The age of your baby might determine what kind of sleep-training method you choose, though. You could try a gentle shush-pat technique with a five-month-old, but you’ll likely have to leave a one-year-old in the crib as they protest (cry or scream) about the new bedtime arrangement. Don’t attempt a formal sleep-training method before four months, until your baby is able to go longer in between feeds and their circadian rhythm starts to develop. (Many babies this age still feed in the night—contrary to popular thinking, sleep training isn’t synonymous with night weaning.) Dickinson says that many four-month-old babies are biologically able to go through the night without a feed, but that doesn’t mean you shouldn’t respond and feed them if other methods of calming them aren’t working. Since every situation is different, we recommend checking with your doctor before withholding your baby’s night-time feeds.
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.
"My first daughter was sleeping through the night (10 p.m. to 9 a.m.) by 6 months. We had a complete bedtime routine: a bath, a book, a bottle, then to bed, a little music in the crib, and asleep in 10 minutes. It was wonderful, but that scenario didn't work for my second daughter and hasn't worked for my son, so I've tried different things for each of them. Sometimes a plan doesn't work. Listen to your baby – he or she will tell you what you need to know."
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.
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.
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.”
"A young child cannot yet understand what is best for him, and he may cry if he does not get what he wants," Ferber writes. "If he wanted to play with a sharp knife, you would not give it to him no matter how hard he cried, and you would not feel guilty or worry about psychological consequences. Poor sleep patterns are also harmful for your child and it is your job to correct them."
• 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.”
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.
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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."
Create a comfortable sleep environment that's tailored to your child. Some babies need more quiet and darkness than others. Recordings of soft music or nature sounds or the sound of a gurgling aquarium can be soothing. Make sure the sheets are cozy (warm them with a hot water bottle or a microwavable heating pad, for example, before laying your baby down) and that sleepwear doesn't chafe or bind. Younger babies may sleep better when swaddled. Don't overdress your child or overheat the room.
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.
"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)."
Not to be confused with the bedtime-routine fading technique described above, bedtime-hour fading involves putting your baby into the crib at the time they usually end up dozing off, and making that their new bedtime for a couple of nights, and then gradually moving it to an earlier time. For example, say you always put your baby down at for the night at 7:30 p.m., but they tend to fuss or cry in the crib for 20 minutes or more, until they finally nod off around eight. This means 7:50 to 8 p.m. is actually their “natural bedtime,” even though you’d like it to be earlier. To figure out when your baby naturally falls asleep, keep a diary for a few nights to track when they finally settle for the night. (Using a video monitor can help with this.) A few nights later, move the whole routine 15 minutes earlier. Continue moving the bedtime earlier by 15 minutes each night (if needed) until your baby has shifted their old habits to nod off at the desired time instead of the later one.