• DIY methods work. Don’t love the rigidity of a particular method? Modify it to suit your own family’s circumstances. Sometimes, a sleep coach can be helpful to come up with modifications that won’t affect the goal of getting baby to sleep through the night, but it’s fine to mix and match until you find a strategy you’re comfortable with. “I don’t think I’ve ever loved and loathed anything as much as I do sleep training. We did it with my son because he was still waking up every three hours at 3.5 months old, and I felt it was more out of habit,” says Margaret, a mom of one. “My husband and I decided that we valued teaching him self-soothing and that in the long run it was worth some short-term effort. I did a ton of research and came up with our own plan—similar to Ferber, but our time limits of letting him fuss weren’t as rigid. It worked, and he’s been a solid sleeper since.”
"There are good times to sleep-train and periods when it may be less likely to work," says developmental psychologist Isabela Granic, Ph.D., coauthor of Bed Timing: The 'When-To' Guide to Helping Your Child to Sleep. "This is because infants and toddlers go through mental growth spurts that make them especially clingy, fussy, and prone to night wakings. They're learning new cognitive skills and often don't sleep as well."
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.
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.
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Sleep training advocates in this category encourage a more gradual approach – soothing the baby to sleep and offering comfort right away when the child cries. Pediatrician William Sears, author of The Baby Sleep Book, is a leading proponent. Parent educator Elizabeth Pantley outlines a step-by-step no tears approach in her book The No-Cry Sleep Solution.
There are various schools of thought on sleep training. Some sleep-training methods fall under the umbrella of “gentle sleep training,” which generally means you’re still going to pick up, rock and soothe baby if she cries. Other methods, often under the “extinction” label, advise parents to let baby self-soothe for the entire night and not open the door until morning. Neither of these methods are right or wrong—it all depends on what works best for you and your family.
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.”
If your baby is growing poorly or is difficult to console, you should talk to your child’s pediatrician to ensure that your child’s sleeping difficulties have no medical cause. Likewise, if you are struggling with depression, it is critical to discuss this with your child’s pediatrician as well as your own physician. Poor sleep can prolong postpartum depression in mothers.
"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."
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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.
Sleep training will look a little bit different for every family, depending on what method you choose to follow. The different methods require different tactics from the parents in order to be successful. Melissa’s tip: take notes! Having a record of how your baby has progressed throughout the sleep training will come in handy when you’re too tired to remember how long (or little) they slept the previous night.
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.
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.