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.
All sleep-training methods have pros and cons, says Vanessa Vance, a child-sleep consultant in Austin, Texas, so it’s important to suss out which one is best for you. “When I work with a family, we discuss what their needs and goals are. Some families may not want any crying, so a gradual approach may work best,” she says. Here, an overview of some of the most popular sleep-training methods:
Singing a few lullabies to set the mood, put her down while she’s settled, she’ll play with her hands and feet for about 10-15 minutes, she starts fussing so I give her a chance to settle (but never does), then it turns into full blown crying. I try to lull, shush, pick up and rock but it doesn’t help. It seems like she doesn’t want to be held nor put down. After crying so much that she turns blue and me rocking the life out of myself she falls asleep. I can’t put her down until she is in deep sleep otherwise she will wake.
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.
Prepare yourself for a few difficult nights. Hearing your baby cry can be excruciating, as every parent knows. During the waiting periods, set a timer and go to a different part of the house, or turn on some music, so you don't have to hear every whimper. As one BabyCenter parent says, "The first week could be rough. Try to relax and know that when it's all over, everyone in your household is going to sleep more easily and happily."
"My son is 6 months old and finally goes to sleep without a struggle! We thought the Ferber method was mean and that alternatives would be better. So we tried it all – Baby Whisperer, No-Cry Sleep Solution, Babywise, etc. None of it worked. Our son is an otherwise happy little guy, but every night and every nap was a battle. We'd spend hours trying to get him to sleep. We delayed trying Ferber until we'd tried everything else unsuccessfully. It worked after the first night! He wakes up better rested and happier (as do we)."
"My first cried it out, and all was well. My second cried it out but it took much longer until all was well. My third, if allowed to cry too long, literally freaked out. He threw himself around his crib and would rarely calm down and fall asleep. On the rare occasion that he fell asleep, he'd wake up within minutes screaming bloody murder. Letting him cry it out was clearly not working so I looked for other options. Find your child's groove. You'll be glad you did."
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.
If you’re on the fence about sleep training, it can be helpful to think of it this way: What is my baby’s developmental need right now? “At 11 months, they don’t need to eat during the night but they do need consistent sleep,” says Garden. Yes, those nights of crying are heartbreaking. But chances are, if you’re considering sleep training, it’s because what you’re currently doing isn’t working for you.
“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...sleep is a complicated issue and there’s very rarely one single thing that can remedy the situation overnight. A professional sleep consultant has the experience and training to recognize which problems result in specific symptoms, and can work with you to develop a personalized plan for your child that addresses those individual issues."
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I know a lot of my clients felt that way before they hired me! But I know it’s a concern that a lot of parents have when they’re thinking about getting some professional help with their little ones’ sleep habits. And it’s a valid question! After all, your mother managed to get you to sleep at some point. Your friend might have four kids who are all champion sleepers, so she should have some answers for you, right? Well, yes.. .and no!
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.
With the fading technique, continue with whatever method you were using to help your baby fall asleep (such as rocking or nursing), but decrease the amount of time you spend doing it until, in theory, you don’t have to do it at all. This is a great technique for minimizing crying, but unfortunately, many parents find it difficult to sustain. “There has to be an end in sight,” explains Mitelman. “For example, we’ll meet this need for five to seven days and then we’ll pull back a little bit.” But if you’re willing to stick to the plan and get your baby to the end goal of going to bed without your assistance, Mitelman says it’s worth a try. “Whichever way the child can get to sleep independently is fine because that’s the key ingredient to sleeping through the night.”