To Sleep Train or Not to Sleep Train?
Photo Via SNOO
Of the many decisions parents have to make at the beginning of their child’s life, whether or not to sleep train is a controversial one. From Ferberizing to “gentle” sleep training methods, there are various ways to tackle sleep training, if at all. Some sleep consultants don’t like calling it “training” because this is your child, not your dog, after all. But for lack of a better term, it’s been proven that babies can learn how to self-soothe through sleep training, which in turn helps everyone in the family get better sleep for the short and long term. More sleep for baby helps them mature—babies develop and grow in their sleep. Better sleep for mama reduces maternal depression and anxiety, and better sleep for both parents helps them function so they can tackle daily activities and problem-solving without tackling each other (as much).
We interviewed three highly regarded sleep consultants for insights that can help parents decide if, when, and how to sleep train. Dr. Harvey Karp is a pediatrician, creator of SNOO, and author of The Happiest Baby on the Block. Emily Oster is an economics professor at Brown University, mother of two, and author of Cribsheet: A Data-Driven Guide to Better, More Relaxed Parenting, from Birth to Preschool and Expecting Better: Why the Conventional Pregnancy Wisdom Is Wrong—and What You Really Need to Know. Karen Micklewright is a postpartum doula and sleep consultant who has also nannied for decades (she also consulted with the author and her husband on healthy sleep habits for their infant son).
What are the short-term and long-term sleep training benefits for both child and parent?
“Babies need sleep to develop and grow. Sleep can’t be made up with the next nap or bedtime,” explains Karen Micklewright. Based on age, babies need a certain amount of sleep every day. “Sleep helps babies process the previous hours of awake time, and be receptive to the next awake hours of stimulation. This is why longer naps are ideal: the first 20 minutes of sleep burns off exhaustion, the next 20 minutes are relaxed sleep, and after 40 minutes is when they go into the deep sleep required to grow. The long term benefits of more sleep are proper development and concentration to learn and grow physically, mentally, and socially,” says Micklewright. Think about how you are as a sleep-deprived adult—nobody functions optimally on less sleep than they need.
Dr. Harvey Karp also stresses the importance of a reliable sleep schedule for parents. He told us, “If a baby is waking up at night, it doesn’t affect them nearly as much as it affects their parents who can’t necessarily nap during the day. Sleep is incredibly important for parents, especially nowadays because we don’t have an extended family to help anymore. Our nuclear families are more likely to be working families taking care of the kids and maintaining jobs, so the parents need rest and extra help, otherwise they’re running on fumes.”
Karp continues, “New moms average six hours of sleep a night, and that’s broken up, so it’s not refreshing sleep. Sleep deprivation leads to all sorts of issues: marital stress, anxiety, breastfeeding problems, illness, postpartum depression, work absenteeism, and unsafe sleeping practices. Today, 60% to 70% of babies who die in their sleep, die in bed with their parents or in unsafe sleep positions. This is mainly due to parents’ helplessness, in turn, compromising their child’s sleep position. If parents sleep more they can perform better at both parenting and their work.”
Based on her research in Cribsheet, Oster confirms evidence that using sleep training methods improves the outcome for parents, including less depression and better general health.
Are there any risks, either physical or emotional, to sleep training?
In Cribsheet, Oster says, “There’s no evidence of long- or short-term harm to infants from sleep training.” Micklewright warns against sleep training too soon, saying it could lead to abandonment issues. Karp admits, “Sleep training is very stressful for parents, but studies have shown that babies do well with it if done correctly. If not done correctly, and it goes on for weeks, it’s ongoing stress, which creates suffering for the entire family unit.”
What’s the best age to begin sleep training?
The experts’ answers differ for this, but the earliest mentioned is the newborn period when sleep cues like blackout curtains and white noise can start helping with sleep. Micklewright suggests starting regimented sleep training when a baby is at least twelve pounds, “When their stomach is big enough for them to be able to sleep through the night without feeding.” After three-months-old, she says, “They are developmentally mature for sleep training because a trusting relationship has been established, they know where home and mom is, and there is no sense of abandonment.”
In Cribsheet, Oster says, “A ten- or eleven-month-old should be able to go through the night without eating. Sleep training babies at that age tends to focus on both their falling asleep on their own and staying asleep through the night. Younger than that, the goal of sleep training a two- or three-month-old baby is to encourage the baby to fall asleep on their own at the start of the night and then only wake if they are hungry. The goal of sleep training is to encourage your child to sleep independently once basic needs like food and diaper changes are met.”
Karp feels the best age to begin sleep training is “five months if your child is still waking up every few hours. Before five months there are so many ups and downs in a child’s sleep cycle—growth spurts, colds, sleep regression—if you start earlier, you’ll likely have to start over.” He also suggests using sleep cues like swaddling, white noise, and swinging to naturally sleep train babies in the first months of life, so you don’t need to implement “cry it out” sleep training. He developed the SNOO to sleep train babies with his suggested sleep cues automatically.
What are the different “cry it out” methods?
First, a definition from Oster: “Broadly, ‘cry it out’ refers to any system where you leave the baby in his crib on his own at the start of the night, and sometimes let him fall back to sleep on his own if he wakes at some point during the night. The name refers to the fact that if you do this, your baby will cry some at the start.”
The different methods:
Extinction—when you close the door and don’t go back into baby’s room until the morning. The problem with this method is that sometimes your baby does need you. They may vomit, they may be sick, they may need your attention.
Extinction with Parental Presence—you sit in the room while they cry but don’t do anything. You’re just present.
Graduated Extinction—when you go in and out of baby’s room at increasingly lengthy intervals. For example, baby cries for five minutes, then you check on him, cries for ten minutes, you check on him, and so on until he stops crying. You don’t go bedside, don’t pick up the child, and don’t spend more than five seconds checking in; otherwise you’re giving them mixed signals, and they’ll think you’re coming to pick them up. Instead, pop in to quickly say, “I love you, go to sleep,” then leave the room.
Pick-Up, Put-Down—when you pick up the child from their crib and calm them down continuously. If they start crying, you calm them down by picking them up. When they stop crying, you put them back in their crib. This cycle continues for a week or two to teach them that they’re safe and you will always respond, but you don’t take the child out of their room.
Wake-and-Sleep—is a method Dr. Karp discusses in his book, The Happiest Baby Guide to Great Sleep. “You let the baby fall asleep in your arms or at the breast,” he says, “and when you go to put baby down, you wake him a little to put them down, then they fall back asleep in their bed. Within those ten seconds, they learn to fall asleep outside of your arms or away from the breast, helping to sleep train gradually.”
Micklewright’s style is similar to Karp’s Wake-and-Sleep method, though she wouldn’t recommend deliberately waking up your baby when placing him in his bed. She teaches a falling-asleep-in-your-arms-while-crying-it-out technique. If they’re crying, it’s either exhaustion or physical discomforts like acid reflux or gas. After three-months-old, it’s okay to put them in their crib after settling to sleep in your arms. If they start crying after you put them down, she recommends, “Trying to help them to fall back to sleep in their crib with lovey cuddles, love touches, and soothing talking like, ‘It’s going to be okay. It’s time for sleep. I love you.’ When they stop crying, walk away. If they start crying when you walk away, you go back, but don’t pick them up—you can calm them down in their bed again. Eventually, they tire, and you’re teaching self-soothing while still being there for them.”
Should there be a time limit on how long you let your baby cry it out?
The experts agree this question should be directed to your child’s pediatrician first. Micklewright says, “A baby younger than six-weeks-old shouldn’t be left alone to cry. After six-weeks-old, there’s no time limit because they’re emotionally mature enough to cry it out alone after all their basic needs are met.”
Over time, the crying should decrease to no crying when the baby has learned how to self-soothe. Babies can cry for an hour or more, which could feel like an eternity to a parent. All three experts recommend parents agreeing on a sleep training plan and sticking to it until you see improvements, including a plan for how long to let the crying go for.
If parents aren’t ready for sleep training, what are the bad sleep habits they should try and break immediately?
From research done related to safety, Oster highly advises against sleeping on a sofa with an infant, which has proven to be extremely dangerous. She says, “The safest place for an infant to sleep is in your room, in their bed, and on their back in the first few months to avoid SIDS.” Ask your pediatrician about other ways to prevent SIDS risks.
Karp says, “The biggest no-no is putting your child into the bassinet when they’re already asleep because they will most likely wake up and you’ll have to start over. The best way to help them learn to fall asleep in their bed is by putting them down when they’re sleepy so they can fall asleep on their own in their bed.” Also, white noise should be low and rumbly, and not too loud or close to the crib.
After the first three months, Micklewright suggests stopping rocking, bouncing, and shushing “because the child needs to get used to sleeping in a still place, preferably their own bed.” Also, “Sleeping in the car and stroller should be rare, saving those for travel or special occasions when it’s unavoidable because a baby can’t fall into their deeper sleep cycle when they’re not in their comfortable bed.” She also suggests minimizing sleeping on you and co-sleeping in your bed because of safety reasons.
Are there some babies for which sleep training simply doesn’t work?
If sleep training doesn’t help a child get better sleep, all three experts agree it’s usually because of the parents’ inability to commit to sleep training. This can come down to improper technique or sending mixed messages to your child. It takes commitment, hard work, and some emotional muscles to sleep train successfully. It’s not easy, and whoever said parenting was? Babies are creatures of habit, and they want what’s familiar—they will gravitate towards the norm. Micklewright reminds us that “habits are easy to start and harder to break.”
Karp points out that “some babies are strong-willed and will be more difficult to sleep train. They may cry for an hour or two before giving in. Ultimately, sleep training is about learning, and every baby can learn. When done correctly, there shouldn’t be a child that doesn’t respond to it.”
Karp adds, “Special cases of illness, acid reflux, and colic make sleep training more difficult. You don’t want to stress a baby more than he or she already is.”
What are some words of advice for parents who don’t feel like they can commit to sleep training?
Oster believes taking care of yourself is “actually part of your responsibility.” And if that means sleep training so you can have more sleep, then that’s all good.
Micklewright says another responsibility as parents is “making sure your baby gets the sleep he needs. It’s a commitment you make when you have children, the same as feeding and putting clothes on their back. And unless necessary, don’t wake a sleeping baby.” Sleep begets sleep remember?
Karp says, “Every family has to do what they have to do in the early months of a child’s life, whether it’s getting help from friends and family to cook meals and do house chores, or hiring help. If you don’t have built-in support, consider getting a SNOO. The SNOO was designed to be a second set of helping hands, not just a responsive bassinet. SNOO can help sleep train a baby without having to ‘cry it out,’ and it’s proven to boost infant sleep by 1-2+ hours per night.” SNOO can be rented, so it’s accessible to more families.
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