• Weissbluth method. This sleep-training method suggests you set up a bedtime routine (bath, book, lullaby), then put baby to sleep, shut the door and don’t re-enter until the next morning. “I tried this, and the first night was awful,” says Jen, a mom of one, who did the Weissbluth method at 4 months. “I turned on the shower and sat in the bathroom so I wouldn’t hear my son cry. But I was watching the baby monitor and saw that after an hour, he found his thumb and fell asleep. The next night was maybe 40 minutes of crying, then 20 minutes the night after that. He’s always happy in the morning, and I feel this was the right choice.”
Parents often wonder how to know if your child needs sleep training or if their sleep habits are just something they’ll grow out of. If your baby is consistently cranky and overtired, it's probably time to look into helping them become a better sleeper. And as Melissa noted, she started sleep training the second time around because she could tell her son was just as frustrated as she was about not sleeping!
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.
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.
Raising a healthy sleeper starts with a consistent bedtime routine. You can start enforcing this when your baby is roughly six weeks old. At the same time every night, read a book together, sing songs, and feed your baby before putting him or her into the crib. It may also help to get your child up at the same time every morning and put him down for naps at regular times.
• Have a solid bedtime routine. Experts say that regardless of which sleep-training method you use, having a stable bedtime—between 5:30 and 7:30 p.m. for infants, Vance suggests—and a steady routine are key. Whether it’s bath, book, lullaby, bed or a different sequence, doing the same thing every evening is part of the bedrock of good sleep hygiene. Blackout curtains and a white noise app may also help.
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 knew I didn’t want to sleep train, so I co-slept with my son until he was about 5 months old,” says Corinna, a mom of two. “At 5 months, I was able to put him in a room on his own, but I would attend to him if he cried. By 10 months, he was sleeping through the night on his own. Maybe I was lucky, but I felt like what worked best for our family was following his lead.”
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.
Sleep training means using behavioral techniques to teach your baby to sleep independently by altering her “sleep onset associations” — or the circumstances your baby needs to fall asleep at bedtime. By removing your presence at bedtime, you are providing new associations with the result that she will learn to fall asleep independently, both at bedtime and when she awakens during the night.
The biggest reason why the solutions that work for one parent don’t work for another is simple. They’re not dealing with the same baby. Some babies are heavily reliant on sleep props. Others can’t sleep in a room that’s too warm. Some may not be getting enough daytime sleep, and others might be overtired. This baby might have developed an association between feeding and falling asleep, whereas that one might be ready to drop their second daytime nap. And, of course, it could be any combination of all of the above, or the many other sleep challenges that babies might experience.
"My first cried it out, and all was well. My second cried it out but it took much longer until all was well. My third, if allowed to cry too long, literally freaked out. He threw himself around his crib and would rarely calm down and fall asleep. On the rare occasion that he fell asleep, he'd wake up within minutes screaming bloody murder. Letting him cry it out was clearly not working so I looked for other options. Find your child's groove. You'll be glad you did."
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.