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.
Simply put, sleep training—also called sleep teaching or sleep learning—is the process of helping your infant learn how to fall asleep and stay asleep. It’s also become a pretty controversial topic, with experts and parents speaking for or against various sleep-training techniques. “It’s like talking politics,” says TJ Gold, MD, a pediatrician at Tribeca Pediatrics in New York City. “But there’s no one right way to get your child to sleep through the night. There are a lot of different ways.”
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.
"I have a 3-month-old who I rock at night. He falls asleep very quickly (much quicker than if I leave him in his crib). If he wakes in the middle of the night, we go to him and comfort him. We don't take him out – we just help soothe him. Why make him feel lonely and abandoned? I have no problem losing a little sleep if it means that he feels like we will be there for him."
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)."
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.”
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.
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.
Also on the far end of the cry it out spectrum is the Baby Wise approach by pediatrician Robert Bucknam and co-author Gary Ezzo. In their book On Becoming Baby Wise, they advise against feeding babies on demand around the clock and instead advocate a parent-led feeding, wake, and sleep schedule. Their method involves following a strict nap and sleep schedule and putting your baby down awake so she can learn to soothe herself to sleep. This means there will be some crying, especially at first, as your baby adjusts to your schedule.
"I have a 6-month-old who has refused to sleep longer than 30 to 90 minutes day or night since he was born! I've tried everything out there except CIO. He's strictly breastfed and relies on that or rocking to get to sleep. He doesn't know how to soothe himself to sleep, and he naps for only 15 minutes. I'm severely sleep deprived. I don't have the heart for CIO, but I think I'll try the revised method where you pat him down and reassure him lovingly while allowing him the opportunity to comfort himself. He's been co-sleeping since day one, and it's going to be tough, but I'm at my wits' end and cannot function."
This is a very gradual sleep-training method ( McGinn gives her clients a two-week plan for implementation) and requires a lot of discipline on the part of the parents. Again, you prep your baby for bed, but instead of leaving the room, you sit in a chair next to the crib. When they fall asleep, leave the room, but every time they wake up, sit back down in the chair until they fall back asleep. Every few nights, move the chair further and further away until you’re out of the room.