As we previously mentioned, introducing healthy sleep habits and routines as early as possible will help significantly during sleep training. If you haven’t already, try to establish a bedtime routine before you start sleep training baby — this will encourage healthy baby sleep patterns. This should be a series of soothing activities that help to calm your baby and prepare them for sleep - things like swaddling, bathing, and rocking usually work well, but every family’s routine will look different.
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.
Though many of the parents I see in clinic have put up with terrible sleep for years, sleep training is a safe and effective tool to help babies learn to soothe themselves at night. For this guide, I reviewed the literature on infant sleep. As director of the Pediatric Sleep Center at Yale University, I have extensive experience helping families to address sleep problems. I have also written a book on the topic, which was inspired by sleepless nights with my own children.
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.
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.
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.
McKenna advises against sleep training and encouraging babies to sleep for long stretches at night. Instead, he urges parents to follow their babies' cues and allow them to wake frequently through the night to feed. A strong advocate for co-sleeping, McKenna encourages bed-sharing and other co-sleeping arrangements, such as putting the baby in a bassinet or crib at the parent's bedside, while also following standard SIDS safety precautions – for example, making sure there are no blankets or stuffed animals around him.
This method involves more tears than the previous two; however, you don’t leave your baby unattended in the room at all. Here’s how the chair method works: start by doing your normal bedtime routine. Then, put a chair very near the crib, bassinet, or bed and sit on the chair as your baby falls asleep. The goal is not to help your child fall asleep, nor to help her calm down necessarily, depending on how you implement it. You are generally not supposed to give your child any attention. The reason you are in the chair is only to reassure them that you are there with them and have not left them alone. Each night you move the chair farther and farther away from the crib until you are right outside the door until eventually, you no longer need the chair at all.
• Know there will be regressions. Teething, illness, vacation and routine shifts all can lead to poor sleep, and that’s all right, Vance says. “Often, you may have to go back to training for a day or two to get back on track, but you won’t lose ground. If your child has been trained to be a good sleeper, one week off schedule because of vacation won’t change that.”
"As you modify your baby's sleep behavior, you are going to have to give up middle-of-the-night crutches, known as negative associations, that may get her back to sleep in the short run but won't prevent her from popping up again in an hour. She may resist the change. The behavior may even get worse before it gets better as she adjusts to new routines, to new positive associations."
"I have two kids. The first one was never left to cry it out – we rocked, sung, walked, drove her to sleep until she was old enough to be read a story. Then, with baby number two, I decided to try CIO and after one night, it worked. At 12 months, she goes to sleep at night by herself and never cries. It was the best thing I did. My husband was against it, but he wasn't the one up four or five times every night for nine months straight! Now our household is very happy and everybody sleeps well."
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.
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.
"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."
For my wife and me, those early days passed in a blur. Nights seemed endless, and no government ordinance was about to come along to shorten our shifts. When he was around 3 months old, our son started sleeping for longer periods and our relief was profound. But after about a month, the baby started waking up at night again. After one nightly waking became two, then three and four, I realized it was time to sleep train our son.
As your baby gets older and their sleep needs change, make sure that you’re adjusting wake times, naps and bedtimes accordingly to help them continue to easily fall asleep and stay asleep. Some parents think of sleep training as a “one-and-done” endeavour: You endure a lot of crying for a few days and your prize is a perfect sleeper. But it’s really a lifestyle change—once your child has the skills to fall asleep, they’ll still need routines, consistency and help adapting when life throws curveballs, like starting daycare, the arrival of a new sibling or going on a trip (where they may have to sleep in a different space or crib). Colds and illnesses, as well as time changes, can also throw a wrench in your perfect schedule. The trick here is to get back on track as soon as possible. If you start allowing or enabling the old, bad habits and sleep associations, it will take longer to return to the regular routine.