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Getting Your Baby to Sleep

Babies do not have regular sleep cycles until about 6 months of age. While newborns sleep about 16 to 17 hours per day, they may only sleep 1 or 2 hours at a time. As babies get older, they need less sleep. However, different babies have different sleep needs. It is normal to expect that a 6-month-old can wake up during the night but go back to sleep after a few minutes.

What are the most common sleep training methods …

The Fading Sleep Training Method (FIO): This is a very gentle, no-tears/no-cry (or very little cry) method of sleep coaching where you “fade it out” (FIO). With the Fading method, you continue to help your baby fall asleep (by rocking or feeding to sleep, for instance), but over time, you gradually do less and less of the ‘work’ to put your baby to sleep, and your baby does more and more. For instance, if you normally rock your baby completely to sleep, you may shorten the amount of time you rock each night until you are rocking for only a few minutes only as a part of the bedtime routine. This method requires quite a bit of patience on the parent’s part, in some cases, but it’s great for families who want to minimize crying as much as possible. This method can be used in infants > 6-8 weeks of age.

Sleep training is a hotly debated topic. Proponents of sleep training argue that it does not harm the child and has benefits for the child and family. Opponents say that “cry-it-out” techniques are cruel to children and cause long-term problems. Unfortunately, much of the debate is propagated by misinformation. This is unfortunate since there is a great deal of knowledge about sleep in children based on scientific studies.

The Pick-Up-Put-Down Sleep Training Method (PUPD): This is another gentler technique. The PUPD method works just the way it sounds: when it’s time to sleep, and your baby is fussing or crying in his crib or bassinet, you pick him up and comfort him until he’s calm and drowsy (BUT NOT ASLEEP). Then, you put him back in his crib to sleep, repeating this cycle until your baby is finally asleep. PUPD is another method that requires quite a bit of patience, depending on your baby, and it won’t work for every baby; some babies find being picked up and put down so often over-stimulating, and they gradually become frustrated and worked up, instead of relaxed. This method can be used in infants > 6-8 weeks of age.

The Chair Sleep Training Method: This method involves more tears than the previous two; however, you don’t leave your baby unattended in the room at all. Here’s how the chair method works: start by doing your normal bedtime routine. Then, put a chair very near the crib, bassinet, or bed and sit on the chair as your baby falls asleep. The goal is neither to help your child fall asleep, nor to help her calm down necessarily, depending on how you implement it. You are generally not supposed to give your child any attention. The reason you are in the chair is only to reassure them that you are there with them and have not left them alone. Each night you move the chair farther and farther away from the crib until you are right outside the door until eventually, you no longer need the chair at all. 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. This method is better for infants > 3 to 6 months of age.

The Ferber Method or Graduated Extinction: This is considered a ‘cry’ method of sleep training. This technique entails allowing your baby to cry while checking on him at intervals. The goal here is to reassure him every so often that you are nearby and to reassure yourself that he is okay. When you go to check on your baby, you are not “supposed” to pick him up nor engage him much, but simply reassure him using your voice and a loving pat for 2-3 minutes, tops (watch the clock!). With this sleep training method, the goal is NOT to help baby fall asleep – that is what he is learning to do on his own! Instead, the idea is that he falls asleep on his own, in the same “environment” in which he will awaken periodically throughout the night. The knowledge of how to fall asleep unassisted at bedtime will pave the way for him/her to go BACK to sleep throughout the night. Over time, you gradually increase the amount of time between your ‘checks’. This method works best for infants between 4 to 6 months and 18 months of age.

The Extinction Sleep Training Method (aka ‘Cry It Out’ or CIO): This sleep training technique usually involves quite a bit of crying on your baby’s part for the first couple of nights but some say it tends to be less crying, overall, since sleep training is ‘done’ faster (for many, but not all, people). The way it works is simple – you do your bedtime routine, put your baby to bed awake, and then leave the room without returning for checks. If your baby cries, you are not supposed to go in to check on her; instead, you let her ‘cry it out’ on her own. The thinking here is that if you allow your baby to cry for a period of time, but then go in and ‘rescue’ her, you have all but guaranteed that she will cry for that amount of time the next night because she will expect you to come and “rescue” her again. If you are going to use cry it out, it is recommended that your baby is at least 6 months old, when almost all babies to be able to get through the night without a feeding.

Reminder: There is no right or wrong method of sleep training; it all comes down to your unique baby and your unique parenting style. What works well for some babies does not work well for others, so do not be surprised if the techniques your friends or family members recommend don’t work the same way for your baby. The bottom line is to choose a technique that you feel comfortable with, and that you think will work well with your baby’s temperament.

Some Helpful Hints

Babies:

  1. Keep your baby calm and quiet when you feed or change her during the night. Try not to stimulate or wake her too much.
  2. Make daytime playtime. Talking and playing with your baby during the day will help lengthen his/her awake times. This will help him/her sleep for longer periods during the night.
  3. Put your baby to bed when drowsy but still awake. This will help your baby learn to fall asleep on his/her own in his/her own bed. Holding or rocking until completely asleep may make it hard for him/her to go back to sleep if he/she wakes up during the night.
  4. Wait a few minutes before responding to your child’s fussing. See if able to fall back to sleep on their own. If they continue to cry, check on them, but don’t turn on the light, play with them, or pick them up. If frantic or is unable to settle, consider what else might be bothering them. They may be hungry, wet or soiled, feverish, or otherwise not feeling well.

Toddlers and preschoolers:

Many parents find their toddler’s bedtime to be the hardest part of the day. Children this age often resist going to sleep, especially if they have older siblings who are still awake. 

  1. Set up a quiet routine before bedtime to help your child understand that it will soon be time to go to sleep. Use this time to read him a story, listen to quiet music, or give him a bath. It may be tempting to play with your child before bed. However, active play may make your child too excited to sleep.
  2. Be consistent. Make bedtime the same time every night. This helps your child know what to expect and helps him establish healthy sleep patterns.
  3. Allow your child to take a favorite thing to bed each night. It’s OK to let your child sleep with a teddy bear, special blanket, or some other favorite toy. These often help children fall asleep—especially if they wake up during the night. Make sure the object is safe. Look for ribbons, buttons, or other parts that may be choking hazards. Stuffing or pellets inside stuffed toys can also be dangerous.
  4. Make sure your child is comfortable. He may like to have a drink of water, a light left on, or the door left slightly open. Try to handle your child’s needs before bedtime so that he doesn’t use them to avoid going to sleep.
  5. Do not let your child sleep in the same bed with you. This can make it harder for him to fall asleep when he is alone.
  6. Do not return to your child’s room every time he complains or calls out. Instead, try the following:
    • Wait several seconds before answering and make your response time longer each time he calls. This will give him a chance to fall asleep on his own.
    • Reassure your child that you are there. If you need to go into the room, do not turn on the light, play with him, or stay too long.
    • Move farther from your child’s bed every time you go in, until you can reassure him verbally without entering his room.
    • Remind him each time he calls that it’s time to go to sleep.

Give it time. Helping your child develop good sleep habits can be a challenge, and it is normal to get upset when a child keeps you awake at night. Try to be understanding. A negative response by a parent can sometimes make a sleep problem worse.

Sleep Training Fact or Fiction

Myth #1: If I let my child cry, they will hate me.

Fact: Multiple studies show that there are no negative consequences in parent-child bond due to sleep training. In fact, some studies actually show an improvement in security between parent and child following sleep training.

Myth #2: I love holding my child at night and singing to her. If I sleep train, I can’t do that anymore.

Fact: Sleep training does not mean giving up the activities you love to do with your child. You can continue to do any and all of these activities as part of the nighttime routine. Sleep training simply involves avoiding these activities just at the time of transition from wake to sleep.

Myth #3: Sleep training means I can’t share a room with my child.

Fact: It is completely fine to sleep in the same room as the child during sleep training. Being close to your child may be more convenient for breast feeding and provide you with reassurance that your child is well. If you want to keep your infant in the same room, the infant should have her own sleep location that is separate from the parents, such as a crib or bassinet. Sharing the same bed with an infant is not safe.

Myth #4: Sleep training is for the benefit of the parents, not the child.

Fact: Although adults to tend to sleep better once the child is sleep trained, it is not for the parent. It is for the child! When a child needs caregiver intervention to fall back asleep each night, this is frustrating. Imagine waking up multiple times each night and having to cry in order to get put back to sleep. This is not easy on the child. Learning how to self-soothe is an important skill for infants to avoid crying nightly.

Myth #5: There are long-term risks and benefits to sleep training.

Fact: Scientific studies have not found long-term risks or benefits to sleep training. There are multiple studies showing short-term improvements in both sleep quality for children and maternal mood.

Myth #6: After I sleep train, my child will sleep through the night.

Fact: No human being actually stays asleep the entire night. We have multiple arousals every hour in which we might fidget or turn over. This movement is actually protective for us. Infants are no different. Even after sleep training, children will wake up multiple times each night, and may roll over, move briefly, or make vocalizations. They key is that after sleep training, they wil be able to put themselves back to sleep after these short awakenings.

Myth #7: I don’t need to sleep train because my child will grow out of it within a few months.

Fact: While it is true that most children will eventually stop needing the caregiver’s help to fall asleep, the timing varies greatly. It is not unusual for 5 and 6-year-olds to still wake up multiple times and want to be fed or rocked to get back to sleep. I know of teenagers that still insist on sleeping next to parents to fall asleep. Will the child outgrow it? Yes, eventually. But in the worst case scenario, it might be when they leave for college.

Myth #8: Sleep training always involves “crying it out”.

Fact: Most of the debate around sleep training stems from the process of allowing an infant to cry. For those that are adamantly opposed to letting a child cry, bu are frustrated by the lack of consistent sleep, there are other sleep training techniques that don’t involve simply leaving an infant in the crib to cry endlessly.

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