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Oh! There's nothing that divides parents more than "sleep training." I've been reading some message boards on the topic and, LORD, does it ever get heated! I'm talking about people writing personal attacks about others on the boards who defend one position or the other.

Why all the hate?

People seem to use the term "Cry It Out," or more affectionately, "CIO," to refer to a number of different methods out there that aim to help children sleep better while tolerating a certain amount of crying. Two well-known pediatricians who support this stance include Dr. Ferber (author of Solve Your Child's Sleep Problems where his method involves checking and reassuring baby at pre-specified and ever-lengthening times) and Dr. Weissbluth (author of Healthy Sleep Habits, Happy Child who provides a few different strategies, one of which, "Extinction," allows children to cry until they fall asleep unassisted).

Proponents of this method feel that it teaches their children a valuable tool: how to fall asleep unassisted. They believe that some amound of crying may be necessary to achieve this, but its effects are not long-lasting or harmful. The methods usually work quickly, often within days. Proponents also feel that the benefits in better sleep for the entire family benefit everyone, including baby.

Opponents of this method feel that it is cruel to allow babies to cry and believe it may lead to loss of trust, self-esteem, and feelings of abandonment. Instead, they opt for approaches in line with attachment parenting. Dr. Sears, author of The Baby Book, is a well-known advocate for these kinds of methods. Another favorite sleep book for this set is The No-Cry Sleep Solution by Elizabeth Pantley, a "parenting educator" as self-described on her blog. These methods are gentle, nurturing, and try to avoid any amount of crying. They believe this leads to more well-adjusted and secure children.

I've read all four books. My question is (as a doctor reading these different views on what's best for children): where is the data supporting these claims? I haven't found in the research (although, I admit I haven't had the time to do an exhaustive search) a study that shows that one or the other is superior in producing emotionally-secure older children or adults. I also haven't found any studies that show that CIO causes harm. Some studies look at crying levels in general but that's certainly not the same; in fact, some have found that babies who are allowed to cry-it-out end up crying less on a whole. It's also hard to extrapolate from studies looking at only one method or another since the there is selection bias, that is, those parents who choose one method over another may be systematically different that those who don't.

I'm not saying one method is better than the other. I think each family needs to decide which philosophy they are most comfortable ascribing to and which fits their family best, like most other parenting decisions. But, it does seem that parents beat up other parents a lot unnecessarily over this.

Don't we all, after all, want what's best for our children? Can't we all be friends?