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.
Cry It Out: This method involves putting your baby into the crib drowsy, but awake. The goal is for your child to learn to fall asleep without your help, so that when your baby inevitably wakes up in the middle of the night, he or she will be able to go back to sleep on his or her own. You say goodnight and leave the room—even if your baby cries. Then, you go back in at increasingly long intervals to briefly reassure your baby. It can be difficult to listen to your baby cry, but parents who have been successful with the technique report that it results in fewer tears overall and more sleep for everyone.
After going through your bedtime routine, put your baby in their crib, leave the room and wait a specific amount of time (say, a minute). Then go in and reassure your baby with words like “Mommy loves you” or some kind of touch, such as a rub or pat. McGinn says it’s preferable not to pick the baby up. Garden, on the other hand, reserves this method for babies seven months and older. (In her opinion, younger babies require a parental presence so they know they haven’t been abandoned, especially if they’ve worked themselves up into a frenzy.)
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.
"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!"

Fading, also known as adult fading or camping out, falls in the middle of the sleep training spectrum. In fading, parents gradually diminish their bedtime role by sitting near your baby until she falls asleep and gradually moving the chair farther away from the crib each night. Another fading approach is to check on your baby and reassure her (without picking her up) every five minutes until she falls asleep.
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.
Hogg agrees with Sears that sleep associations should be positive but disagrees with his techniques. She cautions against letting your baby depend on "props" such as nursing, patting, and rocking to get to sleep. Instead, Hogg's approach calls for going to your baby when he cries, picking him up, and putting him back down as many times as necessary.
Sleep training advocates in this category encourage a more gradual approach – soothing the baby to sleep and offering comfort right away when the child cries. Pediatrician William Sears, author of The Baby Sleep Book, is a leading proponent. Parent educator Elizabeth Pantley outlines a step-by-step no tears approach in her book The No-Cry Sleep Solution.
In the first several weeks of life, babies are hungry at night, leading to an apparent reversal of day and night and erratic sleep patterns. Fortunately, this usually resolves by about 3 weeks of age, after which your child settles into a three- or four-hour cycle, typically following a pattern of waking, feeding and sleeping. At this point, exposing your baby to natural light during the day can help encourage longer periods of daytime wakefulness and more sleep at night.

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.

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.


No one likes to talk about sudden infant death syndrome (SIDS); it is a terrifying topic. SIDS is defined as the sudden death of an infant, which remains unexplained after a thorough investigation. These deaths occur in the first year of life, with the highest risk occurring between 2 and 6 months of age. Fortunately, these deaths are becoming less common, thanks in large part to the early ’90s Back to Sleep campaign, which urged parents to place infants to sleep on their backs. Suffocation is also a major risk for infants if they do not sleep in a safe sleeping environment.
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.
I have a 5 month old girl who has been inconsolable when it’s has come to going to sleep, whether it be nap time or bedtime. Up until 6 weeks ago she was very good at self soothing, where I’d put her down drowsy/almost asleep, put on some soothing music and she’d toss and turn for a few minutes and fall asleep. Initially I thought it was the famous 4 month sleep regression but now it’s starting to get out of hand. Just to note, she used to sleep about 30-45 minutes and occasionally longer. She seemed happy and content when she woke so I assumed she had had enough rest, although I would’ve preferred longer naps. Also to note, She currently sleeps anything up to 8 hours at night and wakes for a feed around 3-5am.
"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."
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.
McKenna advises against sleep training and encouraging babies to sleep for long stretches at night. Instead, he urges parents to follow their babies' cues and allow them to wake frequently through the night to feed. A strong advocate for co-sleeping, McKenna encourages bed-sharing and other co-sleeping arrangements, such as putting the baby in a bassinet or crib at the parent's bedside, while also following standard SIDS safety precautions – for example, making sure there are no blankets or stuffed animals around him.
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.
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.
But when he was about three-and-a-half months old, the routine fell apart. “I would feed him, but he wouldn’t be asleep at the end of the feed,” recalls Welk. “I would rock him until he fell asleep and put him down, and then he would wake up 30 minutes later and I would do it all over again.” Desperate for some rest, Welk brought Greyson into bed with her, but then she ended up just lying still, holding a pacifier in his mouth all night long. “I didn’t know anything about sleep,” says Welk. “I didn’t know you couldn’t just rock them to sleep and then put them down.”
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