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.

"My 4-and-a-half-month-old will only sleep through the night if we do everything the experts say not to do. She must be nursed to sleep unless we want to see her turn purple and cry for 45 minutes or more. She's like a wind-up doll when she starts and never settles until she's comforted, and she's been that way from the beginning. It really became a matter of, "Do we want to sleep, or do we want to do what the books say?" If she's comforted and put down sleeping, she sleeps eight to 10 hours. To all you parents out there who have a baby like mine, do not despair – just do what works for you."
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.”
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.
• Pick-up-put-down method. In this sleep-training method, you put your child to bed while he’s awake and check on him at gradual intervals, as you do with the Ferber method. Unlike with Ferber, you can pick him up and comfort him, holding him for a few minutes before putting him down. Eventually baby will become drowsy enough to fall asleep on his own.
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If you’re on the fence about sleep training, it can be helpful to think of it this way: What is my baby’s developmental need right now? “At 11 months, they don’t need to eat during the night but they do need consistent sleep,” says Garden. Yes, those nights of crying are heartbreaking. But chances are, if you’re considering sleep training, it’s because what you’re currently doing isn’t working for you.
• Having trouble? A consultant can help. Sleep consultants and coaches familiar with different sleep-training methods can answer questions, troubleshoot problems and help you find a method that works with your family. But before you enlist the aid of a sleep coach (whose services can range from a phone consultation to an overnight analysis at your house), look into their qualifications. There’s no national governing body for sleep coaching, but there are various programs that provide certification. For example, the Family Sleep Institute is a national training program; Gentle Sleep Coaches, led by Kim West, is another. Before you commit, find out about the coach’s training and credentials, and ask for referrals and experiences from past clients.
"No Tears" Techniques: Just as some parents and experts believe that it is harmless to allow an older baby to cry for set periods of time, others prefer sleep-training methods that gradually teach the baby to fall asleep without Mom or Dad’s help. For example, one "no tears" method involves sitting in a chair next to the crib while the baby falls asleep, and then, each night, moving the chair farther from the crib until it's in the doorway—and then, finally, outside the room.

"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."

One common misconception about sleep training babies (also called sleep coaching) is that there’s only one way to do it. But this could not be further from the truth! In reality, there are a number of ways many parents can work to help their babies develop healthy sleep habits and stop waking up in the middle of the night or taking short naps. Some methods involve crying, but others involve little to no tears and are very gentle.
• Having trouble? A consultant can help. Sleep consultants and coaches familiar with different sleep-training methods can answer questions, troubleshoot problems and help you find a method that works with your family. But before you enlist the aid of a sleep coach (whose services can range from a phone consultation to an overnight analysis at your house), look into their qualifications. There’s no national governing body for sleep coaching, but there are various programs that provide certification. For example, the Family Sleep Institute is a national training program; Gentle Sleep Coaches, led by Kim West, is another. Before you commit, find out about the coach’s training and credentials, and ask for referrals and experiences from past clients.
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.
Do your research, talk to your doctor and if you’re overwhelmed, consider hiring a sleep consultant or taking a workshop. Your baby’s sleep might seem like a mystery to you, but there are people who understand the complexities and can help. While not everyone agrees with every approach, no one would argue with the benefits of a good night’s sleep, for babies and exhausted parents alike.

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"A young child cannot yet understand what is best for him, and he may cry if he does not get what he wants," Ferber writes. "If he wanted to play with a sharp knife, you would not give it to him no matter how hard he cried, and you would not feel guilty or worry about psychological consequences. Poor sleep patterns are also harmful for your child and it is your job to correct them."
It’s okay if you’re not ready. You aren’t missing out on sleep training if you skip it at 4 months: You truly can start sleep training at any age, even in the toddler years, although experts say it’s smart to be aware of developmental milestones and adjust baby’s sleep schedule accordingly. For example, the week baby learns to walk may be tough to implement a sleep-training schedule, and even a sleep-trained baby may see a regression simply because he’s going through such a developmental shift.

Some experts suggest techniques that are slightly different than these methods. Perhaps the best known is pediatrician Harvey Karp, author of The Happiest Baby on the Block. His method suggests a very specific routine involving the so-called five S's: swaddling, the side or stomach position (for calming your baby, not for sleeping), shushing, swinging, and sucking.
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.
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!
"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."
Camping out involves gradually withdrawing your presence from your child’s room over the course of a week or two. This method is a good fit for parents who are not comfortable with prolonged crying, although it is important to recognize that, for some children, there is no such thing as a “no-cry” solution. The downside is that camping out takes longer than C.I.O.
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: 
Thank you for checking out The Baby Sleep Site! I’m sorry to hear you’re having so much trouble with sleep. Based on your comment, it does sound like your little one might be coming into the 4 month sleep regression. We have an article with a lot of information on that here: https://www.babysleepsite.com/baby-sleep-patterns/4-month-sleep-regression/
"By the time your baby is 3 months old and has developed a fairly predictable 24-hour pattern, it becomes more important for you to provide increasingly consistent structure. If you do your best to establish a reasonable and consistent daily routine and keep to it as much as possible, then it is likely that your child will continue to develop good patterns. If instead you allow the times of your child's feedings, playtimes, baths, and other activities to change constantly, chances are his sleep will become irregular as well."
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