- 01CIO and Ferber are different methods — CIO has no check-ins, Ferber has timed ones
- 02Ferber's full 7-night interval schedule is laid out in detail below
- 03Current evidence shows no long-term harm from either method after 4–6 months of age
- 04Night feeds don't need to stop — they're handled separately from check-in intervals
- 05If it isn't working after 7 nights, it's usually inconsistency or a wake window problem — not method failure
- 06Safe sleep guidelines apply throughout — back to sleep, firm flat surface, no loose bedding
Which approach fits your baby? Ask Lunara's AI.
Lunara's AI can help you work out whether CIO or Ferber fits your baby's age and your own tolerance for crying — in minutes, not hours of forum reading.
Ask Lunara →Cry It Out vs Ferber: Are They the Same Thing?
"Cry it out" gets used loosely in parenting culture to mean almost any method that allows some crying. In sleep science, the two approaches are distinct — and lumping them together is a big part of why so many families abandon sleep training unnecessarily. Choosing Ferber when you meant CIO, or the other way round, produces inconsistent results and more confusion than either method deserves.
| Cry It Out (Extinction) | Ferber (Graduated Extinction) | |
|---|---|---|
| Also called | Full extinction, "cry it out" | Progressive waiting, graduated extinction |
| First published | Weissbluth, 1985 (revised 2003) | Richard Ferber, MD, 1985 (revised 2006) |
| Check-ins | None — no re-entry until morning | Yes — timed, brief, increasing intervals |
| Parental contact | None during crying | Brief verbal and brief touch each interval |
| Interval on Night 1 | Not applicable | 3 minutes, then 5, then 10 |
| How long it takes | Typically 3–5 nights | Typically 5–7 nights |
| Parent difficulty | Higher — no check-ins to lean on | Moderate — check-ins provide structure |
| Best for | Families who find check-ins re-arouse their baby | Most families; first-time sleep trainers |
| Evidence | Same body of research as Ferber [1] | Same body of research as CIO [1] |
Some families find that check-ins re-arouse their baby and prolong crying — for these babies, full CIO can produce less total crying than Ferber. Most parents do better trying Ferber first; if check-ins consistently make the crying worse rather than settling the baby, it's worth discussing a switch to extinction with your health visitor.
For a wider comparison of every sleep training approach — including the chair method and pick-up-put-down — see the sleep training guide.
What Is Cry It Out (Extinction)?
Cry it out — formally called extinction — was developed by paediatrician Marc Weissbluth and described in his book Healthy Sleep Habits, Happy Child. The approach rests on a simple behavioural principle: if a response (crying) is not reinforced by parental attention, it gradually reduces. No check-ins means no partial reinforcement to confuse the signal.
What it involves:
- Complete the bedtime routine and place the baby in the cot awake
- Say goodnight and leave
- Do not re-enter the room until morning, or a pre-agreed minimum interval
- If a genuine medical need arises, respond — but keep interaction to the minimum necessary
- Repeat consistently for five to seven nights before judging the result
What it does not mean: leaving a baby to cry without limit for any reason, withholding food for entire nights, or carrying on regardless of illness. CIO is a settling approach, not sleep deprivation — all of your baby's daytime needs stay exactly the same.
CIO tends to suit families who've noticed that checking in on their baby actually makes things worse — some babies are re-aroused by a parent appearing and then leaving, and cry harder and longer after a check-in than they would with none at all.
What Is the Ferber Method (Graduated Extinction)?
Richard Ferber, MD, director of the Center for Pediatric Sleep Disorders at Boston Children's Hospital, published his method in 1985. The core insight wasn't that babies should cry — it was that sleep associations, the conditions present when a baby falls asleep, get replayed every time they rouse at a sleep-cycle boundary. A baby who falls asleep in a parent's arms will look for those arms at 2am. The method teaches the baby to cross the sleep threshold in the same conditions they'll find during every night waking: alone in their cot.
The biology: from roughly four to six months, babies cycle between light NREM, deep NREM, and REM sleep every 45–60 minutes. At each cycle boundary, every baby briefly arouses. A baby with independent settling skills rolls back to sleep unassisted. A baby who needs feeding, rocking, or holding to fall asleep wakes more fully and signals for that help. Ferber teaches the first pattern.
What "graduated" means: the check-ins aren't comfort-as-usual — they're brief, non-feeding, non-rocking reassurance that you're present and the environment is safe. The lengthening intervals simply give the baby a slightly longer practice window each night.
Is the Ferber Method Safe? What the Research Actually Shows
The safety question is the one most parents actually want answered before they try either method. Critics argue that crying in infancy raises cortisol, and that sustained cortisol elevation harms neurological development — this is the basis of most anti-sleep-training arguments. Here's what the evidence actually shows, limitations included.
Price et al., 2012 — Pediatrics [1]
Finding: no significant differences in emotional and behavioural development, stress regulation, or parent-child attachment between the sleep-trained and control groups at five-year follow-up.
What it doesn't tell us: the study didn't extend past age five, so outcomes into adolescence and adulthood remain unknown.
Gradisar et al., 2016 — RCT, Pediatrics [2]
Finding: on Night 1, baby cortisol was elevated — expected for any arousal event. By Night 3, cortisol was no different from the pre-training baseline. Parent cortisol stayed elevated longer than the baby's.
What it doesn't tell us: the sample was small, and the study followed infants for twelve months, not longer.
Mindell et al., 2006 — Meta-analysis, Sleep [3]
Finding: behavioural sleep interventions are effective and well-tolerated, with no adverse events reported across the studies reviewed.
What it doesn't tell us: methodology varied widely between studies, and publication bias may skew the pool toward positive results.
The weight of current evidence doesn't support long-term harm from either CIO or Ferber once a baby is developmentally ready, typically from four to six months. The claim that sleep training damages attachment isn't supported by the data available. That said, the evidence base isn't enormous — most RCTs have small samples and follow-up windows of one to five years. The honest position is that current evidence is reassuring, not conclusive in every direction. If your family chooses not to sleep train, that's a valid choice with its own evidence base around responsive settling. If you do choose to sleep train, the current evidence supports doing so without guilt.
"On Night 1, baby cortisol was elevated — as expected for any arousal event. By Night 3, it was back to baseline. Parent cortisol stayed elevated longer. The research suggests sleep training is harder on parents than it is on babies." — Lunara Editorial Team, drawing on Gradisar et al., 2016
The Full Ferber Method Schedule: Days 1–7 and Beyond
This is the schedule most competing guides either stop short of or publish as an image rather than usable text. Apply the same night's column to the first settling attempt and to every subsequent waking that night.
| Night | First Wait | Second Wait | Third Wait | All Subsequent Waits |
|---|---|---|---|---|
| 1 | 3 min | 5 min | 10 min | 10 min |
| 2 | 5 min | 10 min | 12 min | 12 min |
| 3 | 10 min | 12 min | 15 min | 15 min |
| 4 | 12 min | 15 min | 17 min | 17 min |
| 5 | 15 min | 17 min | 20 min | 20 min |
| 6 | 17 min | 20 min | 25 min | 25 min |
| 7 | 20 min | 25 min | 30 min | 30 min |
| 8+ | 20 min | 25 min | 30 min | 30 min |
After Night 7: most families find their baby settling with little or no crying by Night 5–7. If you're still using intervals at Night 8+, hold at the Night 7 level — there's no benefit to extending past 30 minutes. If crying hasn't reduced by Night 7, skip ahead to the troubleshooting section before extending the schedule further.
Middle-of-the-night wakings: use that same night's intervals for any waking after the initial settle. On Night 3, the first waking interval is 10 minutes, whether it's 9pm or 4am — and the same schedule applies to any further wakings that night.
How to Do the Ferber Method: A Step-by-Step Guide
Set up a safe, consistent sleep environment
Before starting, confirm every safe sleep baseline is met: firm, flat mattress, no loose bedding, bumpers, or soft toys, and baby placed on their back — this isn't negotiable during unattended periods. Add blackout blinds for every sleep, not just night-time, and continuous white noise at roughly 50–60 dB. A safe, consistent environment means that if the baby wakes between check-ins, the room itself is reassuring: dark, quiet, familiar.
Practical note: if the nursery shares a wall with a living room or TV, white noise matters even more — sudden household sounds triggering the Moro reflex are common and easy to prevent.
Establish a 20–30 minute bedtime routine
Run the same sequence before every sleep for several nights before you start: bath, dim lights, final feed, a brief story or song, then into the cot awake. The order matters more than the exact content — pick three or four steps you can maintain every single night, even an exhausted one. See the infant sleep routine guide for more detail on building this.
Practical note: finish the feed before the final step of the routine, not as the last thing before the cot — otherwise feeding becomes the sleep-onset association you're trying to remove.
Place the baby in the cot drowsy but awake
This is the hardest step for most families to get right, and the most important. "Drowsy but awake" means eyes still open, maybe slow-blinking, but not asleep. If the baby falls fully asleep during the final feed or cuddle, rouse them briefly — a nappy change, a cool flannel — before placing them down. This step is what makes the whole method work: the baby needs to begin the wake-to-sleep transition in the conditions they'll find every time they rouse overnight.
Practical note: most families don't get this right on the first attempt. That's normal — even partial success on some nights builds the association over time.
Leave the room and begin the first interval
Say goodnight calmly and leave. On Night 1, the first interval is three minutes — which will feel like thirty. Don't watch the monitor constantly; go to another room, put on headphones, or have your partner keep time. Hovering at the door watching the clock keeps you in a state of high arousal that makes the next check-in harder and the next wait longer. The intervals are your external regulation tool — trust the timer over your own anxiety.
Practical note: if there are two of you, agree in advance who does each check-in and who stays out. Disagreements at the bedroom door at 2am undo the schedule and distress everyone involved.
Do brief, calm check-ins — 60–90 seconds maximum
When the interval ends, go in, speak calmly and briefly ("You're safe, it's time to sleep, I love you"), offer a brief pat or touch without picking up, feeding, or rocking, then leave — whether the crying has paused, escalated, or the baby is staring right at you. The check-in confirms your presence; it isn't meant to resettle the baby. After leaving, start the next interval from the schedule.
Practical note: the most common mistake is turning a 60-second check-in into a 10-minute rocking session "because they nearly fell asleep." That resets the whole process and teaches the baby that escalating crying buys more contact.
Review the data on Night 3, Night 5, and Night 7
On Night 3, note total settling time versus Night 1, number of wakings, and how long each lasted. Compare Night 3 to Night 5, then review the full week on Night 7. If there's a clear downward trend — even with a wobble or two — keep going. If Night 7 looks the same as Night 1, work through the five causes in the troubleshooting section before deciding the method has failed.
Practical note: log each night's settling time and wake count in Lunara. The weekly trend chart shows the progress that's invisible when you're living it night by night, exhausted.
Night Feeds and Sleep Training: What to Do
Night feeds are handled separately from Ferber check-ins. Before you start, decide which feeds you're keeping — the method doesn't require eliminating all night feeds, and trying to drop them all at once typically derails the whole process.
| Age | Breastfed | Formula-fed | Approach |
|---|---|---|---|
| 4 months | 2–3 feeds | 1–2 feeds | Keep all genuine hunger feeds; use check-in settling for non-feed wakings |
| 5–6 months | 1–2 feeds | 0–1 feeds | Discuss with your health visitor; most formula-fed babies at 6 kg+ can manage one feed-free stretch |
| 7+ months | 0–1 feeds | 0 feeds | Most babies over 7 months don't need overnight nutrition; remaining wakings are usually associative |
When the baby wakes at a planned feed time, feed fully, then return them to the cot awake. The feed doesn't count as a check-in and doesn't interrupt the interval schedule for any non-hunger waking the same night. A dream feed — waking the baby slightly around 10–11pm before you go to sleep yourself — can consolidate the early stretch during the first week for families starting between four and five months, and can usually be withdrawn over one to two weeks once settling improves.
Hunger wake vs. habit wake
Hunger waking: happens after a longer stretch — three to four hours since the last feed — and the baby takes a full feed and settles promptly afterward. Habit waking: happens within 60–90 minutes of the last feed, the feed itself is short and drowsy, and the waking time is consistent night to night rather than tied to feed intervals.
Can I drop all night feeds during Ferber?
Technically yes, but it adds real difficulty. A genuinely hungry baby cries differently from one with a settling association, and that hunger won't resolve through check-in intervals alone. For most families, keeping one feed for the first week and reassessing once settling is established is the lower-risk path.
Night feeds and milk supply
Dropping night feeds while breastfeeding can affect supply, particularly in the first six months. Replacing a dropped night feed with a pumping session during the training period protects supply while your baby learns to settle. Talk to a lactation consultant about timing if supply is a concern.
Ferber Method for Naps
Use the same check-in intervals at nap time as you're using at night — whatever night you're on dictates your nap intervals too. If you're on Night 3, your nap settling intervals are 10, 12, and 15 minutes.
The 60-minute cutoff rule
If the baby hasn't fallen asleep within 60 minutes of being placed down for a nap, end the attempt. Don't leave a baby crying in the cot for 90 or 120 minutes hoping sleep eventually arrives — extended non-sleep crying produces cot aversion, not learning. End the nap, treat it as a short wake window of 15–30 minutes, and try again at the next nap slot. A failed nap attempt doesn't mean the method is failing — naps generally take longer to settle than nights during sleep training.
Nap timing matters more than night timing. Wake windows at four to six months — roughly 1.5 to 2.5 hours — need to be respected for nap settling to succeed. A baby placed down too early, before enough sleep pressure has built, or too late, overtired with elevated cortisol, will cry longer and settle less reliably regardless of method. Log nap times and wake windows to see whether timing, not the method itself, is the real variable.
Ferber Method for Toddlers
The same interval schedule applies to toddlers from 12 months, with adjustments for their cognitive stage. Toddlers understand more about what's happening — they know a parent is nearby — which can intensify distress but also speeds up learning once the pattern clicks.
Cot-sleeping toddler (12–18 months)
Same interval schedule. Add a verbal cue at each check-in — "it's sleep time, I'll see you in the morning." The verbal cue works better than physical contact at this age; some toddlers become more distressed when touched during a check-in, because it signals that a pick-up might follow.
Bed-sleeping toddler (18+ months, or any toddler out of a cot)
A toddler in a bed can leave their room during intervals. Use a baby gate or a closed-but-unlocked door to contain the space. If they open the door mid-interval, walk them back calmly, repeat the verbal cue, and restart the interval. The gate isn't punishment — it's the structure that makes the method actually work; without it, "the method" turns into a hallway negotiation.
Track every night of the schedule. See whether it's working.
Lunara shows settling-time trends across the seven-night schedule — so you know it's working, even on the nights it doesn't feel like it.
Try Lunara Free →When the Ferber Method Isn't Working
If seven nights have passed with no clear downward trend in crying time or number of wakings, the method is usually intact — one of these five variables is undermining it.
1. Inconsistency
Did every caregiver apply the same intervals, at every settling, every night? One "rescue" — picking up mid-interval, feeding outside the planned times, letting the baby into the parental bed — re-teaches the baby that sustained crying eventually produces a response. This is the most common cause of Ferber "failure." If there's been any inconsistency, treat tonight as Night 1 again and make sure every caregiver is aligned first.
2. Wake window error
A baby placed down overtired, past their wake window, has elevated cortisol and is harder to settle — crying runs longer and more intense. A baby placed down too early, without enough sleep pressure, simply isn't ready and will cry for a different reason entirely. Log wake-up times and nap times for three to five days and calculate the actual windows; most families find theirs are 20–40 minutes too long by the end of the day.
3. Residual sleep association
The bedtime feed is still happening as the final step before the cot. Even a brief, drowsy five-minute feed right before placement reactivates the feeding-to-sleep association. Move the bedtime feed earlier in the routine — before the bath rather than after — so there's at least one non-feeding step between the last feed and the cot.
4. Illness, teething, or a developmental leap
Teething pain, ear infections, and developmental leaps all increase night waking independently of sleep associations. If your baby has a new tooth coming through, has been unwell recently, or is showing signs of a leap — increased clinginess, sudden new skills — pause the method and resume once the acute phase passes. Pushing through sleep training during teething pain usually produces more crying and less learning.
5. Genuine ongoing hunger
If night feeds were dropped too quickly, or your baby's caloric needs have increased with a growth spurt, hunger may be driving wakings that no check-in schedule can resolve. Restore one overnight feed, watch whether wakings reduce, and reassess after a week.
When to Avoid the Ferber Method
- Baby is under 4 months corrected age
- Baby is currently unwell, teething acutely, or recovering from illness
- There's been a major disruption in the past two weeks — house move, new sibling, starting nursery, travel across time zones
- Baby has a diagnosed neurological or developmental condition affecting self-regulation — discuss with your paediatrician first
- Baby has reflux or another medical cause of night waking — Ferber doesn't treat the underlying cause
- Either parent isn't in a mental or emotional place to apply the process consistently — inconsistency causes more total distress than a gentler alternative would
If any of those apply, there are gentler alternatives worth exploring in the sleep training guide — the chair method and pick-up-put-down both work more slowly but ask less emotional tolerance of crying. If waking has started suddenly after a period of good sleep, a sleep regression may be the real cause rather than a settling problem at all.
Are You Ready? A Parent Readiness Checklist
Before starting Ferber, both caregivers should be able to say yes to all of these.
- Baby is at least 4 months and currently healthy — no ongoing illness, no acute teething
- No major disruption in the past two weeks — no house move, new nursery, or new sibling this fortnight
- Both caregivers agree on the plan — inconsistency is what undoes the method, so talk the schedule through before Night 1
- You understand the extinction burst — one night, usually Night 3–5, may be worse than Night 1, and that's normal
- You have seven consecutive nights available — avoid starting before a trip, a family event, or a visiting relative
- Night feed decisions are made in advance — know which feeds you're keeping before Night 1, not at 3am
- You have a strategy for your own distress — a distraction, headphones, or leaving the flat during intervals rather than monitoring and escalating your own anxiety
- Safe sleep environment is set — cot clear, baby on back, blackout blind up, white noise on
How Lunara Helps You Track Sleep Training Progress
Sleep training works best with data. Subjectively, a baby who settled in 45 minutes on Night 1 and 30 minutes on Night 3 feels like a failure in the moment — the data shows real progress. Lunara captures what exhausted parents tend to misremember.
- Settling time per night — log when you placed baby down and when they fell asleep; the trend chart shows improvement that feels invisible in the moment
- Wake window compliance — correct timing is the most overlooked variable in sleep training that doesn't seem to be working
- Night waking frequency — a weekly average, so one rough night from teething or a regression doesn't obscure the underlying trend
- Nap durations — cumulative daytime sleep against your baby's age target, shown live
- Ask the AI at 3am — "My baby cried for 45 minutes on Night 5 of Ferber — is this an extinction burst or is something wrong?" and get guidance calibrated to your own logged data, not a forum thread
With Lunara's shared baby tracker, the partner taking the night shift can log wakings and settling times without waking the other partner — both of you see the same weekly progress view the next morning.
Frequently Asked Questions
No. Cry it out (CIO), also called extinction, means leaving the baby to fall asleep without any parental check-ins - you do not re-enter the room until morning. The Ferber method, also called graduated extinction, involves timed check-ins that increase in interval each night. Both aim to teach self-settling, but the Ferber method includes parental reassurance at set intervals. Ferber himself explicitly distinguished his method from full extinction. Most families find the Ferber method more manageable because check-ins reduce parental anxiety.
Most paediatric sleep experts and the American Academy of Pediatrics recommend waiting until at least 4-6 months before starting any form of graduated extinction. By 4 months, babies have begun the 4-month sleep architecture change and are developmentally capable of learning to self-settle. Before 4 months, the neurological maturity required for extinction-based approaches is not reliably present. Many families find that starting between 5-7 months, after the 4-month regression has settled, produces the most predictable outcomes.
Most families see significant improvement within 3-7 nights. Crying duration on Night 1 is typically the longest; Nights 2-3 show measurable reduction for most babies; by Night 5-7, many babies are settling with minimal or no crying. Some families report the full two-week process before consistent independent settling. If no improvement is visible after 7 nights, the most common cause is inconsistency in the routine or incorrect wake window timing - not method failure.
The standard Ferber schedule increases waiting intervals each night: Night 1: 3, 5, 10 minutes (repeat 10); Night 2: 5, 10, 12 minutes; Night 3: 10, 12, 15 minutes; Night 4: 12, 15, 17 minutes; Night 5: 15, 17, 20 minutes; Night 6: 17, 20, 25 minutes; Night 7: 20, 25, 30 minutes. After Night 7, most families either continue extending intervals or find the baby is settling without needing them. The same intervals apply to any middle-of-the-night waking.
The best available evidence indicates no long-term harm. A landmark 2012 randomised controlled trial published in Pediatrics (Price et al.) followed infants through graduated extinction and found no adverse effects on stress hormones, attachment, or emotional and behavioural development at 12-month and 5-year follow-up. A 2016 RCT (Gradisar et al.) and a broader meta-analysis of sleep training studies reached a similarly reassuring conclusion. Critics note that most studies are short-term; however, no published study has demonstrated harm from graduated extinction when applied to developmentally appropriate babies.
Yes, but with a time limit. Apply the same check-in intervals during nap settling. If the baby has not fallen asleep within 60 minutes of the nap start time, end the nap attempt, treat it as a short wake window, and try again at the next nap slot. Crying without falling asleep for more than an hour compounds overtiredness and rarely produces learning - cut the nap attempt and reset.
The modified Ferber method uses shorter check-in intervals, more frequent check-ins, or physical contact during check-ins (patting, brief holding) for parents who find standard intervals too long or distressing. It is slower and less consistent than the standard method, but better than abandoning the approach entirely. A common modification is to reduce all Night 1 intervals by roughly half and ramp up from there over two weeks rather than one.
Yes, but with modifications. Toddlers (12 months+) are cognitively capable of understanding more about the process, which can make both the distress and the learning more intense. The interval schedule remains the same, but toddlers may call out verbally, stand at the cot, or escalate crying in ways that feel different to parents. A consistent verbal check-in ("It's sleep time, I love you, goodnight") without extended physical comfort is effective. Toddlers in a bed rather than a cot require a door handle or gate to prevent them leaving the room during intervals.
If crying has not reduced after 7 nights, review these five causes before concluding the method has failed: (1) Inconsistency - did every caregiver follow the same intervals every time? (2) Wake windows - is the baby going into the cot overtired or not tired enough? (3) Sleep associations - is there a night feed that is now a habit rather than nutritional need? (4) Illness or teething - both increase night waking independently of sleep associations. (5) Developmental leap - a leap can temporarily increase waking. Log data for 3-5 days, identify the pattern, then reassess before abandoning the method.
No - feeding during a check-in resets the process and reinforces feeding as the resettling mechanism. Night feeds are handled separately from check-ins: decide in advance which feeds to keep (based on the baby's age and weight), feed at those predetermined times, then return to the check-in schedule for any other waking. At 4-6 months, breastfed babies may genuinely need one to two overnight feeds; formula-fed babies may be ready to drop to one or none. Your health visitor or GP can help determine appropriate feed targets for your baby's weight.
Yes, but it is significantly harder. Room sharing means the baby can sense your presence without receiving the response they expect, which can escalate distress and extend the process. If room-sharing is not by choice, moving the cot to another room (even temporarily) for the first one to two weeks of sleep training typically produces faster results and less total crying. If room-sharing is required, consider a slower modified approach with shorter initial intervals.
Avoid the Ferber method if: the baby is under 4 months; the baby is unwell, teething acutely, or recovering from an illness; there has been a major life change in the past two weeks (moving house, new sibling, starting nursery); the baby has a diagnosed neurological or developmental condition that affects self-regulation; or either caregiver is not mentally or emotionally in a place to follow the process consistently. Inconsistent application produces more total crying and less learning than either consistent Ferber or a gentler alternative.
Related Articles
References
- Price, A. M. H., Wake, M., Ukoumunne, O. C., & Hiscock, H. (2012). Five-year follow-up of harms and benefits of behavioral infant sleep intervention: Randomized trial. Pediatrics, 130(4), 643-651.
- Gradisar, M., Jackson, K., Spurrier, N. J., et al. (2016). Behavioral interventions for infant sleep problems: A randomized controlled trial. Pediatrics, 137(6).
- Mindell, J. A., Kuhn, B., Lewin, D. S., Meltzer, L. J., & Sadeh, A. (2006). Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep, 29(10), 1263-1276.
- Moon, R. Y., & AAP Task Force on SIDS. (2022). Safe sleep and a healthy sleep environment. Pediatrics, 150(1).
- Ferber, R. (2006). Solve Your Child's Sleep Problems (revised ed.). Fireside.
- Weissbluth, M. (2003). Healthy Sleep Habits, Happy Child (3rd ed.). Ballantine Books.
Keep a log this week. See whether it's working.
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