Everyone seems to have an opinion about when babies should sleep through the night — and how to get them to hit the milestone. If a baby who is old enough to sleep through the night is still waking frequently and disrupting other family members’ rest, sleep training might be worth considering.
Researchers and medical experts have come up with several baby sleep training methods to help little ones and their caregivers get a full night of sleep. That said, they’re each unique, and when considering which will work best for you and your baby, it’s important to find the one that makes you feel the most comfortable and suits your individual situation, says Dr. Mary Carol Burkhardt, a primary care pediatrician at Cincinnati Children’s Hospital. “There is not just one way to parent or sleep train,” she says.
Here, how to know if your child might be a candidate for sleep training and what you need to know about three of the most popular methods.
How to know if your child would benefit from sleep training
To sleep train or not to sleep train? This is a deeply personal question. As Burkhardt explains, most healthy babies ages 4-6 months can sleep for about six hours straight, but that does not mean you should feel forced to sleep train an infant who only sleeps for four hours. She emphasizes that there are many approaches to parenting, and deciding if and how to sleep train is up to the primary caregiver.
The American Academy of Pediatrics (AAP) reports that 20-30% of parents of young children want to help their child learn to sleep through the night. Burkhardt says caregivers in this camp can move ahead with sleep training if the infant is:
- 6+ months old.
- Gaining appropriate weight.
- Able to space several hours between feeds (e.g. does not have digestive or malnourishment problems).
The most popular baby sleep training methods
Though there are many sleep training books and resources on the market, Patti Ideran, a pediatric occupational therapist at Northwestern Medicine Central DuPage in Winfield, Illinois, suggests that most boil down to these three sleep training methods:
- Cry it out (CIO).
- Ferber.
- Gradual extinction.
Research suggests that those who stick with sleep training will likely see improvements after just one week.
Below, experts explain common sleep training methods and offer tips to help you determine which is right for you.
“A consistent routine and response will make the process smoother and faster.”
— DR. MARY CAROL BURKHARDT, PEDIATRICIAN AT CINCINNATI CHILDREN’S HOSPITAL
1. Cry it out (CIO) method
The “cry it out” (CIO) method is as straightforward as it gets. You shut the door and let the baby cry until they fall asleep, explains Ideran.
Some caregivers balk at CIO because they say it feels like abandoning the baby. However, Valerie Crabtree, chief of Psychosocial Services at St. Jude Children’s Research Hospital in Memphis, Tennessee, says there’s no evidence that CIO causes psychological trauma when used with babies who are developmentally ready (usually by 6 months of age) and who receive nurture and attention during the rest of the day.
She acknowledges, “Some parents are simply not comfortable allowing their infant to cry it out. And that is OK. There are other techniques.”
Pros and cons of the “cry it out” method
| Pros | Cons |
| CIO helps teach independence. | It can be distressing for both babies and caregivers. |
| CIO might require a shorter sleep-training period than more gradual methods. | CIO is not recommended for babies with a history of trauma or disrupted caregiver-child relationship. |
| CIO has straightforward “rules,” making it easy to follow. | CIO forces you to hear your little one cry. |
2. Ferber method
Dr. Richard Ferber, the director of The Center for Pediatric Sleep Disorders, at Children’s Hospital Boston, proposes a sleep training method that is a gradual-release version of CIO. “Simply leaving a child in a crib to cry for long periods alone until he falls asleep, no matter how long it takes, is not an approach I approve of,” writes Dr. Ferber in the introduction to his 2006 update of “Solve Your Child’s Sleep Problems Now.”
Ideran calls this the “checking in method.” A caregiver periodically checks on a crying baby, increasing the amount of time between checks until the baby falls asleep.
It is also important for caregivers to avoid picking up the infant during check-ins. “If the parent needs to check on the child, they should be brief and boring,” says Burkhardt.
Here’s a rough schedule of the Ferber approach from the Pediatric Sleep Council:
- Put the baby in the crib while drowsy, not asleep.
- Leave the room and stay away for three minutes.
- Go back and soothe your little one for one to two minutes.
- Leave and stay away for five minutes.
- Check in for one to two minutes.
- Leave and stay away for seven minutes.
- Check in.
- Continue checking in at seven-minute increments until the baby falls asleep.
The Ferber approach recommends nightly increment increases (five, 10 and 12 minutes followed by 10, 12 and 15 minutes).
Pros and cons of the Feber method
| Pros | Cons |
| The Ferber method could feel more natural than CIO. | It requires keeping a rigid schedule. |
| Ferber is a tried-and-true method with proponents in the pediatric field. | Caregivers must have patience and energy to stick with it. |
| The Ferber method has a high measure of success. | Sleep-training period with the Ferber method might take longer than with the CIO method. |
3. Gradual extinction
Gradual extinction focuses on gradually removing external soothers. This type of sleep training gets its name from the behavioral principle of extinction: that if the reward for a behavior is removed, the behavior will stop because it no longer reaps a benefit.
Gradual extinction is exactly what the name implies — a slow, gentle release of rewards for crying during nighttime wakings. Rather than leaving the room for set periods, you stay present while gradually limiting comfort measures. This allows caregivers to ensure that the baby is safe and has no physical needs while creating “conditions for the child to learn to self-settle,” according to research published in the Journal for Clinical Sleep Medicine.
Ideran explains, “The first night, you put your hand on their tummy, and talk to them. They hear you, see you and feel you — but you’re not picking them up.”
On the second night of gradual extinction, remove one of the sensations. Though you might choose to remove verbal soothing or physical touch, your little one still knows you’re there. “That’s the attachment you want,” says Ideran. “They don’t feel like they’re abandoned.”
The third night of gradual extinction can be difficult. It’s on this day that the method feels similar to CIO. You’ll stand in the room without speaking to or touching your little one, even if it comes to tears.
Of course, gradual extinction can be customized to each family. Perhaps you remove a sensation after a few nights instead of just one. The point is that you continue progressing in one direction: toward training your baby to fall asleep independently.
Pros and cons of gradual extinction
| Pros | Cons |
| Gradual extinction is more customizable than other sleep training methods. | It could take longer to find the right pace and technique for your baby. |
| Gradual extinction does not require leaving the baby alone. | The third step can be emotionally difficult for caregivers. |
| When done consistently, gradual extinction should train your baby to self-soothe and fall asleep independently. | This method might take longer in general. |
Expert-approved sleep-training tips
Some babies are naturally good sleepers. For caregivers of those who struggle to fall asleep, sleep training can help. Here are a few tips to successfully train your little one to sleep through the night.
Pick a method that all caregivers will follow.
Ideran, author of “The CALM Baby Method: Solutions for Fussy Days and Sleepless Nights,” says the key to success is getting all caregivers on the same page. This means that every one of the child’s caregivers uses the same sleep training method.
“A consistent routine and response will make the process smoother and faster,” says Burkhardt, adding that “mixed messages” will prolong crying and whining in the hopes that the caregiver “who gives in” will come to the rescue.
Keep a consistent bedtime routine.
A predictable evening schedule helps babies feel secure. The pre-bedtime routine doesn’t need to be complicated. Something as simple as feeding, followed by a diaper change and pajamas can cue the expectation for sleep. Crabtree suggests a consistent bedtime earlier than 8 p.m. while sleep training.
Put the baby to bed drowsy, but awake.
If your baby drifts off during an evening feeding, gently wake the little one before placing them in the crib. Ideran says this will help teach him or her that they can fall back asleep without assistance.
Don’t be afraid to ask for help.
“Parents should always feel comfortable talking to the child’s pediatrician who can screen and assess for specific, individual issues,” says Burkhardt. Sometimes babies struggle to sleep due to an ear infection, growth spurt, teething or even night terrors, she adds.
Remember that you know your child.
“Some babies will cry for 15-20 minutes before settling down, while others can take more time,” notes Burkhardt. Because there is no hard and fast rule for what constitutes an acceptable period of crying, she suggests using a video baby monitor or surreptitiously peeking in to confirm that the child is safe.
Parents and daily caregivers know their child’s cries. Though there is a general consensus among the experts we spoke to that babies can safely cry for more than 20 minutes, you can trust yourself to know when it’s best to check on or comfort your child.
