Babies and CIO

I've gotten a couple of questions and comments lately asking about my well-publicized stance on the CIO (cry-it-out) method of getting your baby to sleep. Pretty much everyone knows that I'm opposed to CIO. But I think it's important to clarify what I consider CIO, and why I really dislike it.

(If your baby is around 4 months, 8 or 9 months, or 18 months, read my post about "sleep regressions" once you finish this post.)

I think* that there are a couple different kinds of babies. There are babies who release tension by crying, and there are babies who increase energy by crying. If you treat them both the same way, you're going to have trouble, so it's key to figure out which kind of kid you have.

A kid who releases tension by crying will not always nurse or be rocked down to sleep. It may happen sometimes, but often times the kid will get progressively more active and jittery, almost manic, as the nursing or rocking session goes on. He or she may cry during the rocking/nursing, and not settle down in a few seconds. It's almost as if the kid wants to cry. If you leave the child alone, the child will wail initially (for anywhere from a few seconds to a few minutes), but then settle down to a fuss or whimper, and will soon fall asleep. A child who releases tension from crying will often wake up happy and refreshed, and will play alone in the bed, co-sleeper, or crib for awhile before you come to get them.

A kid who gains tension by crying will go to sleep easily (and maybe exclusively) by nursing or rocking. It may take awhile, but rocking/nursing is a sure, gradual path toward relaxation and sleep. If left alone before s/he's asleep, s/he'll start to cry. And will cry and cry, increasing in intensity until the child goes hoarse or throws up or you give in and go to comfort him or her. Many kids who increase tension by crying, even if they go to sleep peacefully and happily, will wake up crying or grumpy and need to be gotten immediately from the sleeping area.

If you have a kid who releases tension by crying, the child seems to need to fuss or cry a little before falling asleep. If you don't recognize it, you'll be miserable. You can rock and rock and rock, and your child won't go to sleep easily and will end up crying anyway, but you'll think you're doing something horribly wrong that you can't comfort your baby to sleep. In reality, the child just needs to release tension by crying or fussing, and will go to sleep easily after a few minutes of this.

If you think this might be your child, see what happens if you say goodnight and walk out of the room for a few minutes. If your child starts to quiet down after a minute or two of initial crying, you've got a tension-releaser. Adjust your routine accordingly. (Some parents I know don't want to leave a baby to cry alone ever, so they assign one partner the duty of sitting silently in the room being a comforting presence while the child fusses to sleep, but not interrupting the child's fuss-to-sleep routine. Other parents just say goodnight lovingly and walk out, knowing the child will be asleep in a few minutes.)

Fussing to sleep, or crying to release tension to fall asleep, is not CIO by my definition. CIO is forcing a child to cry until the child falls asleep, even when the child is clearly in distress and gaining tension from the crying.

If you have a kid who increases tension by crying, doing full-blown CIO is, in my opinion, cruel. The books will tell you that letting your child scream and scream is teaching your child to go to sleep on his or her own, but let's be real. Teaching involves showing someone how to do something, and staying with them until they learn. Would you just send your child out alone on a two-wheeler bicycle with no help and practice? Then why would you just decide that since the child is x months old or x weight, it's time to just let the child cry and cry until the child shuts down and falls asleep out of self-defense? It makes no sense. And it can be dangerous to the children.

A kid who builds tension by crying will get progressively more and more upset by crying, and the effects last longer than just that night. There's an American study showing that these kids maintain this tension, and that CIO "changes the nervous system so they're overly sensitive to future trauma." There's a British study showing that lengthy periods of crying can cause brain damage. I'd be interested in seeing a study that figures out if kids who were forced to do CIO have higher rates of insomnia in later life because they associate going to sleep with intense trauma.

Take a few days or weeks to figure out which kind of kid you have, and it will simplify your life immensely. You can try the go-in-every-10-minutes thing and see if it seems to be helping the child relax or making the child more tense. If you have a kid who releases tension by crying or fussing, then that's going to be incorporated into your bedtime and naptime routine (although even releasers will sometimes go down easily and without fussing if you happen to hit the exact sweet spot of time and tiredness). And if you have a kid who gains tension by crying, then you know that CIO isn't even an option to consider for you, as it won't work for more than a night or two without making you both miserable (and maybe causing later problems). You'll have to use other methods to get your child to sleep. It may take longer than you want it to, but it will happen, and eventually your child will go to sleep easily and happily, on his or her own.

(Incidentally, I thought this was all crap when my first son was my only child. He was and still is a kid who increases tension by crying, and if I had let him cry for more than a minute we would have been up all night recovering from it. But then his brother came along, and he'd cry himself to sleep while he was nursing. He needs to be left alone to fuss himself to sleep most nights. When we're in the stroller he'll start wailing out of the blue, then be dead asleep 30 seconds later. I was stunned, but then it all made sense to me that people would talk about how CIO was the greatest thing ever. It wasn't that CIO was so great, it was just that their kids needed to fuss to sleep. As usual, the assumption that all kids are the same was causing huge problems for everyone.

Oh, and my first son, who gained tension by crying, goes to sleep on his own almost every night, with nothing more than a hug and an "I love you, Mom." So even "bad sleepers" will turn good eventually if you listen to what they need.)

* And reading the new Mary Sheedy Kurcinka book about sleep, I found that MSK thinks the same thing, too, which made me beyond happy because she's the most knowledgable parenting expert I know.