Written by: Allyson Hoffman
Reviewed by: Sherrie Neustein
Updated April 20, 2021
Among the many joys of new parenthood comes the challenge of sleep training your little one. Most parents lose sleep (1) themselves as they struggle to get their baby to sleep throughout the night.
Experts define sleeping through the night as six hours of uninterrupted sleep (2). However, most babies don’t develop the ability to sleep through the night until they are about six months old (3). In fact, at least one study shows that nearly 38% of six-month-olds still do not sleep through the night.
Babies may struggle to fall asleep or stay asleep at night for several reasons.
- Infant Sleep Schedule. Babies zero to three months need 14–17 hours of sleep (4), which occurs in short blocks of time throughout the day. They typically sleep in three to four hour bouts (5), which means they’re going to wake up during the night. As your baby grows older, these sleep periods will lengthen.
- Need to Feed. Babies cry at night when they are hungry. Studies show that more feedings of milk or solid foods during the day in older infants decreases nighttime hunger (6). However, babies often still wake up at night for reasons other than hunger, so daytime feedings might not actually make an impact on nighttime awakenings.
- Pain from Teething. More than 82% of babies (7) experience sleep disruption when new teeth are emerging. Gum soreness and pain can contribute to sleeplessness.
Fortunately, there are a number of baby sleep training methods parents can choose from to help their child sleep at night. There is no one best option for all families. The right method varies from family to family and depends on your goals and comfort level.
Extinction, Weissbluth, Cry-it-Out Method
One of the common self-soothing baby sleep methods is the extinction method, sometimes called unmodified extinction, the Weissbluth method, or the “cry-it-out” (CIO) method. This method requires the parent to not answer the child’s cries (8) after putting them to sleep. The behaviors parents ignore with this method include tantrums, calling out to the parents, and crying. The only exceptions to this rule are in instances where the child is ill or in danger.
The CIO method is highly effective in improving sleep for babies, as well as in reducing nighttime wakings and sleep problems. However, parents may feel uncomfortable leaving their child crying alone without comfort. If the parent gives in and comforts the child, the method will not be successful in teaching the baby to self-soothe. Instead, the baby may be motivated to cry for longer periods in the future until they receive comfort.
Extinction with Parental Presence
Extinction with parental presence, also called the “camping it out,” is a modified version of the extinction method (9). Rather than leaving the child alone in their bedroom, the parent stays in the room but still does not comfort the crying child unless there is an emergency.
Some parents may find this method more comfortable than leaving the child completely alone. As a result, they feel more confident that they can follow through with the method. Other parents, however, may feel distressed watching their child cry and not being allowed to comfort them.
Graduated Extinction or Ferber Sleep Method
Parents who wish to train their child to self-soothe but do not want to separate from the child for the entire night may prefer graduated extinction or the Ferber sleep method. Ferber sleep training requires the parent to wait a set amount of crying time before they check in on their child.
There are a few potential approaches to graduated extinction. In fixed graduated extinction, parents wait the same amount of time throughout the night before checking in. For example, they may allow the baby to cry in five-minute bouts before entering the room and soothing.
Alternatively, parents can try incremental graduated extinction. In this approach, parents extend the waiting period after hearing crying. At first, they wait five minutes before entering the room. The next time they wait 10 minutes, and then 15 minutes.
Regardless of which graduated extinction approach parents choose, they should only soothe the baby for a short period of time. Aim for 15 seconds to one minute. This quick check-in allows the child to know parents are present but discourages them from repeating the attention-seeking behavior. Eventually, the method allows the baby to self-soothe independent of comfort or feeding.
Research shows that graduated extinction is effective in reducing the number of times a child wakes up during the night. In fact, evidence indicates that graduated extinction is as effective as unmodified extinction.
Bedtime Fading Method
Rather than encouraging self-soothing, bedtime fading decreases the amount of time spent in bed (10). First, parents delay their child's bedtime by about 15 minutes. The goal is to reduce the amount of time it takes for the child to fall asleep. Once the child grows accustomed to falling asleep quickly, parents back up bedtime in 15- to 30-minute increments until they achieve the ideal bedtime for their child.
Evidence shows the bedtime fading method effectively shortens the time it takes for a child to fall asleep. Researchers suggest that if the child wakes during the night, parents implement graduated extinction as well as bedtime fading.
Scheduled Awakening Method
Scheduled or timed awakenings require parents to time their child’s nighttime habits. Begin by keeping a sleep diary and noting when your child wakes up during the night. Then, wake your child up 15 to 30 minutes before the anticipated wake time. Do the same routines you would if your child woke up spontaneously, such as feeding, rocking, and cuddling. Then, increase the time between awakenings. This approach will allow your child to sleep longer.
While effective, research shows the scheduled awakening method may take several weeks before results are seen. In contrast, results from extinction methods appear within days.
Choosing a Method
Across studies of these different baby sleep methods, 94% show that any of these behavioral interventions for sleeping infants create reliable and sustainable changes. The choice of baby sleep technique comes down to parental preference.
Some sleep methods may feel more comfortable or natural to you as a parent. When in doubt, consult with your pediatrician. Together, you can determine which sleep method is right for you and your baby.
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