Cry it out (extinction): what it involves, and whether it is safe

On your child’s health, your pediatrician has the final word. Check growth, night-feed needs and any medical concerns with them before you change the way your baby sleeps.

What extinction is, and what it is not

Extinction follows a structure: a loving routine, a baby who is fed and dry, a safe crib, a fixed bedtime, scheduled night feeds if the baby still needs them, and a parent keeping an eye on a monitor. Once you have said goodnight, crying on its own is not a reason to go back in. It does not mean ignoring your baby all day, leaving a baby who is sick or hungry, or shutting the door no matter what. Illness, vomiting, a limb caught in the crib slats, or anything that sounds off always gets a response.

Safety: what the research shows

• Reviewing 52 studies for the American Academy of Sleep Medicine, researchers found that unmodified extinction, together with preventive parent education, had the strongest support.
• In a 2016 randomized trial of graduated extinction (with checks) involving 43 babies aged 6 to 16 months, infant cortisol dropped by a small-to-moderate amount relative to controls, and 12 months on there were no differences in emotional or behavioral problems or in attachment.
• In a Melbourne trial where nurses taught behavioral sleep strategies, researchers found no evidence at age 2 of harm to children’s mental health or to parenting, and fewer mothers in the intervention group had depression symptoms.

To be candid about the limits: the samples are modest, most participants were at least 6 months old, and the trials that followed children over time tested behavioral strategies broadly rather than pure extinction. What the research supports is “no harm found,” which is different from proof for every child. Read what the research says.

When it tends not to work, and why

• Families unable to stick with it. An hour of crying that ends in rocking to sleep is tougher on everyone than a consistently followed plan that includes more parental presence.
• Babies whose real issue is schedule or feeding. Walking out of the room will not correct a bedtime that does not suit the baby, or a waking driven by hunger.
• Younger babies. The bulk of the research involved babies 6 months and up, and many younger babies still need to feed at night.
• Babies who are sick, in pain, or have open questions about feeding, weight or breathing. Read sleep training a baby with reflux.
• Any baby whose sleep space is not safe. On the back, on a firm flat surface, in an empty crib. Read safe sleep and sleep training.

What Actually Sleeping does instead

We do not use cry it out, and we do not use wait it out either. Dr. Sam builds a plan around your baby’s age, feeding, temperament, current way of falling asleep and your family’s schedule. Nobody leaves you standing alone outside the door. You receive bootcamp-style coaching ahead of night one, daily 1:1 check-ins that adjust the plan as your baby responds, and naps coached until they are solid. How night feeds are handled depends on your baby’s age and is set in your custom plan.

The result comes with a written guarantee: We guarantee that your baby will sleep 8–12 hours through the night within 14 days of consistent, correct implementation of your sleep plan. If it does not, you get a full refund. Parents who wanted an alternative to cry it out share what happened on our video reviews page.

Safety, whichever approach you take

Your baby should sleep on their back, alone, on a firm, flat surface with no incline, and with no soft toys, pillows, blankets or bedding. The AAP recommends against weighted swaddles and weighted objects on or near a baby. For anything medical, your pediatrician is the authority.

If you would like sleep solved without leaving your baby to cry it out, book a free consultation with Dr. Sam.