Exhausted parents may be eager to get training underway—so how do you know when to start sleep training? “Most infants are ready for some sort of sleep training at 4 to 6 months,” says Lauren Kupersmith, MD, a clinical instructor at the department of pediatrics at NYU Langone Medical Center. “While some pediatricians adhere to the guidelines that infants are ready to be sleep trained when they achieve a particular weight, I feel it’s much more appropriate to wait until they are developmentally ready to self-soothe, at about 4 months old.”
"A young child cannot yet understand what is best for him, and he may cry if he does not get what he wants," Ferber writes. "If he wanted to play with a sharp knife, you would not give it to him no matter how hard he cried, and you would not feel guilty or worry about psychological consequences. Poor sleep patterns are also harmful for your child and it is your job to correct them."

Though many of the parents I see in clinic have put up with terrible sleep for years, sleep training is a safe and effective tool to help babies learn to soothe themselves at night. For this guide, I reviewed the literature on infant sleep. As director of the Pediatric Sleep Center at Yale University, I have extensive experience helping families to address sleep problems. I have also written a book on the topic, which was inspired by sleepless nights with my own children.

Raising a healthy sleeper starts with a consistent bedtime routine. You can start enforcing this when your baby is roughly six weeks old. At the same time every night, read a book together, sing songs, and feed your baby before putting him or her into the crib. It may also help to get your child up at the same time every morning and put him down for naps at regular times.
"My daughter woke every hour on the hour in her crib. I tried every other method available. Finally, at 7 months, we let her cry it out. It took three to four weeks to complete the sleep training and even though it was the hardest thing I've had to do thus far, it was so worth it. She now sleeps about 10 hours a night and loves her crib. We're both happier and have more energy to play."

This is a very gradual sleep-training method ( McGinn gives her clients a two-week plan for implementation) and requires a lot of discipline on the part of the parents. Again, you prep your baby for bed, but instead of leaving the room, you sit in a chair next to the crib. When they fall asleep, leave the room, but every time they wake up, sit back down in the chair until they fall back asleep. Every few nights, move the chair further and further away until you’re out of the room.
Also on the far end of the cry it out spectrum is the Baby Wise approach by pediatrician Robert Bucknam and co-author Gary Ezzo. In their book On Becoming Baby Wise, they advise against feeding babies on demand around the clock and instead advocate a parent-led feeding, wake, and sleep schedule. Their method involves following a strict nap and sleep schedule and putting your baby down awake so she can learn to soothe herself to sleep. This means there will be some crying, especially at first, as your baby adjusts to your schedule.

"My first cried it out, and all was well. My second cried it out but it took much longer until all was well. My third, if allowed to cry too long, literally freaked out. He threw himself around his crib and would rarely calm down and fall asleep. On the rare occasion that he fell asleep, he'd wake up within minutes screaming bloody murder. Letting him cry it out was clearly not working so I looked for other options. Find your child's groove. You'll be glad you did."
Parents are often hesitant to go this route, worried about how much crying will be involved. While McGinn doesn’t deny it can be difficult at first, she finds parents are often surprised by how quickly it works. “Yes, there is a lot of crying, but it’s short term,” she says. “You might get a lot of crying for two to three nights, but then every night is less and less.” She says you should see significant improvement with this method by night three or four but adds that it’s important to try it for a week before determining that it’s not working.
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