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."
"My well-meaning friends are all Ferber addicts. I went against my own instincts with our son and tried with no success. They promised it would get better each night, but on the third night he cried for three hours, much longer than the first two. I felt like a failure and, of course, stressed from all of his crying. Babies have their own personalities, and you shouldn't feel pressured into doing something that 'works for everyone else.'"
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.”
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.
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:
A consistent bedtime routine is the cornerstone of good sleep for children. It should also be a time for parents and babies to bond. Bedtime routines need not be complex. Bathe your child (if you like), change her into pajamas, read her a story, sing a song and feed or soothe her, then put her in her crib. The key is consistency — performing the same activities, in the same sequence, at the same time each evening.
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.