That said, sleep training isn’t a must-do for everyone, and many families who skip sleep training go on to have a child who learns to sleep through the night on her own. “It’s your family and your child, and I think there’s a misconception that pediatricians will force sleep training on your family, when that’s not the case,” Gold says. Experts emphasize that the best approach to sleep training is the one that fits your family.
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.
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.
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.)
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:
"My son is 6 months old and finally goes to sleep without a struggle! We thought the Ferber method was mean and that alternatives would be better. So we tried it all – Baby Whisperer, No-Cry Sleep Solution, Babywise, etc. None of it worked. Our son is an otherwise happy little guy, but every night and every nap was a battle. We'd spend hours trying to get him to sleep. We delayed trying Ferber until we'd tried everything else unsuccessfully. It worked after the first night! He wakes up better rested and happier (as do we)."
"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.
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.
"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."
Proponents of these sleep training methods say it's okay for your child to cry when you put him to bed and leave the room, although they don't advocate letting a baby cry indefinitely. Typically, these methods suggest putting your baby to bed when he's still awake and allowing short periods of crying punctuated by comforting (but not picking up) your child.
Some of these experts think cry it out methods are not good for babies. Pediatrician and "attachment parenting" advocate William Sears devotes an entire chapter of The Baby Sleep Book to a critique of cry it out approaches. Sears, along with no tears advocates such as Elizabeth Pantley (author of The No-Cry Sleep Solution), believes that cry it out techniques can give your child negative associations with bedtime and sleep that could last a lifetime.
"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!"
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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.