"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.
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.”
Sleep experts who support the cry it out approach (as well as most pediatricians) disagree. They say it isn't traumatic for babies to cry alone for short periods of time with frequent check-ins by Mom or Dad – and the end result is a well-rested, happier child. They say no tears sleep strategies may cause babies to be overly dependent on comfort from a parent at bedtime, making it harder for them to learn to soothe themselves to sleep.
McKenna advises against sleep training and encouraging babies to sleep for long stretches at night. Instead, he urges parents to follow their babies' cues and allow them to wake frequently through the night to feed. A strong advocate for co-sleeping, McKenna encourages bed-sharing and other co-sleeping arrangements, such as putting the baby in a bassinet or crib at the parent's bedside, while also following standard SIDS safety precautions – for example, making sure there are no blankets or stuffed animals around him.
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.
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.
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.
This is considered a ‘cry’ method of sleep training. This technique entails allowing your baby to cry while checking on him at intervals. The goal here is to reassure him every so often that you are nearby and to reassure yourself that he is okay. When you go to check on your baby, you are not “supposed” to pick him up nor engage him much, but simply reassure him using your voice and a loving pat for 2-3 minutes, tops (watch the clock!). With this sleep training method, the goal is NOT to help baby fall asleep – that is what he is learning to do on his own! Instead, the idea is that he falls asleep on his own, in the same “environment” in which he will awaken periodically throughout the night. The knowledge of how to fall asleep unassisted at bedtime will pave the way for him/her to go BACK to sleep throughout the night. Over time, you gradually increase the amount of time between your ‘checks’. See a more detailed step-by-step explanation of this method here: The Ferber Method
Crying isn't the goal of this sleep training method, but advocates say it's often an inevitable side effect as your baby adjusts to sleeping on his own. They say the short-term pain of a few tears is far outweighed by the long-term advantages: A child who goes to sleep easily and happily on his own, and parents who can count on a good night's rest.
"By the time your baby is 3 months old and has developed a fairly predictable 24-hour pattern, it becomes more important for you to provide increasingly consistent structure. If you do your best to establish a reasonable and consistent daily routine and keep to it as much as possible, then it is likely that your child will continue to develop good patterns. If instead you allow the times of your child's feedings, playtimes, baths, and other activities to change constantly, chances are his sleep will become irregular as well."
This is a very gentle, no-tears/no-cry (or very little cry) method of sleep coaching where you “fade it out” (FIO). With the Fading method, you continue to help your baby fall asleep (by rocking or feeding to sleep, for instance), but over time, you gradually do less and less of the ‘work’ to put your baby to sleep, and your baby does more and more. For instance, if you normally rock your baby completely to sleep, you may shorten the amount of time you rock each night until you are rocking for only a few minutes only as a part of the bedtime routine. This method requires quite a bit of patience on the parent’s part, in some cases, but it’s great for families who want to minimize crying as much as possible.
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.
"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."
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Sears emphasizes a nurturing, child-centered approach to sleep and warns parents to be wary of one-size-fits-all sleep training. He recommends patiently helping your baby learn to sleep in his own time. He encourages co-sleeping, rocking and nursing your baby to sleep, and other forms of physical closeness to create positive sleep associations now and healthy sleep habits down the road.
"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."
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.)