. If you include a bath, keep it calm and warm rather than stimulating.