Assessing the discontinuities between research, parenting advice, and parenting practice on the use of extinction in infants under 6-months: A critical review of the literature

This research reviews the literature on the use of extinction for sleep in infants with a special focus on parenting advice endorsing the preventive use of extinction (crying it out) in infants under six months. The paper compares claims in popular advice to existing research to evaluate the congruence of advice with research and real-world parenting practice. Results indicate that both parenting advice and empirical literature lack a developmental lens so that knowledge based on older children is applied to very young ones. As a result, very little is known about the necessity, effectiveness, or lack of side effect of unmodulated distress for infants under 6 months. This paper suggests that research inquiry needs to expand beyond the question of "does extinction work?"

Three important questions are covered in this poster: • Does nightwaking that involves parental attention invariably constitute a sleep problem for children and parents? • Does a paradigm of independent, self-settling infant sleep patterns represent a solution or an added stressor? • Are children’s nighttime behaviors and parental sleep interventions related to parent-child well-being? The three research studies presented in this poster explore the possible challenges associated with a focus on various sleeping arrangements and routines. The poster also highlights the importance of alternative approaches and flexibility in mothers’ responses to nightwaking based on maternal perceptions of appropriate care and infants’ temperamental and physiological needs.

NOTE: PLEASE SEE UPDATED RESEARCH POSTER ON THIS PAGE. This research is from 2006. I have updated this with a poster presented in 2022. ABSTRACT: The most empirically supported and endorsed approaches to preventing or ameliorating infant sleep problems involve various forms of extinction (crying it out). This approach is widely recommended by pediatricians and mainstream parenting publications for infants as young as 3- to 4-months. A review of the literature regarding the cry-it-out (CIO) approach to infant sleep reveals that empirical support for this early start date is lacking. Much of the existing literature used to validate the use of extinction with infants does not include infants under 1 year in the sample population. The subset of studies which include infants, do so as part of a much larger sample comprised of wide age ranges (e.g. 9-60 months). Results from these studies do not specify outcomes by age, and obscure the existence of differential effects for infants. Though CIO is recommended as the approach of choice for infant sleep, relatively little is known about its effects on infants under 1 year.