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.
A version of this technique called graduated extinction was popularized by Dr. Richard Ferber in his book “Solve Your Child’s Sleep Problems.” Here, parents check on their child at set intervals. Checks should be brief and to the point: Picking up your child, spending too much time hovering over the crib or otherwise offering more contact than a quick soothing word can be counterproductive. Some babies find these brief checks soothing and will go to sleep more quickly. Others will redouble their crying as soon as their parents leave the room. Parents need to make a judgement about whether or not checking in is helping their baby through this process. If you decide to use checks, I would recommend checking no more than every five minutes and resisting the temptation to check if your child seems to be calming down.
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.
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.
The age of your baby might determine what kind of sleep-training method you choose, though. You could try a gentle shush-pat technique with a five-month-old, but you’ll likely have to leave a one-year-old in the crib as they protest (cry or scream) about the new bedtime arrangement. Don’t attempt a formal sleep-training method before four months, until your baby is able to go longer in between feeds and their circadian rhythm starts to develop. (Many babies this age still feed in the night—contrary to popular thinking, sleep training isn’t synonymous with night weaning.) Dickinson says that many four-month-old babies are biologically able to go through the night without a feed, but that doesn’t mean you shouldn’t respond and feed them if other methods of calming them aren’t working. Since every situation is different, we recommend checking with your doctor before withholding your baby’s night-time feeds.