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.
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.

• Have a solid bedtime routine. Experts say that regardless of which sleep-training method you use, having a stable bedtime—between 5:30 and 7:30 p.m. for infants, Vance suggests—and a steady routine are key. Whether it’s bath, book, lullaby, bed or a different sequence, doing the same thing every evening is part of the bedrock of good sleep hygiene. Blackout curtains and a white noise app may also help.
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.
"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)."
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.
Sleep experts who support the cry it out approach (as well as most pediatricians) disagree. They say it isn't traumatic for babies to cry alone for short periods of time with frequent check-ins by Mom or Dad – and the end result is a well-rested, happier child. They say no tears sleep strategies may cause babies to be overly dependent on comfort from a parent at bedtime, making it harder for them to learn to soothe themselves to sleep.
One common misconception about sleep training babies (also called sleep coaching) is that there’s only one way to do it. But this could not be further from the truth! In reality, there are a number of ways many parents can work to help their babies develop healthy sleep habits and stop waking up in the middle of the night or taking short naps. Some methods involve crying, but others involve little to no tears and are very gentle.
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.
Crying isn't the goal of this sleep training method, but advocates say it's often an inevitable side effect as your baby adjusts to sleeping on his own. They say the short-term pain of a few tears is far outweighed by the long-term advantages: A child who goes to sleep easily and happily on his own, and parents who can count on a good night's rest.

"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."
Most sleep coaches say the ideal time to start sleep training (or promote independent sleep, not necessarily using the cry-it-out method) is based on your baby’s development, but is usually somewhere between four and six months, when your baby hasn’t had much time to get used to nursing or rocking to sleep. At this stage, most babies are also developmentally ready to learn the skill of falling asleep on their own, explains Jennifer Garden, an occupational therapist who runs Sleepdreams in Vancouver. Around four months of age, some babies go through a sleep regression because their sleep cycles change and there are longer periods of lighter sleep per cycle. “It’s a great time to work on independent sleep skills,” says McGinn. Other babies’ slumber derails around this time because they are working on new skills, like moving around and rolling. Some parents choose to wait until things settle down before embarking on a sleep-training method, but you don’t have to, says McGinn.
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