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.
"When my son was younger, we often 'walked him to sleep' by putting him in a sling. Now that he's older, reading him a book, nursing, and cuddling does it. Also, we stopped fighting the earlier bedtime. Since he sleeps with us, he snuggles down with us, and it's become a habit that when the lights go out and Mommy and Daddy snuggle with him, it's bedtime. We rarely struggle with sleeping unless he's having bad teething pain."
Sleep training will look a little bit different for every family, depending on what method you choose to follow. The different methods require different tactics from the parents in order to be successful. Melissa’s tip: take notes! Having a record of how your baby has progressed throughout the sleep training will come in handy when you’re too tired to remember how long (or little) they slept the previous 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.

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.
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.
Yes. Multiple studies have shown that sleep training is both safe and effective, without any studies showing evidence of harm. The best long-term study followed 326 children for the first six years of life. The authors reported that children who had sleep trained via any method in infancy slept better at 2 years of age than children who were not sleep trained, and their mothers were less likely to be depressed. Several years later, the researchers looked at these children again and noted that there was no evidence of emotional or behavioral problems in children who had been sleep trained versus those who had not. As part of this follow-up, the researchers measured the children’s levels of the stress hormone cortisol, which is frequently cited by opponents of sleep training as the mechanism by which crying affects developing brains. The researchers did not find any evidence of differing levels of cortisol secretion between children who had been sleep trained and those who had not.

It’s definitions like this that have given the general term “sleep training” a bit of a bad rep. There are certain methods of sleep training, such as “Cry-It-Out” or the Ferber method, that might make some parents wearisome of sleep training as a whole. However, sleep training does not necessarily equal cry it out. There are many different sleep training methods and practices behind sleep training, including gentle sleep training—the most important part of sleep training is finding the method that works best for you and your baby!
• 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.”
"There are good times to sleep-train and periods when it may be less likely to work," says developmental psychologist Isabela Granic, Ph.D., coauthor of Bed Timing: The 'When-To' Guide to Helping Your Child to Sleep. "This is because infants and toddlers go through mental growth spurts that make them especially clingy, fussy, and prone to night wakings. They're learning new cognitive skills and often don't sleep as well."
Some experts suggest techniques that are slightly different than these methods. Perhaps the best known is pediatrician Harvey Karp, author of The Happiest Baby on the Block. His method suggests a very specific routine involving the so-called five S's: swaddling, the side or stomach position (for calming your baby, not for sleeping), shushing, swinging, and sucking.

• 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.”


There is no right or wrong method of sleep training; it all comes down to your unique baby and your unique parenting style. What works well for some babies does not work well for others, so do not be surprised if the techniques your friends or family members recommend don’t work the same way for your baby. The bottom line is to choose a technique that you feel comfortable with, and that you think will work well with your baby’s temperament.
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.
"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.'"
Most sleep coaches say the ideal time to start sleep training (or promote independent sleep, not necessarily using the cry-it-out method) is based on your baby’s development, but is usually somewhere between four and six months, when your baby hasn’t had much time to get used to nursing or rocking to sleep. At this stage, most babies are also developmentally ready to learn the skill of falling asleep on their own, explains Jennifer Garden, an occupational therapist who runs Sleepdreams in Vancouver. Around four months of age, some babies go through a sleep regression because their sleep cycles change and there are longer periods of lighter sleep per cycle. “It’s a great time to work on independent sleep skills,” says McGinn. Other babies’ slumber derails around this time because they are working on new skills, like moving around and rolling. Some parents choose to wait until things settle down before embarking on a sleep-training method, but you don’t have to, says McGinn.
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