Create a comfortable sleep environment that's tailored to your child. Some babies need more quiet and darkness than others. Recordings of soft music or nature sounds or the sound of a gurgling aquarium can be soothing. Make sure the sheets are cozy (warm them with a hot water bottle or a microwavable heating pad, for example, before laying your baby down) and that sleepwear doesn't chafe or bind. Younger babies may sleep better when swaddled. Don't overdress your child or overheat the room.
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.”
• Ferber method. Also known as timed-interval sleep training, modified sleep training or graduated extinction sleep training, parents using this method put baby down to sleep even if he’s crying, then return to check on him at different time intervals —every five, 10 and 15 minutes, and so on. You don’t pick baby up during these checks but can verbally soothe or pat him. Gradually, the intervals will get longer until eventually baby is sleeping through the night. “We did Ferber once my son was 8 months old. He got the hang of it pretty quickly and has been sleeping on his own for 10 to 12 hours ever since,” says Anika, a mom of one.
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.
"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."
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.
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.
"My first daughter was sleeping through the night (10 p.m. to 9 a.m.) by 6 months. We had a complete bedtime routine: a bath, a book, a bottle, then to bed, a little music in the crib, and asleep in 10 minutes. It was wonderful, but that scenario didn't work for my second daughter and hasn't worked for my son, so I've tried different things for each of them. Sometimes a plan doesn't work. Listen to your baby – he or she will tell you what you need to know."
• 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.
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.
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.