Choosing a Sleep Training Method That Works for Your FamilyEn Español
A survey of strategies from 'cry it out' to 'no cry'
One of the first real life lessons new parents learn is that the old adage about sleeping like a baby is a farce. Sure, some people are blessed with contented little creatures who seem to sleep through the night. For most other parents, sleep is one of the early battles.
Parents often turn to sleep training, a technique for teaching children how to sleep independently. But there is so much (often competing) information out there about how to do sleep training, and the topic can become heated in parenting circles, making it tricky territory to navigate.
When to think about sleep training
From day one people love to ask how the baby is sleeping, but in those early weeks it’s common and, in fact, healthy, for babies to eat every three hours or so around the clock. Slowly parents might get longer stretches, and then just when you think things are improving you hit a dreaded regression.
“I recommend a moderate approach,” says Dr. Wendy Nash, a psychiatrist at the Child Mind Institute. “I would encourage parents not to react on any individual night and instead look for trends and themes.” Growth spurts and teething are common causes of sleep disturbances, but if they last more than a week or two, sleep training would be appropriate.
The earliest recommended age for sleep training varies wildly and can range from three months to over a year. Around six months is typical, but it’s a good idea to get the go ahead from your pediatrician to make sure your baby’s weight is on track and she is getting enough calories during the day.
Sleep training methods
Once you’ve decided to go the sleep training route, it can be a challenge to parse all the different methods out there. In general, they all offer ways to modify your child’s sleep behavior to ensure that the child gets a healthy amount of sleep—and the parents stay sane. And, as Dr. Nash points out, what method you decide on will depend on a host of factors, including age, personal beliefs, and the child’s patterns.
“I would highly recommend that parents evaluate any sleep advice with their own feelings and intuition,” she says. “I think it’s when parents go against their intuition that they become stressed, angry, frustrated with the child.” In addition, “what worked in one developmental phase may not and is almost unlikely to work in another one,” Dr. Nash warns.
Cry it out
Three of the most popular strategies in the so-called cry it out (CIO) camp are spelled out in Richard Ferber’s Solve Your Child’s Sleep Problems, Daniel Weissbluth’s Healthy Sleep Habits, Happy Child, and Jennifer Waldburger and Jill Spivack’s The Sleepeasy Solution. Highlighting the methods commonly called “Ferberizing” or “extinction,” they walk parents through getting their children to sleep independently, even if this means tears. Ferber and the Sleepeasy Solution offer a gradual approach, which Dr. Nash prefers, in which parents put their child to bed and gradually increase the intervals at which they check on the child until he falls asleep. Weissbluth has a more cold turkey approach with no check-ins. Both have their merits, and depend largely on the child; for some the check-ins can actually get the child more worked up instead of having a soothing effect.
Shira Gregory co-slept with her son until he was seven months old and was staunchly against CIO, but realized that neither of them were getting the sleep they needed. After a lot of research and a failed attempt at a more gentle approach, she decided to give the Sleepeasy Solution a go.
“I knew this was going to be one of the hardest things to date to have to deal with,” she recalls. “The first night was predictably horrible, and I had to tell myself he was going to balk at any major change, and that I was ultimately teaching him a valuable skill (to put himself to sleep). By night three, everyone was sleeping well. This was revolutionary.”
Opponents to CIO cite studies showing it causes long-term damage to the child, which proponents of the method debunk with other studies and personal anecdotes of loving, attached children who sleep beautifully.
Dr. Nash points out that one of the main cons of these methods is that they tend to cause the parents distress, which may in turn cause them to overindulge the child the next day to make up for their guilt. “You’re looking for a balance,” she advises, “in terms of tolerating distress and yet helping them make developmentally appropriate steps forward.”
No cry methods
Elizabeth Pantley’s No-Cry Sleep Solution, Tracy Hogg’s The Baby Whisperer, and Kim West’s The Sleep Lady’s Good Night Sleep Tightall spell out more gentle sleep training methods (though even these are often pitted against each other). Hogg offers a “pick up, put down” approach in which you put the baby in her crib but pick her up and comfort her if she fusses, then put her down as soon as she is comforted. Repeat until baby is settled.
West’s method, the Sleep Lady Shuffle, has parents stay in the room to comfort the child as she falls asleep but move further and further from the crib each night. All three authors encourage a number of tools (white noise, black out curtains, a consistent routine) to help create an environment amenable to sleep. These books are largely anecdotal and are written by parents or parenting “experts” rather than medical professionals (though Hogg was a nurse before she became a nanny to the stars).
Megan Lavigne, a parent and certified Gentle Sleep Coach, had a poor sleeper from day one. “I spent countless hours rocking him in our glider, or bouncing with him on a yoga ball trying to get him to sleep,” she recalls. Her son’s sleep improved slightly between three and six months, but then he suddenly returned to waking multiple times a night. She tried waiting it out, but by nine months she knew she had to do something. Within a few nights of gentle sleep training everyone in the family was sleeping better.
What Lavigne liked about the Sleep Lady approach is that “it’s gentle, effective, and flexible enough to allow parents to provide more support to the child when needed.” The down side, however, is that “it can take longer than more rigid techniques due to the gentle nature of the method.”
When sleep training doesn’t work
Before deciding that sleep training isn’t working, be sure that you’ve been consistent and given it enough time for results. “None of these things are going to work the first night,” says Dr. Nash. “At the same time, if after one or two weeks you’re not seeing progress, it’s time to recognize that this is not the right intervention for your kid.”
For Courtney Legatti, sleep training was not the panacea she’d hoped for. She and her husband tried CIO when her son was around six months old, and his sleep improved, but even at 17 months he still wakes at least once a night. “Simon cried for almost 2 hours the first night, around a half hour the second night, and 11 minutes the third,” she recalls. He would cry on and off all night.
“I would end up going in and feeding him because he was very persistent,” she says. “I learned that CIO would work when we put him to bed but not in the middle of the night.” Simon’s reflux may have been to blame, but Legatti isn’t convinced that’s the entire reason. “I honestly think that some babies are just bad sleepers,” she adds.
If sleep training just isn’t working after being consistent for one to two weeks, take a break. Try the same method again later, or a different method. You can also consult your pediatrician or a professional sleep consultant, who can work with you to create a plan tailored to you and your child (and, even more importantly, help you follow through).
Other concerns, like reflux or sensory issues, may also be at the root of the problem. And, most importantly, advises Dr. Nash, trust your instincts.
“Somehow we got this message, maybe from information overload, that we don’t know what to do,” she notes. “I would say you know a lot about what to do next.”