After going through your bedtime routine, put your baby in their crib, leave the room and wait a specific amount of time (say, a minute). Then go in and reassure your baby with words like “Mommy loves you” or some kind of touch, such as a rub or pat. McGinn says it’s preferable not to pick the baby up. Garden, on the other hand, reserves this method for babies seven months and older. (In her opinion, younger babies require a parental presence so they know they haven’t been abandoned, especially if they’ve worked themselves up into a frenzy.)
“I always say bedtime and nap routines can start from day 1. A child is never too young to learn healthy sleep habits and routines! But to get a baby sleeping through the night there are a few things I check. The baby should be at least 15 lbs, no medical concerns, and on a healthy growth curve approved by their pediatrician. If all these points are met, then I'm ready to start getting that little one sleeping through the night!"
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.
The idea behind extinction (or full extinction to differentiate it from graduated extinction) is that you want to extinguish the behaviour (crying) by not responding to it. As with the check-and-console method, go through your bedtime routine, put them in their crib awake, say good night and walk out. This is certainly the most controversial sleep-training method, and even experts disagree on what you should do next—it all depends on what stage your baby is at developmentally, as well as what works for the parents.
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.
No one likes to talk about sudden infant death syndrome (SIDS); it is a terrifying topic. SIDS is defined as the sudden death of an infant, which remains unexplained after a thorough investigation. These deaths occur in the first year of life, with the highest risk occurring between 2 and 6 months of age. Fortunately, these deaths are becoming less common, thanks in large part to the early ’90s Back to Sleep campaign, which urged parents to place infants to sleep on their backs. Suffocation is also a major risk for infants if they do not sleep in a safe sleeping environment.
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.
"I tried Tracy Hogg's approach: Don't leave the baby to cry! Instead, when he starts up, go in there, pick him up, and love him until he stops. Once he's calm, lay him back down. If he starts crying again, repeat. Eventually he'll know it's time to sleep. Hogg said she had to do it 126 times with one child, but it dropped to 30 the next night, four the next, and soon she didn't have to do it at all. I tried this with my 3-month-old and it worked like a charm!"
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.
"I have a 6-month-old who has refused to sleep longer than 30 to 90 minutes day or night since he was born! I've tried everything out there except CIO. He's strictly breastfed and relies on that or rocking to get to sleep. He doesn't know how to soothe himself to sleep, and he naps for only 15 minutes. I'm severely sleep deprived. I don't have the heart for CIO, but I think I'll try the revised method where you pat him down and reassure him lovingly while allowing him the opportunity to comfort himself. He's been co-sleeping since day one, and it's going to be tough, but I'm at my wits' end and cannot function."
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/
"There are good times to sleep-train and periods when it may be less likely to work," says developmental psychologist Isabela Granic, Ph.D., coauthor of Bed Timing: The 'When-To' Guide to Helping Your Child to Sleep. "This is because infants and toddlers go through mental growth spurts that make them especially clingy, fussy, and prone to night wakings. They're learning new cognitive skills and often don't sleep as well."
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.
Prepare yourself for a few difficult nights. Hearing your baby cry can be excruciating, as every parent knows. During the waiting periods, set a timer and go to a different part of the house, or turn on some music, so you don't have to hear every whimper. As one BabyCenter parent says, "The first week could be rough. Try to relax and know that when it's all over, everyone in your household is going to sleep more easily and happily."
There’s also no need to institute a regimented cry-it-out plan if what you’re currently doing is working for your family. But good sleep habits never hurt, and being able to fall asleep on one’s own is a necessary life skill. If you sleep-train at a time that’s developmentally appropriate for your baby and with the basic ingredients of healthy sleep in place, you can minimize the amount of crying your baby (and, let’s face it, you) will do.