"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.
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.
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.
It might be strange to think of sleeping as a skill that does not come naturally. As a new parent, you’re probably so exhausted that you pass out as soon as your head hits the pillow. Your baby, however, doesn’t have this same ability yet. Although they spend a lot of time sleeping, they need to learn when to sleep (day vs. night) and how to sleep. Until they do, they need your assistance, which is why you (as you should) help soothe them to sleep at bedtime and comfort them when they wake in the middle of the night. Sleep training is teaching your baby how to sleep without any help from you - just like you’re able to fall asleep without anyone there to help you do it.
"The more practice your baby gets putting himself to sleep, the quicker the process works. He will fall asleep on his own, and you will get the sleep you need...Don't wait too long, though. The earlier, the better. Remember, once your baby gets older – that is, at least 5 or 6 months – the process of getting your child on a sleep schedule and to sleep through the night gets more difficult."
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.
With the fading technique, continue with whatever method you were using to help your baby fall asleep (such as rocking or nursing), but decrease the amount of time you spend doing it until, in theory, you don’t have to do it at all. This is a great technique for minimizing crying, but unfortunately, many parents find it difficult to sustain. “There has to be an end in sight,” explains Mitelman. “For example, we’ll meet this need for five to seven days and then we’ll pull back a little bit.” But if you’re willing to stick to the plan and get your baby to the end goal of going to bed without your assistance, Mitelman says it’s worth a try. “Whichever way the child can get to sleep independently is fine because that’s the key ingredient to sleeping through the night.”
"I tried Tracy Hogg's approach: Don't leave the baby to cry! Instead, when he starts up, go in there, pick him up, and love him until he stops. Once he's calm, lay him back down. If he starts crying again, repeat. Eventually he'll know it's time to sleep. Hogg said she had to do it 126 times with one child, but it dropped to 30 the next night, four the next, and soon she didn't have to do it at all. I tried this with my 3-month-old and it worked like a charm!"
It’s difficult if not impossible to sleep train if you share a bed with your child. There’s good evidence that bed sharing is associated with sleep difficulties in infancy and beyond. One survey of more than 50,000 Norwegian families showed that bed sharing was associated with more frequent night awakenings at both 6 and 18 months. Switching your child to sleeping independently for a week or so prior to sleep training can be helpful as you can soothe your child to sleep in the new sleeping environment first.
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.
I have a 5 month old girl who has been inconsolable when it’s has come to going to sleep, whether it be nap time or bedtime. Up until 6 weeks ago she was very good at self soothing, where I’d put her down drowsy/almost asleep, put on some soothing music and she’d toss and turn for a few minutes and fall asleep. Initially I thought it was the famous 4 month sleep regression but now it’s starting to get out of hand. Just to note, she used to sleep about 30-45 minutes and occasionally longer. She seemed happy and content when she woke so I assumed she had had enough rest, although I would’ve preferred longer naps. Also to note, She currently sleeps anything up to 8 hours at night and wakes for a feed around 3-5am.
Sears emphasizes a nurturing, child-centered approach to sleep and warns parents to be wary of one-size-fits-all sleep training. He recommends patiently helping your baby learn to sleep in his own time. He encourages co-sleeping, rocking and nursing your baby to sleep, and other forms of physical closeness to create positive sleep associations now and healthy sleep habits down the road.
That’s right! Your baby of course needs to be ready - but before they are, YOU need to be ready too. Sleep training requires a commitment from parents. You’ll also want to be sure you’re logistically ready for sleep training, as it’s best to start when you don’t have anything that might disrupt the training coming in the near future, such as a vacation or trip.
"As a last resort, I broke down and gave Ferber a try. It's been two and a half weeks, and I see no real improvement. My daughter goes down faster at night, but the crying breaks my heart. I miss snuggling with her. She still wakes up every 30 to 90 minutes after her first two-hour stretch. She shrieks when it's time for a nap. I broke down and nursed her to sleep for her afternoon nap because I couldn't stand to see her so exhausted."
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.
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.
This is a very gentle, no-tears/no-cry (or very little cry) method of sleep coaching where you “fade it out” (FIO). With the Fading method, you continue to help your baby fall asleep (by rocking or feeding to sleep, for instance), but over time, you gradually do less and less of the ‘work’ to put your baby to sleep, and your baby does more and more. For instance, if you normally rock your baby completely to sleep, you may shorten the amount of time you rock each night until you are rocking for only a few minutes only as a part of the bedtime routine. This method requires quite a bit of patience on the parent’s part, in some cases, but it’s great for families who want to minimize crying as much as possible.
After going through your bedtime routine, put your baby in their crib, leave the room and wait a specific amount of time (say, a minute). Then go in and reassure your baby with words like “Mommy loves you” or some kind of touch, such as a rub or pat. McGinn says it’s preferable not to pick the baby up. Garden, on the other hand, reserves this method for babies seven months and older. (In her opinion, younger babies require a parental presence so they know they haven’t been abandoned, especially if they’ve worked themselves up into a frenzy.)