The Baby Sleep Guide Part 2: Sleep Training 101
An overview of the most common effective sleep training approaches–so you can choose the right fit for your family!
by Steve Silvestro, MD @zendocsteve
You can also listen to this article as a podcast on your favorite podcast app or click on the player below:
Is there any phrase that inspires such an odd mix of hope and dread in new parents more than those two words?
The promise of better sleep for you and your baby, mingled with the fear of how hard it might be to get there—not to mention worries about crying (by both you and your baby) and the fact that everyone seems to have an opinion that they’re more than happy to share with you.
It can feel quite overwhelming!
Well, just as the Baby Sleep Guide, Part One laid out expectations for normal baby sleep and tips to help your baby develop good sleep habits early on, this article aims to give you everything you need to know about sleep training.
Think of this as Sleep Training 101—and by the end, both you and your baby will be ready to achieve the sleep of your dreams.
How Do You Know You’re Ready for Sleep Training?
So, let’s say that your little one is wonderful in many ways, but isn’t quite a “magic sleeper” and you think you might need to try sleep training.
How do you know you’re ready—besides the fact that both you and your baby are exhausted?
Well, most books will say that you can start official sleep training methods at four months. However, I disagree—that 4-month sleep regression that most babies experience tends to get in the way. Even though it’s often the reason why parents start thinking about sleep training, everything that’s causing the regression—your baby’s rapid development, changes in brainwaves during sleep—makes it hard for sleep training to really take hold as quickly as it could at other ages.
Instead, look to what’s happening in the daytime as your guide to being ready for sleep training at night. Remember how I said that most babies will start to form a true naptime schedule somewhere between 4-6 months? Once your baby’s naps seem to become more regular, as in landing at specific times each day, then you know that your baby is getting hardwired to have more success with sleep training at night.
Once your baby has a fairly regular nap schedule, that’s your sign that nighttime sleep training is ready to go.
(*Some babies aren’t great nappers, and they don’t need to be to start nighttime sleep training. Even if your baby doesn’t fall asleep for naps very easily, try to notice whether she gets tired around the same times throughout the day. If she does, you’re good to go! If not, you might be missing some of your baby’s sleepy cues; click here to learn your baby’s signals.)
Which Sleep Training Method Is Right for You?
Okay, so you’re ready to start sleep training—but walk into the baby section of any bookstore and you’ll soon be drowning in a sea of different books and approaches.
How do you choose which to use?
Well, know upfront that every sleep training approach involves some sort of crying, even the ones that claim to be “no-cry.” Think about it: you’re trying to get your baby to do something he doesn’t want to do—go back to sleep without your help. It’s a big change, and change is hard. Think of how you’d feel if you had a nice, comfy routine and someone suddenly wanted you to change it—you might cry, too!
What makes each of the sleep training approaches different is 1). How much crying there is, and 2). What you’re doing about it.
Here’s a quick overview of the most popular sleep training techniques:
1). Extinction/Cry It Out/The Weissbluth Method
This is the official, full-on “cry it out” approach and is best described in Mark Weissbluth’s famous book, Healthy Sleep Habits, Happy Child.
Essentially, once you put your baby down to bed—“drowsy but awake”—you leave the room and don’t go back. Crying ensues (sometimes for everyone involved!), and it’s important to know that it can often last an hour or more the first night.
It’s hard for many parents, but ideally those crying spurts get shorter and shorter until you see significant improvement after just three or four nights—and potentially no crying at all within a week. Getting through those hard first few nights can ideally give you many nights of better sleep later on.
2). Graduated Extinction/The Ferber Method
Richard Ferber outlines his popular method in the book Solve Your Child’s Sleep Problems, although it probably gained more cultural popularity with the movie Meet the Fockers.
Because of the movie, the Ferber Method is perhaps the one most people think about when they hear “cry it out.” But it’s not quite the same as the full-on, shut-the-door Weissbluth approach.
The difference between Ferber and Weissbluth is that with Ferber, you are going back into the room at intervals until your baby is asleep. For instance, on the first night you go back after 3 minutes, then 5 minutes, then 10, 10, 10, and so on until your baby falls asleep. On the second night, you go back after 5 minutes, then 10, 15, 15, 15… Each night, the intervals get longer and longer until finally you get to a night where your baby is falling asleep before you go back even once.
It’s the going back in that makes this approach feel better to some parents, as it can feel like you’re letting your baby know that you’re still there.
When you go back in, you are not to pick up your baby. Instead, you can verbally comfort her, letting her know that you are still there, but that it’s time to sleep. Sometimes having a buzzword or phrase to use each time—something like, “time for night-night”—can be helpful.
The Ferber approach can still be hard for many parents, but like the Weissbluth method, it should ideally give you significant results within 3-4 nights.
3). The Chair Method/Sleep Lady Shuffle/Camping Out
This approach is a bit less well-known, but is probably best described in Good Night, Sleep Tight, by Kim West (“the Sleep Lady”).
The Chair Method requires exactly that—a chair. You set the chair right next to your baby’s crib, and sit in it after putting your baby down “drowsy but awake.” When your baby cries, you can verbally reassure him.
What sets this method apart from Ferber and Weissbluth, besides the fact that you’re still in the room, is that you can also reassure your baby by rubbing his belly or back, or even by picking him up if he gets too upset. If you pick him up, however, the idea is to only hold him for a minute or two to settle him down, and then you put him back into the crib while he’s still awake.
This process is repeated as long as it takes for your baby to fall asleep. Then, every two or three nights, you move your chair further and further away from the crib—until at some point you are out of the room. One family I’ve worked with who had used this method said of their son, “It’s like he thinks we live right outside his room! We hear him stir on the monitor and shout down the hall, ‘Lie down!’ and he goes back to sleep!”
The Chair Method may appeal to parents who don’t want to leave their baby while he’s crying. Other parents, however, might find it harder to be in the room and not picking the baby up all the time. This is why there are so many different sleep books—no one approach is right for every family and every baby.
In Good Night, Sleep Tight, Kim West reports that this approach should work for the average baby in less than two weeks.
4). The “No-Cry” Sleep Solution
Many parents strongly feel that they can’t let their babies cry as they learn to fall asleep on their own. This is where Elizabeth Pantley’s book, The No-Cry Sleep Solution, comes in.
Pantley developed her approach as a way to help parents avoid “crying it out.” Her method isn’t necessarily one “solution,” but rather a collection of dozens of tips, pointers, and approaches that you can experiment with as time goes on. These tips range from some things we’ve already mentioned in Part One (making the room dark at night, introducing a bedtime routine), to other ideas like using a lovey after age 4 months, having a fixed wake-up time each morning, and going to bed earlier than you might think (i.e., 6:30 or 7PM).
When it comes to actually putting the baby to sleep, Pantley relies on a “pick up, put down” approach that’s somewhat similar to Kim West’s: try to put your baby down drowsy but awake, pick him up if he cries, set him down once he’s drowsy again, and repeat the process until he’s finally asleep.
So really, then, there is crying—it’s just that you’re catching your baby’s discomfort within moments, ideally before full-on wailing develops, and that your baby isn’t crying himself to sleep.
Parents who find success with Pantley’s approach usually report that it takes anywhere from several weeks to a couple of months to fully kick in. So if you dive into this, know that it’s going to take some work. Still, if the idea of the “cry it out” methods just doesn’t sit well with you, then this is the book to check out.
Will Your Baby Be Hungry in the Middle of the Night?
This is the big question, right? How can you tell if your baby is waking up because she needs to eat? If you’re trying to push your baby to sleep for longer stretches at night, won’t she be hungry?
If you’ve sleep trained for a few days and your baby isn’t waking up in the middle of the night, then the easy answer is “no.”
But what if your baby does still wake up?
Well, on the one hand, I’d say that the real goals of sleep training should be 1). To make going to bed easier—to help your baby learn to neither need you nor to need to eat in order to fall asleep, and 2). To decrease the total number of night wakings, as opposed to eliminating them altogether. Many babies do still need to eat in the middle of the night (remember that “through the night” at 4-6 months is 4-6 hours). It would just be nice for them not to need to eat as often at 9 months as they did at 3 months.
So how do you tell if your baby is hungry versus just waking up for comfort? This part is harder to tell, but a rough idea is that if your baby is nursing for only 5 or so minutes, or if she’s taking only 2-3 ounces from a bottle at night and is over six months old, then that “meal” is probably more for comfort than for hunger.
If your baby is nursing longer than that or is taking more than that from a bottle, then she’s probably truly hungry. Skipping over those scheduled feedings would be like you skipping lunch at noon—your body is used to eating at that time, so skipping the meal makes you feel miserable.
However, there is a technique that you can use to try and shorten those nighttime feeds to the point that you know your baby isn’t so hungry. The idea is to slowly decrease the amount of milk that your baby is getting at each feeding, essentially trimming down that hunger. [Note that you may want to check in with your pediatrician to make sure your baby’s weight and development are okay to do this before you start.]
Here’s how to do it:
If your baby is bottle-fed, try to shave off half an ounce every other day. Once the volume of each nighttime feeding is down to only 2-3 ounces, then it’s likely that your baby is now waking up just for comfort, rather than true hunger.
With nursing, it’s a little more difficult, but still worth a try. Over the course of a few nights, take note of how long the average middle-of-the-night nursing session is. Then, try and shave off a minute or two every couple of nights. Perhaps a more effective way would be to try and pull off a few moments before your baby is fully satisfied—satisfied enough to be drowsy, but not totally satisfied and not asleep—ideally resulting in your nursing sessions getting shorter over several nights.
Once middle-of-the-night nursing sessions are down to five minutes or less, or your over-6-month-old’s bottles are down to no more than 2-3 ounces, then you can feel more comfortable that your baby is waking up more out of habit than hunger.
At this point, knowing that your baby isn’t very hungry at 2AM, and having started a bit of sleep training already, you can now try to get those longer stretches that everyone needs and craves.
In Defense of Crying
I’m going to be honest. I tend to recommend the Weissbluth and Ferber approaches most because by the time parents come to me, they’re exhausted, sleep deprived, and at wit’s end.
And I know that for most babies and most families, if they can make it through three or four nights of crying, then after that they’ll be so much better off for the long haul—better able to feel well rested, more sane, and able to enjoy life together without the heavy dread of nighttime battles weighing on their minds.
But I also know that even with months of sleep deprivation, the crying part is still a hard sell.
Of course, I could talk about all the rational arguments. I could tell parents that dozens of studies have shown that babies who’ve “cried it out” have actually been shown to be “more secure, predictable, less irritable, and to cry and fuss less after the intervention.” I can talk about how mothers have reported no significant effect on nursing, and that studies show improvement in parents’ well-being after sleep training. I can even talk about how some studies have looked at kids five years later and found no differences in behavior, attachment, friendships, or parent-child relationships.
But I also know that it’s the emotional part that’s hard to wrap our heads around. I’m a dad. I was there with my own kids. I totally and completely get it.
For my family—and I believe this is true for many families—what finally clicks is the realization that moving forward is better than what is going on now. The worry and fear that the crying will cause some ominous problem in the future gets washed away by the realization that chronic sleep deprivation for you and your baby is a problem now—a huge, life-altering, emotionally exhausting problem, and it needs to be fixed.
It’s this huge realization that is for many parents the straw that breaks the camel’s back.
Three Final Takeaway Points
And so, I leave you with these—no matter where you stand in your own sleepless journey as a parent, no matter which approach you determine is right for you and your family, it’s these final three takeaway points that I believe will be most helpful to you along the way:
- Do what works for you as long as it works for you—knowing that, at some point, you’re likely to feel that it doesn’t work for you anymore. Every baby is different. Every family is different. That’s why there are so many sleep books—if there were one right approach, there would be one book. Choose what makes you and your family feel the best. If you reach a point where this approach no longer seems to be the best fit for you, recognize that, be aware of that, reassess, and move forward.
- Once you pick a plan, stick to it and don’t turn back. Starting a sleep training method and then giving up halfway through will only make sleep training that much harder (see this episode on Intermittent Reinforcement). Every sleep method involves some tears—whether they’re yours and/or your baby’s. That’s why I’ve been honest in saying that the crying approaches can involve over an hour of crying the first night, and the Sleep Lady and No-Cry approaches can take several weeks to work. They’re not easy. Buy the book linked above for the method you choose, learn it well, pick a date, steel yourself up for it, and dive in.
- A new way to think about sleep training. The very phrase “sleep training” makes it sound like we are forcing something upon our babies. Instead, think of what you’re doing as getting out of your baby’s way. For months now, you’ve been helping your baby fall asleep—because it seemed natural, or was easiest, or there didn’t seem to be any other way—but in the process it’s kept her from figuring how to do it on her own. Your baby wants to learn, needs to learn, and perhaps now is the time to stop thrusting ourselves in the way as a crutch and simply get out of her way.
It’s that last point that’s the hardest one to swallow, isn’t it? Yet I’ve also come to realize that it’s the most important.
Parenting is a delicate, sometimes heart-wrenching dance between holding our kids’ hands and letting them go.
We might think that we have more time—letting go of the first two-wheeler, watching them walk into kindergarten, the first kiss, or driving off to college—but our first real challenge is to let go in these first few months. It’s not fair that it comes so soon!
It’s my hope that with all the information we’ve covered above, plus everything from Part One of the Baby Sleep Guide, you can feel more confident as you take on the challenge of guiding yourself and your baby to sleep better each and every night.
I would say good luck, but I know that in time, it’s going to turn out alright.