C.I.O. is the most famous sleep training technique, and the most controversial — although, despite its daunting name, it is safe and effective. In its simplest form, unmodified extinction, you place your infant down at bedtime, drowsy but awake, and then leave the room, without returning to check on or soothe your baby. This method will work quickly, but often produces prolonged periods of crying for a few nights, which can be difficult for parents to tolerate.
Honestly, in our personalized consultations, we try to avoid this method as much as possible. If you are going to use cry it out, we recommend your baby is at least 6 months old, but preferably 10 months or older, when we expect almost all babies to be able to get through the night without a feeding. It is not for the faint at heart. We find that laying a foundation in the beginning with other strategies and techniques can reduce crying even if this method is used in the end, however.
As you might suspect, this method can be very difficult, depending on temperament, and can take many days or weeks. It can be difficult to avoid engaging with your child (and “watching them cry” is very difficult), and it will likely be a little confusing to the child (particularly younger ones) when you don’t. However, with time and consistency, this can be a good option for parents who do not want to leave their child alone to cry but who haven’t had success with other methods, either.

Sleep experts who support the cry it out approach (as well as most pediatricians) disagree. They say it isn't traumatic for babies to cry alone for short periods of time with frequent check-ins by Mom or Dad – and the end result is a well-rested, happier child. They say no tears sleep strategies may cause babies to be overly dependent on comfort from a parent at bedtime, making it harder for them to learn to soothe themselves to sleep.
Typically, formula-fed infants who are growing well no longer need to feed at night by 6 months. Breastfed infants may continue a little bit longer, but typically no longer feed at night by 9 months. If your baby has been falling asleep independently at bedtime for a month but still waking to feed, you may want to consider weaning at night. Be aware that if you are breastfeeding, this may lead to a reduction in milk supply.
This is a very gentle, no-tears/no-cry (or very little cry) method of sleep coaching where you “fade it out” (FIO). With the Fading method, you continue to help your baby fall asleep (by rocking or feeding to sleep, for instance), but over time, you gradually do less and less of the ‘work’ to put your baby to sleep, and your baby does more and more. For instance, if you normally rock your baby completely to sleep, you may shorten the amount of time you rock each night until you are rocking for only a few minutes only as a part of the bedtime routine. This method requires quite a bit of patience on the parent’s part, in some cases, but it’s great for families who want to minimize crying as much as possible.
Some families opt to hire a sleep consultant or sleep coach to help them with sleep training. Just like deciding what sleep training method is best for your family, the decision to hire a sleep coach is a completely personal one. We talked to Rachel Turner, a certified sleep consultant and owner of Hello Sleep, and asked her how why a family might consider hiring a sleep consultant. Here's what she had to say: 

Finding the ideal bedtime can be tricky in the first few months of life. Infants who take a late afternoon nap (say, 4 to 6 p.m.) may go to bed as late as 9 or 10 p.m. A good rule of thumb is that your baby will probably sleep three to four hours after his last nap ends, but you may need to experiment, adjusting your baby’s nap and bedtime schedule to figure out what works best.
It’s okay if you’re not ready. You aren’t missing out on sleep training if you skip it at 4 months: You truly can start sleep training at any age, even in the toddler years, although experts say it’s smart to be aware of developmental milestones and adjust baby’s sleep schedule accordingly. For example, the week baby learns to walk may be tough to implement a sleep-training schedule, and even a sleep-trained baby may see a regression simply because he’s going through such a developmental shift.

Singing a few lullabies to set the mood, put her down while she’s settled, she’ll play with her hands and feet for about 10-15 minutes, she starts fussing so I give her a chance to settle (but never does), then it turns into full blown crying. I try to lull, shush, pick up and rock but it doesn’t help. It seems like she doesn’t want to be held nor put down. After crying so much that she turns blue and me rocking the life out of myself she falls asleep. I can’t put her down until she is in deep sleep otherwise she will wake.
Cry It Out: This method involves putting your baby into the crib drowsy, but awake. The goal is for your child to learn to fall asleep without your help, so that when your baby inevitably wakes up in the middle of the night, he or she will be able to go back to sleep on his or her own. You say goodnight and leave the room—even if your baby cries. Then, you go back in at increasingly long intervals to briefly reassure your baby. It can be difficult to listen to your baby cry, but parents who have been successful with the technique report that it results in fewer tears overall and more sleep for everyone.

In clinic, I help parents with their children’s sleep problems. But in my own home, I found it challenging to apply the techniques I recommended to others. What seems obvious in a brightly-lit exam room is harder to follow at 2 a.m. Like many pediatricians do with their own children, I elected to try extinction sleep training, which involves letting a child cry in order to learn to soothe himself to sleep on his own. Night one was relatively easy, but night two left my wife in tears and me feeling like a heel. Things improved on night three, and our son scarcely cried on night four. By the end of the week, he was sleeping through the night again.


After going through your bedtime routine, put your baby in their crib, leave the room and wait a specific amount of time (say, a minute). Then go in and reassure your baby with words like “Mommy loves you” or some kind of touch, such as a rub or pat. McGinn says it’s preferable not to pick the baby up. Garden, on the other hand, reserves this method for babies seven months and older. (In her opinion, younger babies require a parental presence so they know they haven’t been abandoned, especially if they’ve worked themselves up into a frenzy.)
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