10 December, 2012

Pros and Cons of CIO

OPINION
My employers want me to sleep train their 5 month old using CIO. I think this method is incredibly cruel and studies have shown brain damage and its possible link to mental health disorders later in life, and causes issues with trust. How do I educate them of the dangers? - Anonymous

28 comments:

MissWi said...

CIO in my opinion is the only way to sleep train. It teaches the child to know what their body needs and how to respond to it. I know of a nanny who's parents did not let her CIO when she was a child and she has had difficulty falling asleep her whole life.
Every child I have cared for has CIO and it lasted all of 2-3 days before they learned what their body wanted. My current used to require fans that were loud and rocking to fall asleep. Soon after letting her CIO, she couldn't stand the old method of soothing and went right to sleep. At 14 months she is.the best napper/sleeper I've seen.
Maybe it is you that needs to be educated

... said...

My parents did not use CIO with me but did on my brother. I am the one with the mental health issues as well as some emotional. I also had behavioral issues as a child. My brother was the most tame, even keel child ever. He has no issues as an adult.

RBTC said...

what is CIO?

oh well said...

Cry It Out

Nay The Nanny said...

I like the mix method (lol forget what it is actually called.) Where you let them cry a bit, comfort them without holding them, let them cry a little longer, etc. It has proven to work for me and also doesn't seem as cruel because you are still letting the LO know you are there but that its time to sleep. Best of both worlds and eventually they go down without crying at all.

♥ Amy Darling ♥ said...

As a mother who has successfully raised 3 children, I can say if it wasn't for CIO, my sanity would never have existed.

Now as a nanny, I find it annoying when parents, esp. Attachment Parenting ones, instruct me to do certain things so their child will fall asleep easier. I have had to massage + rock children as well as walk back and forth while carrying a child. I also have had to sing certain songs to them just so they could fall asleep.
I believe these are detrimental in the long run because the child only learns to depend upon others to do something that is so natural, they shouldn't need any help in doing it. Yes, falling asleep.

When my children were younger, in order to effectively sleep train them, I had to let them CIO at times. The benefits were that when it was nap time, I told them to go to sleep and they knew what that meant. They had to lie down and close their eyes and fall asleep on their own.

Children do not need to be coddled prior to sleeping nor do they need it during.
They need to learn that sleep is a natural thing and they need to learn to do it on their own w/no help.

Where have you read CIO causes brain damage and mental issues?
None of my children have had any of these. In fact, when I mention I let them CIO as babies, they laughingly say they have no recollection.

Wednesday said...

if my mother hadnt used cry it out with me she would have never made dinner, helped her other 4 kids with homework, sports, whatever and i have no recollection and needless to say no ill will or trust issues towards her either.

I am now helping the family I nanny for sleep train their 6 month old by the CIO method and he has taken to it quite well.

and if I may say so myself, its not really your position to "educate" the parents. you are there to help them care for their child the way they see fit. If they ask your opinion then respectfully present it otherwise, do your job.

Bethany said...

I haven't heard of any peer reviewed research on CIO and long term damage.

All I know is different babies need different was of learning to sleep.

It may help you to feel better about CIO by reading up on. Actually read the book. It's not leaving baby to cry herself into oblivion.

Put your prejudice aside and ask yourself

Is CIO working with the baby?

If it's not you can suggest different sleep training techniques with the parents and let them decide to continue CIO or not.

♥ Amy Darling ♥ said...

Many parents feel that a baby crying is the end of the world. It isn't. Trust me.

wednesday said...

Exactly, Amy. they're tears- not blood!

MANanny said...

There actually is a lot of new research out there that does not bode well for those who support crying it out. Stress levels raise to abnormally high levels when this method is used and remain that way for at least 10 minutes AFTER the baby has finished crying. The reason sleep training works on such a young baby like that is that they have given up. I'm sorry, but at five months a baby is NOT trying to manipulate you-if they're crying, It's because they are trying to tell you something. So what if that something is I want to be held/comforted? For my baby, I want her to feel safe & secure whether that it convenient for me or not. I'll put some links up when I can and I'm not on my phone. Prob won't be till later tonight/tomorrow. I work looooong hours!

Nanny2twins said...

I agree with the previous poster who said that 5 months is to young for CIO. I think there is a time and place for this method, but not yet.

Jane said...

Maybe they're trying to tell you that they are tired and need to go to sleep without all the fussing over them?


Anyway give me the articles?

BTW I am expecting actual journal articles not an opinion piece by a hack psychologist or SAHM with a part time job writing for her blog or yahoo.

Jane said...

5 months isn't too young it's about perfect in my estimation.
Many countries around the world have their babies sleep trained by 3 months old.

Babies also benefit from a well rested caregiver.
OP,
I highly doubt they are telling you to put the baby in a room and let him cry to sunrise.
This is one of the scenarios you keep your mouth shut.
If it's too much for you find another job.

MaNanny said...

I'd love to see some legitimate peer reviewed research that shows the benefits of the Ferber method as it is put into practice today. I'm afraid research and history itself indicates that it's not normal for a baby (in this case, 5 months old) to sleep the hours that is convenient for us. It actually seems to be indicative of our selfish, American society of how we expect our babies to sleep.

I'll be thrilled to share my legitimate, "actual journal articles" whenever I get home!

mananny said...

Jane, what in the world are you talking about? That is something that a hack psychologist or SAHM working for yahoo would say "many countries have their babies sleep trained by 3 months." You are talking about research? Let me see that on paper. Give me a break. This whole CIO/sleep training method is not only pretty new, It's not natural to what people have been doing since the beginning of time.

mananny said...

Anyway, OP, for you-a nice resource might be The Baby Whisperer. While, I don't agree with everything in her book. I think the parents might be open to the EASY method-Eat, Activity, Sleep, You. Google or get the book for more info.

MissMannah said...

Mananny, I agree The Baby Whisperer is a great book. She advocates comforting the baby as soon as he gets upset but leaving the room as soon as he's calm again. She also acknowledges this can take a very long time before the baby understands how to self-soothe.

In my opinion, CIO is no big deal. Like others said, tears are not the end of the world. It bothers the adult more than the baby. All the studies saying that crying leads to mental problems are either flawed or biased, from what I've seen. I also think babies are capable of sleep training at 2-3 months. C started sleeping through the night at 10 weeks and that's because her parents started sleep training her early.

anon poster said...

I did CIO with my daughter at 9 months after trying absolutely every other method to get her to sleep (she wouldn't sleep longer than 2 hours without waking up to nurse...in my bed or in hers). She cried for 45 minutes (we checked on her every 5) the first night, 10 minutes the second, and she has slept through the night ever since. She's now 4 and is a happy, secure, smart little girl.

I'm sorry, but as a working parent I need at least a solid 4-5 hours of sleep per night to function. At my daughter's worst (right before we Ferberized), I was so tired that I would burst into tears several times per day for absolutely no reason, I found myself running red lights because I was too tired to notice they were red, and I was so irritable my husband used the "D" word more than once. Another year of that and I honestly think our family would have been destroyed. Sleep deprivation is torture. It doesn't make you a hero to never let your baby cry nor does it make you a monster to let it happen.

My son on the other hand was a great sleeper without CIO all along! Every baby and every family is different. I don't know if 5 months is too young...it's none of my business and I'm not a professional. If you're that worried about it why don't you go with the parents to the Pediatrician to suggest some sleep solutions. If the Pediatrician thinks it's dangerous than he/she will say so.

For the record, my Pediatrician (Chief of Pediatrics at a large academic medical center) recommended Ferber to me when I went to him for sleep advice.

Dr. Juris said...

Good study analyzing books regarding the two methods: http://www.journalsleep.org/Articles/291212.pdf

NVMommovedtoTX said...

As PP's have said, the type of CIO method you use is what is important. If your employers want you to use this for night sleeping then you can use the gradual method of leaving them from shorter, then longer times until they can adjust.
Ask your employers for more details on the type of method they have in mind. Update them on it each day so they can be informed and decide if they want to make changes or how to proceed.

nycmom said...

Dr. Juris,
Good summary article. As it says, the key factor is how hard it is to actually design a double blind, randomized, controlled study. And even harder to ensure a family follows it.

Some more original/recent research which supports CIO having positive mental health benefits for mom and no negative consequences for baby:

http://www.ncbi.nlm.nih.gov/pubmed/12612272

http://www.ncbi.nlm.nih.gov/pubmed/22983788

http://www.ncbi.nlm.nih.gov/pubmed/18762495

There are studies that show CIO can result in indeterminate persistence of elevated cortisol levels, a stress marker, in infants. However, I am not aware of any decent studies showing this has any long term correlations. Nor any clear clinical correlation of simply measuring cortisol levels as a health marker.

http://www.ncbi.nlm.nih.gov/pubmed/21945361

Crying is stressful, but so is not sleeping. There is certainly a lot more data supporting the negative sequelae of chronic sleep disruptions in early childhood and adulthood compared to any long term effects of controlled cry it out. On the other hand, there are studies to support strong attachment in co-sleeping babies and studies showing a whole range of mental health problems that develop in children from international adoptions that increases with longer duration in orphanages.

The bottom-line is something obvious: you need to be in tune with your individual child's needs. Most parents of children with different temperaments see how obvious it is that there is not one size fits all sleep solution. CIO can be a great tool. It is worth trying. But it is no magic bullet and simply does not work for all infants. Like virtually all things in parenting, you need to know your own kids and their needs. Any pediatrician or parent who would advocate CIO as a one stop solution for all infants is one who just hasn't met enough babies yet. Even Ferber's updated book shows his growth as a parent and doctor -- still advocating the benefits of CIO, but also allowing for the benefits of co-sleeping and flexibility in any family. Conversely, the same can and should be said for co-sleeping which is equally not an absolute solution for every child or family.

oceanblue said...

We can debate all day about CIO, so not the point.

Way I see it OP doesn't want to use the method the baby's parents have chosen.

The reason seems to be she doesn't approve of the method in her system of beliefs, so she feels she needs to "educate" the parents to do things the way should would.

She's not saying she tried CIO and it doesn't seem to be working and wants suggestions on new ideas to try.
Nope! Sounds to me like she is digging in her heels and wants the parents to comply with her wishes and her beliefs.

Which to me is way over the line.

OP, my advice to you is do the job you were asked to do and don't be that controlling nanny.

If CIO doesn't work after you've actually tried it and/or MB & DB ask for different methods then you can "educate them".
Ugh!


♥ Amy Darling ♥ said...

As both a nanny and mother, it is sometimes so hard for me to keep my mouth shut when my bosses parenting methods sharply contradict my own.

I truly believe in letting a child CIO in order to get them to learn to sleep effectively by themselves. I did it w/all 3 of my children (now adults) and they all learned to go to sleep on their own by the time they were toddlers. They have 0 recollection of being in their cribs as infants crying while Mommy left them alone to fall asleep. In fact, when I mention to them how sometimes in my job I have to coddle the child to sleep prior to putting them in their own bed, they think it is ridiculous at best.

Anyway, part of being a nanny is keeping your own parenting opinions under wraps. Unless specifically asked for your advice, it is always best to just do your job as you are instructed to do.
However, if a parent were to ask me to do something neglectful and/or abusive, of course common sense would dictate that then one should step in and do the right thing.

We are hired as employees of the parents and since we are working for THEM, we are obligated to do what they tell us to do. If we do not agree, we are free to find another position.

I know it is hard, but it is what we are being paid to do.
One good idea is during interviews, to discuss certain parenting techniques and see if both sides are on the same page. I.e., I am opposed to Attachment Parenting so if a family practiced this method, I would know early on we would not be a good fit.

Siriusly James said...

I've cared for 40+ children in my career, and I am proud to say I have never used CIO. Oh, I'm also proud to say that I have never had any trouble getting children to sleep.
http://www.phdinparenting.com/2008/07/05/no-cry-it-out/
You are absolutely right, 5 months is too young to CIO. As is 50 months. And 5 years. And 50 years.
I will NOT use CIO. If a parent asked me to do it I would say no. It is not the way I treat children, period.

http://kellymom.com/parenting/nighttime/sleep/

http://www.phdinparenting.com/2009/02/28/gentle-baby-and-toddler-sleep-tips/

oh well said...

I assume that the parents want to use CIO in the best circumstances, that is when the baby has given cues that she is tired, and she is expected to go for a long nap at that time. Presumably you will tell the baby that she needs to go to sleep, and you will go through a soothing routine with her. This is not about dropping the baby randomly in the crib without warning and moving away. I am not a big fan of CIO for its own sake, but I think that it is important to help a baby fall asleep on their own. I am not a professional, though.

I just want to say that you seem to take your job very seriously, and I think that your family is very lucky to have you around.

MissMannah said...

"5 months is too young to CIO. As is 50 months. And 5 years. And 50 years."

I am 30 years old and will occasionally cry myself to sleep. It feels nice and cathartic to just cry sometimes. Why are we so afraid of crying? Why do we feel we have to put a stop to it, at any costs?

Denvernanny said...

I have to agree with NVMommovedtoTX. My current charge is the most restless sleeper I've ever encountered - he requires rocking and bouncing to get him to sleep, and wakes up if I even lean over to put him in his bed. I don't know if it's because he's a naturally light sleeper or that he needs to be sleep-trained, but I feel perfectly comfortable following his mom's directives. If she gets tired of having to do the same things to get him to sleep, she'll let me know, and we can try to let him cry it out. If not, I'm happy to hold and rock him for his naps. One good thing about being the nanny is that I can follow his mom's directions, as a good employee, and not worry too much about how he's sleeping when I'm not there. By the way, I have two children of my own: it didn't matter what we tried with either of them, they slept exactly the way they wanted to.