“You’ll never sleep again.” Sound familiar? There’s a reason this cliche is often repeated at baby showers: In those first few months of parenting, before baby has an established sleep-wake cycle and needs to be fed only every few hours, sleep is fractured and confusing, with a long stretch just as likely to occur midafternoon as it is in the middle of the night. And that’s normal. But once baby is a few months old—after she’s dropped those middle-of-the-night feedings and has established a somewhat predictable sleep-wake cycle—sleep training her can help your whole family get some much-needed nighttime shut-eye. Here, what you need to know before choosing the best sleep-training method for your family.
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."
A version of this technique called graduated extinction was popularized by Dr. Richard Ferber in his book “Solve Your Child’s Sleep Problems.” Here, parents check on their child at set intervals. Checks should be brief and to the point: Picking up your child, spending too much time hovering over the crib or otherwise offering more contact than a quick soothing word can be counterproductive. Some babies find these brief checks soothing and will go to sleep more quickly. Others will redouble their crying as soon as their parents leave the room. Parents need to make a judgement about whether or not checking in is helping their baby through this process. If you decide to use checks, I would recommend checking no more than every five minutes and resisting the temptation to check if your child seems to be calming down.
Once you launch your plan, stick to it. Parents who've been through sleep training agree that consistency is the key. Unless you realize that your child simply isn't physically or emotionally ready and you decide to put the program on hold for a while, follow through with it for a couple of weeks. When your baby wakes you up at 2 a.m., you may be tempted to give in and hold or rock him, but if you do, your hard work will be wasted and you'll have to start over from square one.
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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.
Finding the ideal bedtime can be tricky in the first few months of life. Infants who take a late afternoon nap (say, 4 to 6 p.m.) may go to bed as late as 9 or 10 p.m. A good rule of thumb is that your baby will probably sleep three to four hours after his last nap ends, but you may need to experiment, adjusting your baby’s nap and bedtime schedule to figure out what works best.
"I have a 3-month-old who I rock at night. He falls asleep very quickly (much quicker than if I leave him in his crib). If he wakes in the middle of the night, we go to him and comfort him. We don't take him out – we just help soothe him. Why make him feel lonely and abandoned? I have no problem losing a little sleep if it means that he feels like we will be there for him."
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.
C.I.O. is the most famous sleep training technique, and the most controversial — although, despite its daunting name, it is safe and effective. In its simplest form, unmodified extinction, you place your infant down at bedtime, drowsy but awake, and then leave the room, without returning to check on or soothe your baby. This method will work quickly, but often produces prolonged periods of crying for a few nights, which can be difficult for parents to tolerate.
It’s definitions like this that have given the general term “sleep training” a bit of a bad rep. There are certain methods of sleep training, such as “Cry-It-Out” or the Ferber method, that might make some parents wearisome of sleep training as a whole. However, sleep training does not necessarily equal cry it out. There are many different sleep training methods and practices behind sleep training, including gentle sleep training—the most important part of sleep training is finding the method that works best for you and your baby!
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.”
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Honestly, in our personalized consultations, we try to avoid this method as much as possible. If you are going to use cry it out, we recommend your baby is at least 6 months old, but preferably 10 months or older, when we expect almost all babies to be able to get through the night without a feeding. It is not for the faint at heart. We find that laying a foundation in the beginning with other strategies and techniques can reduce crying even if this method is used in the end, however.
If your baby is growing poorly or is difficult to console, you should talk to your child’s pediatrician to ensure that your child’s sleeping difficulties have no medical cause. Likewise, if you are struggling with depression, it is critical to discuss this with your child’s pediatrician as well as your own physician. Poor sleep can prolong postpartum depression in mothers.
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.