• 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.
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:
"My daughter woke every hour on the hour in her crib. I tried every other method available. Finally, at 7 months, we let her cry it out. It took three to four weeks to complete the sleep training and even though it was the hardest thing I've had to do thus far, it was so worth it. She now sleeps about 10 hours a night and loves her crib. We're both happier and have more energy to play."
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.
While researching the different sleep training methods to decide which one is right for you, also remember that every baby and every family is different. What one mom swears by, another mom swears off. You will see the most success from sleep training if you use your intuition to pick a method that you know you and your baby will be comfortable with.
Typically, formula-fed infants who are growing well no longer need to feed at night by 6 months. Breastfed infants may continue a little bit longer, but typically no longer feed at night by 9 months. If your baby has been falling asleep independently at bedtime for a month but still waking to feed, you may want to consider weaning at night. Be aware that if you are breastfeeding, this may lead to a reduction in milk supply.
• Chair method. Also called the sleep lady shuffle or gradual withdrawal and popularized by Kim West, LCSW-C, author of Good Night, Sleep Tight, this method starts with you sitting in a chair next to baby’s crib. Each night, you move the chair farther away from the crib, verbally soothing or shushing baby when she cries (although occasional patting and picking up are okay) until you’re no longer in the room. This method can be helpful for older babies and toddlers who may suffer from separation anxiety and can understand that Mom and Dad are just on the other side of the door, but it also works for younger babies.
The biggest reason why the solutions that work for one parent don’t work for another is simple. They’re not dealing with the same baby. Some babies are heavily reliant on sleep props. Others can’t sleep in a room that’s too warm. Some may not be getting enough daytime sleep, and others might be overtired. This baby might have developed an association between feeding and falling asleep, whereas that one might be ready to drop their second daytime nap. And, of course, it could be any combination of all of the above, or the many other sleep challenges that babies might experience.
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.
"I have a 3-month-old who I rock at night. He falls asleep very quickly (much quicker than if I leave him in his crib). If he wakes in the middle of the night, we go to him and comfort him. We don't take him out – we just help soothe him. Why make him feel lonely and abandoned? I have no problem losing a little sleep if it means that he feels like we will be there for him."
Simply put, sleep training—also called sleep teaching or sleep learning—is the process of helping your infant learn how to fall asleep and stay asleep. It’s also become a pretty controversial topic, with experts and parents speaking for or against various sleep-training techniques. “It’s like talking politics,” says TJ Gold, MD, a pediatrician at Tribeca Pediatrics in New York City. “But there’s no one right way to get your child to sleep through the night. There are a lot of different ways.”
Fading, also known as adult fading or camping out, falls in the middle of the sleep training spectrum. In fading, parents gradually diminish their bedtime role by sitting near your baby until she falls asleep and gradually moving the chair farther away from the crib each night. Another fading approach is to check on your baby and reassure her (without picking her up) every five minutes until she falls asleep.
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.
"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.'"
Parents are often hesitant to go this route, worried about how much crying will be involved. While McGinn doesn’t deny it can be difficult at first, she finds parents are often surprised by how quickly it works. “Yes, there is a lot of crying, but it’s short term,” she says. “You might get a lot of crying for two to three nights, but then every night is less and less.” She says you should see significant improvement with this method by night three or four but adds that it’s important to try it for a week before determining that it’s not working.