Sleep training means using behavioral techniques to teach your baby to sleep independently by altering her “sleep onset associations” — or the circumstances your baby needs to fall asleep at bedtime. By removing your presence at bedtime, you are providing new associations with the result that she will learn to fall asleep independently, both at bedtime and when she awakens during the night.
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.
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.
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:
Once you launch your plan, stick to it. Parents who've been through sleep training agree that consistency is the key. Unless you realize that your child simply isn't physically or emotionally ready and you decide to put the program on hold for a while, follow through with it for a couple of weeks. When your baby wakes you up at 2 a.m., you may be tempted to give in and hold or rock him, but if you do, your hard work will be wasted and you'll have to start over from square one.
• Ferber method. Also known as timed-interval sleep training, modified sleep training or graduated extinction sleep training, parents using this method put baby down to sleep even if he’s crying, then return to check on him at different time intervals —every five, 10 and 15 minutes, and so on. You don’t pick baby up during these checks but can verbally soothe or pat him. Gradually, the intervals will get longer until eventually baby is sleeping through the night. “We did Ferber once my son was 8 months old. He got the hang of it pretty quickly and has been sleeping on his own for 10 to 12 hours ever since,” says Anika, a mom of one.
As you might suspect, this method can be very difficult, depending on temperament, and can take many days or weeks. It can be difficult to avoid engaging with your child (and “watching them cry” is very difficult), and it will likely be a little confusing to the child (particularly younger ones) when you don’t. However, with time and consistency, this can be a good option for parents who do not want to leave their child alone to cry but who haven’t had success with other methods, either.
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.)