As you might suspect, this method can be very difficult, depending on temperament, and can take many days or weeks. It can be difficult to avoid engaging with your child (and “watching them cry” is very difficult), and it will likely be a little confusing to the child (particularly younger ones) when you don’t. However, with time and consistency, this can be a good option for parents who do not want to leave their child alone to cry but who haven’t had success with other methods, either.
Though many of the parents I see in clinic have put up with terrible sleep for years, sleep training is a safe and effective tool to help babies learn to soothe themselves at night. For this guide, I reviewed the literature on infant sleep. As director of the Pediatric Sleep Center at Yale University, I have extensive experience helping families to address sleep problems. I have also written a book on the topic, which was inspired by sleepless nights with my own children.
All sleep-training methods have pros and cons, says Vanessa Vance, a child-sleep consultant in Austin, Texas, so it’s important to suss out which one is best for you. “When I work with a family, we discuss what their needs and goals are. Some families may not want any crying, so a gradual approach may work best,” she says. Here, an overview of some of the most popular sleep-training methods:
• Having trouble? A consultant can help. Sleep consultants and coaches familiar with different sleep-training methods can answer questions, troubleshoot problems and help you find a method that works with your family. But before you enlist the aid of a sleep coach (whose services can range from a phone consultation to an overnight analysis at your house), look into their qualifications. There’s no national governing body for sleep coaching, but there are various programs that provide certification. For example, the Family Sleep Institute is a national training program; Gentle Sleep Coaches, led by Kim West, is another. Before you commit, find out about the coach’s training and credentials, and ask for referrals and experiences from past clients.
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!
"When my son was younger, we often 'walked him to sleep' by putting him in a sling. Now that he's older, reading him a book, nursing, and cuddling does it. Also, we stopped fighting the earlier bedtime. Since he sleeps with us, he snuggles down with us, and it's become a habit that when the lights go out and Mommy and Daddy snuggle with him, it's bedtime. We rarely struggle with sleeping unless he's having bad teething pain."
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.”
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 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.
• Ferber method. Also known as timed-interval sleep training, modified sleep training or graduated extinction sleep training, parents using this method put baby down to sleep even if he’s crying, then return to check on him at different time intervals —every five, 10 and 15 minutes, and so on. You don’t pick baby up during these checks but can verbally soothe or pat him. Gradually, the intervals will get longer until eventually baby is sleeping through the night. “We did Ferber once my son was 8 months old. He got the hang of it pretty quickly and has been sleeping on his own for 10 to 12 hours ever since,” says Anika, a mom of one.
"My well-meaning friends are all Ferber addicts. I went against my own instincts with our son and tried with no success. They promised it would get better each night, but on the third night he cried for three hours, much longer than the first two. I felt like a failure and, of course, stressed from all of his crying. Babies have their own personalities, and you shouldn't feel pressured into doing something that 'works for everyone else.'"
That’s right! Your baby of course needs to be ready - but before they are, YOU need to be ready too. Sleep training requires a commitment from parents. You’ll also want to be sure you’re logistically ready for sleep training, as it’s best to start when you don’t have anything that might disrupt the training coming in the near future, such as a vacation or trip.
"I have a 5 1/2-month-old baby girl who has never once in her life "cried it out." From night one in the hospital, she has slept with me. She is rocked and nursed to sleep and when she starts to grunt/wiggle beside me, I simply shift near enough for her to latch on to my breast, and she nurses back to a deep sleep before either of us fully wakes. I follow Dr. Sears' attachment style parenting and my baby has never once in all her life cried during the night or even fully woken up."
• Know there will be regressions. Teething, illness, vacation and routine shifts all can lead to poor sleep, and that’s all right, Vance says. “Often, you may have to go back to training for a day or two to get back on track, but you won’t lose ground. If your child has been trained to be a good sleeper, one week off schedule because of vacation won’t change that.”
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.
On the advice of a sleep consultant, Welk and her husband took away Greyson’s pacifier, moved his bottle to before his bath (so he wouldn’t associate feeding with going to sleep) and chose to start with a very gentle method (because he was only four months old at the time). Greyson’s dad put him in the crib and stood next to him, patting him until he fell asleep, for about a week. That went well, and then they started leaving him immediately after putting him in the crib without patting him fully to sleep. “For about a month, he would cry or fuss every night for 10 to 15 minutes before falling asleep,” recalls Welk. It was hard to hear her baby cry, but she feels confident that it was for the greater good because they were both well rested and happy during the day. Now, Greyson is 11 months old and a champ sleeper, having weaned himself from night feeds at seven months.