"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)."
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.
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.
This method involves more tears than the previous two; however, you don’t leave your baby unattended in the room at all. Here’s how the chair method works: start by doing your normal bedtime routine. Then, put a chair very near the crib, bassinet, or bed and sit on the chair as your baby falls asleep. The goal is not to help your child fall asleep, nor to help her calm down necessarily, depending on how you implement it. You are generally not supposed to give your child any attention. The reason you are in the chair is only to reassure them that you are there with them and have not left them alone. Each night you move the chair farther and farther away from the crib until you are right outside the door until eventually, you no longer need the chair at all.
Fading, also known as adult fading or camping out, falls in the middle of the sleep training spectrum. In fading, parents gradually diminish their bedtime role by sitting near your baby until she falls asleep and gradually moving the chair farther away from the crib each night. Another fading approach is to check on your baby and reassure her (without picking her up) every five minutes until she falls asleep.
The most well known cry it out technique is the one developed by pediatrician Richard Ferber, director of the Center for Pediatric Sleep Disorders at Children's Hospital Boston. Ferber says that in order to fall asleep on their own and sleep through the night, babies have to learn to soothe themselves. Ferber believes that teaching a baby to soothe himself may involve leaving him alone to cry for prescribed periods of time.
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.
In the first several weeks of life, babies are hungry at night, leading to an apparent reversal of day and night and erratic sleep patterns. Fortunately, this usually resolves by about 3 weeks of age, after which your child settles into a three- or four-hour cycle, typically following a pattern of waking, feeding and sleeping. At this point, exposing your baby to natural light during the day can help encourage longer periods of daytime wakefulness and more sleep at night.
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 have two kids. The first one was never left to cry it out – we rocked, sung, walked, drove her to sleep until she was old enough to be read a story. Then, with baby number two, I decided to try CIO and after one night, it worked. At 12 months, she goes to sleep at night by herself and never cries. It was the best thing I did. My husband was against it, but he wasn't the one up four or five times every night for nine months straight! Now our household is very happy and everybody sleeps well."
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.
Once you launch your plan, stick to it. Parents who've been through sleep training agree that consistency is the key. Unless you realize that your child simply isn't physically or emotionally ready and you decide to put the program on hold for a while, follow through with it for a couple of weeks. When your baby wakes you up at 2 a.m., you may be tempted to give in and hold or rock him, but if you do, your hard work will be wasted and you'll have to start over from square one.
"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."
Not to be confused with the bedtime-routine fading technique described above, bedtime-hour fading involves putting your baby into the crib at the time they usually end up dozing off, and making that their new bedtime for a couple of nights, and then gradually moving it to an earlier time. For example, say you always put your baby down at for the night at 7:30 p.m., but they tend to fuss or cry in the crib for 20 minutes or more, until they finally nod off around eight. This means 7:50 to 8 p.m. is actually their “natural bedtime,” even though you’d like it to be earlier. To figure out when your baby naturally falls asleep, keep a diary for a few nights to track when they finally settle for the night. (Using a video monitor can help with this.) A few nights later, move the whole routine 15 minutes earlier. Continue moving the bedtime earlier by 15 minutes each night (if needed) until your baby has shifted their old habits to nod off at the desired time instead of the later one.