Proven Controlled Crying Extinction Protocol
The extinction method involves placing the infant in their crib at a consistent bedtime after a calming routine, then allowing them to cry without parental intervention until they fall asleep independently, with 60-70% of children showing improvement in sleep onset and night waking within 1-2 weeks. 1, 2
Prerequisites Before Starting
Age and Safety Requirements
- Infant must be at least 4-6 months old when circadian rhythms are developing and night feedings may be reduced 3
- Ensure the infant is medically healthy with no underlying conditions requiring nighttime intervention 1
- Always maintain safe sleep environment: supine position on firm surface, no soft objects or loose bedding, room-sharing without bed-sharing 4, 3, 5
Establish Foundation First
- Implement a consistent bedtime routine (e.g., "Brush, Book, Bed") at the same time nightly before starting extinction 1, 3
- Create appropriate sleep environment: firm mattress, comfortable room temperature, safe crib meeting current standards 4, 1
- Ensure 12-hour light/dark cycle exposure during the day to support circadian rhythm development 3
The Extinction Protocol Implementation
Night One Through Week One
- Place infant in crib drowsy but awake at designated bedtime after completing bedtime routine 1
- Leave the room and do not return regardless of crying duration, except to ensure physical safety (no intervention for comfort) 1, 6
- Expect peak crying on night one (average 43 minutes), with most parents reporting "a great deal of stress" during this initial night 2
- Crying typically decreases dramatically by end of week one (average 8.5 minutes) 2
- Do not make eye contact, talk to, or pick up the infant during night wakings - complete extinction of reinforcement is critical 1, 6
Expected Timeline and Outcomes
- 83% of parents report successful implementation on first attempt 2
- Median time to completion is 7 days, with 79% achieving success within 2 weeks 2
- Expect "extinction burst" (temporary increase in crying intensity/duration) in first 2-3 nights before improvement 1
- May experience "spontaneous recovery" (return of crying after initial improvement) - maintain consistency without reverting to previous responses 1
Critical Implementation Points
What Makes or Breaks Success
- Consistency is non-negotiable - any parental response during crying resets the learning process and prolongs the intervention 1, 6
- Both parents/caregivers must agree on the plan and implement identically 2
- The systematic ignoring approach produces more rapid results than gradual methods, though both are ultimately effective 1, 6
- Common side effects include morning sleepiness initially and the extinction burst phenomenon 1
Safety Monitoring Without Intervention
- Parents may check infant safety via video monitor or brief visual check without entering room 1
- If entering to ensure physical safety, do so silently without eye contact, touch only if absolutely necessary for safety, then immediately leave 6
Important Caveats and Contraindications
When NOT to Use Extinction
- Infants under 4 months when frequent night feeding is physiologically necessary 3
- Breastfed infants may require night feedings longer due to rapid breast milk digestion - nutritional needs must be balanced against sleep training 3
- Medical conditions requiring nighttime monitoring or intervention 1
- Parents with significant concerns about infant distress or inability to maintain consistency 7, 8
Alternative Consideration
- If full extinction is not tolerable for parents, modified extinction with brief checks (49.5% of parents choose this) shows similar outcomes with slightly longer timeline 2
- However, responsive methods without extinction show comparable sleep outcomes with less maternal stress and depression, though may take longer 8
Long-Term Safety Data
- High-quality 5-year follow-up data shows no harm to emotional development, conduct behavior, psychosocial functioning, or parent-child relationship from behavioral sleep interventions 3