• Chair method. Also called the sleep lady shuffle or gradual withdrawal and popularized by Kim West, LCSW-C, author of Good Night, Sleep Tight, this method starts with you sitting in a chair next to baby’s crib. Each night, you move the chair farther away from the crib, verbally soothing or shushing baby when she cries (although occasional patting and picking up are okay) until you’re no longer in the room. This method can be helpful for older babies and toddlers who may suffer from separation anxiety and can understand that Mom and Dad are just on the other side of the door, but it also works for younger babies.
• Have a solid bedtime routine. Experts say that regardless of which sleep-training method you use, having a stable bedtime—between 5:30 and 7:30 p.m. for infants, Vance suggests—and a steady routine are key. Whether it’s bath, book, lullaby, bed or a different sequence, doing the same thing every evening is part of the bedrock of good sleep hygiene. Blackout curtains and a white noise app may also help.
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.
In clinic, I help parents with their children’s sleep problems. But in my own home, I found it challenging to apply the techniques I recommended to others. What seems obvious in a brightly-lit exam room is harder to follow at 2 a.m. Like many pediatricians do with their own children, I elected to try extinction sleep training, which involves letting a child cry in order to learn to soothe himself to sleep on his own. Night one was relatively easy, but night two left my wife in tears and me feeling like a heel. Things improved on night three, and our son scarcely cried on night four. By the end of the week, he was sleeping through the night again.
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.”
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.
"No Tears" Techniques: Just as some parents and experts believe that it is harmless to allow an older baby to cry for set periods of time, others prefer sleep-training methods that gradually teach the baby to fall asleep without Mom or Dad’s help. For example, one "no tears" method involves sitting in a chair next to the crib while the baby falls asleep, and then, each night, moving the chair farther from the crib until it's in the doorway—and then, finally, outside the room.
It’s difficult if not impossible to sleep train if you share a bed with your child. There’s good evidence that bed sharing is associated with sleep difficulties in infancy and beyond. One survey of more than 50,000 Norwegian families showed that bed sharing was associated with more frequent night awakenings at both 6 and 18 months. Switching your child to sleeping independently for a week or so prior to sleep training can be helpful as you can soothe your child to sleep in the new sleeping environment first.
Simply put, sleep training—also called sleep teaching or sleep learning—is the process of helping your infant learn how to fall asleep and stay asleep. It’s also become a pretty controversial topic, with experts and parents speaking for or against various sleep-training techniques. “It’s like talking politics,” says TJ Gold, MD, a pediatrician at Tribeca Pediatrics in New York City. “But there’s no one right way to get your child to sleep through the night. There are a lot of different ways.”
Adapt the method to fit your family. If you want to try a method like this but find it too harsh, you can use a more gradual approach. For instance, you can stretch out Ferber's seven-day program over 14 days, increasing the wait every other night rather than every night. Remember your primary objective: To give yourself and your child a good night's rest.
This method involves more tears than the previous two; however, you don’t leave your baby unattended in the room at all. Here’s how the chair method works: start by doing your normal bedtime routine. Then, put a chair very near the crib, bassinet, or bed and sit on the chair as your baby falls asleep. The goal is not to help your child fall asleep, nor to help her calm down necessarily, depending on how you implement it. You are generally not supposed to give your child any attention. The reason you are in the chair is only to reassure them that you are there with them and have not left them alone. Each night you move the chair farther and farther away from the crib until you are right outside the door until eventually, you no longer need the chair at all.
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.