Cry Out Sleep Training for Baby? What Scientific Studies Reveal about the Impacts on Children and Parents

There are pros and cons to using this cry-out approach in which parents ignore the baby’s crying at night except to ensure his/her physical well-being.

In terms of effectiveness, based on 3 studies, the results show that after using this approach for 3 months, most babies can sleep through the night. One study indicated that 20 out 23 babies who originally had sleeping problems could sleep through the night after using this approach for 3 months.

People may think that this kind of training could affect the child's emotional well-being, but based on 1 reviewed longitudinal study, sleeping training during infancy has no long-term negative influences on children’s mental health, behavior problems, or parent-child bonding. 

However, one study indicates that this "cry-out" approach can be distressing to parents and so is difficult to implement consistently. Therefore, a modified cry-out approach is suggested which involves “the parents staying in the child’s room at bedtime but ignoring the child and his/her behavior. Some parents find this approach more acceptable and are able to be more consistent.”

Created on November 21 2015 at 08: 00 AM

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Details of Scientific Answers: Click on each bullet to Read References



1: "Reducing Nocturnal Awakening And Crying Episodes In Infants And Young Children: A Comparison Between Scheduled Awakenings And Systematic Ignoring," Pediatrics, 1988, by VI Rickert, CM Johnson. (Citations: 183).

Infants and toddlers (N = 33) exhibiting spontaneous awakening and crying episodes during the night were randomly assigned to one of three groups: scheduled awakenings, systematic ignoring or control. Scheduled awakenings consisted of a parent arousing and feeding or consoling the child 15 to 60 minutes before typical spontaneous awakenings. Once spontaneous awakenings were precluded, scheduled awakenings by parents were gradually eliminated. Systematic ignoring consisted of allowing the child to "cry it out" without parental attention except to ensure physical well-being of their child. Children in the scheduled awakening group and the systematic ignoring group awoke and cried less frequently than children in the control group during 8 weeks of treatment and during two follow-up checks, 3 and 6 weeks after treatment. Systematic ignoring was found to be more effective than the scheduled awakenings condition during 1 week of treatment; otherwise effects of the two conditions were similar. Implications of the use of these treatment procedures are discussed.

2: "Management Of Infant Sleep Problems In A Residential Unit," Child: care, health and development , 1994, by R Leeson, J Barbour, D Romaniuk. (Citations: 40).

Torrens House provides a short residential programme for families with a baby (8–12 months of age) identified by parents as having a sleep problem such as waking frequently at night and being difficult to settle. The programme involves the promotion of infant self-settling by the use of a controlled crying technique, together with wrapping, cessation of night feeds and establishment of a day-time routine. Twenty families (with 23 babies) were followed through the programme and for 3 months afterwards. There were significant decreases in the number of times the babies woke, the number of night-feeds and the length of time awake at night at 1 month follow-up, with a reduction in depressive symptomatology of the parents and a perceived improvement in their infants' behaviour. Twenty of the 23 babies were sleeping well at 3 month follow-up.

3: "Treatment Of Sleep Problems In Families With Small Children: Is Written Information Enough?," Acta Paediatrica, 2002, by B Eckerberg. (Citations: 39).

The aim of this study was to evaluate a standardized sleep programme, i.e. a two-step variation of graduated extinction, where the child is first taught to fall asleep by him/herself at bedtime (first intervention) and 2 wk later also after night wakings (second intervention). The outcome after consultations with a therapist followed by telephone support during both interventions was compared with the outcome after giving written information only during the first intervention and therapist support during the second. A total of 67 families with infants exhibiting spontaneous awakening and crying episodes during the night were randomly assigned to either programme. There were no significant differences in terms of outcome between the two groups. In both groups the number of registered night wakings decreased immediately following the first intervention. At registration, at 1 mo and 3 mo later, all parents, with the exception of one couple at the 3-mo follow-up, reported that the sleep problem had improved.



1: "Five-Year Follow-Up Of Harms And Benefits Of Behavioral Infant Sleep Intervention: Randomized Trial," Pediatrics, 2012, by AMH Price, M Wake, OC Ukoumunne, H Hiscock. (Citations: 29).

Randomized trials have demonstrated the short- to medium-term effectiveness of behavioral infant sleep interventions. However, concerns persist that they may harm children’s emotional development and subsequent mental health. This study aimed to determine long-term harms and/or benefits of an infant behavioral sleep program at age 6 years on (1) child, (2) child-parent, and (3) maternal outcomes.


1: "Behavioral Treatment Of Bedtime Problems And Night Wakings In Infants And Young Children," Sleep, 2006, by P SLEEP. (Citations: 383).

This paper reviews the evidence regarding the effi cacy of behavioral treatments for bedtime problems and night wakings in young children. It is based on a review of 52 treatment studies by a task force appointed by the American Academy of Sleep Medicine to develop practice parameters on behavioral treatments for the clinical management of bedtime problems and night wakings in young children. The fi ndings indicate that behavioral therapies produce reliable and durable changes. Across all studies, 94% report that behavioral interventions were effi cacious, with over 80% of children treated demonstrating clinically significant improvement that was maintained for 3 to 6 months. In particular, empirical evidence from controlled group studies utilizing Sackett criteria for evidence-based treatment provides strong support for unmodifi ed extinction and preventive parent education. In addition, support is provided for graduated extinction, bedtime fading/positive routines, and scheduled awakenings. Additional research is needed to examine delivery methods of treatment, longer-term effi cacy, and the role of pharmacological agents. Furthermore, pediatric sleep researchers are strongly encouraged to develop standardized diagnostic criteria and more objective measures, and to come to a consensus on critical outcome variables.


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