Parenting Advice Books About Child Sleep: Cosleeping and Crying It Out
Kathleen D. Ramos, PhD1; Davin M. Youngclarke, MA2
California State University, Fresno, CA; 2Department of Family Medicine, University of California, San Francisco, CA
1
Study Objectives: To identify the book sources of parenting advice about
child sleep and then characterize those sources with respect to their au-
thorship and the content of advice about cosleeping and cry-it-out sleep
training.
Setting: Availability in the United States market.
Sample: Forty currently available parenting advice books about sleep
were identified.
Intervention: N/A.
Measurement and Results: Most books were accessible regarding price
and reading grade level. Most authors either had a medical background
or no professional credentials. With regard to cosleeping, 28% of books
endorsed it, 32% took no position, and 40% opposed it. Those that en-
dorsed cosleeping generally recommended long-term bed sharing, but a
few suggested room sharing only during the first few months after birth.
INTRODUCTION
PARENTING IS DIFFICULT, AND PARENTS OFTEN FIND
THEMSELVES IN NEED OF HELP. PARENTS ARE VERY
LIKELY TO SEEK ADVICE FROM “EXPERT” SOURCES, in-
cluding books.1 One issue about which parents seek expert advice
is sleep. However, the content of that advice is the subject of great
controversy.
Content analysis of parenting advice books on other topics has
been useful to help to identify trends in advice to parents, which
is in turn used to detect biases in the field of parent education, to
identify the degree to which parenting advice coincides with the
evidence on the issue, and to recognize changing cultural stan-
dards.2-4 Analysis of sleep advice books for parents may be useful
for similar reasons. Those who work directly with parents need to
understand what type of advice parents seek and are exposed to
through popular media such as self-help books in order to com-
municate meaningfully with parents about sleep, or even to rec-
ommend reading to answer parent questions. Developmental and
sleep researchers may use information about the content of these
advice books to identify the controversies that are amenable to
scientific testing.
LITERATURE REVIEW
Issues in Infant Sleep
Sleep is a human necessity, and children spend one third to one
Disclosure Statement
This was not an industry supported study. Dr. Ramos has received consulting
fees from Community Medical Providers. Dr. Youngclarke has indicated no
financial conflict of interest.
Submitted for publication May 8, 2006
Accepted for publication August 23, 2006
Address correspondence to: Dr. Ramos, Department of Child, Family & Con-
sumer Sciences, 5300 N Campus Dr, M/S FF12, Fresno, CA 93740-8019;
Tel: (559) 278-4720; Fax: (559) 278-7824; E-mail: kramos@csufresno.edu
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With regard to crying it out, 61% of books endorsed it, 8% took no posi-
tion, and 31% opposed it. Most of those that endorsed crying it out recom-
mended scheduled checking, but a few suggested a cold-turkey method.
More than half of the books presented advice that explicitly supported
either cosleeping or crying it out and rejected the other.
Conclusions: A medical perspective on sleep predominates in parenting
advice in this area. That perspective is typically opposed to cosleeping
and supportive of sleep training. However, a substantial minority present
an opposite position.
Keywords: Bed-sharing, cosleeping, crying, parenting advice, sleep
training
Citation: Ramos KD; Youngclarke DM. Parenting advice books about
child sleep: cosleeping and crying it out. SLEEP 2006;29(12):1616-1623.
half of their lives sleeping. Newborns may spend even more of
their time in sleep.5 Sleep is also a time of profound vulnerability,
during which our human ancestors would have been at great risk
from predators. Consequently, sleep behaviors may be driven by
evolution and therefore may be deeply engrained and critically
important to the development of infants and young children. In
the modern world, sleep may also be a source of problems for
many. Researchers report that 20% to 40% of infants and toddlers
have sleep problems that disrupt the lives of their families.6,7
A survey of parents in a pediatrics office8 found that parents
rate parenting books as a helpful source of information, more
helpful in fact than talking to friends, watching other parents,
reading magazines, or getting information from church and par-
enting classes. Nearly half wanted more information about spe-
cific developmental issues, and three quarters of those surveyed
wished they could borrow parenting books from their doctor’s of-
fice. A much larger national survey of parents of young children9
revealed that three quarters of parents used books along with
magazines, television, and videos to get information about chil-
drearing. Whereas 4 in 10 reported talking to their child’s physi-
cian about sleep, 3 in 10 wished they had more information about
their child’s sleep. However, professional advice about the sleep
of infants and toddlers is often contradictory.
Popular Advice to Parents about Infant Sleep
Casual observers have noted that 2 distinct and contradictory
positions have emerged, the so-called “Ferberizers” and “Sear-
sites,”10 referring to 2 physicians, Richard Ferber and William
Sears. Ferber advocates a form of “crying it out” (extinction of
sleep-related crying through systematic parental nonresponsive-
ness) that may include periodic touch and verbal attempts to calm
the baby while still enforcing solitary sleep. Ferber asserts that
sleep training helps babies learn to regulate their own sleep and
that this is the primary goal of his approach. Sears advocates close
physical contact at all hours of the day and night, including par-
ent-child cosleeping. He contends that parental responsiveness at
night helps foster secure parent-child attachments and this is the
primary goal of his approach.
Parenting Advice Books About Sleep—Ramos and Youngclarke
 Table 1—Included Books

Title Author Publisher & Year Library Holding Cosleeping Cry It Out
50 Easy Ways to Get Your Child Dana Kenny P.S. Publications 1996 0 Opposes Opposes
to Sleep
365 Ways to Get Your Paula Elbirt, MD,a & Adams Media 69 Presents pros Advocates scheduled
Child to Sleep Linda Lee Small Corporation 2001 and cons checking
Baby & Toddler Sleep John Pearce, MDa,c & Fisher Books 1999 266 Opposes Advocates cold turkey
Program Jane Bidder
The Family Bed Tine Thevenin Tine Thevenin 1976 571 Advocates long-term Opposes
bed sharing
Getting Your Child to Sleep… Vicki Lansky MJF Books 1991 1035 Presents pros Presents pros
and Back to Sleep and cons and cons
Good Nights Jay Gordon, MD,a & St. Martin’s 305 Advocates long-term Opposes
Maria Goodavage Press 2002 bed sharing
The Good sleep Guide for Angela Henderson Hawthorn House 10 Endorses early Advocates scheduled
You and Your Baby 2002 bed sharing checking
Good Sleeping Guide Charlotte Prestona Fisher Books 1999 47 Opposes Advocates scheduled
checking
Guide to Your Child’s Sleep American Academy of Villard 1999 646 Opposes Advocates scheduled
Pediatrics (editor: George checking
J. Cohen, MDa,c)
Healthy Sleep Habits, Marc Weissbluth, MDa,c Fawcett Books 1987 686 Opposes Advocates cold turkey
Happy Child
Help Your Baby To Sleep Penney Hamesb Thorsons 2002 3 Presents pros Advocates scheduled
and cons checking
Helping Your Child Sleep Joanne Cuthbertson & Doubleday 1985 246 Warns against Advocates scheduled
Through the Night Susie Schevill checking
How To Get a Good Night’s Sleep Heather Welford Thorsons 1995 6 Endorses early Endorses scheduled
room-sharing checking
How to Get Your Baby to William Sears, MD,a & Little, Brown, and 132 Endorses long-term Opposes
Sleep Martha Sears, RN Company 2001 bed sharing
In Search of Sleep Bonny Reichert Sarasota Press 2001 73 Endorses early bed Opposes
sharing or room sharing
Is My Child Overtired? Will Wilkoff, MDa Fireside 2000 172 Opposes Advocates cold turkey
Keys to Children’s Sleep Susan E. Gottlieb, MDa Barron’s 1993 193 Presents pros Advocates scheduled
Problems and cons checking
Nighttime Parenting William Sears, MDa Plume 1985 748 Advocates long-term Opposes
bed sharing
The No-Cry Sleep Solution Elizabeth Pantley Contemporary 439 Endorses long-term Opposes
Books 2002 bed sharing
The Parentalk Guide to Sleep Kate Daymonda Hodder & 2 Warns against Advocates both cold
Stoughton 2001 turkey and scheduled
checking
Silent Nights Brian Symon, MBa Oxford University 128 Warns against Advocates cold turkey
Press 1998
Sleep: A Practical Guide Katy Holland DK Publishing 2004 53 Presents pros Advocates gradual
for Parents and cons withdrawal
Sleep: Practical Parenting Prisca Middlemiss PAN Books 1999 5 Presents pros Advocates scheduled
Problem Solvers and cons checking
Sleep: Practical Parenting Siobhan Stirling Hamlyn 2003 2 Presents pros Presents pros and cons
Problem Solvers and cons
The Sleep Book for Rebecca Huntley, MSWb Parenting Press, 597 Presents pros Presents pros and cons
Tired Parents Inc. 1991 and cons
Sleep: How to Teach Your Child Tamara Eberlein Pocket Books 1996 162 Presents pros Advocates both cold
to Sleep Like a Baby and cons turkey and scheduled
checking
Sleep: The Brazelton Way T. Berry Brazelton, MD,a & Perseus 522 Opposes Warns against
Joshua D. Sparrow, MD Publishing 2003
Sleep: The Easy Way to Beatrice Hollyer & Cassell Illustrated 1996 118 Warns Against Opposes
Lucy Smith
Sleeping: Last Straw Strategies Michelle Kennedy Barron’s 2003 109 Endorses early Opposes
room-sharing
Sleeping Like a Baby Avi Sadehc Yale University 177 Warns against Endorses scheduled
Press 2001 checking

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 Table 1—continued

Title Author Publisher & Year Library Holding Cosleeping Cry It Out
Sleeping Through the Night Jodi A. Mindell, PhDb,c Harper Collins 1997 598 Presents pros Advocates scheduled
and cons checking
Sleepless Children: A Handbook David Haslam, MBa,c Long Shadow 218 Presents pros Endorses cold turkey
Books 1984 and cons for Parents
Solve Your Child’s Sleep Problems Richard Ferber, MDa,c Fireside 1985 1428 Opposes Advocates scheduled
checking
Solving Children’s Sleep Problems Lyn Quineb,c Beckett Karlson ltd 1997 4 Warns against Advocates both cold
turkey and scheduled
checking
Sound Sleep Sarah Woodhouse Hawthorn Press 2003 10 Presents pros Advocates scheduled
and cons checking
Sweet Dreams Paul M. Fleiss, MD, Lowell House 2000 198 Advocates long-term Opposes
MPH,a & Frederick bed sharing
Hodges, DPhil
Teach Your Baby to Sleep Charles E. Schaeffer, PhD,b,c Signet 1987 593 No mention Advocates cold turkey
Through the Night & Michael R. Petronko, PhD
Three in a Bed Deborah Jackson Bloomsbury 137 Advocates long-term Opposes
Publishing 1989 bed sharing
Winning Bedtime Battles Charles E. Schaeffer, Barnes & Noble 197 Opposes Advocates scheduled
PhD,b,c & Theresa Foy Books 1992
DiGeronimo, MED checking
The World of Children’s Sleep Alexander Z. Michaelis Medical 195 Warns against No mention
Golbin, MD, PhDa,c Publishing Corp. 1994

a
Medical background
b
Psychological counseling background
c
Published in academic literature

Research on Cosleeping and Sleep Training
Researchers have explored both cosleeping and sleep training
but with results that do not directly lead to incontrovertible ad-
vice. Randomized trials of behavioral sleep-training interventions
that involve crying consistently demonstrate moderate success in
preventing or eliminating night waking in infants and toddlers.11-14
This effect tends to be small and not sustained over time11,14; how-
ever, even small temporary improvements may reduce parenting
stress12 and maternal depression.11
Others have argued that a purely behavioral perspective on
infant sleep fails to acknowledge the social nature of sleep in
families15 and that widely accepted beliefs of health-care workers
about infant sleep disregard infant autonomy and dignity in favor
of a universal approach.16 Furthermore, the issue of attachment
has not been explored with respect to cry-it-out sleep training, and
some have expressed concern that sleeping patterns convenient
for parents may come at the high price of insecure parent-child
attachments.17
Research on cosleeping has established that it is very common
in families with young children.18-21 Furthermore, there appear to
be 2 patterns, cosleeping as a response to existing sleep problems
in the child and cosleeping as part of a personal or cultural belief
system.22,23 A substantial amount of research has been conducted
on the safety of cosleeping with newborns,24,25 with results that are
not easily interpreted. However, it should be noted that the Ameri-
can Academy of Pediatrics26 is opposed to infants and adults shar-
ing sleep space on the basis that it is hazardous. Research on the
psychological sequelae of cosleeping suggests that it is associated
with self-reliant toddlers,27 short-term cognitive gains in elemen-
tary school,28 and positive self-concept in adulthood.29 However,
cosleeping is consistently associated with behavioral sleep prob-
lems in childhood, at least among those who cosleep reactive-
ly.22,30-33
This debate appears to be steeped in ideology, but 2 methodo-
logic issues with the research complicate the dispensation of par-
enting advice about infant sleep. First, even though crying it out
and cosleeping, at least in their most “pure” or extreme forms, are
polarized and inherently contradictory approaches to infant sleep,
the reality of what actually happens in people’s lives is largely lost
amid the debate. Descriptive studies suggest that parents often
utilize some combination of sleep training and cosleeping despite
their theoretical contradiction.20,34 Advice will be most helpful if
it addresses this reality. Secondly, both sleep consolidation and
warm, nurturing family relationships are important outcomes, but
existing research seldom considers both. Advice that is focused
on only 1 of these outcomes may neglect legitimate concerns of
parents and their young children.
The objective of this review of advice books targeted toward
parents is to provide a description of the currently available books
for parents in the area of infant sleep. In addition to exploring
characteristics of the books and their authors, we examine the
degree to which parenting advice can be dichotomized into 2 op-
posing camps, 1 supporting cosleeping and 1 supporting cry-it-
out sleep training. Furthermore, we explore the reasons offered
in support of cosleeping and against it, and delineate the different
types of cosleeping and crying it out endorsed in readily available
advice books.
METHODS
We searched the online databases of 2 of the most widely

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 available national booksellers, Amazon© and Barnes & Noble© by
searching keywords “parenting” combined with “sleep.” These
sources were chosen for their accessibility and as nationally uni-
form sources of parenting advice books for ordinary people. The
goal was to acquire a list of books that a parent with genuine con-
cerns but little or no prior knowledge of this issue might choose
to read. No restrictions were made by date of publication. Avail-
ability was the key feature: if a book could be identified with this
search and purchased from either of these common sources, it was
included. The original search was conducted in August 2002. A
follow-up search was conducted in July 2004 to identify any re-
cently published books meeting the inclusion criteria.
Books were included if they were primarily about the sleep of
healthy young children and the target audience was parents. Our
search strategy was designed to be sensitive (i.e., to identify all
the available books on the subject that parents might encounter).
Thus, many books were identified and subsequently excluded,
including storybooks for children about sleep or bedtime, collec-
tions of lullabies or bedtime activities, advice books that focus
on sleep in special populations (e.g., autistic children) or children
under special circumstances (e.g., while grieving), guides to diag-
nosis and treatment of sleep disorders written for clinicians, books
about sleep in school-aged children or adolescents, early editions
of books for which a more recent edition could be found, general
parenting books that may include sleep but are not primarily about
it, and books in a language other than English. The final sample
included 40 books written by a total of 47 authors and coauthors.
Each book was analyzed to identify the presented positions on
cosleeping and cry-it-out sleep training. The authors conferred on
each book, and the classifications presented are the product of
consensus after discussion. Cosleeping was defined as parent and
child sharing a sleep space, whether in the same bed (bed sharing)
or only in the same room (room sharing). Cry-it-out sleep training
was defined as extinction of sleep-related crying through consis-
tent nonresponsiveness in order to teach children how to sleep
independently. To summarize positions on cosleeping and sleep
training, the authors carefully read each book in the sample, rat-
ing each on the presentation of these topics. The final format for
classification on these issues rated each book’s endorsement of
cosleeping and crying it out on 5-point scales. For those who en-
dorsed crying it out, the type of training program was noted, and,
for those who endorsed cosleeping, the specific form of cosleep-
ing was also noted. The details of these classification systems are
presented in the results section. We also noted the reasons offered
in support of, or in opposition to, cosleeping and tabulated the
frequency with which those arguments are used.
In addition, we explored characteristics of the books, including
the number of authors, geographic location of the first author, the
list price, and the reading grade level using the SMOG (Simple
Measure of Gobbledygook) readability formula35 for each book.
We attempted to capture the number of copies sold; however, this
information is considered proprietary and not readily released by
publishers. Therefore, as an estimate of circulation, we investi-
gated the number of libraries with the book in their holdings. We
determined this number by looking up each title in the OCLC
(Online Computer Library Center) WorldCat electronic database,
which is a combined catalog of the holdings of thousands of li-
braries worldwide.
Furthermore, we examined characteristics of the authors includ-
ing sex and professional credentials. Credentials of the authors
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were explored 2 ways. “About the Author” paragraphs included
in most books were examined for whether the author claimed a
medical background or a psychological counseling background.
For the few books without an “about the author” paragraph, any
information was gleaned from the introduction. In addition, we
indexed each author’s history of scientific publication by search-
ing 2 scientific databases of published material in peer-reviewed
journals (MEDLINE for medical literature and PsychINFO for
psychological literature). One author (KDR) conducted all the
searches on the same day in August 2004, searching author’s
name plus the keyword “sleep.” The number of contributions to
the indexed literature were noted and divided into primary sourc-
es (in which data were collected) and secondary sources (in which
no original data were reported). To be included, publications had
to be primarily about sleep in humans and include some discus-
sion of children.
Simple proportions, means, and medians were calculated for
descriptive purposes. Interitem correlations, t tests, and χ2 analy-
ses were used to explore relationships between the position on
cosleeping and crying it out and other variables.
RESULTS
Characteristics of Authors
First authors were roughly split between men (43%) and wom-
en (57%). The books were written by authors with widely varying
credentials. Most first authors (n = 29, 73%) had never published
in the academic literature. The remaining 11 first authors had
published as few as 1 and as many as 51 articles (median = 5,
mode = 1) about children’s sleep that were indexed in medical or
psychological databases. Nearly half of the first authors (n = 17;
40%) had a medical background, mostly medical doctors. A few
(n = 6; 15%) had a background in clinical psychology or counsel-
ing. One author (2%) was an academic researcher. Nearly half of
the books (n = 16; 43%) had a first author with no professional
credentials at all.
Among those books written by a first author with no profes-
sional credentials, slightly more than half (n = 9) were written
in a journalistic style and essentially presented the positions of
recognized medical experts. Several of these authors were jour-
nalists by profession, and many of these books were published
by parenting magazines (e.g., “Parenting” and “Child”), by com-
panies that produce baby products (e.g., Johnson & Johnson), or
were endorsed by medical organizations (e.g., the UK’s National
Childbirth Trust). These books presented information from a
generally medical perspective. The remaining books written by
authors with no professional credentials (n = 7) offered personal
experience or opinions to support their positions. These authors
did not present a restatement of the positions of large medical or-
ganizations but, instead, offered insights or suggestions based on
their own experiences or the collective wisdom of unnamed “real
parents” known to the author. This was presented as a legitimate
source of expertise. Illustrative of this position, 1 book included
on the back cover the statement that “Success with resolving her
babies’ sleep problems inspired her to write this book.”
Characteristics of Books
Characteristics of the 40 books included in the review are de-
scribed in Table 2.
Parenting Advice Books About Sleep—Ramos and Youngclarke
 Table 2—Characteristics of Books

Author(s) in the United States 24 (60%) 5

Author(s) in the United Kingdom 13 (33%)
Author(s) in Canada 1 (2½%) advocate
Author(s) in Australia 1 (2½%)
Author(s) in Israel
Single author
1 (2½%)
29 (73%)
9 oppose
Two authors 10 (25%) 6
Edited book with many authors 1 (2½%)
Year of publication Median 1999 endorse
Price Median $10.95
Length Median 175 pages
Reading level
Number of libraries holding book
Median 10th grade
Median 174
7 warn
12 pros
Cosleeping
and cons
Each book was classified independently by the authors accord-
ing to its positions on cosleeping and crying it out (support, op-
pose, or take no position). However, a simple division into these 3
groups seemed to oversimplify what are often nuanced opinions.
Therefore, we divided the supportive positions into 2 degrees of
support, advocating and endorsing. To advocate a position was Figure 1—Positions on cosleeping.
to recommend it as the best course of action and provide instruc-
tions for how to do it. To endorse a behavior was to present it as tions for how to stop it, such as “If your children climb in between
a perfectly acceptable alternative, perhaps with some conditions. you and your spouse, roll toward the middle and squish them just
The opposing positions were also divided into 2 degrees of op- enough to make it a very unpleasant place to sleep.”39
position, warning and opposing. To warn about a position was to Some books appear to take a position without being quite so
acknowledge that some may feel differently but to offer a general explicit about it. For instance, Reichert40 never states that she
recommendation against. To oppose a position was to clearly state endorses cosleeping. However, she lists several of the reasons
that it is undesirable and harmful. In addition to these clear po- people oppose it, and she systematically deconstructs those argu-
sitions, some books presented the advantages and disadvantages ments, leaving the reader with the impression that cosleeping is
(pros and cons) without taking a position. acceptable even if it has not been advocated. We characterized
One book did not address cosleeping, but, among the other 39, this as endorsement of cosleeping. On the other hand, some leave
the variety of positions presented is presented in Figure 1. There the impression that they think cosleeping is problematic even
was a wide range of positions on cosleeping, with the largest num- if they haven’t outright opposed it. For instance, Quine41 writes
ber of books (30%) presenting pros and cons without taking a po- that some parents may not mind the “wriggling and kicking” and
sition. Those presenting pros and cons often included statements therefore may cosleep happily, but then she adds, “Most parents,
such as: however, wish to share their bed together alone. Mothers, and
I am not suggesting that you should try bed-sharing if your particularly fathers, resent small children making a regular ap-
child does not sleep. What I am saying is that you should do pearance in their bedroom late at night or in the small hours of the
what you think is right and best, not what I think is best, nor morning.”41p27 We characterized this as warning against cosleep-
what anyone else advocates. All I want to do is show some ing.
of the advantages and disadvantages, and leave it to you to The presentation of cosleeping was quite complex in some
make a decision.36 books and very simplistic in others. The most commonly cited
reasons to support cosleeping (see Table 3) were that it is natu-
Those who advocate cosleeping are clear that they think it is
ral, it helps build a strong mother-infant attachment, it prevents
best. For instance, Sears37p23 says explicitly: “…I have advocated
sudden infant death syndrome, is easier when breastfeeding, and
this cosleeping arrangement with my patients. It works for most
helps the parent get more sleep. Books that presented the advan-
families most of the time.” Furthermore, his reasons make it clear
tages and disadvantages of cosleeping without advocating it of-
that he thinks cosleeping is obviously more enlightened as to the
fered similar reasons but were less likely to assert that it improves
true nature of children and parenthood. “Sharing sleep involves
attachment, prevents sudden infant death syndrome, or helps the
more than a decision about where your child sleeps. It reflects
parent sleep. Those books opposing cosleeping offered reasons
an attitude of acceptance of your child as a little person with big
for that position as well. The group of books opposing cosleeping
needs.” Those who oppose cosleeping are typically just as clear.
did not represent such a unified position as did those support-
Kenny’s book of tips includes 1 page headed by these instructions
ing cosleeping, but the most common arguments (see Table 4)
in very large letters: “Tip 13: Avoid Letting Baby Sleep in Your
were that it causes sleep problems for the child and interferes with
Bed.” The first line of text reads “You really won’t be doing any-
adult sleep. Those books that presented pros and cons without
one any favors by letting your infant sleep with you.”38p22 Some
advocating cosleeping offered some similar arguments; however,
are so adamantly opposed to cosleeping that they provide sugges-
they were less likely to claim that cosleeping causes sleep prob-
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 Table 3—Reasons Offered to Support Cosleeping

Books Supporting Books Presenting

Cosleeping No. (%) Cosleeping, but
(n = 11) Offering No
Position No. (%) 11 oppose
(n = 12)
Improves breastfeeding 10 (91%) 9 (75)
Improves attachment 9 (82) 4 (33) 20
Helps parent sleep 9 (82) 5 (42) advocate
Prevent SIDS 8 (73) 3 (25)
It’s natural 8 (73) 6 (50) 1 warns
Provide emotional security 7 (64) 5 (42)
Mom wants to be close 5 (46) 4 (33)
Meet baby’s needs 5 (46) 6 (50) 3 pros
Helps baby sleep
Baby needs healthy touch
5 (46)
5 (46)
7 (58)
4 (33)
and cons
Baby seems to want it 3 (27) 1 (8)
Easy to check on baby 2 (18) 4 (33) 4 endorse
lems in the child and more likely to assert that it interferes with Figure 2—Positions on crying it out.
the parents’ sex life and the opportunity to have some time alone.
Among those books endorsing cosleeping, there were really 2 the amount or degree of protest. These methods are both based on
different patterns recommended: early cosleeping and long-term the principles of behavior extinction. Of the books that endorsed
cosleeping. The early cosleeping books endorsed cosleeping only crying it out, most (n = 15, 65%) recommended scheduled check-
during the first few weeks or months after birth. One book rec- ing. A smaller number (n = 6, 25%) recommended cold turkey,
ommending early cosleeping proposed bed sharing, 2 suggested and a few (n = 3, 13%) provided instructions on both methods,
room sharing with the baby sleeping in a bassinette, and 1 pro- noting that either could be used.
vided guidance on both variations of early cosleeping. A larger
group of books (n = 7) recommended long-term bed sharing, the Combinations of Positions
prototypical family bed approach. The positions presented in the books on these 2 issues were
typically oppositional, just as it had been proposed they might
Cry-It-Out Sleep Training be. Slightly more than half the books (n = 22) took either a firm
All but 1 of the books addressed cry-it-out sleep training. There position against cosleeping but for crying it out, or a position for
was consensus among the books on crying it out, with most of cosleeping but against crying it out (χ2(4, n = 40) = 25.23, p <
the books either advocating or endorsing it (see Figure 2). Those 0.001). See Table 5 for details.
advocating sleep training stated absolutely that such training is However, a substantial minority of books (n = 18) did not fit
clearly in the child’s best interest. For instance, Pearce and Bid- neatly into the dichotomy of the so-called “Ferberizers” versus
der42 wrote: “Believe it or not, leaving your child alone to cry in “Searsites.” The largest group was comprised of 10 books that
bed is a way to show your love and care for him…If you can help explicitly recommended cry-it-out sleep training and then either
your child get himself to sleep, you’ll be preparing him for a life didn’t mention cosleeping or presented some advantages and dis-
of independence.” 42p66 advantages without taking a position on the practice. Three books
A substantial minority of books were strictly opposed to offered arguments on both issues without taking a position on
sleep training. Sears and Sears43 even wrote: “Beware of sleep either. Two books endorsed early cosleeping followed by sleep
trainers”43p7 as the heading of a section in which they offered, in training to establish independent sleep some time during the first
no uncertain terms, why sleep training damages the child’s trust year after birth. The 3 remaining books were opposed to both
in his parents and generally interferes with adequate care of the cosleeping and crying it out. Instead, they recommended gentle
child. Pantley44 described her attempt to sleep train her infant, and forms of sleep training that do not involve crying.
her conclusion: “I decided then and there: they are all wrong. Hor- The books that fell neatly into the cosleeping versus sleep
ribly, intolerably, painfully wrong. I was convinced that this was training dichotomy tended to be written by authors with a medi-
a simplistic and harsh way to treat another human being, let alone cal background (71% of books written by a medical professional
the precious little love of my life.” 44p5 A very few books discussed versus 39% of those written by a nonmedical author; χ2(1, n = 40)
crying it out but refrained from taking a position on it, and these = 3.88, p < 0.05) and to be written by men (71% of books written
did not take a position on cosleeping either but, rather, presented by men versus 39% of those written by women; χ2(1, n = 40) =
a list of options. 3.88, p < 0.05). Furthermore, books that fell into the dichotomy
While the support for sleep training was more widespread, the were longer (average 204 versus 158 pages; t38 = -2.05, p < 0.05),
books represented 2 basic variations on crying it out. Scheduled more expensive (average $13.70 versus $9.17; t38 = -2.49, p <
checking (sometimes called “controlled crying”) recommends pe- 0.05), and written at a higher reading grade level (average 11.1
riodic visits to calm and reassure the crying baby, whereas cold versus 9.5 grade; t38 = -3.04, p < 0.01) than books that did not
turkey teaches solitary sleep by simply putting the baby in the pre- reflect the dichotomy.
determined sleeping space and leaving him or her there no matter Finally, there did appear to be a relationship between an au-

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 Table 4—Reasons Offered to Oppose Cosleeping Table 5—Relative Positions on Cosleeping and Crying It Out

Books Opposing Books Presenting Position on Crying It Out

Cosleeping Cosleeping, but Position on Cosleeping Opposed No position In favor
No. (%) Offering No Opposed 3 1 12
(n = 16) Position No. (%) No position 0 3 10
(n = 12) In favor 9 0 2
Causes sleep problems 12 (77) 4 (33)
Hurts parent’s sleep 10 (65) 8 (67) about a potentially medical sleep problem. However, for most
Unsafe 7 (42) 4 (33) children, sleep is an element of their behavioral and psychologi-
Causes dependency 7 (42) 5 (42) cal make-up, so that a medical perspective may be unnecessary.
Won’t be able to get them 5 (29) 6 (50) Several of these books refer explicitly to the dichotomy be-
out later
tween cosleeping and sleep training. The existence of the dichot-
Harms parents’ marriage 5 (29) 1 (8)
omy seems to be widely recognized among the authors of this
Parent may be trying to meet 5 (29) 3 (25)
own emotional needs sample of books. As a general characterization, books written by
Parent needs time alone 4 (24) 8 (67) medical professionals tend to take contradictory positions on co-
Hurts parents’ sex life 3 (18) 7 (58) sleeping and sleep training, and those positions tend to be in favor
Not normal in this culture 2 (12) 3 (25) of sleep training and opposed to cosleeping. Whether this is the
Risk of sexual abuse or 1 (6) 1 (8) correct position remains to be determined, as the existing body of
sexual overstimulation research is inconclusive in many ways, and largely incomplete.
thor’s academic publishing history and his or her position on co- The reasons offered in support of or in opposition to cosleep-
sleeping. Academicians who wrote books about sleep, it seems, ing are noteworthy in that they highlight the need for research in
were not advocates of cosleeping. Specifically, none of those au- this area. It might also be noted that the unanswered questions
thors with a history of academic publication (n = 10) supported are generally not medical in nature; most pertain to normative
cosleeping, whereas one third of those without a publication his- child development and family science. Assertions are often di-
tory (n = 11 of 30) advocated it (χ2 (2, n = 40) = 9.27, p < 0.01). rectly contradictory, even on issues that are amenable to objective
research. For instance, 82% of books advocating of cosleeping
DISCUSSION claim that it helps parents get more sleep, yet 65% of books op-
posing cosleeping claim that it interferes with adult sleep. To our
This review of parenting advice books about sleep practices knowledge, the only published research on this question is based
reveals how great is the supply of information and advice about on a very small number of subjects and actually demonstrates no
children’s sleep. Parents have a wide selection of resources easily difference in total sleep time for the mother between bed shar-
available to them and at reasonable cost. This review does not ex- ing and separate sleeping arrangements.45 Despite this, maternal
amine sleep advice administered through general parenting books sleep is 1 of the major arguments being put forth by authors on
and through parenting magazines, which may reach an even larger both sides of the cosleeping controversy. Furthermore, the books
audience. However, the number of books specifically on the top- presenting pros and cons without taking a position present a
ic of sleep suggests a tremendous need for or interest in advice somewhat different picture of cosleeping than do those that take
on this topic. Even since these data were analyzed, several new a position. The differences between them highlight deficiencies
books in this genre have appeared on the market, including a revi- in the body of research literature informing these parenting advi-
sion of Ferber’s famous advice book. This revision has created a sors. Those areas of uncertainty, seized upon by proponents for
media stir because it presents a position on cosleeping that is dif- their purposes and opponents for theirs, represent fertile research
ferent from the original. It is noteworthy that Sears, often depicted questions. Do children who cosleep have a more secure attach-
as Ferber’s oppositional character, has also modified his views ment to their parents? Do they develop sleep problems after co-
on cosleeping. Both Sears and Ferber have moved closer to the sleeping? Is the sleep quality of parents of cosleeping children
middle, to the position that where a child sleeps is not nearly as different from that of solitary sleeping children? Do parents of
important as interactions during the transition to and from sleep. cosleeping children suffer from lack of time to themselves, and
However, this has been perceived by the public as experts not does cosleeping interfere with adult sexual relationships? These
being trustworthy because they change their minds and flip posi- are apparently important questions with practical implications for
tions. families of young children.
Books on the topic are authored by people from a variety of With regard to cosleeping, the advice is quite varied without
professions and those without any professional background. It is expert consensus. In fact, the largest number of books discusses
notable that nonprofessionals write a great many of the advice cosleeping without even taking a position. This may reflect the
books in this area and that the medical profession dominates contentious debate, both in public and professional circles, about
among those books with a professional author. Researchers, child cosleeping. While there is a consensus against cosleeping among
development specialists, and psychologists are not well represent- the relatively few authors who have published in academic litera-
ed. ture, the consensus is much broader in support of sleep training.
The lack of a professional background in sleep of most of the Despite the contradictions, parents are offered quite a bit of ad-
authors is of debatable significance. One might argue that medical vice on how to accomplish their own sleep preference with their
professionals trained in sleep medicine would provide more reli- young children. The lack of clear scientific evidence does not
able information to parents, especially if the reader is concerned stop many of the authors from dispensing strong advice.
SLEEP,
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 Given the need for advice and the degree of controversy in the
area of children’s sleep, it would be desirable to rate the qual-
ity of advice offered in these parenting books by comparison to
truths established through scientific research. This task must be
postponed, however, until there is scientific consensus on these
issues. In the meantime, parents are likely to be more confused
after reading the expert opinions than they were beforehand.
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