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.

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.
• 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.
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.
This sleep training technique usually involves quite a bit of crying on your baby’s part for the first couple of nights but some say it tends to be less crying, overall, since sleep training is ‘done’ faster (for many, but not all, people). The way it works is simple – you do your bedtime routine, put your baby to bed awake, and then leave the room without returning for checks. If your baby cries, you are not supposed to go in to check on her; instead, you let her ‘cry it out’ on her own. The thinking here is that if you allow your baby to cry for a period of time, but then go in and ‘rescue’ her, you have all but guaranteed that she will cry for that amount of time the next night because she will expect you to come and “rescue” her again.
There’s also no need to institute a regimented cry-it-out plan if what you’re currently doing is working for your family. But good sleep habits never hurt, and being able to fall asleep on one’s own is a necessary life skill. If you sleep-train at a time that’s developmentally appropriate for your baby and with the basic ingredients of healthy sleep in place, you can minimize the amount of crying your baby (and, let’s face it, you) will do.
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