Sleep Training
What is meant by “Sleep Training”?
Sleep training encompasses any attempt to teach your baby how to fall and stay asleep independently, self-soothing without your help (e.g. without being rocked, nursed, shushed, etc.)
The most common method is ‘cry-it-out’ which involves allowing your baby to cry for various periods of time. There are ‘no-cry’ approaches as well, but they are generally less effective (source). I’ll cover these methods below.
Sleep Training is a distinct process from Night Weaning, where you decrease and eventually eliminate night milk feeds. However, some people tackle these at the same time, with the goal of having baby sleep straight through the night.
Should I sleep train?
The benefits of successful sleep training - for both baby and parents - are clear:
Longer and higher quality sleep for baby (source)
Better daytime mood for baby (makes sense, given the above) (source)
Improved maternal sleep quality (source) and mental health (source)
While I don’t know any studies that explore this issue, anecdotally I believe it can lead to a healthier relationship between partners, since everyone is a kinder spouse when better rested!
However, if the partners are not on the same page about sleep training, it can actually increase conflict
All parents are eager for better sleep, but many are uncomfortable with the notion of letting their baby cry, or feel strange withholding their soothing
This understandable discomfort is heightened by the claim circulating in certain internet communities that “cry-it-out” methods are harmful to the child - this has been debunked by research:
In a randomized-control trial, sleep trained babies showed no difference in parental attachment or behavior compared to controls
Yes, cortisol level did go up after a bout of crying, but doesn’t appear to have an impact beyond that (and levels were actually lower the next morning)
I was always amazed how after a night of awful crying, my daughter would greet me with a smile in the morning, as if nothing had happened - no grudges held!
A five-year followup study found that there was no difference in child’s stress levels, behavior, or child-parent closeness and attachment
Personally, I think sleep training can be an unpleasant process but is ultimately totally worth it, if it works (which is the case for 80% of babies according to this study)
But if it doesn't feel right for you, don’t do it! Your child will eventually learn to sleep independently, and in the meantime, co-sleeping is a viable alternative that may help improve sleep.
However, if you’re turned off from sleep training because you fear other’s judgment or worry about (false) claims that it will damage your child’s psyche, then I’d seriously reconsider
See if you can reframe it in your mind as helping them learn the lifelong skill of self-soothing
Remember - you will still be super responsive to their cries during the entire day
If you have two working parents, sleep training may be more essential to the functioning of your family unit than if one parent is at home and able to take a nap during the day when baby naps (not to minimize the real challenges of being a stay-at-home parent, but it does allow for a different rhythm)
When to start sleep training
Best window is 4-6 months: start sleep training no earlier than 4 months; while there’s no age that’s too late, it may get harder in toddler years
Make sure your baby isn’t sick or teething when you begin
Ensure you have no upcoming travel plans for the next 2 weeks - while some babies successfully sleep train in just 3-4 days, it’s much more common for it to take a week or two
Tackle nighttime sleep first and then do naps later. This is because there is more “sleep pressure” at night - the biological drive, regulated by hormones, that builds throughout the day and causes us to feel tired.
Consider “sleep conditioning” earlier: around 2-3 months, there are some strategies you can try that may lay a good foundation for later sleep training
“Drowsy but Awake”
Put baby down to sleep when they are super sleepy (eyes heavy, body calm) but not yet fully asleep
This gives them the opportunity to practice settling themselves to sleep - it may take a minute or two of squirming and grunting as they get comfortable
If they proceed to cry, pick them up and help them to sleep - this is too young to truly “cry-it-out”
Practice this just once or twice a day, rather than every time they go to sleep
Some babies pick this up quickly, while others struggle, so don’t feel pressure to keep practicing if your baby falls into the latter camp
“Le Pause”
When your baby starts to fuss during the night or a nap, give it a minute or two before rushing in to calm them - it’s possible they will soothe themselves back to sleep. If they don’t, then you can come in to help - the idea is to avoid leaping in too quickly.
This concept was dubbed “Le Pause” in the entertaining book “Bringing Up Bebe” about an American mother’s experience raising her baby in Paris - supposedly, this practice is the secret to French babies sleeping through the night way earlier and more easily
Certainly if baby wakes up in the morning or from a nap and isn’t crying, let them chill happily for a while so they don’t come to expect you immediately upon waking
“Eat, Play, Sleep”
Establishing this cycle means you are feeding your baby after their naps, rather than feeding them to sleep
This helps to avoid the association between nursing/feeding and sleep, which means it will be easier to later teach falling asleep independently
However, nursing/feeding to sleep is also a very natural and normal habit, so if this doesn’t feel right to you, don’t force it (we never really did this)
If sleep is super high priority to you and/or your baby seems pretty easygoing, then I recommend giving these strategies a shot, but it’s also okay to just wait until the 4-6 month period when you will more officially begin sleep training
The notorious 4 month regression (which can begin as early as 3 months): this is a major shift in baby’s sleep patterns where they mature towards a more adult-like rhythm, cycling between light, deep sleep and REM
The challenge is there is a brief period of wakening in between cycles - as adults, we hardly aware of this and just drift back to sleep, but babies often have trouble getting back to sleep
Their sleep cycles are also much shorter in length (~45 mins compared to 90 mins in adults)
This results in frequent night wakings until baby learns to “connect sleep cycles” - a baby that had previously been sleeping 5-7 hours stretches may suddenly be up almost every hour or two
The regression hits babies differently but for many (including our family) it can be absolutely brutal
There’s some debate on whether to begin sleep training during this regression or wait until after
The problem is that for many babies, there is no “after” - in fact, “regression” is a misnomer, because the shift in sleep cycles is a permanent change
This is different than later sleep regressions that occur during major developmental milestones or after travel/illness - these are truly temporary
In my opinion, if things don’t get better on their own after a week, then they won’t ever get better until they learn to self soothe between cycles - so I do recommend beginning sleep training during the regression, as long as baby is at least 4 months
Night weaning timing
What is night weaning?
Every baby’s feeding pattern is different, but here’s a typical timeline:
4-6 months: 2 night feeds, usually with a longer stretch of sleep before the first feed
6-9 months: consolidate to 1 night feed
9-12 months: no more night feeds
I’m reluctant to give specific schedules and hours that babies can go without feeding, because there is huge variability
Some babies naturally wean themselves off night feeds, going longer and longer stretches between feeds, but for many babies the parents have to intentionally drive the process
This requires gradually decreasing the minutes of breastfeeding or ounces of bottle feeding over the course of a week or so
It helps if you increase the intake of milk and/or solids during the day, to ensure baby is still getting enough total calories in a 24-hour period (source)
Another option is to add a “dream feed”: this is when you sneak in around 10pm/11pm (right before you go to sleep yourself) and feed your baby while they’re still half asleep, so that it gives you a longer stretch before they next need to feed again
This works well for some babies, but others are too roused and struggle to get back to sleep
Some people choose to continue with a night feed if it helps baby sleep a bit longer in the morning - it’s a question of how much you value total hours of adult sleep vs. contiguous/uninterrupted hours
So, how does night weaning fit with sleep training?
These are separate processes, and while some people tackle them together, most do sleep training first (between 4-6 months) and night weaning later (6-12 months)
To implement sleep training while your baby is still taking night feeds, you’ll just need to be clear on the baby’s current feeding schedule, so you can determine whether a wakeup should “count” as a feeding, or a night waking where the sleep training rules apply
Again, I’m not prescribing a specific schedule, this is just an example to illustrate how this would work for a baby who currently feeds twice a night around 1am and 4-5am:
Baby goes to bed at 8pm
Apply sleep training rules to any wakeups before 1am
If baby wakes after 1am, give Feed #1
Apply sleep training rules to any wakeups in the 3 hours following Feed #1
If baby wakes up after that (so 4am at earliest), give Feed #2
Apply sleep training protocol to any wakeups until Morning Feed
Methods
All sleep training methods have a common goal: to eliminate baby’s’ reliance on “parent-controlled sleep associations” to fall asleep - things like rocking, bouncing, nursing/feeding, patting, shushing, singing, handholding, etc.
If baby depends on these to fall asleep at the beginning of the night, they may also need them to fall back asleep throughout the night, which is problematic
There are other sleep associations related to the bedtime routine and environment that are great to keep, and signal to baby that it’s time to sleep: bedtime book/song, white noise, swaddle/sleep sack, turning lights off, etc.
Pacifiers are tricky:
They are incredibly helpful as a soothing mechanism but when they fall out during the night, young babies may need a parent’s help to reinsert them
If this happens once or twice a night, not a big deal, but if it’s happening 10+ times, it’s a problem
It’s not until 7-8 months old that babies are capable of replacing them by themselves
If you’re starting sleep training closer to 4 months, you would have to be on replacing duty for many months, so I would instead ditch the pacifier as part of sleep training
However, if you’re starting closer to 6 months, it’s a shorter time so I’d just push through, since the pacifier may be a great tool once baby can use it independently
In all of the below methods, baby is put to sleep “drowsy but awake” so that they learn to fall fully asleep themselves; where the methods differ is how the parent handles the inevitable crying that occurs as they learn this skill
“Cry it Out” or “Controlled Crying”
This is what most people refer to when they say “sleep training” - after a bedtime routine, you put baby in the crib when they are drowsy but awake, and following some amount of crying, they eventually put themselves to sleep
When they wake up during the night, they also must self-soothe back to sleep after some amount of crying
The crying can be really difficult to listen do, but one framing that helped me was to think about crying as a natural release after a long day
To check-in or not: in some variations of this method, the parent provides “check-ins” when you come in to briefly comfort the baby verbally or by patting on the back:
“Gradual Extinction” or “Ferber Method” involve check-ins at particular intervals
“Full Extinction” or “Weissbluth Method” don’t involve any check-ins
Research suggests that the “no check in” methods have better efficacy, but the check-in methods are more popular
One challenge with check-ins is that you need to really stick to keeping them quick and minimizing contact, which can be hard to do once you’re in there (one exception is if you smell a poopy diaper - then def pick up your baby and change them!)
I say this as someone who often “broke the rules” of our protocol and picked up the baby. I ultimately found that the black-and-white aspect of full extinction made it easier to stay consistent.
It may also depend on how your baby reacts to check-ins - for some, it helps calm them down and gets them closer to self-soothing, but for others it can just further aggravate (“you’re here, but you’re just going to leave me again and I have to go through the whole separation sadness again?!”)
Honestly, I think check-ins are mostly valuable for the parents, to feel a little better about the whole thing!
If you choose to do check-ins, you can use the specific intervals Ferber recommends but there is not particular magic in these numbers so feel free to set your own if it’s easier to remember (like 5, 10, 15, etc. the first night, and then 10, 15, 20, etc. the second night)
Even if doing full extinction with no check-ins, you should still monitor in case baby gets hurt, throws up, etc. just don’t respond to anything short of one of those emergencies
Crying times vary: There is huge variation based on your baby’s temperament - some may initially protest for as little as 20 minutes, or as long as 2-3 hours
The super long crying sessions are awful to witness and it’s tempting to eventually give in, but then you are teaching them that they just need to cry longer to get you to respond
The way I tried to frame it: the crying is so unfortunate, I should at least make it “worth it” and let it serve the purpose of teaching her to fall asleep - if I give in, then all that pain of crying was for “nothing”
That said, if the hours-long crying is continuing for days or weeks, perhaps put sleep training on hold and try later or with a different method; it’s not the right solution for all babies
The amount of crying should gradually decrease over time, though it’s not always linear. And zero crying may not be a realistic end-goal: many babies will always do a little whimpering/crying before falling asleep
Remember - there’s falling asleep initially at bedtime, and then there’s getting back to sleep after night wakings (as they move from one sleep cycle to another). Sometimes sleep training works really well for one of these phases but takes a lot longer for the other.
Pick Up- Put Down
This is considered a “gentler” sleep training approach, but bear in mind it typically takes a lot longer to work
You put baby in bed (drowsy but awake!) and give them a few minutes to try to settle down on their own
If baby is still crying, pick them up and provide a minute or two of comfort (rocking, verbally, etc). When they are calm but still awake, put them back in the crib and leave the room
If baby doesn’t self-settle after a few minutes, you go back in and repeat the pick-up/put-down process, as many times as necessary until they eventually fall asleep
The hope is that over time, the number of pickups decreases until they don’t need any
It’s essential that baby isn’t falling asleep in your arms during pickups, otherwise they aren’t actually learning the skill of self-soothing
Chair/Mattress Method (sometimes called Sleep Lady Shuffle)
This is another gentle method that may take a longer time to work, and can be hard to consistently implement - frankly, I wouldn't recommend it for babies. However, I have found it to be useful during toddler sleep regressions so I’m including it.
The idea is that sometimes your mere presence in the room is enough to help calm your baby as they learn to fall asleep on their own
You put baby down to sleep drowsy but awake, and then sit in a chair right next to their crib until they fall asleep
If they’re crying, you can verbally soothe them but avoid physical contact
Same process when baby wakes up during the night
After a few days (~3 days) with the chair in this position, you move it so it’s halfway to the door
A few days later, you move the chair to the doorway, and later to the hallway with the door open so baby can see you, and finally to the hallway out of view but within earshot
Keep in mind that if babies fall asleep with you nearby, they may expect you to still be there when they wake during the night, resulting in lots of crying during night wakings
Another challenge with this method compared to “cry it out” is you are right there, hearing the cries up close, which can be emotionally draining and thus tempting to give up
With toddlers, however, cry-it-out methods may no longer work and so this is a helpful alternative - in fact, I’ve done this method but using a mattress instead of a chair, where I actually spend the night in the various positions. Not pleasant but it worked to help my daughter feel safe going to sleep by herself again. Visit this page more toddler sleep tips.
Implementation
Know thyself
If you suspect one parent is going to struggle more than then other listening to baby’s cries (and is more likely to cave), perhaps have that parent go watch a movie or go out for dinner for the first night or two, when crying will be the worst
Alternatively, there are professional sleep trainers you can pay to come to your house and sleep train for you! (Olive - Celtic Sleep in SF)
Write down the plan
This is a good commitment mechanism and ensures you and any other caregivers are on the same page
It’s also a chance to talk through all the different scenarios - e.g if you’re still doing feeds, what’s the timing and protocol for those? At what point in the morning is it an acceptable wake-up time (vs. considered a “night waking”?)
This was our super detailed sleep plan when my daughter was 5 months old (it’s extra complicated because she was still taking two night feeds at the time - hopefully yours is simpler!)
Sleep consultants can also help you formulate and stick to a plan; they won’t offer some revolutionary, magic bullet idea you can’t find elsewhere on the internet, but they provide additional accountability and honestly it sometimes just feels good to talk to an “expert” about this stuff. Here are my top two recs:
Jessica at Luli Sleep: no nonsense style
Dr. Angelique Millette: brings more of a psychology lens, helpful for toddlers and older children
Be honest with “drowsy but awake”
If your baby is technically still awake but right on the verge of falling asleep, that doesn't really count and won’t give her the chance to learn self-soothing
If baby falls asleep while feeding, you should wake her up so she self-soothes to sleep, as unnatural as that feels
Don’t mistake fussing for crying
Fussing or whimpering is different than full fledged crying, and shouldn’t start the clock for a check-in, or trigger a “pick-up/put down”
There are also degrees of crying to listen for - if you’re almost at the check-in time, but you’ve noticed the cries are softening, perhaps give it a couple more minutes
Baby monitor visuals can give you more information too -if they had been crying while sitting/standing, but are now crying while lying down, they may be close to self-soothing and thus I wouldn’t rush in yet
If there is a meaningful pause in crying, I would restart the check-in clock
Utilize technology:
You may want to ignore any crying that occurs before a certain time - for instance, if you don’t go in for a night feed until 3am. If you have an iPhone and the Nanit, you can create a rule on your phone that turns the volume on at specific times
Go the Shortcuts
Click the triple dots next to “Set Volume” in Starter Shortcuts - I like to set it to 50%
Click the Automation icon at the bottom and “New Automation” button
Select “Time of Day” and enter the time (3am), select “Run Immediately” and “next”
Select “Set Volume” within Starter Shortcuts
It should look like this
When you go to sleep, leave your Nanit app open with the sound icon unmuted, but silence the volume on your phone itself
Your volume will remain off until 3am, at which point it will turn on and you’ll hear any baby sounds!
You can create multiple Automations - for instance, you could create one for 6:30am. After the 3am feed, you’d again silence the volume on your phone (while keeping Nanit open and unmuted) and it wouldn’t turn back on until 6:30am.
Re-training
It’s a common misconception that sleep training is a “one and done” process
In reality, you’ll have to do some “retraining” after regressions (the most common being around 8-10 months, 12 months, and 18 months), travel or sickness
Travel can be especially tricky if you’re sharing a space with friends/family and don’t want them to be awoken by crying - it’s very understandable to fall into “bad habits” to keep things quiet during those times. Do whatever it takes!
If your baby is sick, definitely give yourself permission to provide more comfort; but if he’s merely teething, I would try to maintain your normal sleep training protocols - babies go through teething a lot those first years and you don’t want to be constantly undoing all your hard-won progress
If you do need to retrain, it won’t be like starting from zero - hopefully it’s significantly shorter than the original sleep training
Toddler sleep issues are a whole other beast, as there is an even greater psychological component
