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.
On the advice of a sleep consultant, Welk and her husband took away Greyson’s pacifier, moved his bottle to before his bath (so he wouldn’t associate feeding with going to sleep) and chose to start with a very gentle method (because he was only four months old at the time). Greyson’s dad put him in the crib and stood next to him, patting him until he fell asleep, for about a week. That went well, and then they started leaving him immediately after putting him in the crib without patting him fully to sleep. “For about a month, he would cry or fuss every night for 10 to 15 minutes before falling asleep,” recalls Welk. It was hard to hear her baby cry, but she feels confident that it was for the greater good because they were both well rested and happy during the day. Now, Greyson is 11 months old and a champ sleeper, having weaned himself from night feeds at seven months.
"My 3-month-old doesn't sleep through the night, and it's fine with me. I keep her in her crib or a bassinet until her 3 a.m. feeding, and then she joins my husband and me until we get up for work. She won't go in her crib unless she's already asleep, usually from nursing and rocking, but she'll fall asleep in her bassinet beside our bed. She's happy and we're happy, and even if it goes against the wisdom of the experts, it's working for us."
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.
• 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.
"A young child cannot yet understand what is best for him, and he may cry if he does not get what he wants," Ferber writes. "If he wanted to play with a sharp knife, you would not give it to him no matter how hard he cried, and you would not feel guilty or worry about psychological consequences. Poor sleep patterns are also harmful for your child and it is your job to correct them."
"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."
• Pick-up-put-down method. In this sleep-training method, you put your child to bed while he’s awake and check on him at gradual intervals, as you do with the Ferber method. Unlike with Ferber, you can pick him up and comfort him, holding him for a few minutes before putting him down. Eventually baby will become drowsy enough to fall asleep on his own.
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.
“I knew I didn’t want to sleep train, so I co-slept with my son until he was about 5 months old,” says Corinna, a mom of two. “At 5 months, I was able to put him in a room on his own, but I would attend to him if he cried. By 10 months, he was sleeping through the night on his own. Maybe I was lucky, but I felt like what worked best for our family was following his lead.”
Sleep experts who support the cry it out approach (as well as most pediatricians) disagree. They say it isn't traumatic for babies to cry alone for short periods of time with frequent check-ins by Mom or Dad – and the end result is a well-rested, happier child. They say no tears sleep strategies may cause babies to be overly dependent on comfort from a parent at bedtime, making it harder for them to learn to soothe themselves to sleep.
• Weissbluth method. This sleep-training method suggests you set up a bedtime routine (bath, book, lullaby), then put baby to sleep, shut the door and don’t re-enter until the next morning. “I tried this, and the first night was awful,” says Jen, a mom of one, who did the Weissbluth method at 4 months. “I turned on the shower and sat in the bathroom so I wouldn’t hear my son cry. But I was watching the baby monitor and saw that after an hour, he found his thumb and fell asleep. The next night was maybe 40 minutes of crying, then 20 minutes the night after that. He’s always happy in the morning, and I feel this was the right choice.”
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.