If your baby is growing poorly or is difficult to console, you should talk to your child’s pediatrician to ensure that your child’s sleeping difficulties have no medical cause. Likewise, if you are struggling with depression, it is critical to discuss this with your child’s pediatrician as well as your own physician. Poor sleep can prolong postpartum depression in mothers.
Thank you for your comment! We agree, and we think most parents do, that cry-it-out is a last resort, and we always recommend trying a gentle sleep coaching method first. That said, the research on cry-it-out is that, done correctly and not as a replacement for parenting your baby, it is not harmful, and can indeed be beneficial when you consider the damage that lack of sleep can do to a baby’s overall health and well-being. We have an article with further information about our philosophy on cry-it-out here: https://www.babysleepsite.com/sleep-training/cry-it-out-age/
Some experts suggest techniques that are slightly different than these methods. Perhaps the best known is pediatrician Harvey Karp, author of The Happiest Baby on the Block. His method suggests a very specific routine involving the so-called five S's: swaddling, the side or stomach position (for calming your baby, not for sleeping), shushing, swinging, and sucking.
A version of this technique called graduated extinction was popularized by Dr. Richard Ferber in his book “Solve Your Child’s Sleep Problems.” Here, parents check on their child at set intervals. Checks should be brief and to the point: Picking up your child, spending too much time hovering over the crib or otherwise offering more contact than a quick soothing word can be counterproductive. Some babies find these brief checks soothing and will go to sleep more quickly. Others will redouble their crying as soon as their parents leave the room. Parents need to make a judgement about whether or not checking in is helping their baby through this process. If you decide to use checks, I would recommend checking no more than every five minutes and resisting the temptation to check if your child seems to be calming down.
"As a last resort, I broke down and gave Ferber a try. It's been two and a half weeks, and I see no real improvement. My daughter goes down faster at night, but the crying breaks my heart. I miss snuggling with her. She still wakes up every 30 to 90 minutes after her first two-hour stretch. She shrieks when it's time for a nap. I broke down and nursed her to sleep for her afternoon nap because I couldn't stand to see her so exhausted."
All sleep-training methods have pros and cons, says Vanessa Vance, a child-sleep consultant in Austin, Texas, so it’s important to suss out which one is best for you. “When I work with a family, we discuss what their needs and goals are. Some families may not want any crying, so a gradual approach may work best,” she says. Here, an overview of some of the most popular sleep-training methods:
"The more practice your baby gets putting himself to sleep, the quicker the process works. He will fall asleep on his own, and you will get the sleep you need...Don't wait too long, though. The earlier, the better. Remember, once your baby gets older – that is, at least 5 or 6 months – the process of getting your child on a sleep schedule and to sleep through the night gets more difficult."
C.I.O. is the most famous sleep training technique, and the most controversial — although, despite its daunting name, it is safe and effective. In its simplest form, unmodified extinction, you place your infant down at bedtime, drowsy but awake, and then leave the room, without returning to check on or soothe your baby. This method will work quickly, but often produces prolonged periods of crying for a few nights, which can be difficult for parents to tolerate.
Nicole Johnson is the founder and lead sleep consultant of The Baby Sleep Site®. Since she began in 2008, and with the help of her team of sleep consultants, she has helped over 40,000 families improve their sleep. She has also held a position on the board of the International Association of Child Sleep Consultants (IACSC) since 2015. Millions of visitors land on The Baby Sleep Site each year, and Nicole and her team are here to find solutions for your family’s sleep problems that will match your baby's temperament and your parenting style.
It might be strange to think of sleeping as a skill that does not come naturally. As a new parent, you’re probably so exhausted that you pass out as soon as your head hits the pillow. Your baby, however, doesn’t have this same ability yet. Although they spend a lot of time sleeping, they need to learn when to sleep (day vs. night) and how to sleep. Until they do, they need your assistance, which is why you (as you should) help soothe them to sleep at bedtime and comfort them when they wake in the middle of the night. Sleep training is teaching your baby how to sleep without any help from you - just like you’re able to fall asleep without anyone there to help you do it.
• No tears method. Created by sleep expert Elizabeth Pantley, this technique, also known as the no-cry method, involves subtly shifting your child’s sleep habits. For example, one trick, known as “fading,” suggests gradually easing out of baby’s go-to sleep strategy. For instance, if she always needs to be rocked, you would rock less and less until you can put her down to sleep without any rocking. Another technique, called substitution, switches out the routine—so if baby always nurses before bedtime, read a book instead.
Yes. Multiple studies have shown that sleep training is both safe and effective, without any studies showing evidence of harm. The best long-term study followed 326 children for the first six years of life. The authors reported that children who had sleep trained via any method in infancy slept better at 2 years of age than children who were not sleep trained, and their mothers were less likely to be depressed. Several years later, the researchers looked at these children again and noted that there was no evidence of emotional or behavioral problems in children who had been sleep trained versus those who had not. As part of this follow-up, the researchers measured the children’s levels of the stress hormone cortisol, which is frequently cited by opponents of sleep training as the mechanism by which crying affects developing brains. The researchers did not find any evidence of differing levels of cortisol secretion between children who had been sleep trained and those who had not.
As your baby gets older and their sleep needs change, make sure that you’re adjusting wake times, naps and bedtimes accordingly to help them continue to easily fall asleep and stay asleep. Some parents think of sleep training as a “one-and-done” endeavour: You endure a lot of crying for a few days and your prize is a perfect sleeper. But it’s really a lifestyle change—once your child has the skills to fall asleep, they’ll still need routines, consistency and help adapting when life throws curveballs, like starting daycare, the arrival of a new sibling or going on a trip (where they may have to sleep in a different space or crib). Colds and illnesses, as well as time changes, can also throw a wrench in your perfect schedule. The trick here is to get back on track as soon as possible. If you start allowing or enabling the old, bad habits and sleep associations, it will take longer to return to the regular routine.
A consistent bedtime routine is the cornerstone of good sleep for children. It should also be a time for parents and babies to bond. Bedtime routines need not be complex. Bathe your child (if you like), change her into pajamas, read her a story, sing a song and feed or soothe her, then put her in her crib. The key is consistency — performing the same activities, in the same sequence, at the same time each evening.
With the fading technique, continue with whatever method you were using to help your baby fall asleep (such as rocking or nursing), but decrease the amount of time you spend doing it until, in theory, you don’t have to do it at all. This is a great technique for minimizing crying, but unfortunately, many parents find it difficult to sustain. “There has to be an end in sight,” explains Mitelman. “For example, we’ll meet this need for five to seven days and then we’ll pull back a little bit.” But if you’re willing to stick to the plan and get your baby to the end goal of going to bed without your assistance, Mitelman says it’s worth a try. “Whichever way the child can get to sleep independently is fine because that’s the key ingredient to sleeping through the night.”