If your infant isn’t sleeping through the night after several months, you have lots of company.
Nearly 40% of babies still aren’t sleeping for that coveted six-hour stretch at 6 months old. Around 4 months, many parents start exploring sleep training.
While there’s no one-size-fits-all approach to sleep training an infant, Novant Health pediatrician Dr. Eric Gibbs explains when sleep training may be appropriate, the different methods parents use and how to decide what’s right for your family.
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What is sleep training?
Sleep training is the process of helping babies establish a consistent sleep schedule and learning to fall asleep independently, or to fall back asleep if they wake up crying. Parents usually ask about it when their baby wakes frequently at night and they’re looking for ways to improve sleep.
When we’re talking about baby sleep, what’s considered normal?
Until 3 months of age, frequent nighttime wakeups are normal. Many babies can go about three hours between feeds, and may lengthen those stretches at night as they get older.
By around 4 months, many babies are sleeping longer stretches with one to two wake-ups at night. The goal is gradual progress toward longer nighttime stretches and eventually, sleeping through the night.
At what age can you start sleep training a baby?
Four months at the earliest, and with approval from your pediatrician. I usually see the most success with sleep training at this age. I do not see success when parents try to sleep train any earlier.
What are the different types of sleep training methods?
There are three main types of sleep training:
- Graduated extinction: If your baby is crying, you check on them at gradually longer intervals. For example, you go in after five minutes, then 10, then 15. You briefly soothe them each time. This is widely referred to as the Ferber method, and is appropriate to start at 4 months.
- Unmodified extinction: This is also referred to as “cry it out.” You don’t go back to their room, allowing your baby to learn to self-soothe independently.
- The chair method: First, you’re right there soothing them while they're crying; then you gradually move further away. Instead of standing over the crib, you sit in a chair next to it. Then you gradually move the chair further away until they can fall asleep without you.
What can parents do to get the best results with sleep training?
Trying out a method aligned with your sleep goals is important. I like to talk with the parents and see what they want to achieve with sleep training. Success for some parents means as little crying as possible. For others, it means sleeping through the night as quickly as possible.
Once you start, stay consistent. Try a method for about one week before switching. For “cry it out,” you’ll usually know within three to four days whether it’s working. If no progress is being made, it may be beneficial to take a break from sleep training for a couple of weeks before trying again.
Remember: Every baby is different, and different babies will respond to different sleep-training methods.
What are common hesitations that come up around sleep training?
The main one is the hesitation to let your baby cry. I like to prepare my parents before they start sleep training by telling them it will be difficult. It’s not easy to let your baby cry. Some parents are also concerned about long-term effects.
According to the research we have, there are no long-term attachment issues or mental health issues for babies that were left to cry it out.
Are there cases where sleep training is not the best course of action?
Absolutely. Sleep training may not be appropriate if your baby still needs overnight feeds due to weight gain or feeding concerns. In those cases, focus first on healthy sleep habits. (See the next question.)
Mental health also plays a role in the decision to sleep-train. For some parents, listening to their baby cry takes more of a toll on their mental health than the sleep they’re losing.
The choice to sleep-train is case-by-case. That’s why the best thing to do if you’re considering it is to talk to your pediatrician.
Is there anything you wish expecting or new parents knew about sleep before they were in the thick of it?
In the first three to four months, we’re less focused on sleep and more focused on ensuring feeding is going well and that everyone is taking care of themselves. This is a good time to start building healthy sleep habits that can lay the foundation for successful sleep training.
To build healthy infant sleep habits early:
- Put your baby down slightly drowsy, not fully asleep.
- Keep daytime bright and active.
- Keep nighttime dim and quiet, even when your baby is awake.
- As your baby approaches 3 to 4 months, avoid naps longer than two to three hours.
Pick one book about sleep and stick with it as your go-to resource, as long as your pediatrician approves. My recommendations are “Precious Little Sleep,” by Alexis Dubief or “Moms on Call, Basic Baby Care 0-6 Months” by Laura Hunter and Jennifer Walker, an RN. Use books as guidelines for sleep, not rules to follow to the letter.
I think a lot of parents would say: Don’t wake a sleeping baby, no matter what. But it sounds like you believe otherwise.
Absolutely. In the newborn period, your baby will likely need to be woken up for frequent feedings. Not letting your baby nap for too long during the day can help support longer stretches of sleep at night.
If a parent wanted to start tonight on sleep training or just healthier sleep habits, what’s one small thing they could do?
Before feeding during a nighttime wakeup, pause for a minute or two. Your baby may resettle on their own or take a pacifier. Being able to go longer stretches without feeding is a significant step toward sleeping through the night.
Infant sleep is challenging. While no one approach works for every baby, your pediatrician can help you create a plan that fits your child and your family. “We’re here to help,” Gibbs said. “Don’t be afraid to ask for our support.”
