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.


That said, sleep training isn’t a must-do for everyone, and many families who skip sleep training go on to have a child who learns to sleep through the night on her own. “It’s your family and your child, and I think there’s a misconception that pediatricians will force sleep training on your family, when that’s not the case,” Gold says. Experts emphasize that the best approach to sleep training is the one that fits your family.
This is considered a ‘cry’ method of sleep training. This technique entails allowing your baby to cry while checking on him at intervals. The goal here is to reassure him every so often that you are nearby and to reassure yourself that he is okay. When you go to check on your baby, you are not “supposed” to pick him up nor engage him much, but simply reassure him using your voice and a loving pat for 2-3 minutes, tops (watch the clock!). With this sleep training method, the goal is NOT to help baby fall asleep – that is what he is learning to do on his own! Instead, the idea is that he falls asleep on his own, in the same “environment” in which he will awaken periodically throughout the night. The knowledge of how to fall asleep unassisted at bedtime will pave the way for him/her to go BACK to sleep throughout the night. Over time, you gradually increase the amount of time between your ‘checks’. See a more detailed step-by-step explanation of this method here: The Ferber Method
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.

"I tried Tracy Hogg's approach: Don't leave the baby to cry! Instead, when he starts up, go in there, pick him up, and love him until he stops. Once he's calm, lay him back down. If he starts crying again, repeat. Eventually he'll know it's time to sleep. Hogg said she had to do it 126 times with one child, but it dropped to 30 the next night, four the next, and soon she didn't have to do it at all. I tried this with my 3-month-old and it worked like a charm!"
Some families opt to hire a sleep consultant or sleep coach to help them with sleep training. Just like deciding what sleep training method is best for your family, the decision to hire a sleep coach is a completely personal one. We talked to Rachel Turner, a certified sleep consultant and owner of Hello Sleep, and asked her how why a family might consider hiring a sleep consultant. Here's what she had to say: 
This is another gentler technique. The PUPD method works just the way it sounds: when it’s time to sleep, and your baby is fussing or crying in his crib or bassinet, you pick him up and comfort him until he’s calm and drowsy. Then, you put him back in his crib to sleep, repeating this cycle until your baby is finally asleep. PUPD is another method that requires quite a bit of patience, depending on your baby, and it won’t work for every baby; some babies find being picked up and put down so often over-stimulating, and they gradually become frustrated and worked up, instead of relaxed.
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.
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.”
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.
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.
"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."
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.
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."

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.
Hi @Adriana – Thank you for writing to us. Sorry to hear that your toddler is having issues with sleeping in her own crib and sleeping through the night! There are MANY parents that use gentle sleep training with their toddlers and even preschoolers and older! If that’s what you’re comfortable with – go for it! If you’d like help formulating a Plan just for her, please contact us for some more info and recommendations! Good luck Adriana!!

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If your baby is older than six months, don’t worry, McGinn says: “It’s never too late to develop good sleep habits.” Dickinson says he finds nine months to be a bit of a sweet spot for parents in terms of getting babies to sleep through the night. “They are at a good age for understanding routines and don’t need to eat during the night,” he explains.
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