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.
"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."
“The biggest reason why the solutions that work for one parent don’t work for another is simple. They’re not dealing with the same baby...sleep is a complicated issue and there’s very rarely one single thing that can remedy the situation overnight. A professional sleep consultant has the experience and training to recognize which problems result in specific symptoms, and can work with you to develop a personalized plan for your child that addresses those individual issues."
“I knew I didn’t want to sleep train, so I co-slept with my son until he was about 5 months old,” says Corinna, a mom of two. “At 5 months, I was able to put him in a room on his own, but I would attend to him if he cried. By 10 months, he was sleeping through the night on his own. Maybe I was lucky, but I felt like what worked best for our family was following his lead.”
Thank you for your comment! We agree, and we think most parents do, that cry-it-out is a last resort, and we always recommend trying a gentle sleep coaching method first. That said, the research on cry-it-out is that, done correctly and not as a replacement for parenting your baby, it is not harmful, and can indeed be beneficial when you consider the damage that lack of sleep can do to a baby’s overall health and well-being. We have an article with further information about our philosophy on cry-it-out here: https://www.babysleepsite.com/sleep-training/cry-it-out-age/
"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."
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.
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.
Some of these experts think cry it out methods are not good for babies. Pediatrician and "attachment parenting" advocate William Sears devotes an entire chapter of The Baby Sleep Book to a critique of cry it out approaches. Sears, along with no tears advocates such as Elizabeth Pantley (author of The No-Cry Sleep Solution), believes that cry it out techniques can give your child negative associations with bedtime and sleep that could last a lifetime.
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Healthy sleep is so important for your baby AND you! If your baby isn’t sleeping, chances are you aren’t either. Sleep deprivation in children has been linked to obesity, behavioral problems, learning issues, and more later on in life. Sleep deprivation in adults can lead to similar issues, and has even been shown to play a role in Postpartum Anxiety and even depression in parents. Teaching and establishing healthy sleep habits right from the start will make sleep training easier and, more importantly, help keep you and your baby well-rested!
• No tears method. Created by sleep expert Elizabeth Pantley, this technique, also known as the no-cry method, involves subtly shifting your child’s sleep habits. For example, one trick, known as “fading,” suggests gradually easing out of baby’s go-to sleep strategy. For instance, if she always needs to be rocked, you would rock less and less until you can put her down to sleep without any rocking. Another technique, called substitution, switches out the routine—so if baby always nurses before bedtime, read a book instead.
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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.
There are many different sleep training methods to choose from, but the most common methods are one of or a variation of one the five we've explained below. You might find that one of these methods sounds like it would be a perfect match for you, OR you might find aspects from each plan that you like. Just like Melissa said, don't feel like you need to stick to a certain method 100%. Make the plan work for you!
Camping out involves gradually withdrawing your presence from your child’s room over the course of a week or two. This method is a good fit for parents who are not comfortable with prolonged crying, although it is important to recognize that, for some children, there is no such thing as a “no-cry” solution. The downside is that camping out takes longer than C.I.O.
• 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.”
"As you modify your baby's sleep behavior, you are going to have to give up middle-of-the-night crutches, known as negative associations, that may get her back to sleep in the short run but won't prevent her from popping up again in an hour. She may resist the change. The behavior may even get worse before it gets better as she adjusts to new routines, to new positive associations."
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.