Hogg agrees with Sears that sleep associations should be positive but disagrees with his techniques. She cautions against letting your baby depend on "props" such as nursing, patting, and rocking to get to sleep. Instead, Hogg's approach calls for going to your baby when he cries, picking him up, and putting him back down as many times as necessary.
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.”
Camping out involves gradually withdrawing your presence from your child’s room over the course of a week or two. This method is a good fit for parents who are not comfortable with prolonged crying, although it is important to recognize that, for some children, there is no such thing as a “no-cry” solution. The downside is that camping out takes longer than C.I.O.
Some families opt to hire a sleep consultant or sleep coach to help them with sleep training. Just like deciding what sleep training method is best for your family, the decision to hire a sleep coach is a completely personal one. We talked to Rachel Turner, a certified sleep consultant and owner of Hello Sleep, and asked her how why a family might consider hiring a sleep consultant. Here's what she had to say:
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.
"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.
While you may have read up on various sleep training methods while pregnant or in the early weeks of baby’s life, it’s a good idea to speak with your pediatrician before you start. For example, if your child is gaining weight slowly or was a preemie, he may not be ready to drop a nighttime feeding and may need a sleep-training schedule that’s adapted to a few middle-of-the-night wake-ups.
Cry It Out: This method involves putting your baby into the crib drowsy, but awake. The goal is for your child to learn to fall asleep without your help, so that when your baby inevitably wakes up in the middle of the night, he or she will be able to go back to sleep on his or her own. You say goodnight and leave the room—even if your baby cries. Then, you go back in at increasingly long intervals to briefly reassure your baby. It can be difficult to listen to your baby cry, but parents who have been successful with the technique report that it results in fewer tears overall and more sleep for everyone.
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.
"My 5-month-old was waking every two hours at night. I was so tired I wanted to die. I finally caved in, put in earplugs, and let him cry it out – which he did, all night! But then, something amazing happened the next night: He slept a full 12 hours and awoke rosy and cheerful. It's been that way ever since, and he's even a better napper now. I know that it is hard to listen to your precious little one cry, but a sleep-deprived, miserable mom and baby is a terrible thing too."
"My 4-and-a-half-month-old will only sleep through the night if we do everything the experts say not to do. She must be nursed to sleep unless we want to see her turn purple and cry for 45 minutes or more. She's like a wind-up doll when she starts and never settles until she's comforted, and she's been that way from the beginning. It really became a matter of, "Do we want to sleep, or do we want to do what the books say?" If she's comforted and put down sleeping, she sleeps eight to 10 hours. To all you parents out there who have a baby like mine, do not despair – just do what works for you."
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.
"As you modify your baby's sleep behavior, you are going to have to give up middle-of-the-night crutches, known as negative associations, that may get her back to sleep in the short run but won't prevent her from popping up again in an hour. She may resist the change. The behavior may even get worse before it gets better as she adjusts to new routines, to new positive associations."
If your baby is older than six months, don’t worry, McGinn says: “It’s never too late to develop good sleep habits.” Dickinson says he finds nine months to be a bit of a sweet spot for parents in terms of getting babies to sleep through the night. “They are at a good age for understanding routines and don’t need to eat during the night,” he explains.