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.
There are various schools of thought on sleep training. Some sleep-training methods fall under the umbrella of “gentle sleep training,” which generally means you’re still going to pick up, rock and soothe baby if she cries. Other methods, often under the “extinction” label, advise parents to let baby self-soothe for the entire night and not open the door until morning. Neither of these methods are right or wrong—it all depends on what works best for you and your family.

• 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.
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.
"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."

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.


"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."

Honestly, in our personalized consultations, we try to avoid this method as much as possible. If you are going to use cry it out, we recommend your baby is at least 6 months old, but preferably 10 months or older, when we expect almost all babies to be able to get through the night without a feeding. It is not for the faint at heart. We find that laying a foundation in the beginning with other strategies and techniques can reduce crying even if this method is used in the end, however.
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.

Exhausted parents may be eager to get training underway—so how do you know when to start sleep training? “Most infants are ready for some sort of sleep training at 4 to 6 months,” says Lauren Kupersmith, MD, a clinical instructor at the department of pediatrics at NYU Langone Medical Center. “While some pediatricians adhere to the guidelines that infants are ready to be sleep trained when they achieve a particular weight, I feel it’s much more appropriate to wait until they are developmentally ready to self-soothe, at about 4 months old.”
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• DIY methods work. Don’t love the rigidity of a particular method? Modify it to suit your own family’s circumstances. Sometimes, a sleep coach can be helpful to come up with modifications that won’t affect the goal of getting baby to sleep through the night, but it’s fine to mix and match until you find a strategy you’re comfortable with. “I don’t think I’ve ever loved and loathed anything as much as I do sleep training. We did it with my son because he was still waking up every three hours at 3.5 months old, and I felt it was more out of habit,” says Margaret, a mom of one. “My husband and I decided that we valued teaching him self-soothing and that in the long run it was worth some short-term effort. I did a ton of research and came up with our own plan—similar to Ferber, but our time limits of letting him fuss weren’t as rigid. It worked, and he’s been a solid sleeper since.”
It’s difficult if not impossible to sleep train if you share a bed with your child. There’s good evidence that bed sharing is associated with sleep difficulties in infancy and beyond. One survey of more than 50,000 Norwegian families showed that bed sharing was associated with more frequent night awakenings at both 6 and 18 months. Switching your child to sleeping independently for a week or so prior to sleep training can be helpful as you can soothe your child to sleep in the new sleeping environment first.
"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."
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!

"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."

Thank you for checking out The Baby Sleep Site! I’m sorry to hear you’re having so much trouble with sleep. Based on your comment, it does sound like your little one might be coming into the 4 month sleep regression. We have an article with a lot of information on that here: https://www.babysleepsite.com/baby-sleep-patterns/4-month-sleep-regression/


While you may have read up on various sleep training methods while pregnant or in the early weeks of baby’s life, it’s a good idea to speak with your pediatrician before you start. For example, if your child is gaining weight slowly or was a preemie, he may not be ready to drop a nighttime feeding and may need a sleep-training schedule that’s adapted to a few middle-of-the-night wake-ups.
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.
Most experts recommend starting when your baby is between 4 and 6 months old. By about 4 months, babies have typically started to develop a regular sleep-wake cycle and dropped most of their night feedings. These are signs they may be ready to start sleep training. Many babies this age are also developmentally able to sleep for long stretches at night.
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